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1.
Rev. SPAGESP ; 21(2): 139-153, jul.-dez. 2020. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1125737

RESUMO

Este trabalho objetiva relatar experiências grupais vividas durante a implantação de projeto extensionista de atenção à saúde de trabalhadores da Atenção Básica (AB) em um município mineiro. As ações foram desenvolvidas em três semestres letivos consecutivos, como resultado de parceria entre uma universidade pública federal e um Centro de Referência em Saúde do Trabalhador. Equipes executoras contaram com 86 estudantes de Psicologia, sob supervisão de três docentes; 340 trabalhadores foram atendidos. Por meio dos processos grupais foi possível acolher o sofrimento manifesto pelos trabalhadores e, em paralelo, estudantes e formadores puderam construir aprendizados acerca das situações vividas. Dificuldades na execução do projeto foram relatadas pelos estudantes e espelharam a realidade comum ao trabalho dos psicólogos que atuam na AB.


This work intends to report group experiences lived during the implementation of an extension project of health care for Primary Care workers (PC) in a city in Minas Gerais. The actions were developed in three consecutive semesters, as a result of a partnership between a federal public university and a Reference Center in Occupational Health. The executing teams had 86 Psychology students, under the supervision of three teachers; 340 workers were met. Through the group processes, it was possible to embrace the suffering manifested by the workers and, in parallel, students and trainers were able to build learning about the situations experienced. Difficulties in the execution of the project were reported by the students and reflected the reality common to the performance of psychologists working in PC.


Este trabajo tiene la intención de informar las experiencias grupales vividas durante la implementación de un proyecto de extensión de atención de salud para trabajadores de la Atención Primaria (AP) en un ayuntamiento de Minas Gerais. Las acciones se desarrollaron en tres semestres seguidos, como resultado de una asociación entre una universidad pública federal y un Centro de Referencia en Salud del Trabajador. Los equipos ejecutores tenían 86 estudiantes de Psicología, bajo la supervisión de tres profesores; 340 trabajadores fueron atendidos. Mediante los procesos grupales, se hizo posible acoger el sufrimiento manifestado por los trabajadores y, paralelamente, los estudiantes y los formadores pudieron desarrollar el aprendizaje sobre las situaciones vividas. Las dificultades en la ejecución del proyecto fueron informadas por los estudiantes y reflejaban la realidad común al trabajo de los psicólogos que actúan en la AP.


Assuntos
Humanos , Masculino , Feminino , Estresse Psicológico , Trabalho , Saúde do Trabalhador , Processos Grupais , Mão de Obra em Saúde , Promoção da Saúde , Categorias de Trabalhadores
2.
Rev. enferm. UERJ ; 28: 49596, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1094830

RESUMO

Objetivo: descrever as principais recomendações sobre ações de prevenção de contágio relacionadas à exposição ocupacional dos profissionais de saúde atuantes frente à COVID-19, disponíveis até março de 2020. Conteúdo: A atual pandemia da doença causada pelo novo coronavírus SARS-CoV-2 tem transmissão favorecida pelo contato próximo e desprotegido com secreções ou excreções de pacientes infectados, principalmente por meio de gotículas salivares. Práticas organizacionais de prevenção devem ser previstas antes da chegada do paciente ao serviço de saúde, reduzindo o fluxo de atendimento, no primeiro atendimento e durante as ações assistenciais, para minimizar a exposição ocupacional ao agente biológico. Profissionais de saúde classificados como grupo de risco devem ser afastados de atividades de risco de contaminação. Aqueles contaminados ou adoecidos devem permanecer em quarentena para minimizar a propagação da COVID-19. Considerações finais: os cuidados para prevenção de contaminação de trabalhadores nesta pandemia pelo novo coronavírus devem ser priorizados, evitando impactos negativos na assistência à população que busca atendimento nos serviços de saúde.


Objective: to describe the main recommended actions on prevention actions related to occupational exposure of health professionals working at COVID-19, available until March 2020. Content: The current pandemic disease caused by the new SARS-CoV-2 coronavirus has its transmission favored by close and unprotected contact with secretions or excretions from infected patients, mainly through salivary droplets. Organizational prevention practices should be prioritized, since patient's arrival at the health service, optimizing the flow of care, the first care and during health care actions, to minimize occupational exposure to the biological agent. Health professionals classified as a risk group should be removed from activities at risk of contamination. Those contaminated or adulterated must remain in quarantine to minimize the spread of COVID-19. Final considerations: care to avoid contamination of workers in this pandemic by the new coronavirus must be prioritized, prevented from affecting the assistance to the population that seeks assistance in health services.


Objetivo: describir las principales acciones recomendadas sobre acciones de prevención relacionadas con la exposición ocupacional de los profesionales de la salud que trabajan en COVID-19, disponible hasta marzo de 2020. Contenido: La enfermedad pandémica actual causada por el nuevo coronavirus SARS-CoV-2 tiene su transmisión favorecida por contacto cercano y sin protección con secreciones o excreciones de pacientes infectados, principalmente a través de gotas salivales. Se deben priorizar las prácticas de prevención organizacional, desde la llegada del paciente al servicio de salud, optimizando el flujo de atención, la primera atención y durante las acciones de atención de salud, para minimizar la exposición ocupacional al agente biológico. Los profesionales de la salud clasificados como grupo de riesgo deben ser retirados de las actividades en riesgo de contaminación. Las personas contaminadas o adulteradas deben permanecer en cuarentena para minimizar la propagación de COVID-19. Consideraciones finales: se debe priorizar la atención para evitar la contaminación de los trabajadores en esta pandemia por el nuevo coronavirus, evitando que afecte la asistencia a la población que busca asistencia en los servicios de salud.


Assuntos
Humanos , Pneumonia Viral , Riscos Ocupacionais , Fatores de Risco , Saúde do Trabalhador , Pessoal de Saúde , Infecções por Coronavirus , Pandemias , Mão de Obra em Saúde , Profissionais de Enfermagem , Condições de Trabalho , Enfermagem , Betacoronavirus
3.
J Korean Med Sci ; 35(44): e387, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-33200593

RESUMO

Coronavirus disease 2019 (COVID-19) has penetrated our daily lives, leading us to a new normal era. The unexpected impact of COVID-19 has posed a unique challenge for the health care system, bringing innovation around the world. Considering the current pandemic pattern, comprehensive preparedness strategies of healthcare resources need to be implemented to prepare for a large resurgence of COVID-19 within a short time. With the unprecedented spread of the new pandemic and the impending influenza season, scientific evidence-based schemes need to be developed through cooperation, coordination, and solidarity. Based on the early experience with the current pandemic, this narrative interpretive review of qualitative studies suggests a 6-domain plan to establish a better health care system that is prepared to deal with the current and future public health crises. The 6 domains are medical institutions, medical workforce, medical equipment, COVID-19 surveillance, data and information application, and governance structure.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Recursos em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Assistência à Saúde , Mão de Obra em Saúde , Humanos , Pneumonia Viral/epidemiologia , Pesquisa Qualitativa
4.
Bone Joint J ; 102-B(11): 1446-1456, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33135433

RESUMO

AIMS: Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, and to investigate interventions countering such behaviours. METHODS: A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database in April 2020, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to which we adhered. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were included for review. RESULTS: Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. A narrative review was performed in light of the significant heterogeneity displayed by the eligible studies. A total of 13 papers discussed the prevalence of GBSD, while 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. The impact of this includes poor workforce representation, lower salaries, and less career success, including in academia, for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions. CONCLUSION: GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty. Cite this article: Bone Joint J 2020;102-B(11):1446-1456.


Assuntos
Ortopedia/estatística & dados numéricos , Sexismo/prevenção & controle , Sexismo/estatística & dados numéricos , Sucesso Acadêmico , Emprego/economia , Emprego/normas , Emprego/estatística & dados numéricos , Feminino , Mão de Obra em Saúde/economia , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Masculino , Mentores , Ortopedia/economia , Ortopedia/educação , Ortopedia/normas , Papel do Médico , Prevalência , Sexismo/economia , Mudança Social , Fatores Socioeconômicos
5.
BMJ Open ; 10(11): e042750, 2020 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-33177146

RESUMO

INTRODUCTION: The current COVID-19 pandemic is a global threat. This elicits questions on the level of preparedness and capacity of health systems to respond to emergencies relative to other parts of the world. METHODS: This cross-sectional study uses publicly available core health data for 53 African countries to determine risk factors for cumulative COVID-19 deaths and cases per million in all countries in the continent. Descriptive statistics were determined for the indicators, and a negative binomial regression was used for modelling the risk factors. RESULTS: In sub-Saharan Africa, an increase in the number of nursing and midwifery personnel decreased the risk of COVID-19 deaths (p=0.0178), while a unit increase in universal healthcare (UHC) index of service coverage and prevalence of insufficient physical activity among adults increased the risk of COVID-19 deaths (p=0.0432 and p=0.0127). An increase in the proportion of infants initiating breast feeding reduced the number of cases per million (p<0.0001), while an increase in higher healthy life expectancy at birth increased the number of cases per million (p=0.0340). CONCLUSION: Despite its limited resources, Africa's preparedness and response to the COVID-19 pandemic can be improved by identifying and addressing specific gaps in the funding of health services delivery. These gaps impact negatively on service delivery in Africa, which requires more nursing personnel and increased UHC coverage to mitigate the effects of COVID-19.


Assuntos
Aleitamento Materno , Infecções por Coronavirus/epidemiologia , Exercício Físico , Indicadores Básicos de Saúde , Mão de Obra em Saúde , Expectativa de Vida , Pneumonia Viral/epidemiologia , Assistência de Saúde Universal , África/epidemiologia , Betacoronavirus , Infecções por Coronavirus/mortalidade , Estudos Transversais , Humanos , Tocologia , Enfermeiras e Enfermeiros/provisão & distribução , Pandemias , Pneumonia Viral/mortalidade
6.
Hum Resour Health ; 18(1): 83, 2020 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-33129313

RESUMO

This commentary addresses the critically important role of health workers in their countries' more immediate responses to COVID-19 outbreaks and provides policy recommendations for more sustainable health workforces. Paradoxically, pandemic response plans in country after country, often fail to explicitly address health workforce requirements and considerations. We recommend that policy and decision-makers at the facility, regional and country-levels need to: integrate explicit health workforce requirements in pandemic response plans, appropriate to its differentiated levels of care, for the short, medium and longer term; ensure safe working conditions with personal protective equipment (PPE) for all deployed health workers including sufficient training to ensure high hygienic and safety standards; recognise the importance of protecting and promoting the psychological health and safety of all health professionals, with a special focus on workers at the point of care; take an explicit gender and social equity lens, when addressing physical and psychological health and safety, recognising that the health workforce is largely made up of women, and that limited resources lead to priority setting and unequitable access to protection; take a whole of the health workforce approach-using the full skill sets of all health workers-across public health and clinical care roles-including those along the training and retirement pipeline-and ensure adequate supervisory structures and operating procedures are in place to ensure inclusive care of high quality; react with solidarity to support regions and countries requiring more surge capacity, especially those with weak health systems and more severe HRH shortages; and acknowledge the need for transparent, flexible and situational leadership styles building on a different set of management skills.


Assuntos
Infecções por Coronavirus/epidemiologia , Mão de Obra em Saúde/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Humanos
9.
Emergencias ; 32(5): 320-331, 2020 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33006832

RESUMO

OBJECTIVES: To estimate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the organization of Spanish hospital emergency departments (EDs). To explore differences between Spanish autonomous communities or according to hospital size and disease incidence in the area. MATERIAL AND METHODS: Survey of the heads of 283 EDs in hospitals belonging to or affiliated with Spain's public health service. Respondents evaluated the pandemic's impact on organization, resources, and staff absence from work in March and April 2020. Assessments were for 15-day periods. Results were analyzed overall and by autonomous community, hospital size, and local population incidence rates. RESULTS: A total of 246 (87%) responses were received. The majority of the EDs organized a triage system, first aid, and observation wards; areas specifically for patients suspected of having COVID-19 were newly set apart. The nursing staff was increased in 83% of the EDs (with no subgroup differences), and 59% increased the number of physicians (especially in large hospitals and locations where the COVID-19 incidence was high). Diagnostic tests for the severe acute respiratory syndrome coronavirus 2 were the resource the EDs missed most: 55% reported that tests were scarce often or very often. Other resources reported to be scarce were FPP2 and FPP3 masks (38% of the EDs), waterproof protective gowns (34%), and space (32%). More than 5% of the physicians, nurses, or other emergency staff were on sick leave 20%, 19%, and 16% of the time. These deficiencies were greatest during the last half of March, except for tests, which were most scarce in the first 15 days. Large hospital EDs less often reported that diagnostic tests were unavailable. In areas where the COVID-19 incidence was higher, the EDs reported higher rates of staff on sick leave. Resource scarcity differed markedly by autonomous community and was not always associated with the incidence of COVID-19 in the population. CONCLUSION: The COVID-19 pandemic led to organizational changes in EDs. Certain resources became scarce, and marked differences between autonomous communities were detected.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Pandemias , Pneumonia Viral/epidemiologia , Absenteísmo , Adulto , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Surtos de Doenças , Serviço Hospitalar de Emergência/organização & administração , Recursos em Saúde/provisão & distribução , Necessidades e Demandas de Serviços de Saúde , Mão de Obra em Saúde/estatística & dados numéricos , Número de Leitos em Hospital , Hospitais Públicos/organização & administração , Hospitais Públicos/estatística & dados numéricos , Humanos , Incidência , Recursos Humanos em Hospital/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Alocação de Recursos , Síndrome do Desconforto Respiratório do Adulto/diagnóstico , Síndrome do Desconforto Respiratório do Adulto/etiologia , Espanha/epidemiologia , Triagem/organização & administração
10.
Artigo em Inglês | MEDLINE | ID: mdl-33007820

RESUMO

Rapid and profound changes anticipated in the future of work will have significant implications for the education and training of occupational safety and health (OSH) professionals and the workforce. As the nature of the workplace, work, and the workforce change, the OSH field must expand its focus to include existing and new hazards (some yet unknown), consider how to protect the health and well-being of a diverse workforce, and understand and mitigate the safety implications of new work arrangements. Preparing for these changes is critical to developing proactive systems that can protect workers, prevent injury and illness, and promote worker well-being. An in-person workshop held on February 3-4, 2020 at The University of Texas Health Science Center (UTHealth) School of Public Health in Houston, Texas, USA, examined some of the challenges and opportunities OSH education will face in both academic and industry settings. The onslaught of the COVID-19 global pandemic reached the United States one month after this workshop and greatly accelerated the pace of change. This article summarizes presentations from national experts and thought leaders across the spectrum of OSH and professionals in the fields of strategic foresight, systems thinking, and industry, and provides recommendations for the field.


Assuntos
Infecções por Coronavirus , Saúde do Trabalhador/educação , Pandemias , Pneumonia Viral , Betacoronavirus , Mão de Obra em Saúde , Humanos , Texas , Estados Unidos , Local de Trabalho
11.
J Glob Health ; 10(2): 020509, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33110592

RESUMO

Background: The COVID-19 pandemic has overwhelmed hospitals in several areas in high-income countries. An effective response to this pandemic requires health care workers (HCWs) to be present at work, particularly in low- and middle-income countries (LMICs) where they are already in critically low supply. To inform whether and to what degree policymakers in Bangladesh, and LMICs more broadly, should expect a drop in HCW attendance as COVID-19 continues to spread, this study aims to determine how HCW attendance has changed during the early stages of the COVID-19 pandemic in Bangladesh. Methods: This study analyzed daily fingerprint-verified attendance data from all 527 public-sector secondary and tertiary care facilities in Bangladesh to describe HCW attendance from January 26, 2019 to March 22, 2020, by cadre, hospital type, and geographic division. We then regressed HCW attendance onto fixed effects for day-of-week, month, and hospital, as well as indicators for each of three pandemic periods: a China-focused period (January 11, 2020 (first confirmed COVID-19 death in China) until January 29, 2020), international-spread period (January 30, 2020 (World Health Organization's declaration of a global emergency) until March 6, 2020), and local-spread period (March 7, 2020 (first confirmed COVID-19 case in Bangladesh) until the end of the study period). Findings: On average between January 26, 2019 and March 22, 2020, 34.1% of doctors, 64.6% of nurses, and 70.6% of other health care staff were present for their scheduled shift. HCWs' attendance rate increased with time in 2019 among all cadres. Nurses' attendance level dropped by 2.5% points (95% confidence interval (CI) = -3.2% to -1.8%) and 3.5% points (95% CI = -4.5% to -2.5%) during the international-spread and the local-spread periods of the COVID-19 pandemic, relative to the China-focused period. Similarly, the attendance level of other health care staff declined by 0.3% points (95% CI = -0.8% to 0.2%) and 2.3% points (95% CI = -3.0% to -1.6%) during the international-spread and local-spread periods, respectively. Among doctors, however, the international-spread and local-spread periods were associated with a statistically significant increase in attendance by 3.7% points (95% CI = 2.5% to 4.8%) and 4.9% points (95% CI = 3.5% to 6.4%), respectively. The reduction in attendance levels across all HCWs during the local-spread period was much greater at large hospitals, where the majority of COVID-19 testing and treatment took place, than that at small hospitals. Conclusions: After a year of significant improvements, HCWs' attendance levels among nurses and other health care staff (who form the majority of Bangladesh's health care workforce) have declined during the early stages of the COVID-19 pandemic. This finding may portend an even greater decrease in attendance if COVID-19 continues to spread in Bangladesh. Policymakers in Bangladesh and similar LMICs should undertake major efforts to achieve high attendance levels among HCWs, particularly nurses, such as by providing sufficient personal protective equipment as well as monetary and non-monetary incentives.


Assuntos
Infecções por Coronavirus , Mão de Obra em Saúde/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Pandemias , Pneumonia Viral , Atenção Secundária à Saúde/estatística & dados numéricos , Atenção Terciária à Saúde/estatística & dados numéricos , Adulto , Bangladesh/epidemiologia , Betacoronavirus , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Atenção Secundária à Saúde/organização & administração , Atenção Terciária à Saúde/organização & administração
12.
AMA J Ethics ; 22(10): E856-861, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33103647

RESUMO

Native Americans have twice the poverty rate of the general US population, suffer significant health inequity, and are chronically underrepresented, at only 0.08%, in the US physician workforce. The COVID-19 pandemic has illuminated key ethical, clinical, and economic complexities in health decision making among Native patients. This article discusses 3 levels of autonomy relevant to health decisions, including taking care of our own by increasing numbers of Native medical students.


Assuntos
Infecções por Coronavirus , Educação Médica , Equidade em Saúde , Serviços de Saúde do Indígena , Mão de Obra em Saúde , Índios Norte-Americanos , Pandemias , Médicos , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Tomada de Decisões , Humanos , Autonomia Pessoal , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Pneumonia Viral/virologia
14.
Hum Resour Health ; 18(1): 71, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33076909

RESUMO

Regulation of the health workforce and accreditation of educational institutions are intended to protect the public interest, but evidence of the impact of these policies is scarce and occasionally contradictory. The body of research that does exist primarily focuses on policies in the global north and on the major health professions. Stress on accreditation and regulatory systems caused by surges in demand due to the COVID-19 pandemic, privatization of education, rising patient expectations, and emergence of new health worker categories has created urgency for innovation and reform. To understand and evaluate this innovation, we look forward to receiving manuscripts which contribute to the evidence base on the implementation, management, and impact of health worker education and practice regulation, including the intersection of education accreditation and workforce regulation policy. We particularly look forward to manuscripts from underrepresented parts of the globe and underrepresented health workforce sectors that address policy effectiveness, explore different models of regulation, and present innovations that we can all learn from.


Assuntos
Acreditação/normas , Ocupações em Saúde/educação , Mão de Obra em Saúde/normas , Infecções por Coronavirus/epidemiologia , Política de Saúde , Humanos , Pandemias , Pneumonia Viral/epidemiologia
15.
PLoS One ; 15(10): e0241331, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33095834

RESUMO

BACKGROUND: In the early phase of the Covid-19 pandemic, mainly data related to the burden of care required by infected patients were reported. The aim of this study was to illustrate the timeline of actions taken and to measure and analyze their impact on surgical patients. METHOD: This is a retrospective review of actions to limit Covid-19 spread and their impact on surgical activity in a Swiss tertiary referral center. Data on patient care, human resources and hospital logistics were collected. Impact on surgical activity was measured by comparing 6-week periods before and after the first measures were taken. RESULTS: After the first Swiss Covid-19 case appeared on February 25, progressively restrictive measures were taken over a period of 23 days. Covid-19 positive inpatients increased from 5 to 131, and ICU patients from 2 to 31, between days 10 and 30, respectively, without ever overloading resources. A 43% decrease of elective visceral surgical procedures was observed after Covid-19 (295 vs 165, p<0.01), while the urgent operations (all specialties) decreased by 39% (1476 vs 897, p<0.01). Fifty-two and 38 major oncological surgeries were performed, respectively, representing a 27% decrease (p = 0.316). Outpatient consultations dropped by 59%, from 728 to 296 (p<0.01). CONCLUSION: While allowing for maximal care of Covid-19 patients during the pandemic, the shift of resources limited the access to elective surgical care, with less impact on cancer care.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/tendências , Neoplasias/cirurgia , Pneumonia Viral/epidemiologia , Oncologia Cirúrgica/tendências , Assistência Ambulatorial/tendências , Infecções por Coronavirus/virologia , Alocação de Recursos para a Atenção à Saúde , Mão de Obra em Saúde/tendências , Hospitalização/tendências , Humanos , Unidades de Terapia Intensiva , Pandemias , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase , Encaminhamento e Consulta/tendências , Estudos Retrospectivos , Suíça/epidemiologia , Centros de Atenção Terciária
17.
PLoS One ; 15(10): e0240503, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33035244

RESUMO

BACKGROUND: In this paper, we predict the health and economic consequences of immediate investment in personal protective equipment (PPE) for health care workers (HCWs) in low- and middle-income countries (LMICs). METHODS: To account for health consequences, we estimated mortality for HCWs and present a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model with Bayesian multivariate sensitivity analysis and Monte Carlo simulation. Data sources included inputs from the World Health Organization Essential Supplies Forecasting Tool and the Imperial College of London epidemiologic model. RESULTS: An investment of $9.6 billion USD would adequately protect HCWs in all LMICs. This intervention would save 2,299,543 lives across LMICs, costing $59 USD per HCW case averted and $4,309 USD per HCW life saved. The societal ROI would be $755.3 billion USD, the equivalent of a 7,932% return. Regional and national estimates are also presented. DISCUSSION: In scenarios where PPE remains scarce, 70-100% of HCWs will get infected, irrespective of nationwide social distancing policies. Maintaining HCW infection rates below 10% and mortality below 1% requires inclusion of a PPE scale-up strategy as part of the pandemic response. In conclusion, wide-scale procurement and distribution of PPE for LMICs is an essential strategy to prevent widespread HCW morbidity and mortality. It is cost-effective and yields a large downstream return on investment.


Assuntos
Infecções por Coronavirus/patologia , Análise Custo-Benefício , Mão de Obra em Saúde/economia , Equipamento de Proteção Individual/economia , Pneumonia Viral/patologia , Teorema de Bayes , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Países em Desenvolvimento , Pessoal de Saúde/estatística & dados numéricos , Humanos , Método de Monte Carlo , Pandemias/economia , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia
19.
Cell ; 183(2): 296-300, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33064983

RESUMO

The SARS-CoV-2 pandemic has revealed that Africa needs a new public health order to be resilient, to adapt, and to cope with 21st-century disease threats. The new order will need strengthened continental and national public health institutions; local manufacturing of vaccines, therapeutics, and diagnostics; attraction, training, and retention of a public health workforce; and fostering of respectful local and international partnerships.


Assuntos
Doenças Transmissíveis/terapia , Saúde Pública , África , Controle de Doenças Transmissíveis , Doenças Transmissíveis/diagnóstico , Ocupações em Saúde/educação , Mão de Obra em Saúde , Humanos , Cooperação Internacional , Saúde Pública/educação , Administração em Saúde Pública
20.
Postgrad Med J ; 96(1140): 633-638, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32907877

RESUMO

After the dramatic coronavirus outbreak at the end of 2019 in Wuhan, Hubei province, China, on 11 March 2020, a pandemic was declared by the WHO. Most countries worldwide imposed a quarantine or lockdown to their citizens, in an attempt to prevent uncontrolled infection from spreading. Historically, quarantine is the 40-day period of forced isolation to prevent the spread of an infectious disease. In this educational paper, a historical overview from the sacred temples of ancient Greece-the cradle of medicine-to modern hospitals, along with the conceive of healthcare systems, is provided. A few foods for thought as to the conflict between ethics in medicine and shortage of personnel and financial resources in the coronavirus disease 2019 era are offered as well.


Assuntos
Infecções por Coronavirus/epidemiologia , Ética Médica/história , Alocação de Recursos para a Atenção à Saúde/ética , Hospitais/história , Pandemias/história , Pneumonia Viral/epidemiologia , Quarentena/história , Betacoronavirus , Cólera/epidemiologia , Cólera/história , Mão de Obra em Saúde , Juramento Hipocrático , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , História Antiga , História Medieval , Humanos , Hanseníase/epidemiologia , Hanseníase/história , Peste/epidemiologia , Peste/história , Alocação de Recursos , Estados Unidos/epidemiologia
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