The impact of the non-essential business closure policy on Covid-19 infection rates

This research to analyze the impact of closure policy Teleju brothel by Pekanbaru govermentin 2010. Guidelines for works are Pekanbaru Local Regulations No. 12 of 2008 on Social Order-liness. Closure this brothel inflicts positive and negative impact for society.The research wasconducted to obtain early stage formula for the government to take action against the prostitu-tion activities. This research uses policy research approach with a qualitative method, becausein prostitution activities and prohibition by goverment is an assessment that needs to be done byanalyzing documents and unstructured interview.The results showed that after the closing of the Teleju brothel have an impact on the deploy-ment of a prostitution and affect the economy of the surrounding residents. Government seeksto tackle prostitution in Pekanbaru by moving the brothel, conduct regular raids and providetraining. The effort is considered to be less than the maximum because the handling is not basedon the root of the problem and not programmed properly. There are several causes of failure ofgovernment to overcome the prostitution problem in Pekanbaru, including: policy content isless focus on the prostitution problem, the government did not proceeds with data, lack of finan-cial support, contra productive programs between local government with the police and TNI,and the policy object is difficult to be given understanding.

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58 Use of Abdominal Wall or Sucutaneous Drain to Reduce the Risk of Surgical Site Infections

British Journal of Surgery ◽

10.1093/bjs/znab134.356 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

H Mistry ◽

B Woolner ◽

A John

Keyword(s):

Surgical Site Infection ◽

Open Cholecystectomy ◽

Surgical Site Infections ◽

Standard Operating Procedure ◽

Site Infection ◽

Infection Rates ◽

Local Evidence ◽

Audit Data ◽

The Impact ◽

To Receive

Abstract Introduction Open abdominal surgery confers potentially greater risk of surgical site infections, and local evidence suggests use of drains can reduce this. Our objectives were: Assessing local rates and risk factors of infections and if use of drains can reduce the rates of infections. Method Retrospectively looking from 01/01/2018 to 31/12/2018, at patients following laparotomy or open cholecystectomy. Data collection on demographics, smoking/alcohol status, heart, respiratory or renal disease or diabetes, steroid use and CEPOD status, as well as use of drain and the outcome of infection using inpatient and online patient records. Results 84 patients included, 25 had drains inserted. There were 13 documented cases of surgical site infection, all of whom had no drain post-op. Other parameters shown to be most prevalent in the patients with a surgical site infection include being current/ex-smoker (8/13), having heart disease (9/13), and elective procedures. Conclusions Aiming to reduce the risk of surgical site infections can improve morbidity and potentially mortality outcomes. Our audit data showed that there appears to be a benefit of inserting intra-abdominal or subcutaneous drains. We will create a standard operating procedure of all patient to receive drains post-op and then re-audit to assess the impact this has on infection rates.

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The Effect of Vaccination Rates on the Infection of COVID-19 under the Vaccination Rate below the Herd Immunity Threshold

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147491 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7491

Author(s):

Yi-Tui Chen

Keyword(s):

Infection Rate ◽

Herd Immunity ◽

The United States ◽

Vaccination Rate ◽

Infection Rates ◽

Vaccination Rates ◽

The United Kingdom ◽

The World ◽

Almost All ◽

The Impact

Although vaccination is carried out worldwide, the vaccination rate varies greatly. As of 24 May 2021, in some countries, the proportion of the population fully vaccinated against COVID-19 has exceeded 50%, but in many countries, this proportion is still very low, less than 1%. This article aims to explore the impact of vaccination on the spread of the COVID-19 pandemic. As the herd immunity of almost all countries in the world has not been reached, several countries were selected as sample cases by employing the following criteria: more than 60 vaccine doses per 100 people and a population of more than one million people. In the end, a total of eight countries/regions were selected, including Israel, the UAE, Chile, the United Kingdom, the United States, Hungary, and Qatar. The results find that vaccination has a major impact on reducing infection rates in all countries. However, the infection rate after vaccination showed two trends. One is an inverted U-shaped trend, and the other is an L-shaped trend. For those countries with an inverted U-shaped trend, the infection rate begins to decline when the vaccination rate reaches 1.46–50.91 doses per 100 people.

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Reducing Broad Spectrum Antimicrobial Use in Extracorporeal Membrane Oxygenation (ECMO): Reduce AMMO Study

Clinical Infectious Diseases ◽

10.1093/cid/ciab118 ◽

2021 ◽

Author(s):

Aditya Shah ◽

Priya Sampathkumar ◽

Ryan W Stevens ◽

John K Bohman ◽

Brian D Lahr ◽

...

Keyword(s):

Time Series ◽

Extracorporeal Membrane Oxygenation ◽

Broad Spectrum ◽

Antimicrobial Prophylaxis ◽

Current Evidence ◽

Antimicrobial Use ◽

Infection Rates ◽

Interrupted Time Series Analysis ◽

Membrane Oxygenation ◽

The Impact

Abstract Background The use of extracorporeal membrane oxygenation (ECMO) in critically ill adults is increasing. There are currently no guidelines for antimicrobial prophylaxis. We analyzed 7 years of prophylactic antimicrobial use across three time series for patients on ECMO at our institution in the development, improvement, and streamlining of our ECMO antimicrobial prophylaxis protocol. Study design and Methods In this quasi-experimental interrupted time series analysis, we evaluated the impact of an initial ECMO antimicrobial prophylaxis protocol, implemented in 2014, on antimicrobial use and NHSN reportable infection rates. Then, following a revision and streamlining of the protocol in November 2018, we re-evaluated the same metrics. Results Our study population included 338 ICU patients who received ECMO between July 2011 and November 2019. After implementation of the first version of the protocol we did not observe significant changes in antimicrobial use or infection rates in these patients; however, following revision and streamlining of the protocol, we demonstrated a significant reduction in broad spectrum antimicrobial use for prophylaxis in patients on ECMO without any evidence of a compensatory increase in infection rates. Conclusion Our final protocol significantly reduces broad spectrum antimicrobial use for prophylaxis in patients on ECMO. We propose a standard antimicrobial prophylaxis regimen for patients on ECMO based on current evidence and our experience.

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Burst Suppression for ICP Control

Journal of Intensive Care Medicine ◽

10.1177/0885066615593939 ◽

2016 ◽

Vol 32 (2) ◽

pp. 130-139 ◽

Cited By ~ 1

Author(s):

Frederick A. Zeiler ◽

Eva Akoth ◽

Lawrence M. Gillman ◽

Michael West

Keyword(s):

Reference Lists ◽

Burst Suppression ◽

Suppressive Therapy ◽

Cochrane Library ◽

Infection Rates ◽

Assessment Development ◽

Severe Hypotension ◽

Grade Methodology ◽

Clinical Trials Registry ◽

The Impact

Background: The goal of our study was to perform a systematic review of the literature to determine the effect that burst suppression has on intracranial pressure (ICP) control. Methods: All articles from MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to January 2015), reference lists of relevant articles, and gray literature were searched. The strength of evidence was adjudicated using both the Oxford and the Grading of Recommendation Assessment Development and Education (GRADE) methodology. Results: Seven articles were considered for review. A total of 108 patients were studied, all receiving burst suppression therapy. Two studies failed to document a decrease in ICP with burst suppression therapy. There were reports of severe hypotension and increased infection rates with barbiturate-based therapy. Etomidate-based suppressive therapy was linked to severe renal dysfunction. Conclusions: There currently exists both Oxford level 2b and GRADE C evidence to support that achieving burst suppression reduces ICP, and also has no effect on ICP, in severe traumatic brain injury. The literature suggests burst suppression therapy may be useful for ICP reduction in certain cases, although these situations are currently unclear. In addition, the impact on patient functional outcome is unclear. Further prospective study is warranted.

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Standardising intraoperative irrigation with 0.05% chlorhexidine gluconate in caesarean delivery to reduce surgical site infections: A single institution experience

Journal of Perioperative Practice ◽

10.1177/1750458919850727 ◽

2019 ◽

Vol 30 (1-2) ◽

pp. 24-33

Author(s):

Theresa Mangold ◽

Erin Kinzel Hamilton ◽

Helen Boehm Johnson ◽

Rene Perez

Keyword(s):

Treatment Group ◽

Surgical Site Infection ◽

Infection Rate ◽

Caesarean Delivery ◽

Chlorhexidine Gluconate ◽

Control Group ◽

Antibiotic Administration ◽

Site Infection ◽

Infection Rates ◽

The Impact

Background Surgical site infection is a significant cause of morbidity and mortality following caesarean delivery. Objective To determine whether standardising intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery could decrease infection rates. Methods This was a process improvement project involving 742 women, 343 of whom received low-pressured 0.05% chlorhexidine gluconate irrigation during caesarean delivery over a one-year period. Infection rates were compared with a standard-of-care control group (399 women) undergoing caesarean delivery the preceding year. Results The treatment group infection rate met the study goal by achieving a lower infection rate than the control group, though this was not statistically significant. A significant interaction effect between irrigation with 0.05% chlorhexidine gluconate and antibiotic administration time existed, such that infection occurrence in the treatment group was not dependent on antibiotic timing, as opposed to the control group infection occurrence, which was dependent on antibiotic timing. Conclusion Intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery did not statistically significantly reduce the rate of infections. It did render the impact of antibiotic administration timing irrelevant in prevention of surgical site infection. This suggests a role for 0.05% chlorhexidine gluconate irrigation in mitigating infection risk whether antibiotic prophylaxis timing is suboptimal or ideal.

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Retrospective Study on Personal Protective Equipment During Pandemic Link to Outbreak of Carbpenem-Resistant Enterobacteriace

Antimicrobial Stewardship & Healthcare Epidemiology ◽

10.1017/ash.2021.17 ◽

2021 ◽

Vol 1 (S1) ◽

pp. s9-s10

Author(s):

Kenisha Evans ◽

Jennifer LeRose ◽

Angela Beatriz Cruz ◽

Lavina Jabbo ◽

Teena Chopra

Keyword(s):

Retrospective Study ◽

Infection Control ◽

Personal Protective Equipment ◽

Horizontal Transmission ◽

Control Measures ◽

Protective Equipment ◽

Local Health ◽

Infection Rates ◽

Infection Control Measures ◽

The Impact

Background: In 2019, according to the Centers for Disease Control and Prevention, carbapenem-resistant Enterobacteriaceae (CRE), had cost the lives of >35,000 patients, particularly the most virulent plasmid-mediated New Delhi metallo-β-lactamase (NDM). Although healthcare systems normally have strict surveillance and infection control measures for CRE, the rapid emergence of novel SAR-CoV-2 and COVID-19 led to a shortage of personal protective equipment (PPE) and medical supplies. As a result, routine infection practices, such as contact precautions, were violated. Studies have shown this depletion and shift in resources compromised the control of infections such CRE leading to rising horizontal transmission. Method: A retrospective study was conducted at a tertiary healthcare system in Detroit, Michigan, to determine the impact of PPE shortages during the COVID-19 pandemic on NDM infection rates. The following periods were established during 2020 based on PPE availability: (1) pre-PPE shortage (January–June), (2) PPE shortage (July–October), and (3) post-PPE shortage (November–December). Rates of NDM per 10,000 patient days were compared between periods using the Wilcoxon signed rank-sum test. Isolates were confirmed resistant by NDM by molecular typing performed by the Michigan State Health Department. Patient characteristics were gathered by medical chart review and patient interviews by telephone. Results: Overall, the average rate of NDM infections was 1.82 ±1.5 per 10,000 patient days. Rates during the PPE shortage were significantly higher, averaging 3.6 ±1.1 cases per 10,000 patient days (P = .02). During this time, several infections occurred within patients on the same unit and/or patients with same treating team, suggesting possible horizontal transmission. Once PPE stock was replenished and isolation practices were reinstated, NDM infection rates decreased to 0.77 ±1.1 per 10,000 patient days. Conclusion: Control of CRE requires strategic planning with active surveillance, antimicrobial constructs, and infection control measures. The study illustrates that in times of crisis, such as the COVID-19 pandemic, the burden of effective infection control requires much more multidisciplinary efforts to prevent unintentional lapses in patient safety. A swift response by the state and local health departments at a tertiary-care healthcare center conveyed a positive mitigation of the highest clinical threats and decreased horizontal transmission of disease.Funding: NoDisclosures: None

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Using the LIST model to Estimate the Effects of Contact Tracing on COVID-19 Endemic Equilibria in England and its Regions

10.1101/2020.06.11.20128611 ◽

2020 ◽

Author(s):

Rosalyn J. Moran ◽

Alexander J. Billig ◽

Maell Cullen ◽

Adeel Razi ◽

Jean Daunizeau ◽

...

Keyword(s):

Endemic Equilibrium ◽

Contact Tracing ◽

Model Parameters ◽

Infection Rates ◽

Stable States ◽

Medium Term ◽

The Stability ◽

Lower Death Rate ◽

The Impact ◽

List Model

AbstractGovernments across Europe are preparing for the emergence from lockdown, in phases, to prevent a resurgence in cases of COVID-19. Along with social distancing (SD) measures, contact tracing – find, track, trace and isolate (FTTI) policies are also being implemented. Here, we investigate FTTI policies in terms of their impact on the endemic equilibrium. We used a generative model – the dynamic causal ‘Location’, ‘Infection’, ‘Symptom’ and ‘Testing’ (LIST) model to identify testing, tracing, and quarantine requirements. We optimised LIST model parameters based on time series of daily reported cases and deaths of COVID-19 in England— and based upon reported cases in the nine regions of England and in all 150 upper tier local authorities. Using these optimised parameters, we forecasted infection rates and the impact of FTTI for each area—national, regional, and local. Predicting data from early June 2020, we find that under conditions of medium-term immunity, a ‘40%’ FTTI policy (or greater), could reach a distinct endemic equilibrium that produces a significantly lower death rate and a decrease in ICU occupancy. Considering regions of England in isolation, some regions could substantially reduce death rates with 20% efficacy. We characterise the accompanying endemic equilibria in terms of dynamical stability, observing bifurcation patterns whereby relatively small increases in FTTI efficacy result in stable states with reduced overall morbidity and mortality. These analyses suggest that FTTI will not only save lives, even if only partially effective, and could underwrite the stability of any endemic steady-state we manage to attain.

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Clinical academic research in the time of Corona: a simulation study in England and a call for action

10.1101/2020.04.14.20065417 ◽

2020 ◽

Cited By ~ 2

Author(s):

Amitava Banerjee ◽

Michail Katsoulis ◽

Alvina G. Lai ◽

Laura Pasea ◽

Thomas A. Treibel ◽

...

Keyword(s):

Academic Staff ◽

Academic Research ◽

Academic Community ◽

System Level ◽

Clinical Activity ◽

Infection Rates ◽

Community Needs ◽

Academic Workforce ◽

The Uk ◽

The Impact

AbstractBackgroundCoronavirus (COVID-19) poses health system challenges in every country. As with any public health emergency, a major component of the global response is timely, effective science. However, particular factors specific to COVID-19 must be overcome to ensure that research efforts are optimised. We aimed to model the impact of COVID-19 on the clinical academic response in the UK, and to provide recommendations for COVID-related research.MethodsWe constructed a simple stochastic model to determine clinical academic capacity in the UK in four policy approaches to COVID-19 with differing population infection rates: “Italy model” (6%), “mitigation” (10%), “relaxed mitigation” (40%) and “do-nothing” (80%) scenarios. The ability to conduct research in the COVID-19 climate is affected by the following key factors: (i) infection growth rate and population infection rate (from UK COVID-19 statistics and WHO); (ii) strain on the healthcare system (from published model); and (iii) availability of clinical academic staff with appropriate skillsets affected by frontline clinical activity and sickness (from UK statistics).FindingsIn “Italy model”, “mitigation”, “relaxed mitigation” and “do-nothing” scenarios, from 5 March 2020 the duration (days) and peak infection rates (%) are 95(2.4%), 115(2.5%), 240(5.3%) and 240(16.7%) respectively. Near complete attrition of academia (87% reduction, <400 clinical academics) occurs 35 days after pandemic start for 11, 34, 62, 76 days respectively – with no clinical academics at all for 37 days in the “do-nothing” scenario. Restoration of normal academic workforce (80% of normal capacity) takes 11,12, 30 and 26 weeks respectively.InterpretationPandemic COVID-19 crushes the science needed at system level. National policies mitigate, but the academic community needs to adapt. We highlight six key strategies: radical prioritisation (eg 3-4 research ideas per institution), deep resourcing, non-standard leadership (repurposing of key non-frontline teams), rationalisation (profoundly simple approaches), careful site selection (eg protected sites with large academic backup) and complete suspension of academic competition with collaborative approaches.

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