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1.
Acta Dermatovenerol Croat ; 291(1): 21-29, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34477059

RESUMO

Hand hygiene is one of the cornerstones in ensuring effective infection control during the Coronavirus disease 2019 (COVID-19) outbreak. We aimed to investigate the prevalence of new-onset occupational HE during the COVID-19 outbreak in healthcare workers (HCWs) and the clinical course, clinical features, and risk factors of occupational hand eczema (HE). A total of 159 volunteer HCWs (female: n=112; male: n=47, mean age=35.55±7.03 years) working in a pandemic hospital were included. Participants were questioned in terms of daily hand hygiene, use of gloves, and signs and symptoms associated with HE before and during the COVID-19 pandemic. HCWs were divided into two groups classified as non-COVID and COVID, according to the unit they worked in. In our study, 55 participants reported new-onset signs and/or symptoms associated with HE during the COVID-19 pandemic. 59 participants described an increase in signs and/or symptoms associated with HE. The presence of newly-formed or increased signs and/or symptoms associated with HE was found to be 71.7%. A significant increase in dryness, itching, pain/burning, erythema, and scaling was observed (P<0.05). No difference was found between the COVID and non-COVID groups in terms of newly formed and/or increased signs and symptoms (P>0.05). The study included a limited number of participants, and the participants self-reported the signs and symptoms associated with HE. During the COVID-19 period, there has been a significant increase in the signs and symptoms of occupational HE as a result of increased hand hygiene practices in HCWs.


Assuntos
COVID-19/epidemiologia , Dermatite Ocupacional/epidemiologia , Eczema/epidemiologia , Higiene das Mãos , Pessoal de Saúde , Controle de Infecções/métodos , Adulto , Feminino , Humanos , Masculino , Pandemias , Prevalência , Fatores de Risco , SARS-CoV-2
2.
Antimicrob Resist Infect Control ; 10(1): 113, 2021 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-34332622

RESUMO

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic has again demonstrated the critical role of effective infection prevention and control (IPC) implementation to combat infectious disease threats. Standards such as the World Health Organization (WHO) IPC minimum requirements offer a basis, but robust evidence on effective IPC implementation strategies in low-resource settings remains limited. We aimed to qualitatively assess IPC implementation themes in these settings. METHODS: Semi-structured interviews were conducted with IPC experts from low-resource settings, guided by a standardised questionnaire. Applying a qualitative inductive thematic analysis, IPC implementation examples from interview transcripts were coded, collated into sub-themes, grouped again into broad themes, and finally reviewed to ensure validity. Sub-themes appearing ≥ 3 times in data were highlighted as frequent IPC implementation themes and all findings were summarised descriptively. RESULTS: Interviews were conducted with IPC experts from 29 countries in six WHO regions. Frequent IPC implementation themes including the related critical actions to achieve the WHO IPC core components included: (1) To develop IPC programmes: continuous advocacy with leadership, initial external technical assistance, stepwise approach to build resources, use of catalysts, linkages with other programmes, role of national IPC associations and normative legal actions; (2) To develop guidelines: early planning for their operationalization, initial external technical assistance and local guideline adaption; (3) To establish training: attention to methods, fostering local leadership, and sustainable health system linkages such as developing an IPC career path; (4) To establish health care-associated (HAI) surveillance: feasible but high-impact pilots, multidisciplinary collaboration, mentorship, careful consideration of definitions and data quality, and "data for action"; (5) To implement multimodal strategies: clear communication to explain multimodal strategies, attention to certain elements, and feasible but high-impact pilots; (6) To develop monitoring, audit and feedback: feasible but high-impact pilots, attention to methods such as positive (not punitive) incentives and "data for action"; (7) To improve staffing and bed occupancy: participation of national actors to set standards and attention to methods such as use of data; and (8) To promote built environment: involvement of IPC professionals in facility construction, attention to multimodal strategy elements, and long-term advocacy. CONCLUSIONS: These IPC implementation themes offer important qualitative evidence for IPC professionals to consider.


Assuntos
COVID-19/prevenção & controle , Implementação de Plano de Saúde/normas , Controle de Infecções/normas , Organização Mundial da Saúde , COVID-19/epidemiologia , Infecção Hospitalar/prevenção & controle , Implementação de Plano de Saúde/estatística & dados numéricos , Recursos em Saúde/normas , Recursos em Saúde/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Internacionalidade , Pesquisa Qualitativa
3.
Isr Med Assoc J ; 23(8): 469-474, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34392619

RESUMO

BACKGROUND: Hip fractures in elderly patients are a major cause of morbidity and mortality. Variability in length of hospital stay (LOS) was evident in this population. The coronavirus disease-2019 (COVID-19) pandemic led to prompt discharge of effected patients in order to reduce contagion risk. LOS and discharge destination in COVID-19 negative patients has not been studied. OBJECTIVES: To evaluate the LOS and discharge destination during the COVID-19 outbreak and compare it with a similar cohort in preceding years. METHODS: A retrospective study was conducted comparing a total of 182 consecutive fragility hip fracture patients operated on during the first COVID-19 outbreak to patients operated on in 2 preceding years. Data regarding demographic, co-morbidities, surgical management, hospitalization, as well as surgical and medical complications were retrieved from electronic charts. RESULTS: During the pandemic 67 fragility hip fracture patients were admitted (COVID group); 55 and 60 patients were admitted during the same time periods in 2017 and 2018, respectively (control groups). All groups were of similar age and gender. Patients in the COVID group had significantly shorter LOS (7.2 ± 3.3 vs. 8.9 ± 4.9 days, P = 0.008) and waiting time for a rehabilitation facility (7.2 ± 3.1 vs. 9.3 ± 4.9 days, P = 0.003), but greater prevalence of delirium (17.9% vs. 7% of patients, P = 0.028). In hospital mortality did not differ among groups. CONCLUSIONS: LOS and time to rehabilitation were significantly shorter in the COVID group. Delirium was more common in this group, possibly due to negative effects of social distancing.


Assuntos
COVID-19 , Delírio , Fixação de Fratura , Fraturas do Quadril , Controle de Infecções , Tempo de Internação/estatística & dados numéricos , Complicações Pós-Operatórias , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Delírio/diagnóstico , Delírio/epidemiologia , Delírio/etiologia , Feminino , Fixação de Fratura/efeitos adversos , Fixação de Fratura/métodos , Fixação de Fratura/reabilitação , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/cirurgia , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Israel/epidemiologia , Masculino , Inovação Organizacional , Avaliação de Processos e Resultados em Cuidados de Saúde , Alta do Paciente/tendências , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Gestão de Riscos/organização & administração , SARS-CoV-2/isolamento & purificação
4.
Isr Med Assoc J ; 23(8): 475-478, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34392620

RESUMO

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic had enormous impact on many aspects of our society, including huge medical, social, and economic challenges. OBJECTIVES: To evaluate the impact of the first wave of the COVID-19 pandemic and the related movement restrictions on the incidence of hip fractures in different age groups. METHODS: This single center retrospective observational study included all patients over 60 years old admitted to our hospital with the diagnosis of hip fracture during March and April 2020. Exclusion criteria were periprosthetic or pathologic fractures and multitrauma. We collected the same data on all patients with hip fractures admitted during March and April of 2018 and 2019. RESULTS: Mean patient age increased from 81.7 to 85.0 years. Only two of 49 patients tested positive for COVID-19. The data show a decrease of 38% in fracture load, but a striking decrease of 85% and 59% among sexagenarians and septuagenarian, respectively. There was no decrease among nonagenarians. Early mortality, both at 30 days and 90 days, was twice as common during the pandemic. However, stratification by age group demonstrated that the risks of early mortality were the same as previous years. Mean waiting time for surgery decreased from 27.5 to 18.9 hours. Patient discharge to home over a rehabilitation facility increased from 9% to 17. CONCLUSIONS: The COVID-19 pandemic affected the epidemiology of hip fractures in the elderly. The incidence of fractures and age distribution were significantly different from other years. Discharge destinations were also affected. The management of hip fracture patients was not compromised.


Assuntos
COVID-19 , Fraturas do Quadril , Administração dos Cuidados ao Paciente , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Fraturas do Quadril/mortalidade , Fraturas do Quadril/reabilitação , Fraturas do Quadril/terapia , Humanos , Incidência , Controle de Infecções/métodos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade , Avaliação de Processos e Resultados em Cuidados de Saúde , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/tendências , Estudos Retrospectivos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação
5.
Isr Med Assoc J ; 23(8): 479-483, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34392621

RESUMO

BACKGROUND: Little is known regarding the impact of the coronavirus disease-2019 (COVID-19) pandemic on the incidence of hip fractures among older adults. OBJECTIVES: To compare the characteristics of patients with a hip fracture following a fall during the COVID-19 pandemic year and during the preceding year. METHODS: We conducted a retrospective cohort study of older patients who had undergone surgery for hip fracture repair in a major 495-bed hospital located in northern central Israel following a fall. Characteristics of patients who had been hospitalized in 2020 (pandemic year, n=136) and in 2019 (non-pandemic year, n=151) were compared. RESULTS: During the pandemic year, patients were less likely to have fallen in a nursing facility, to have had muscle or balance problems, and to have had a history of falls and fractures following a fall. Moreover, the average length of stay (LOS) in the hospital was shorter; however, the average time from the injury to hospitalization was longer. Patients were less likely to have acquired a postoperative infection or to have died. During the pandemic year, postoperative infection was only associated with prolonged LOS. CONCLUSIONS: The COVID-19 pandemic may have had a positive impact on the behavior of older adults as well as on the management of hip fracture patients. However, healthcare providers should be aware of the possible reluctance to seek care during a pandemic. Moreover, further research on the impact of the change in management during COVID-19 on hip fracture survival is warranted.


Assuntos
Acidentes por Quedas , COVID-19 , Fixação de Fratura , Fraturas do Quadril , Controle de Infecções , Complicações Pós-Operatórias , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Fixação de Fratura/métodos , Fixação de Fratura/reabilitação , Fixação de Fratura/estatística & dados numéricos , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/etiologia , Fraturas do Quadril/cirurgia , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Israel/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , SARS-CoV-2/isolamento & purificação
6.
Isr Med Assoc J ; 23(8): 484-489, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34392622

RESUMO

BACKGROUND: Surgery for hip fractures within 48 hours of admission is considered standard. During the lockdown period due to the coronavirus disease-2019 (COVID-19) epidemic, our medical staff was reduced. OBJECTIVES: To compare the demographics, treatment pathways, and outcomes of patients with hip fractures during the COVID-19 epidemic and lockdown with the standard at routine times. METHODS: A retrospective study was conducted of all patients who were treated surgically for hip fracture in a tertiary center during the COVID-19 lockdown period between 01 March and 01 June 2020 and the equivalent period in 2019. Demographic characteristics, time to surgery, surgery type, hospitalization time, discharge destination, postoperative complications, and 30- and 90-day mortality rates were collected for all patients. RESULTS: During the COVID-19 period, 105 patients were operated due to hip fractures compared to 136 in the equivalent period with no statistical difference in demographics. The rate of surgeries within 48 hours of admission was significantly higher in the COVID-19 period (92% vs. 76%, respectively; P = 0.0006). Mean hospitalization time was significantly shorter (10 vs. 12 days, P = 0.037) with diversion of patient discharge destinations from institutional to home rehabilitation (P < 0.001). There was a significant correlation between the COVID-19 period and lower 90-day mortality rates (P = 0.034). No statistically significant differences in postoperative complications or 30-day mortality rates were noted. CONCLUSIONS: During the COVID-19 epidemic, despite the limited staff and the lack of therapeutic sequence, there was no impairment in the quality of treatment and a decrease in 90-day mortality was noted.


Assuntos
COVID-19 , Fixação de Fratura , Fraturas do Quadril , Controle de Infecções , Complicações Pós-Operatórias , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Fixação de Fratura/efeitos adversos , Fixação de Fratura/métodos , Fixação de Fratura/reabilitação , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/cirurgia , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Israel/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Mortalidade , Inovação Organizacional , Avaliação de Processos e Resultados em Cuidados de Saúde , Alta do Paciente , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , SARS-CoV-2/isolamento & purificação
7.
Natl Med J India ; 34(1): 10-14, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34396997

RESUMO

Background: . Coronavirus disease 2019 (Covid-19) was first described in December 2019 and has evolved into an ongoing global pandemic. Cancer patients on chemotherapy are immunocompromised and are at the highest risk of Covid-19-related complications. We describe our experience with the management of haematology-oncology and stem cell transplant (SCT) patients receiving curative chemotherapy in a hospital with a high influx of Covid-19 patients. Methods: . We did a prospective observational study at a 99-bedded cancer centre of a tertiary care teaching hospital from April 2020 to September 2020. Preventive measures taken were categorized as follows: (i) staff: screening, mandatory use of personal protective equipment (PPE), risk stratification of potential exposure and testing and isolation as needed; (ii) patients: mandatory viral polymerase chain reaction testing, segregation of positive and untested patients and testing of family members; and (iii) environment: mandatory regular cleaning, visitor restriction, telemedicine services and reassignment of priority to clinic visits. Treatment of the underlying conditions was continued with added precautions. Results: . A total of 54 patients were included in the analysis, including 48 with haematological malignancies and 6 for stem cell therapy. Preventive measures were universally applied, and chemotherapy with a curative intent was initiated as per protocol. Three patients were detected to have Covid-19 infection before admission and one after the institution of chemotherapy. Nine patients died after the first cycle of chemotherapy, 2 due to severe Covid-19-related illness and 7 due to complications of chemotherapy or disease progression. Conclusions: . In the wake of the Covid-19 pandemic, treatment for haematological malignancies must continue while balancing the risk of Covid-19 infections. Our report emphasizes the effectiveness of measures such as hand hygiene, social isolation, patient segregation, use of masks and PPE and universal pre-treatment testing for Covid-19 in reducing the risk of infection in a high-risk clinical setting.


Assuntos
COVID-19 , Neoplasias Hematológicas , Controle de Infecções , Gestão de Riscos , Transplante de Células-Tronco , Telemedicina/organização & administração , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Teste para COVID-19/métodos , Busca de Comunicante/métodos , Feminino , Neoplasias Hematológicas/epidemiologia , Neoplasias Hematológicas/terapia , Humanos , Hospedeiro Imunocomprometido/imunologia , Índia/epidemiologia , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Gestão de Riscos/métodos , Gestão de Riscos/organização & administração , SARS-CoV-2 , Transplante de Células-Tronco/métodos , Transplante de Células-Tronco/estatística & dados numéricos
9.
Medicine (Baltimore) ; 100(34): e27026, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34449478

RESUMO

BACKGROUND: There is no definite conclusion about comparison of better effectiveness between N95 respirators and medical masks in preventing health-care workers (HCWs) from respiratory infectious diseases, so that conflicting results and recommendations regarding the protective effects may cause difficulties for selection and compliance of respiratory personal protective equipment use for HCWs, especially facing with pandemics of corona virus disease 2019. METHODS: We systematically searched MEDLINE, Embase, PubMed, China National Knowledge Infrastructure, Wanfang, medRxiv, and Google Scholar from initiation to November 10, 2020 for randomized controlled trials, case-control studies, cohort studies, and cross-sectional studies that reported protective effects of masks or respirators for HCWs against respiratory infectious diseases. We gathered data and pooled differences in protective effects according to different types of masks, pathogens, occupations, concurrent measures, and clinical settings. The study protocol is registered with PROSPERO (registration number: 42020173279). RESULTS: We identified 4165 articles, reviewed the full text of 66 articles selected by abstracts. Six randomized clinical trials and 26 observational studies were included finally. By 2 separate conventional meta-analyses of randomized clinical trials of common respiratory viruses and observational studies of pandemic H1N1, pooled effects show no significant difference between N95 respirators and medical masks against common respiratory viruses for laboratory-confirmed respiratory virus infection (risk ratio 0.99, 95% confidence interval [CI] 0.86-1.13, I2 = 0.0%), clinical respiratory illness (risk ratio 0.89, 95% CI 0.45-1.09, I2 = 83.7%, P = .002), influenza-like illness (risk ratio 0.75, 95% CI 0.54-1.05, I2 = 0.0%), and pandemic H1N1 for laboratory-confirmed respiratory virus infection (odds ratio 0.92, 95% CI 0.49-1.70, I2 = 0.0%, P = .967). But by network meta-analysis, N95 respirators has a significantly stronger protection for HCWs from betacoronaviruses of severe acute respiratory syndrome, middle east respiratory syndrome, and corona virus disease 2019 (odds ratio 0.43, 95% CI 0.20-0.94). CONCLUSIONS: Our results provide moderate and very-low quality evidence of no significant difference between N95 respirators and medical masks for common respiratory viruses and pandemic H1N1, respectively. And we found low quality evidence that N95 respirators had a stronger protective effectiveness for HCWs against betacoronaviruses causative diseases compared to medical masks. The evidence of comparison between N95 respirators and medical masks for corona virus disease 2019 is open to question and needs further study.


Assuntos
Pessoal de Saúde , Máscaras , Respiradores N95 , Infecções Respiratórias/prevenção & controle , Viroses/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Humanos , Controle de Infecções/métodos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/prevenção & controle , Metanálise em Rede , Infecções Respiratórias/virologia
10.
Antimicrob Resist Infect Control ; 10(1): 114, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34353356

RESUMO

BACKGROUND: In healthcare facilities, nosocomial transmissions of respiratory viruses are a major issue. SARS-CoV-2 is not exempt from nosocomial transmission. Our goals were to describe COVID-19 nosocomial cases during the first pandemic wave among patients in a French university hospital and compliance with hygiene measures. METHODS: We conducted a prospective observational study in Grenoble Alpes University Hospital from 01/03/2020 to 11/05/2020. We included all hospitalised patients with a documented SARS-CoV-2 diagnosis. Nosocomial case was defined by a delay of 5 days between hospitalisation and first symptoms. Hygiene measures were evaluated between 11/05/2020 and 22/05/2020. Lockdown measures were effective in France on 17/03/2020 and ended on 11/05/2020. Systematic wearing of mask was mandatory for all healthcare workers (HCW) and visits were prohibited in our institution from 13/03/2021 and for the duration of the lockdown period. RESULTS: Among 259 patients included, 14 (5.4%) were considered as nosocomial COVID-19. Median time before symptom onset was 25 days (interquartile range: 12-42). Eleven patients (79%) had risk factors for severe COVID-19. Five died (36%) including 4 deaths attributable to COVID-19. Two clusters were identified. The first cluster had 5 cases including 3 nosocomial acquisitions and no tested HCWs were positive. The second cluster had 3 cases including 2 nosocomial cases and 4 HCWs were positive. Surgical mask wearing and hand hygiene compliance were adequate for 95% and 61% of HCWs, respectively. CONCLUSIONS: The number of nosocomial COVID-19 cases in our hospital was low. Compliance regarding mask wearing, hand hygiene and lockdown measures drastically reduced transmission of the virus. Monitoring of nosocomial COVID-19 cases during the first wave enabled us to determine to what extent the hygiene measures taken were effective and patients protected. Trial registration Study ethics approval was obtained retrospectively on 30 September 2020 (CECIC Rhône-Alpes-Auvergne, Clermont-Ferrand, IRB 5891).


Assuntos
COVID-19/epidemiologia , Infecção Hospitalar/epidemiologia , SARS-CoV-2/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , COVID-19/virologia , Teste para COVID-19/métodos , Infecção Hospitalar/virologia , Feminino , França/epidemiologia , Higiene das Mãos/métodos , Pessoal de Saúde , Hospitais Universitários/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Masculino , Máscaras/microbiologia , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Estudos Retrospectivos
11.
Infect Dis Clin North Am ; 35(3): 697-716, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34362539

RESUMO

The built environment has been integral to response to the global pandemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In particular, engineering controls to mitigate risk of exposure to SARS-CoV-2 and other newly emergent respiratory pathogens in the future will be important. Anticipating emergence from this pandemic, or at least adaptation given increasing administration of effective vaccines, and the safety of patients, personnel, and others in health care facilities remain the core goals. This article summarizes known risks and highlights prevention strategies for daily care as well as response to emergent infectious diseases and this parapandemic phase.


Assuntos
COVID-19 , Defesa Civil , Instalações de Saúde/tendências , Controle de Infecções , Gestão da Segurança/organização & administração , COVID-19/epidemiologia , COVID-19/prevenção & controle , Defesa Civil/métodos , Defesa Civil/organização & administração , Ambiente Controlado , Arquitetura Hospitalar/métodos , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , SARS-CoV-2
12.
PLoS One ; 16(8): e0255236, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34347810

RESUMO

Behavioral epidemiology suggests that there is a tight dynamic coupling between the timeline of an epidemic outbreak, and the social response in the affected population (with a typical course involving physical distancing between individuals, avoidance of large gatherings, wearing masks, etc). We study the bidirectional coupling between the epidemic dynamics of COVID-19 and the population social response in the state of New York, between March 1, 2020 (which marks the first confirmed positive diagnosis in the state), until June 20, 2020. This window captures the first state-wide epidemic wave, which peaked to over 11,000 confirmed cases daily in April (making New York one of the US states most severely affected by this first wave), and subsided by the start of June to a count of consistently under 1,500 confirmed cases per day (suggesting temporary state-wide control of the epidemic). In response to the surge in cases, social distancing measures were gradually introduced over two weeks in March, culminating with the PAUSE directive on March 22nd, which mandated statewide shutdown of all nonessential activity. The mandates were then gradually relaxed in stages throughout summer, based on how epidemic benchmarks were met in various New York regions. In our study, we aim to examine on one hand, whether different counties exhibited different responses to the PAUSE centralized measures depending on their epidemic situation immediately preceding PAUSE. On the other hand, we explore whether these different county-wide responses may have contributed in turn to modulating the counties' epidemic timelines. We used the public domain to extract county-wise epidemic measures (such as cumulative and daily incidence of COVID-19), and social mobility measures for different modalities (driving, walking, public transit) and to different destinations. Our correlation analyses between the epidemic and the mobility time series found significant correlations between the size of the epidemic and the degree of mobility drop after PAUSE, as well as between the mobility comeback patterns and the epidemic recovery timeline. In line with existing literature on the role of the population behavioral response during an epidemic outbreak, our results support the potential importance of the PAUSE measures to the control of the first epidemic wave in New York State.


Assuntos
COVID-19/epidemiologia , Comportamentos Relacionados com a Saúde/fisiologia , Controle de Infecções , Surtos de Doenças , Epidemias , História do Século XXI , Atividades Humanas/estatística & dados numéricos , Humanos , Controle de Infecções/legislação & jurisprudência , Controle de Infecções/métodos , Programas Obrigatórios/legislação & jurisprudência , Máscaras , New York/epidemiologia , Distanciamento Físico , Quarentena/psicologia , Quarentena/estatística & dados numéricos , SARS-CoV-2/fisiologia , Fatores de Tempo , Transportes/estatística & dados numéricos
13.
PLoS One ; 16(8): e0255680, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34347855

RESUMO

New emerging infectious diseases are identified every year, a subset of which become global pandemics like COVID-19. In the case of COVID-19, many governments have responded to the ongoing pandemic by imposing social policies that restrict contacts outside of the home, resulting in a large fraction of the workforce either working from home or not working. To ensure essential services, however, a substantial number of workers are not subject to these limitations, and maintain many of their pre-intervention contacts. To explore how contacts among such "essential" workers, and between essential workers and the rest of the population, impact disease risk and the effectiveness of pandemic control, we evaluated several mathematical models of essential worker contacts within a standard epidemiology framework. The models were designed to correspond to key characteristics of cashiers, factory employees, and healthcare workers. We find in all three models that essential workers are at substantially elevated risk of infection compared to the rest of the population, as has been documented, and that increasing the numbers of essential workers necessitates the imposition of more stringent controls on contacts among the rest of the population to manage the pandemic. Importantly, however, different archetypes of essential workers differ in both their individual probability of infection and impact on the broader pandemic dynamics, highlighting the need to understand and target intervention for the specific risks faced by different groups of essential workers. These findings, especially in light of the massive human costs of the current COVID-19 pandemic, indicate that contingency plans for future epidemics should account for the impacts of essential workers on disease spread.


Assuntos
COVID-19/transmissão , Controle de Infecções , Distanciamento Físico , Recursos Humanos , COVID-19/epidemiologia , Epidemias/prevenção & controle , Pessoal de Saúde/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Controle de Infecções/estatística & dados numéricos , Modelos Estatísticos , Cidade de Nova Iorque/epidemiologia , Ocupações/estatística & dados numéricos , Pandemias , Quarentena/estatística & dados numéricos , Fatores de Risco , Populações Vulneráveis/estatística & dados numéricos , Recursos Humanos/organização & administração , Recursos Humanos/estatística & dados numéricos
14.
Lancet Infect Dis ; 21(8): e209-e221, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34331890

RESUMO

Health-care-associated infections are the most prevalent adverse events of hospital care, posing a substantial threat to patient safety and burden on society. Hand hygiene with alcohol-based hand rub is the most effective preventive strategy to reduce health-care-associated infections. Over the past two decades, various interventions have been introduced and studied to improve hand hygiene compliance among health-care workers. The global implementation of the WHO multimodal hand hygiene improvement strategy and constant efforts to replace the use of soap and water with alcohol-based hand rub have led to a faster and more efficient hand cleaning method. These strategies have strongly contributed to the success of behaviour change and a subsequent decrease in health-care-associated infections and cross-transmission of multidrug-resistant organisms worldwide. The WHO multimodal behaviour change strategy requires a series of elements including system change as a prerequisite for behaviour, change, education, monitoring and performance feedback, reminders in the workplace, and an institutional safety climate. Successful adoption of the promotion strategy requires adaptation to available resources and sociocultural contexts. This Review focuses on the major advances and challenges in hand hygiene research and practices in the past 20 years and sets out various ways forward for improving this lifesaving action.


Assuntos
COVID-19/prevenção & controle , Infecção Hospitalar/prevenção & controle , Higiene das Mãos/história , Pessoal de Saúde , Publicações/estatística & dados numéricos , Fidelidade a Diretrizes , Guias como Assunto , Desinfecção das Mãos/métodos , Higiene das Mãos/tendências , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Controle de Infecções/métodos , Pesquisa/tendências
15.
J Alzheimers Dis ; 83(1): 43-49, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34219720

RESUMO

We aimed to explore the awareness and preparedness of dementia caregivers and people with mild cognitive deficits on how to prevent COVID-19 infection and cope with the indirect consequences of the pandemic. A total of 139 patient-caregiver dyads received a telephone survey and 109 completed the survey. The majority of respondents reported having a moderate-to-good knowledge of the typical manifestations of COVID-19. Conversely, only few of them were informed of the atypical presentations and on how to recognize emergency warning signs. Filling the knowledge gaps on COVID-19 in the most vulnerable people may represent a significant resource to tackle the pandemic.


Assuntos
COVID-19 , Cuidadores , Demência/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Letramento em Saúde , Idoso , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Cuidadores/educação , Cuidadores/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/métodos , Letramento em Saúde/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Itália/epidemiologia , Masculino , SARS-CoV-2 , Inquéritos e Questionários , Avaliação de Sintomas/métodos
19.
Antimicrob Resist Infect Control ; 10(1): 102, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215330

RESUMO

INTRODUCTION: In late 2019, a novel coronavirus was detected in China. Supported by its respiratory transmissibility, even by people infected without symptomatic disease, this coronavirus soon began to rapidly spread worldwide. BACKGROUND: Many countries have implemented different infection control and containment strategies due to ongoing community transmission. In this context, contact tracing as well as adequate testing and consequent quarantining of high-risk contacts play leading roles in containing the virus by interrupting infection chains. This approach is especially important in the hospital setting where contacts often cannot be avoided and physical distance is usually not possible. Furthermore, health care workers (HCWs) usually have contact with a variety of vulnerable people, making it essential to identify infections among hospital employees as soon as possible to interrupt the rapid spread of SARS-CoV-2 in the facility. Several electronic tools for contact tracing, such as specific software or mobile phone apps, are available for the public health sector. In contrast, contact tracing in hospitals often has to be carried out without helpful electronic tools, and an enormous amount of human resources is typically required. AIM: For rapid contact tracing and effective infection control and management measures for HCWs in hospitals, adapted technical solutions are needed. METHODS: In this study, we report the development of our containment strategy to a web-based contact tracing and rapid point-of-care-testing workflow. RESULTS/CONCLUSION: Our workflow yielded efficient control of the rapidly evolving situation during the SARS-CoV-2 pandemic from May 2020 until January 2021 at a German University Hospital.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/transmissão , Redes de Comunicação de Computadores , Busca de Comunicante/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Pandemias , Testes Imediatos , SARS-CoV-2 , COVID-19/epidemiologia , Alemanha/epidemiologia , Hospitais Universitários , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Aplicativos Móveis , Recursos Humanos em Hospital , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Estações do Ano , Software , Fluxo de Trabalho
20.
Prev Chronic Dis ; 18: E65, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34197284

RESUMO

INTRODUCTION: Telehealth plays a role in the continuum of care, especially for older adults during the COVID-19 pandemic. Our objective was to examine factors associated with the accessibility of telehealth services during the COVID-19 pandemic among older adults. METHODS: We analyzed the nationally representative Medicare Current Beneficiary Survey COVID-19 Rapid Response Supplement Questionnaire of beneficiaries aged 65 years or older. Two weighted multivariable logistic regression models were used to examine associations between usual providers who offered telehealth 1) during the COVID-19 pandemic and 2) to replace a regularly scheduled appointment. We examined factors including sociodemographic characteristics, comorbidities, and digital access and literacy. RESULTS: Of the beneficiaries (n = 6,172, weighted n = 32.4 million), 81.2% reported that their usual providers offered telehealth during the COVID-19 pandemic. Among those offered telehealth services, 56.8% reported that their usual providers offered telehealth to replace a regularly scheduled appointment. Disparities in accessibility of telehealth services by sex, residing area (metropolitan vs nonmetropolitan), income level, and US Census region were observed. Beneficiaries who reported having internet access (vs no access) (OR, 1.75, P < .001) and who reported ever having participated in video, voice, or conference calls over the internet before (vs not) (OR, 2.18, P < .001) were more likely to report having access to telehealth. Non-Hispanic Black beneficiaries (versus White) (OR, 1.57, P = .007) and beneficiaries with comorbidities (vs none) (eg, 2 or 3 comorbidities, OR, 1.25, 95% P = .044) were more likely to have their usual provider offer telehealth to replace a regularly scheduled appointment. CONCLUSION: Although accessibility of telehealth has increased, inequities raise concern. Educational outreach and training, such as installing and launching an online web conferencing platform, should be considered for improving accessibility of telehealth to vulnerable populations beyond the COVID-19 pandemic.


Assuntos
COVID-19 , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Controle de Infecções/métodos , Medicare/estatística & dados numéricos , Telemedicina , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Comorbidade , Estudos Transversais , Demografia , Feminino , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/organização & administração , Humanos , Acesso à Internet/estatística & dados numéricos , Masculino , Determinação de Necessidades de Cuidados de Saúde , SARS-CoV-2 , Fatores Socioeconômicos , Telemedicina/métodos , Telemedicina/organização & administração , Telemedicina/estatística & dados numéricos , Estados Unidos/epidemiologia
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