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4.
Global Health ; 16(1): 94, 2020 10 08.
Artículo en Inglés | MEDLINE | ID: mdl-33032616

RESUMEN

INTRODUCTION: COVID-19 has rapidly and radically changed the face of human health and social interaction. As was the case with COVID-19, the world is similarly unprepared to respond to antimicrobial resistance (AMR) and the challenges it will produce. COVID-19 presents an opportunity to examine how the international community might better respond to the growing AMR threat. MAIN BODY: The impacts of COVID-19 have manifested in health system, economic, social, and global political implications. Increasing AMR will also present challenges in these domains. As seen with COVID-19, increasing healthcare usage and resource scarcity may lead to ethical dilemmas about prioritization of care; unemployment and economic downturn may disproportionately impact people in industries reliant on human interaction (especially women); and international cooperation may be compromised as nations strive to minimize outbreaks within their own borders. CONCLUSION: AMR represents a slow-moving disaster that offers a unique opportunity to proactively develop interventions to mitigate its impact. The world's attention is currently rightfully focused on responding to COVID-19, but there is a moral imperative to take stock of lessons learned and opportunities to prepare for the next global health emergency.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Coronavirus/prevención & control , Farmacorresistencia Microbiana , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Planificación en Desastres/organización & administración , Predicción , Salud Global , Humanos , Cooperación Internacional , Neumonía Viral/epidemiología
5.
J Loss Prev Process Ind ; : 104310, 2020 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-33013002

RESUMEN

The coronavirus disease (COVID-19) brought the world to a halt in March 2020. Various prediction and risk management approaches are being explored worldwide for decision making. This work adopts an advanced mechanistic model and utilizes tools for process safety to propose a framework for risk management for the current pandemic. A parameter tweaking and an artificial neural network-based parameter learning model have been developed for effective forecasting of the dynamic risk. Monte Carlo simulation was used to capture the randomness of the model parameters. A comparative analysis of the proposed methodologies has been carried out by using the susceptible, exposed, infected, quarantined, recovered, deceased (SEIQRD) model. A SEIQRD model was developed for four distinct locations: Italy, Germany, Ontario, and British Columbia. The learning-based approach resulted in better outcomes among the models tested in the present study. The layer of protection analysis is a useful framework to analyze the effect of different safety measures. This framework is used in this work to study the effect of non-pharmaceutical interventions on pandemic risk. The risk profiles suggest that a stage-wise releasing scenario is the most suitable approach with negligible resurgence. The case study provides valuable insights to practitioners in both the health sector and the process industries to implement advanced strategies for risk assessment and management. Both sectors can benefit from each other by using the mathematical models and the management tools used in each, and, more importantly, the lessons learned from crises.

6.
Health Secur ; 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33017195

RESUMEN

Mass vaccination is a crucial public health intervention during outbreaks or pandemics for which vaccines are available. The US government has sponsored the development of medical countermeasures, including vaccines, for public health emergencies; however, federally supported programs, including the Public Health and Emergency Preparedness program and Cities Readiness Initiative, have historically emphasized antibiotic pill dispensing over mass vaccination. While mass vaccination and pill dispensing programs share similarities, they also have fundamental differences that require dedicated preparedness efforts to address. To date, only a limited number of public assessments of local mass vaccination operational capabilities have been conducted. To fill this gap, we interviewed 37 public health and preparedness officials representing 33 jurisdictions across the United States. We aimed to characterize their existing mass vaccination operational capacities and identify challenges and lessons learned in order to support the efforts of other jurisdictions to improve mass vaccination preparedness. We found that most jurisdictions were not capable of or had not planned for rapidly vaccinating their populations within a short period of time (eg, 1 to 2 weeks). Many also noted that their focus on pill dispensing was driven largely by federal funding requirements and that preparedness efforts for mass vaccination were often self-motivated. Barriers to implementing rapid mass vaccination operations included insufficient personnel qualified to administer vaccinations, increased patient load compared to pill-dispensing modalities, logistical challenges to maintaining cold chain, and operational challenges addressing high-risk populations, including children, pregnant women, and non-English-speaking populations. Considering the expected availability of a severe acute respiratory syndrome coronavirus 2 vaccine for distribution and dispensing to the public, our findings highlight critical considerations for planning possible future mass vaccination events, including during the novel coronavirus disease 2019 pandemic.

8.
Cancer Cell ; 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33038939

RESUMEN

During the COVID-19 pandemic, research on "cytokine storms" has been reinvigorated in the field of infectious disease, but it also has particular relevance to cancer research. Interleukin-6 (IL-6) has emerged as a key component of the immune response to SARS-CoV-2, such that the repurposing of anti-IL-6 therapeutics for COVID-19 is now a major line of investigation, with several ongoing clinical trials. We lay a framework for understanding the role of IL-6 in the context of cancer research and COVID-19 and suggest how lessons learned from cancer research may impact SARS-CoV-2 research and vice versa.

9.
Surgery ; 2020 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-33039110

RESUMEN

BACKGROUND: The Lombardy region suffered severely during the acute phase of the coronavirus diease 2019 outbreak in Italy (Mar-Apr 2020) with 16,000 diagnosed coronavirus disease 2019-related deaths (49% of the total coronavirus disease 2019-related deaths in Italy). In the area surrounding Pavia during the critical stage of the outbreak (Mar-Apr 2020), 1,225 of the documented 4,200 deaths were related to coronavirus disease 2019 infection, with a mortality rate of 181/100,000 inhabitants and an increase in deaths of 138% compared with the same period during previous years. Our aim was to report the experience of the Department of Vascular Surgery of Pavia (Lombardy, Italy), including the lessons learned and future perspectives regarding the management of coronavirus disease 2019 patients who developed severe acute ischemia with impending lower limb loss or deep vein thrombosis. MATERIALS AND METHODS: We carried out a retrospective data collection of coronavirus disease 2019 patients with severe acute ischemia of the lower limbs or deep vein thrombosis, which we observed in our department during the period March 1, 2020, to April 30, 2020. Primary outcomes of the analysis were postoperative mortality for all patients and amputation rates only in those coronavirus disease 2019 patients suffering from acute lower limb ischemia. Secondary outcomes were the prevalence of the disease among admitted coronavirus disease 2019 patients, and any possible correlation among inflammatory parameters, thrombolytic status, and the presence of acute ischemia or deep vein thrombosis. RESULTS: We observed 38 patients (28 male) with severe coronavirus disease 2019 infection (6 with lower limb arterial thrombosis and 32 with deep vein thrombosis). The median patient age was 64 years (range 30-94 y). In the arterial group, 3 had thrombosis on plaque and 3 on healthy arteries ("simple" arterial thrombosis). All underwent operative or hybrid (open/endo) revascularization; 1 patient died from major organ failure and 1 patient underwent major amputation. In the deep vein thrombosis group, 9 (28%) patients died from major organ failure, despite aggressive medical therapy. In patients with simple arterial thrombosis and those with deep vein thrombosis, we observed a decrease in inflammatory parameters (C-reactive protein) and in D-dimer and fibrinogen after aggressive therapy (P <.001). CONCLUSION: Our study confirms that critically ill, coronavirus disease 2019 patients who develop arterial and deep vein thrombosis have a high risk of mortality, but, if treated properly, there is an improvement in overall survival, especially in patients of 60 years of age or younger.

10.
Artículo en Inglés | MEDLINE | ID: mdl-33039307

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges for healthcare systems worldwide. The Queen Elizabeth Hospital, Birmingham, has one of the largest burns, hands and plastics department in the UK, totalling 83 doctors. Our response to the COVID-19 response was uniquely far reaching, with our department being given responsibility of an entire 36 bed medical COVID-19 ward in addition to our commitment to specialty-specific work, and saw half of our work force re-deployed to Intensive Treatment Unit (ITU). Our aim was to exploit the high calibre of doctors found in plastic surgery, and to demonstrate, we were able to support the COVID-19 effort beyond our normal scope of practice. In order to achieve this aim, the department underwent significant structural and leadership changes. Factors considered included: rota and shift pattern changes to implement depth and resilience to sudden fluctuations in staffing levels; a preparatory phase for focussed upskilling and relevant training packages to be delivered; managing the COVID-19 ward cover and ITU deployment; adjustments to our front of house and elective specialty-specific service, including developing alternative and streamlined patient pathways; mitigating the effects on plastic surgical training during the pandemic; the importance of communications for patient care and physician wellbeing; and leadership techniques and styles we considered important. By sharing our experience during this pandemic, we hope to reflect on and share lessons learned, as well as to demonstrate that it is possible to rapidly mobilise and retrain plastic surgeons at all levels to contribute safely and productively beyond a specialty-specific scope of care.

11.
Otolaryngol Head Neck Surg ; : 194599820957277, 2020 Oct 13.
Artículo en Inglés | MEDLINE | ID: mdl-33045919

RESUMEN

The COVID-19 pandemic has challenged every surgical discipline. Lessons learned from Hurricane Katrina have informed our department's management of the current crisis. That experience impressed upon us a profound appreciation for shared decision making in the face of scarce resources, an evolving clinical context, and potential harm to patients and health care workers. To that end, we have formed a Resource Utilization Committee to prospectively review all nonemergent surgical cases during the current crisis. This has allowed "state-of-the-pandemic" otolaryngologic care in a real-time, collaborative, and high-information setting. In addition, to protect our patients and health care workers, it has influenced our institution's thoughtful application of COVID testing and the use of personal protective equipment.

12.
Can Assoc Radiol J ; : 846537120963649, 2020 Oct 13.
Artículo en Inglés | MEDLINE | ID: mdl-33047608

RESUMEN

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has led to widespread changes in all health care settings including academic radiology departments. The purpose of this survey-based study was to investigate the impact of COVID-19 on radiology resident training and education workflow in Canada in terms of the nature, scale, and heterogeneity of the changes, preparedness and adaptation, and perceptions of the present and future of radiology training. METHODS: A 30-question web-based survey was sent to 17 radiology residency program directors across Canada. A separate 32-question survey was sent to 460 residents currently enrolled in a radiology residency in Canada. These surveys were open for 3 weeks. RESULTS: We received responses from 16 program directors and 80 residents (response rates 94.1% and 17.4%, respectively). Most respondents agreed that objectives were being met for knowledge and interpretation but less so for case volumes and technical skills. Less time was allotted for on-site activities (eg, readouts) with more time for off-site activities (eg, videoconferencing). Daytime rotations were at least partly cancelled. Most respondents felt these changes were met with enthusiasm by both faculty and residents. However, there were perceived challenges including lack of training on virtual platforms for delivery of teaching and decreased staff-resident interaction, with short- and long-term anxiety reported. CONCLUSIONS: The coronavirus disease 2019 has dramatically changed radiology resident training in Canada, with increased virtual learning at the expense of cancelled rotations and the resultant reduction in case volumes and staff-resident interaction. Although adopted with enthusiasm, these changes present substantial challenges and anxiety regarding the future of radiology resident education.

13.
Washington, D.C.; OPAS; 2020-10-14. (OPAS/CDE/VT/20-0035).
en Portugués | PAHO-IRIS | ID: phr-52840

RESUMEN

A Organização Pan-Americana da Saúde, em parceria com os Centros de Controle e Prevenção de Doenças dos Estados Unidos, iniciou um trabalho colaborativo em 2016 com delegados do Brasil, México e Paraguai com vistas a transferir capacidades para realizar a vigilância sorológica integrada da imunidade populacional e transmissão de várias doenças infecciosas usando a tecnologia de ensaio de micro-esferas multiplex (MBA, do inglês multiplex bead assay). Este ensaio permite a análise do perfil de anticorpos para até 96 antígenos de vários agentes patogênicos na mesma amostra de sangue seco. A vigilância sorológica, ou sorovigilância, é uma ferramenta cada vez mais utilizada por sua capacidade de gerar informações que auxiliem na caracterização da transmissão de doenças, no monitoramento do impacto de intervenções como a vacinação e, por exemplo, para identificar populações suscetíveis. A iniciativa tem sido um processo de aprendizagem por meio do trabalho interprogramático para desenvolver a vigilância sorológica integrada de múltiplos agravos que costumam ser tratados de maneira programaticamente separada, mas que na realidade se sobrepõem nos mesmos grupos populacionais e áreas geográficas. Este documento apresenta os resultados do terceiro encontro regional, realizado na cidade de Cuernavaca (México) nos dias 3 e 4 de março de 2020, com delegados dos países participantes da iniciativa, parceiros e aliados interessados. Esta publicação destaca as lições aprendidas na primeira fase de transferência de capacidades, oportunidades e próximos passos para expandir a vigilância sorológica integrada na Região das Américas como uma ferramenta para fortalecer a vigilância de doenças transmissíveis.


Asunto(s)
Epidemiología , Betacoronavirus , Servicios de Vigilancia Epidemiológica , Vigilancia , Enfermedades Transmisibles , Enfermedades Desatendidas
14.
Washington, D.C.; PAHO; 2020-10-14. (PAHO/CDE/VT/20-0035).
en Inglés | PAHO-IRIS | ID: phr-52839

RESUMEN

In 2016, the Pan American Health Organization, in partnership with the U.S. Centers for Disease Control and Prevention, began a collaborative effort with delegates from Brazil, Mexico, and Paraguay aimed at transferring technical capacity for integrated serological surveillance of population immunity and transmission of multiple infectious diseases, using the multiplex bead assay (MBA) platform. MBA makes it possible to analyze the antibodies of up to 96 antigens of various pathogens in a single dried-spot blood sample. Serological surveillance is being increasingly used for its ability to generate information that helps characterize disease transmission and monitor the impact of interventions such as vaccination, and to identify susceptible populations. This initiative has served as a learning process based on interprogrammatic work to develop integrated serological surveillance of various diseases and events that are often addressed separately from a programmatic standpoint, but which in reality overlap in the same population groups and geographical areas. This document presents the results of the third regional meeting, held in the city of Cuernavaca, Mexico, on 4-5 March 2020, and attended by delegates from the participating countries, partners, and stakeholders. This publication highlights the lessons learned during the first stage of capacity transfer, and discusses opportunities and next steps to expand integrated serological surveillance in the Region of the Americas as a tool for strengthening surveillance of communicable diseases.


Asunto(s)
Enfermedades Transmisibles , Américas , Pruebas Serológicas , Vigilancia , Enfermedades Desatendidas , Epidemiología , Servicios de Vigilancia Epidemiológica , Betacoronavirus
15.
Washington, D.C.; OPS; 2020-10-05. (OPS/CDE/VT/20-0035).
en Español | PAHO-IRIS | ID: phr-52798

RESUMEN

La Organización Panamericana de la Salud, en alianza con los Centros para el Control y la Prevención de Enfermedades de Estados Unidos de América, inició un trabajo colaborativo en el 2016 con delegados de Brasil, México y Paraguay, con vistas a transferir capacidades para realizar la vigilancia serológica integrada de la inmunidad poblacional y de la transmisión de múltiples enfermedades infecciosas usando el ensayo de perlas múltiples denominado multiplex bead assay (MBA). Este ensayo permite analizar el perfil de anticuerpos para hasta 96 antígenos de diversos patógenos en una misma muestra de sangre seca. La vigilancia serológica o serovigilancia es una herramienta cada vez más utilizada por su capacidad de generar información que ayuda a caracterizar la transmisión de las enfermedades y a monitorear el impacto de intervenciones como la vacunación y en la que se puede, por ejemplo, identificar población susceptible. La iniciativa ha sido un proceso de aprendizaje a través del trabajo interprogramático para desarrollar la vigilancia serológica integrada de diversas enfermedades y eventos que suelen estar programáticamente separados, pero que en la realidad se superponen en los mismos grupos de población y zonas geográficas. En este documento se presentan los resultados de la tercera reunión regional, celebrada en la ciudad de Cuernavaca (México) el 3 y 4 de marzo del 2020, con delegados de los países participantes en la iniciativa, socios y aliados interesados. En esta publicación se destacan las lecciones aprendidas en la primera fase de transferencia de capacidades, las oportunidades y los próximos pasos para expandir la vigilancia serológica integrada en la Región de las Américas como una herramienta para fortalecer la vigilancia de las enfermedades transmisibles.


Asunto(s)
Enfermedades Transmisibles , Enfermedades Desatendidas , Epidemiología , Vigilancia , Servicios de Vigilancia Epidemiológica , Betacoronavirus
17.
Diabetes Res Clin Pract ; 169: 108491, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33011208
19.
BMJ Glob Health ; 5(10)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33051286

RESUMEN

Internationally supported activities to build public health capacity and improve compliance with International Health Regulations (2005) so that countries are better able to 'prevent, protect against, control and provide a public health response to the international spread of disease' have had a positive impact in recent years. However, despite the proliferation of technical guidance, tools and roadmaps, as the recent COVID-19 emergency demonstrates, a significant challenge still remains. The unique and complex environment within countries is increasingly being recognised as a factor which needs greater consideration if system strengthening activities are to be successful.This paper reflects on the learning from and charts out the journey of the authors' in their efforts to support the Pakistan government to improve compliance with International Health Regulations, specifically through strengthening its Integrated Disease Surveillance and Response (IDSR) system.To effect change, public health technical specialists bring their grounded technical and scientific expertise along with their softer public health skills of, among other things, relationship building and multisector working. In the authors' experience, the importance of taking time throughout to build and maintain strong trusted relationships and peer-to-peer support has been the key to the successes experienced. The nature of this relationship and ongoing reflexive dialogue enabled the co-construction of the reality of the background environment, which, in turn, led to more realistic visioning of the desired system for IDSR, and therefore more appropriate bespoke technical support to be given, leading to the design and initial implementation of a country owned system developed with sustainability in mind.

20.
Artículo en Inglés | MEDLINE | ID: mdl-33081367

RESUMEN

BACKGROUND: The COVID-19 pandemic has swept the world like a gigantic tsunami, turning social and economic activities upside down. METHODS: This paper presents some of the innovative response strategies implemented by the public health system, healthcare facilities, and government in South Korea, which has been hailed as the model country for its success in containing COVID-19. Korea reinvented its public health infrastructure with a sense of urgency. RESULTS: Korea's success rests on its readiness, with the capacity for massive testing and obtaining prompt test results, effective contact tracing based on its world-leading mobile technologies, timely provision of personal protective equipment (PPE) to first responders, effective treatment of infected patients, and invoking citizens' community and civic conscience for the shared goal of defeating the pandemic. The lessons learned from Korea's response in countering the onslaught of COVID-19 provide unique implications for public healthcare administrators and operations management practitioners. CONCLUSION: Since many epidemic experts warn of a second wave of COVID-19, the lessons learned from the first wave will be a valuable resource for responding to the resurgence of the virus.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/epidemiología , Difusión de Innovaciones , Gobierno , Administración de Instituciones de Salud , Humanos , Neumonía Viral/epidemiología , Administración en Salud Pública , República de Corea/epidemiología
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