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1.
J Coll Physicians Surg Pak ; 30(1): S32-S34, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33650422

RESUMEN

Ophthalmology is a specialty which involves close contact with patients. Personal protective equipment (PPE) along with modifications in examination techniques and equipment are needed to avoid spread of coronavirus infectious disease (COVID-19) to health professionals. This communication aims to highlight and critically analyse the measures suggested to control this spread. We also highlighted our experience with protective gear modifications. As with any practice, triage is cornerstone. Use of disinfectants, good personal hygiene practices and PPE for patients and staff, must be adopted for safe ophthalmology practices. Key Words: COVID-19, Ophthalmology, Personal protective equipment (PPE).


Asunto(s)
/epidemiología , Oftalmopatías/epidemiología , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Oftalmología/métodos , Pandemias , Equipo de Protección Personal , /transmisión , Comorbilidad , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos
2.
J Coll Physicians Surg Pak ; 30(1): S35-S37, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33650423

RESUMEN

Aerosol generating procedures (AGPs) performed in the operating room during general anesthesia and surgery can contaminate the operation room environment putting the anesthetist, surgeons and paramedical staff at risk of infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The polymerase chain reaction (PCR) test for SARS-CoV-2 has low sensitivity and is time-bound. Emergent surgical cases might not give ample time for SARS-CoV-2 evaluation. These issues have called for adaptation of an anesthesia technique that can ensure safety measures regarding airway management in emergent cases; and can limit the chances of viral spread in case the patient is a carrier of coronavirus disease 2019 (COVID-19). In this communication, we summarised the modifications required in anesthesia technique during intubation and extubation of a patient's airway that would decrease the risk of virus transmission to the operation theatre staff. Key Words: COVID-19, SARS-CoV-2, Emergent surgeries, Anesthesia technique.


Asunto(s)
Manejo de la Vía Aérea/métodos , Urgencias Médicas , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias , Equipo de Protección Personal , /transmisión , Humanos
4.
J Transl Med ; 19(1): 109, 2021 03 16.
Artículo en Inglés | MEDLINE | ID: mdl-33726787

RESUMEN

BACKGROUND: No versatile web app exists that allows epidemiologists and managers around the world to comprehensively analyze the impacts of COVID-19 mitigation. The http://covid-webapp.numerusinc.com/ web app presented here fills this gap. METHODS: Our web app uses a model that explicitly identifies susceptible, contact, latent, asymptomatic, symptomatic and recovered classes of individuals, and a parallel set of response classes, subject to lower pathogen-contact rates. The user inputs a CSV file of incidence and, if of interest, mortality rate data. A default set of parameters is available that can be overwritten through input or online entry, and a user-selected subset of these can be fitted to the model using maximum-likelihood estimation (MLE). Model fitting and forecasting intervals are specifiable and changes to parameters allow counterfactual and forecasting scenarios. Confidence or credible intervals can be generated using stochastic simulations, based on MLE values, or on an inputted CSV file containing Markov chain Monte Carlo (MCMC) estimates of one or more parameters. RESULTS: We illustrate the use of our web app in extracting social distancing, social relaxation, surveillance or virulence switching functions (i.e., time varying drivers) from the incidence and mortality rates of COVID-19 epidemics in Israel, South Africa, and England. The Israeli outbreak exhibits four distinct phases: initial outbreak, social distancing, social relaxation, and a second wave mitigation phase. An MCMC projection of this latter phase suggests the Israeli epidemic will continue to produce into late November an average of around 1500 new case per day, unless the population practices social-relaxation measures at least 5-fold below the level in August, which itself is 4-fold below the level at the start of July. Our analysis of the relatively late South African outbreak that became the world's fifth largest COVID-19 epidemic in July revealed that the decline through late July and early August was characterised by a social distancing driver operating at more than twice the per-capita applicable-disease-class (pc-adc) rate of the social relaxation driver. Our analysis of the relatively early English outbreak, identified a more than 2-fold improvement in surveillance over the course of the epidemic. It also identified a pc-adc social distancing rate in early August that, though nearly four times the pc-adc social relaxation rate, appeared to barely contain a second wave that would break out if social distancing was further relaxed. CONCLUSION: Our web app provides policy makers and health officers who have no epidemiological modelling or computer coding expertise with an invaluable tool for assessing the impacts of different outbreak mitigation policies and measures. This includes an ability to generate an epidemic-suppression or curve-flattening index that measures the intensity with which behavioural responses suppress or flatten the epidemic curve in the region under consideration.


Asunto(s)
/epidemiología , Control de Infecciones , Internet , Aplicaciones Móviles , /etiología , Simulación por Computador , Modificador del Efecto Epidemiológico , Inglaterra/epidemiología , Epidemias , Predicción/métodos , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/normas , Israel/epidemiología , Cadenas de Markov , Vigilancia de la Población/métodos , Factores de Riesgo , Sudáfrica/epidemiología
5.
Emerg Infect Dis ; 27(4): 1229-1231, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33755002

RESUMEN

Severe acute respiratory syndrome coronavirus 2 can persist on surfaces, suggesting possible surface-mediated transmission of this pathogen. We found that fomites might be a substantial source of transmission risk, particularly in schools and child daycares. Combining surface cleaning and decontamination with mask wearing can help mitigate this risk.


Asunto(s)
Transmisión de Enfermedad Infecciosa/prevención & control , Fómites/virología , Control de Infecciones , /aislamiento & purificación , Anciano , Número Básico de Reproducción , /prevención & control , /virología , Niño , Jardines Infantiles/normas , Descontaminación/métodos , Contaminación de Equipos/prevención & control , Desinfección de las Manos/métodos , Humanos , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Máscaras , Casas de Salud/normas , Instituciones Académicas/normas , Estados Unidos/epidemiología
6.
BMC Nephrol ; 22(1): 81, 2021 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-33676397

RESUMEN

BACKGROUND: Emory Dialysis serves an urban and predominantly African American population at its four outpatient dialysis facilities. We describe COVID-19 infection control measures implemented and clinical characteristics of patients with COVID-19 in the Emory Dialysis facilities. METHODS: Implementation of COVID-19 infection procedures commenced in February 2020. Subsequently, COVID-19 preparedness assessments were conducted at each facility. Patients with COVID-19 from March 1-May 31, 2020 were included; with a follow-up period spanning March-June 30, 2020. Percentages of patients diagnosed with COVID-19 were calculated, and characteristics of COVID-19 patients were summarized as medians or percentage. Baseline characteristics of all patients receiving care at Emory Dialysis (i.e. Emory general dialysis population) were presented as medians and percentages. RESULTS: Of 751 dialysis patients, 23 (3.1%) were diagnosed with COVID-19. The median age was 67.0 years and 13 patients (56.6%) were female. Eleven patients (47.8%) were residents of nursing homes. Nineteen patients (82.6%) required hospitalization and 6 patients (26.1%) died; the average number of days from a positive SARS-CoV-2 (COVID) test to death was 16.8 days (range 1-34). Two patients dialyzing at adjacent dialysis stations and a dialysis staff who cared for them, were diagnosed with COVID-19 in a time frame that may suggest transmission in the dialysis facility. In response, universal masking in the facility was implemented (prior to national guidelines recommending universal masking), infection control audits and re-trainings of PPE were also done to bolster infection control practices. CONCLUSION: We successfully implemented recommended COVID-19 infection control measures aimed at mitigating the spread of SARS-CoV-2. Most of the patients with COVID-19 required hospitalizations. Dialysis facilities should remain vigilant and monitor for possible transmission of COVID-19 in the facility.


Asunto(s)
Afroamericanos , Instituciones de Atención Ambulatoria/normas , Control de Infecciones/métodos , Diálisis Renal/normas , Poblaciones Vulnerables/etnología , Anciano , /etnología , Susceptibilidad a Enfermedades , Femenino , Georgia , Humanos , Masculino , Persona de Mediana Edad , Telemedicina , Población Urbana
7.
CJEM ; 23(1): 128-129, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33683607
8.
J Plast Reconstr Aesthet Surg ; 74(1): 199-202, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33645504

RESUMEN

Coronavirus disease-2019 (COVID-19) is the infectious disease caused by the recently discovered coronavirus, SARS-CoV2. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019. The number of publications with regard to COVID-19-related information is exponentially increasing, but there are also some retracted papers appearing on PubMed, including those retracted from The Lancet Global Health and the New England Journal of Medicine. In a PubMed search for "COVID," there were 1595 articles by April 1, 2020. As of June 30, the number of articles has now reached 25,913. In this editorial, 4 specific areas of information are looked at but the principles apply to many other areas of medicine. The specifics looked at are PPE for tracheostomy, testing for COVID-19, pregnancy and COVID-19, and surgical expectations during redeployment. We must make no mistake that we are seeing a disease that modern medicine has never encountered before. This article is not aimed at belittling or dismissing any of the advice of the Royal Colleges' or PHE advice, but it demonstrates the tsunami of information and the ambiguity that surgeons are experiencing throughout the UK right now. This is unlikely to be the end of progression regarding healthcare planning and development for unencountered viruses9. In the next few months and beyond, there are likely to be adaptions and revisions of more documents advising on various aspects of healthcare with regard to COVID-19 management and for possible future viruses not yet seen by the modern world before.


Asunto(s)
Control de Infecciones , Procedimientos Quirúrgicos Reconstructivos , Servicio de Cirugía en Hospital , /epidemiología , Humanos , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Difusión de la Información , Innovación Organizacional , Procedimientos Quirúrgicos Reconstructivos/métodos , Procedimientos Quirúrgicos Reconstructivos/tendencias , Servicio de Cirugía en Hospital/organización & administración , Servicio de Cirugía en Hospital/tendencias
9.
BMJ Open ; 11(3): e044644, 2021 03 02.
Artículo en Inglés | MEDLINE | ID: mdl-33653758

RESUMEN

INTRODUCTION: Since its onset, the COVID-19 pandemic has caused significant morbidity and mortality worldwide, with particularly severe outcomes in healthcare institutions and congregate settings. To mitigate spread, healthcare systems have been cohorting patients to limit contacts between uninfected patients and potentially infected patients or healthcare workers (HCWs). A major challenge in managing the pandemic is the presence of currently asymptomatic/presymptomatic individuals capable of transmitting the virus, who could introduce COVID-19 into uninfected cohorts. The optimal combination of personal protective equipment (PPE), testing and other approaches to prevent these events is unclear, especially in light of ongoing limited resources. METHODS: Using stochastic simulations with a susceptible-exposed-infected-recovered dynamic model, we quantified and compared the impacts of PPE use, patient and HCWs surveillance testing and subcohorting strategies. RESULTS: In the base case without testing or PPE, the healthcare system was rapidly overwhelmed, and became a net contributor to the force of infection. We found that effective use of PPE by both HCWs and patients could prevent this scenario, while random testing of apparently asymptomatic/presymptomatic individuals on a weekly basis was less effective. We also found that even imperfect use of PPE could provide substantial protection by decreasing the force of infection. Importantly, we found that creating smaller patient/HCW-interaction subcohorts can provide additional resilience to outbreak development with limited resources. CONCLUSION: These findings reinforce the importance of ensuring adequate PPE supplies even in the absence of testing and provide support for strict subcohorting regimens to reduce outbreak potential in healthcare institutions.


Asunto(s)
/prevención & control , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Prestación de Atención de Salud , Personal de Salud , Humanos , Modelos Teóricos , Pandemias , Equipo de Protección Personal
12.
JAMA Netw Open ; 4(3): e212618, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33755167

RESUMEN

Importance: This study assesses the role of telehealth in the delivery of care at the start of the COVID-19 pandemic. Objectives: To document patterns and costs of ambulatory care in the US before and during the initial stage of the pandemic and to assess how patient, practitioner, community, and COVID-19-related factors are associated with telehealth adoption. Design, Setting, and Participants: This is a cohort study of working-age persons continuously enrolled in private health plans from March 2019 through June 2020. The comparison periods were March to June in 2019 and 2020. Claims data files were provided by Blue Health Intelligence, an independent licensee of the Blue Cross and Blue Shield Association. Data analysis was performed from June to October 2020. Main Outcomes and Measures: Ambulatory encounters (in-person and telehealth) and allowed charges, stratified by characteristics derived from enrollment files, practitioner claims, and community characteristics linked to the enrollee's zip code. Results: A total of 36 568 010 individuals (mean [SD] age, 35.71 [18.77] years; 18 466 557 female individuals [50.5%]) were included in the analysis. In-person contacts decreased by 37% (from 1.63 to 1.02 contacts per enrollee) from 2019 to 2020. During 2020, telehealth visits (0.32 visit per person) accounted for 23.6% of all interactions compared with 0.3% of contacts in 2019. When these virtual contacts were added, the overall COVID-19 era patient and practitioner visit rate was 18% lower than that in 2019 (1.34 vs 1.64 visits per person). Behavioral health encounters were far more likely than medical contacts to take place virtually (46.1% vs 22.1%). COVID-19 prevalence in an area was associated with higher use of telehealth; patients from areas within the top quintile of COVID-19 prevalence during the week of their encounter were 1.34 times more likely to have a telehealth visit compared with those in the lowest quintile (the reference category). Persons living in areas with limited social resources were less likely to use telehealth (most vs least socially advantaged neighborhoods, 27.4% vs 19.9% usage rates). Per enrollee medical care costs decreased by 15% between 2019 and 2020 (from $358.32 to $306.04 per person per month). During 2020, those with 1 or more COVID-19-related service (1 470 721 members) had more than 3 times the medical costs ($1701 vs $544 per member per month) than those without COVID-19-related services. Persons with 1 or more telehealth visits in 2020 had considerably higher costs than persons having only in-person ambulatory contacts ($2214.10 vs $1337.78 for the COVID-19-related subgroup and $735.87 vs $456.41 for the non-COVID-19 subgroup). Conclusions and Relevance: This study of a large cohort of patients enrolled in US health plans documented patterns of care at the onset of COVID-19. The findings are relevant to policy makers, payers, and practitioners as they manage the use of telehealth during the pandemic and afterward.


Asunto(s)
Atención Ambulatoria , Pautas de la Práctica en Medicina , Telemedicina , Adulto , Atención Ambulatoria/economía , Atención Ambulatoria/métodos , Atención Ambulatoria/estadística & datos numéricos , /prevención & control , Estudios de Cohortes , Costos y Análisis de Costo , Femenino , Humanos , Control de Infecciones/métodos , Seguro de Salud/estadística & datos numéricos , Masculino , Innovación Organizacional/economía , Pautas de la Práctica en Medicina/economía , Pautas de la Práctica en Medicina/organización & administración , Pautas de la Práctica en Medicina/estadística & datos numéricos , Telemedicina/economía , Telemedicina/organización & administración , Telemedicina/estadística & datos numéricos , Estados Unidos/epidemiología
13.
PLoS One ; 16(3): e0247865, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33657142

RESUMEN

COVID-19 is a global threat with an increasing number of infections. Research on IgG seroprevalence among health care workers (HCWs) is needed to re-evaluate health policies. This study was performed in three pandemic hospitals in Istanbul and Kocaeli. Different clusters of HCWs were screened for SARS-CoV-2 infection. Seropositivity rate among participants was evaluated by chemiluminescent microparticle immunoassay. We recruited 813 non-infected and 119 PCR-confirmed infected HCWs. Of the previously undiagnosed HCWs, 22 (2.7%) were seropositive. Seropositivity rates were highest for cleaning staff (6%), physicians (4%), nurses (2.2%) and radiology technicians (1%). Non-pandemic clinic (6.4%) and ICU (4.3%) had the highest prevalence. HCWs in "high risk" group had similar seropositivity rate with "no risk" group (2.9 vs 3.5 p = 0.7). These findings might lead to the re-evaluation of infection control and transmission dynamics in hospitals.


Asunto(s)
/epidemiología , Personal de Salud/tendencias , /inmunología , /inmunología , Hospitales/tendencias , Humanos , Control de Infecciones/métodos , Control de Infecciones/tendencias , Pandemias , Prevalencia , Factores de Riesgo , Estudios Seroepidemiológicos , Turquia/epidemiología
14.
A A Pract ; 15(3): e01417, 2021 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-33687348

RESUMEN

Health care workers performing aerosolizing procedures on patients with transmissible infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at high-risk for disease acquisition. Current guidelines designed to protect health care workers during aerosolizing procedures prioritize personal protective equipment and enhanced infection control techniques, in particular during procedures such as intubation. To date, little emphasis has been placed on risk mitigation in the setting of bronchoscopy, a procedure that has significant aerosolization potential. Herein, we present an innovative closed bronchoscopy system designed to reduce aerosolization during bronchoscopy.


Asunto(s)
Broncoscopía/métodos , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Invenciones , Maniquíes , Broncoscopía/instrumentación , Personal de Salud , Humanos , Equipo de Protección Personal
15.
Pediatr Int ; 63(3): 260-263, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33656224

RESUMEN

Coronavirus disease 2019 (COVID-19) has spread worldwide within a short period, and there is still no sign of an end to the pandemic. Management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant women at the time of delivery presents a unique challenge. To fulfill the goal of providing adequate management of such women and their infants, and to decrease the risk of exposure of the healthcare providers, tentative guidelines are needed until more evidence is collected. Practical preventative action is required that takes into account the following infection routes: (i) aerosol transmission from mothers to healthcare providers, (ii) horizontal transmission to healthcare providers from infants infected by their mothers, and (iii) horizontal transmission from mothers to infants. To develop standard operating procedures, briefings/training simulations should be carried out, taking into account the latest information. Briefings should be carefully conducted to clarify the role and procedures. Healthcare providers should wear personal protective equipment. If it is physically possible, neonatal resuscitation should be performed in a separate area next to the delivery room. If a separate area is not available, the infant warmer should be placed at least 2 m away from the delivery table, or partitioned off in the same room. A minimum number of skilled personnel should participate in resuscitation using the latest neonatal resuscitation algorithms.


Asunto(s)
/transmisión , Salas de Parto , Control de Infecciones/métodos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/virología , /terapia , Femenino , Personal de Salud , Humanos , Recién Nacido , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Madres , Equipo de Protección Personal , Embarazo , Complicaciones Infecciosas del Embarazo/terapia , Resucitación/métodos , Entrenamiento Simulado
17.
Soc Sci Med ; 274: 113794, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33662772

RESUMEN

The role of socio-economic conditions has been largely implicit in mathematical epidemiological models. However, measures to address the current pandemic, specifically the relevant interventions proposing physical distancing, have highlighted how social determinants affect contagion and mortality dynamics of COVID-19. For the most part, these social determinants are not present in either policy discussions or in epidemiological models. We argue for the importance of incorporating social determinants of health into the modelling dynamics of COVID-19, and show how global variation of these conditions may be integrated into relevant models. In doing so, we also highlight a key political economy aspect of reproduction dynamics in epidemics.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles , Control de Infecciones/métodos , Modelos Teóricos , Determinantes Sociales de la Salud , Humanos , Pandemias/prevención & control , Cuarentena , Factores Socioeconómicos
18.
Arch Argent Pediatr ; 119(2): 76-82, 2021 04.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33749192

RESUMEN

INTRODUCTION: The objective of this study was to analyze available resources, guidelines in use, and preparedness to care for newborn infants at maternity centers in Argentina during the COVID-19 pandemic. METHOD: Cross-sectional study based on a survey administered to medical and nursing staff. In May 2020, Argentine facilities with more than 500 annual births were contacted; 58 % of these were from the public sector. RESULTS: In total, 104/147 facilities answered (71 %). All had guidelines for care during the pandemic, and 93 % indicated they had been trained on how to use them. A companion was not allowed during childbirth in 26 % of private facilities and in 60 % of public ones (p < 0.01). Deferred cord clamping was recommended in 87 %; rooming-in with asymptomatic newborns was promoted in 62 %; breastfeeding using protective measures was recommended in 70 %; and breast milk using a bottle, in 23 %. In 94 %, family visiting in the Neonatology Unit was restricted. Difficulties included the unavailability of individual rooms for symptomatic newborn infants and a potential shortage of health care staff and personal protective equipment. CONCLUSIONS: All facilities are aware of the national guidelines to fight the pandemic. Most have the resources to comply with the recommended protective measures. There is uncertainty as to whether personal protective equipment, staff, and physical space available at the different facilities would be enough if cases increased significantly.


Asunto(s)
/prevención & control , Recursos en Salud/provisión & distribución , Cuidado del Lactante/organización & administración , Control de Infecciones/organización & administración , Servicios de Salud Materna/organización & administración , Argentina/epidemiología , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Política de Salud , Humanos , Cuidado del Lactante/estadística & datos numéricos , Recién Nacido , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Control de Infecciones/estadística & datos numéricos , Masculino , Servicios de Salud Materna/estadística & datos numéricos , Pandemias , Equipo de Protección Personal/provisión & distribución , Guías de Práctica Clínica como Asunto , Embarazo
19.
Dig Surg ; 38(2): 158-165, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33640885

RESUMEN

BACKGROUND: This survey aimed to register changes determined by the COVID-19 pandemic on pancreatic surgery in a specific geographic area (Germany, Austria, and Switzerland) to evaluate the impact of the pandemic and obtain interesting cues for the future. METHODS: An online survey was designed using Google Forms focusing on the local impact of the pandemic on pancreatic surgery. The survey was conducted at 2 different time points, during and after the lockdown. RESULTS: Twenty-five respondents (25/56) completed the survey. Many aspects of oncological care have been affected with restrictions and delays: staging, tumor board, treatment selection, postoperative course, adjuvant treatments, outpatient care, and follow-up. Overall, 60% of respondents have prioritized pancreatic cancer patients according to stage, age, and comorbidities, and 40% opted not to operate high-risk patients. However, for 96% of participants, the standards of care were guaranteed. DISCUSSION/CONCLUSIONS: The first wave of the COVID-19 pandemic had an important impact on pancreatic cancer surgery in central Europe. Guidelines for prompt interventions and prevention of the spread of viral infections in the surgical environment are needed to avoid a deterioration of care in cancer patients in the event of a second wave or a new pandemic. High-volume centers for pancreatic surgery should be preferred and their activity maintained. Virtual conferences have proven to be efficient during this pandemic and should be implemented in the near future.


Asunto(s)
/prevención & control , Accesibilidad a los Servicios de Salud/tendencias , Pancreatectomía/tendencias , Neoplasias Pancreáticas/cirugía , Pautas de la Práctica en Medicina/tendencias , Cuidados Posteriores/métodos , Cuidados Posteriores/normas , Cuidados Posteriores/tendencias , Actitud del Personal de Salud , Europa (Continente)/epidemiología , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud/normas , Humanos , Control de Infecciones/métodos , Control de Infecciones/tendencias , Estadificación de Neoplasias , Pancreatectomía/normas , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patología , Pandemias , Aceptación de la Atención de Salud , Atención Perioperativa/métodos , Atención Perioperativa/normas , Atención Perioperativa/tendencias , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/normas , Tiempo de Tratamiento/normas , Tiempo de Tratamiento/tendencias
20.
J Med Internet Res ; 23(2): e22197, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33566791

RESUMEN

BACKGROUND: To control the COVID-19 pandemic, people should adopt protective behaviors at home (self-isolation, social distancing, putting shopping and packages aside, wearing face coverings, cleaning and disinfecting, and handwashing). There is currently limited support to help individuals conduct these behaviors. OBJECTIVE: This study aims to report current household infection control behaviors in the United Kingdom and examine how they might be improved. METHODS: This was a pragmatic cross-sectional observational study of anonymous participant data from Germ Defence between May 6-24, 2020. Germ Defence is an open-access fully automated website providing behavioral advice for infection control within households. A total of 28,285 users sought advice from four website pathways based on household status (advice to protect themselves generally, to protect others if the user was showing symptoms, to protect themselves if household members were showing symptoms, and to protect a household member who is at high risk). Users reported current infection control behaviors within the home and intentions to change these behaviors. RESULTS: Current behaviors varied across all infection control measures but were between sometimes (face covering: mean 1.61, SD 1.19; social distancing: mean 2.40, SD 1.22; isolating: mean 2.78, SD 1.29; putting packages and shopping aside: mean 2.75, SD 1.55) and quite often (cleaning and disinfecting: mean 3.17, SD 1.18), except for handwashing (very often: mean 4.00, SD 1.03). Behaviors were similar regardless of the website pathway used. After using Germ Defence, users recorded intentions to improve infection control behavior across all website pathways and for all behaviors (overall average infection control score mean difference 0.30, 95% CI 0.29-0.31). CONCLUSIONS: Self-reported infection control behaviors other than handwashing are lower than is optimal for infection prevention, although handwashing is much higher. Advice using behavior change techniques in Germ Defence led to intentions to improve these behaviors. Promoting Germ Defence within national and local public health and primary care guidance could reduce COVID-19 transmission.


Asunto(s)
/prevención & control , Control de Infecciones/métodos , Intervención basada en la Internet , /epidemiología , Estudios Transversales , Transmisión de Enfermedad Infecciosa/prevención & control , Composición Familiar , Conductas Relacionadas con la Salud , Humanos , Encuestas y Cuestionarios , Reino Unido/epidemiología
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