scholarly journals COVID-19: SARS-CoV-2 susceptibility in healthcare workers – cluster study at a German Teaching Hospital

4open ◽  
2020 ◽  
Vol 3 ◽  
pp. 6
Author(s):  
Michael A. Scherer ◽  
Alexander von Freyburg ◽  
Björn L.D.M. Brücher ◽  
Ijaz S. Jamall ◽  
Annette Schmidt ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Teaching Hospital ◽  
Healthcare Workers ◽  
Healthcare Providers ◽  
Fold Increase ◽  
Local Health ◽  
Patient Contact ◽  
Repeated Testing ◽  
Asymptomatic Carriers ◽  
Patient Load

Purpose: The local health department (in German: Gesundheitsamt) ordered a shutdown of a teaching hospital due to the severe acute respiratory syndrome coronavirus (SARS-CoV-2) outbreak – one index patient and five infected healthcare workers – and put it under quarantine. For the first time, all patients plus all employees of one German hospital (healthcare providers, physicians, and nurses) were tested to detect silent or asymptomatic carriers. Methods: A serial polymerase chain reaction (PCR) test for SARS-CoV-2 was performed three times (1) between April 3rd and 5th, 2020 [n = 1171], (2) between April 8th and 9th, 2020 [n = 953] and (3) between April 14th and 17th, 2020 [n = 983]. Results: The teaching hospital’s proven coronavirus disease 2019 (COVID-19) patient load on Friday, April 3rd, 2020, was 34 patients, of whom 11 were on ventilation in the intensive care unit (ICU), one in the intermediate care unit (IMC), and 22 in the infectious disease ward. Another 32 patients in a different infectious disease ward were suspected for COVID-19 with test results pending. COVID-19 silent carrier (asymptomatic) positivity rates based on the phases of testing were (1) n = 24 (2.1%), (2) n = 25 (2.6%) and n = 9 (0.9%). The cumulative infection rate for healthcare providers, physical therapists, physicians, and nurses was 1.8%, 4.5%, 4.8%, and 11.9% which were associated with the type and extent of COVID-19 patient contact (p < 0.05). Conclusion: Despite prior proper preparation, a COVID-19 positive patient load of up to 34.8% (46 of 132 hospital beds) resulted in a 10- to 20-fold increase in risk for healthcare workers for SARS-CoV-2 compared to the general population. Because of asymptomatic carriers, a COVID-19-free hospital cannot be expected to exist. Based on our experience, repeated testing of all staff members with patient contact is necessary and is the best option to effectively contain the virus. Those having the most contact with patients had the highest risk of becoming infected (10- to 20-fold higher risk), with nurses being at the highest risk.

scholarly journals When Refugees Care for Refugees in Lebanon: Providing Contextually Appropriate Care from the Ground Up

2021 ◽  
Vol 8 (3) ◽  
pp. 1-22
Author(s):  
Diane Duclos ◽  
Fouad Mohamed Fouad ◽  
Karl Blanchet
Keyword(s):  
Healthcare Workers ◽  
Systems Of Care ◽  
Healthcare Providers ◽  
Local Health ◽  
Local Responses ◽  
Clinical Encounters ◽  
Research Article ◽  
Appropriate Care ◽  
Complex Landscape ◽  
Care Relationships

Despite a surge in initiatives to integrate foreign-trained physicians into local health systems and a drive to learn from localised humanitarian initiatives under the COVID-19 pandemic, we still know little about the on-the-ground strategies developed by refugee doctors to meet the needs of refugee patients. In Lebanon, displaced Syrian health professionals have mounted informal, local responses to care for displaced Syrian patients. Drawing on ethnographic work shadowing these healthcare providers across their medical and non-medical activities, we explore how clinical encounters characterised by shared histories of displacement can inform humanitarian medicine. Our findings shed light on the creation of breathing spaces in crises. In particular, our study reveals how displaced healthcare workers cope with uncertainty, documents how displaced healthcare workers expand the category of ‘appropriate care’ to take into account the economic and safety challenges faced by patients, and locates the category of ‘informality’ within a complex landscape of myriad actors in Lebanon. This research article shows that refugee-to-refugee healthcare is not restricted to improvised clinical encounters between ‘frontliners’ and ‘victims of war’. Rather, it is proactively enacted from the ground up to foster appropriate care relationships in the midst of violent, repeated, and protracted disruptions to systems of care.

scholarly journals Creation of a specific and separated pediatric intra-hospital pathway in primary level hospitals during the era of COVID-19

2021 ◽  
Vol 19 ◽  
pp. 205873922110108
Author(s):  
Marco Manfredi ◽  
Pietro Ragni ◽  
Giancarlo Gargano
Keyword(s):  
Quality Of Care ◽  
Severe Acute Respiratory Syndrome ◽  
Healthcare Workers ◽  
Health Agency ◽  
Local Health ◽  
Primary Level ◽  
Level Hospital ◽  
Rule Out

Every new pandemic forces us to start new specific behaviors both in the civil life and within the hospitals trying to contain the spreading of the infection and preserve the more fragile people. In this regard, at the debut of Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) pandemic, our Local Health Agency had drastically modified every clinical and organizational pathways in order to limit the diffusion of the infection as well as to maintain a good quality of care and preserve healthcare workers. We report how we have modified the usual pediatric intra-hospital pathways in our primary level hospital to avoid mixing children with suspected and non-suspected symptoms of SARS-CoV-2 infection. Before every hospitalization, regardless of symptoms, each child and him/her parent/caregiver are undergone to rapid antigenic and molecular swab to rule out a SARS-CoV-2 infection; hence, positive patients are transferred to Pediatric Unit of third level hospital equipped by a Pediatric COVID Intensive Unit. We think the healthcare behaviors described in this manuscript can help to reduce the intra-hospital spreading of SARS-CoV-2, although children seem to have a minimal role in the dissemination, but we cannot let down your guard. Simultaneously we observed that the overall children requiring inpatient pediatric evaluation and hospitalization have dramatically decreased from the beginning of pandemic.

scholarly journals 2019 Novel Coronavirus Vaccination among Post-graduate Residents and Fellows

2021 ◽  
Vol 12 ◽  
pp. 215013272110229
Author(s):  
Mostafa Abohelwa ◽  
Mohamed Elmassry ◽  
John Abdelmalek ◽  
Drew Payne ◽  
Kenneth Nugent
Keyword(s):  
Side Effects ◽  
Healthcare Workers ◽  
Healthcare Providers ◽  
The United States ◽  
Health Sciences ◽  
Institutional Review Board ◽  
Institutional Review ◽  
Texas Tech University ◽  
Novel Coronavirus ◽  
United States Healthcare

Background Coronavirus-2 (COVID-19) has caused a worldwide pandemic since December 2019. Since then, clinical trials with vaccines have been started and completed, and at present, 3 COVID-19 vaccines have been approved for use in the United States. Healthcare providers were among the first to get vaccinated, but the precise attitudes of healthcare workers toward vaccination are uncertain. Objective To understand residents and fellows’ attitudes toward vaccination and record any side effects after vaccination. Methods We conducted an anonymous survey that was open from 3-1-2021 to 3-12-2021 using distribution lists from the Graduate Medical Education office on the Lubbock campus of the Texas Tech University Health Sciences Center after getting approval from the Institutional Review Board (L21-088). Results Eighty-one residents and fellows (26.6% out of 304) responded to our survey. Among those who responded, 63 (77.8 %) were between 25 and 35 years old, and 41 (50.6%) were males. Seventy-seven (95.1%) received the vaccine (Pfizer-BioNTech), 78 (96.3%) reported that they supported vaccination, and 3 (3.7%) reported that they did not want vaccination. Eight members (9.8%) had tested positive for COVID-19 infection before vaccination, but only 1 (1.23%) had tested positive for COVID-19 antibodies. All residents and fellows reported side effects after the vaccination, including pain at the injection site (77; 100%), local redness (9; 11.6%), local swelling (13; 16.8%), fever (25; 32.5%), fatigue (25; 32.5%), chills (34; 44.1 %), headache (38; 49.4%). Conclusions Most medical trainees have a high interest in COVID-19 vaccination; however, a few reported that they did not want vaccination.

scholarly journals Has the COVID 19 Virus Changed Adherence to Hand Washing among Healthcare Workers?

2021 ◽  
Vol 11 (4) ◽  
pp. 53
Author(s):  
Rosalia Ragusa ◽  
Marina Marranzano ◽  
Alessandro Lombardo ◽  
Rosalba Quattrocchi ◽  
Maria Alessandra Bellia ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Washing ◽  
World Health ◽  
Patient Contact ◽  
Who Guidelines ◽  
Descriptive Data ◽  
Different Types ◽  
Health Organization ◽  
Hospital Wards

The aim of the study was to assess adherence to hand washing by healthcare workers (HCWs) and its variations over time in hospital wards. We wanted to check whether the pandemic had changed the behavior of HCWs. The study was conducted between 1 January 2015, and 31 December 2020. The HCWs were observed to assess their compliance with the Five Moments for Hand Hygiene. We described the percentage of adherence to World Health Organization (WHO) guidelines stratified per year, per specialty areas, per different types of HCWs. We also observed the use of gloves. Descriptive data were reported as frequencies and percentages. We observed 13,494 hand hygiene opportunities. The majority of observations concerned nurses who were confirmed as the category most frequently involved with patients. Hospital’s global adherence to WHO guidelines did not change in the last six years. During the pandemic, the rate of adherence to the procedure increased significantly only in Intensive Care Unit (ICU). In 2020, the use of gloves increased in pre-patient contact. The hand-washing permanent monitoring confirmed that it is very difficult to obtain the respect of correct hand hygiene in all opportunities, despite the ongoing pandemic and the fear of contagion.

scholarly journals Access to Alcohol-Based Hand Rub Is Associated With Improved Hand Hygiene in an Ebola-Threatened District of Western Uganda

2020 ◽  
Vol 41 (S1) ◽  
pp. s457-s457
Author(s):  
Mohammed Lamorde ◽  
Matthew Lozier ◽  
Maureen Kesande ◽  
Patricia Akers ◽  
Olive Tumuhairwe ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Wide Distribution ◽  
Patient Contact ◽  
Improve Hand Hygiene ◽  
Before And After ◽  
Hygiene Compliance ◽  
Handwashing With Soap

Background: Ebola virus disease (EVD) is highly transmissible and has a high mortality rate. During outbreaks, EVD can spread across international borders. Inadequate hand hygiene places healthcare workers (HCWs) at increased risk for healthcare-associated infections, including EVD. In high-income countries, alcohol-based hand rub (ABHR) can improve hand hygiene compliance among HCWs in healthcare facilities (HCF). We evaluated local production and district-wide distribution of a WHO-recommended ABHR formulation and associations between ABHR availability in HCF and HCW hand hygiene compliance. Methods: The evaluation included 30 HCF in Kabarole District, located in Western Uganda near the border with the Democratic Republic of the Congo, where an EVD outbreak has been ongoing since August 2018. We recorded baseline hand hygiene practices before and after patient contact among 46 healthcare workers across 20 HCFs in August 2018. Subsequently, in late 2018, WHO/UNICEF distributed commercially produced ABHR to all 30 HCFs in Kabarole as part of Ebola preparedness efforts. In February 2019, our crossover evaluation distributed 20 L locally produced ABHR to each of 15 HCFs. From June 24–July 5, 2019, we performed follow-up observations of hand hygiene practices among 68 HCWs across all 30 HCFs. We defined hand hygiene as handwashing with soap or using ABHR. We conducted focus groups with healthcare workers at baseline and follow-up. Results: We observed hand hygiene compliance before and after 203 and 308 patient contacts at baseline and follow-up, respectively. From baseline to follow-up, hand hygiene compliance before patient contact increased for ABHR use (0% to 17%) and handwashing with soap (0% to 5%), for a total increase from 0% to 22% (P < .0001). Similarly, hand hygiene after patient contact increased from baseline to follow-up for ABHR use (from 3% to 55%), and handwashing with soap decreased (from 12% to 7%), yielding a net increase in hand hygiene compliance after patient contact from 15% to 62% (P < .0001). Focus groups found that HCWs prefer ABHR to handwashing because it is faster and more convenient. Conclusions: In an HCF in Kabarole District, the introduction of ABHR appeared to improve hand hygiene compliance. However, the confirmation of 3 EVD cases in Uganda 120 km from Kabarole District 2 weeks before our follow-up hand hygiene observations may have influenced healthcare worker behavior and hand hygiene compliance. Local production and district-wide distribution of ABHR is feasible and may contribute to improved hand hygiene compliance among healthcare workers.Funding: NoneDisclosures: Mohammed Lamorde, Contracted Research - Janssen Pharmaceutica, ViiV, Mylan

scholarly journals Diagnostic Tests Can Stem the Threat of Antimicrobial Resistance: Infectious Disease Professionals Can Help

2020 ◽  
Author(s):  
Dana Trevas ◽  
Angela M Caliendo ◽  
Kimberly Hanson ◽  
Jaclyn Levy ◽  
Christine C Ginocchio
Keyword(s):  
Infectious Disease ◽  
Antimicrobial Resistance ◽  
Diagnostic Tests ◽  
Healthcare Providers ◽  
Federal Funding ◽  
Antibiotic Use ◽  
Advisory Council ◽  
Resistant Bacteria ◽  
Research Development ◽  
Antibiotic Resistant

Abstract Uptake of existing diagnostics to identify infections more accurately could minimize unnecessary antibiotic use and decrease the growing threat of antibiotic resistance. The Infectious Diseases Society of America (IDSA) and the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) agree that, to improve uptake of existing diagnostics, healthcare providers, health systems, and payors all need better clinical and economic outcomes data to support use of diagnostic tests over empiric use of antibiotics, providers need better tools and education about diagnostic tests, and diagnostics developers need federal funding in the absence of a viable diagnostics market. Recommendations from PACCARB and the IDSA are amplified. Incentives for—and challenges to—diagnostics research, development, and uptake are summarized. Advocacy opportunities are given for infectious disease professionals to join the fight against antimicrobial resistance.

scholarly journals Adenovirus and RNA-based COVID-19 vaccines’ perceptions and acceptance among healthcare workers in Saudi Arabia: a national survey

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048586
Author(s):  
Mohamad-Hani Temsah ◽  
Mazin Barry ◽  
Fadi Aljamaan ◽  
Abdullah Alhuzaimi ◽  
Ayman Al-Eyadhy ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Healthcare Workers ◽  
Online Survey ◽  
Healthcare Providers ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Vectored Vaccine ◽  
To Receive

ObjectivesThe aim of this study was to compare the perception, confidence, hesitancy and acceptance rate of various COVID-19 vaccine types among healthcare workers (HCWs) in Saudi Arabia, a nation with Middle East respiratory syndrome coronavirus experience.DesignNational cross-sectional, pilot-validated questionnaire.SettingOnline, self-administered questionnaire among HCWs.ParticipantsA total of 2007 HCWs working in the Kingdom of Saudi Arabia participated; 1512 (75.3%) participants completed the survey and were included in the analysis.InterventionData were collected through an online survey sent to HCWs during 1–15 November 2020. The main outcome measure was HCW acceptance of COVID-19 candidate vaccines. The associated factors of vaccination acceptance were identified through a logistic regression analysis and via measurement of the level of anxiety, using the Generalised Anxiety Disorder 7 scale.ResultsAmong the 1512 HCWs who were included, 62.4% were women, 70.3% were between 21 and 40 years of age, and the majority (62.2%) were from tertiary hospitals. In addition, 59.5% reported knowing about at least one vaccine; 24.4% of the participants were sure about their willingness to receive the ChAdOx1 nCoV-19 vaccine, and 20.9% were willing to receive the RNA BNT162b2 vaccine. However, 18.3% reported that they would refuse to receive the Ad5-vectored vaccine, and 17.9% would refuse the Gam-COVID-Vac vaccine. Factors that influenced the differential readiness of HCWs included their perceptions of the vaccine’s efficiency in preventing the infection (33%), their personal preferences (29%) and the vaccine’s manufacturing country (28.6%).ConclusionsAwareness by HCWs of the several COVID-19 candidate vaccines could improve their perceptions and acceptance of vaccination. Reliable sources on vaccine efficiency could improve vaccine uptake, so healthcare authorities should use reliable information to decrease vaccine hesitancy among frontline healthcare providers.

123 A Novel Way of Thinking About Blast Injury Classification

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S82-S83
Author(s):  
Zachary J Collier ◽  
Katherine J Choi ◽  
Ian F Hulsebos ◽  
Christopher H Pham ◽  
Haig A Yenikomshian ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Healthcare Providers ◽  
Fold Increase ◽  
Tissue Loss ◽  
Blast Injuries ◽  
Full Thickness ◽  
Icu Admission ◽  
Burn Center ◽  
Body Regions ◽  
Organ Systems

Abstract Introduction Blast injuries present unique challenges to civilian and military healthcare providers because of the complex and often severe nature of injuries spanning numerous anatomical regions, tissue types, and organ systems. Due to these factors, we devised a novel wound-focused classification system for implementation during triage and management of blast injuries to optimize outcomes and applied this system to patients treated at an ABA-certified burn center over 5 years. Methods A retrospective analysis of patients treated by an ABA-certified burn center for blast-related injuries from September 1, 2014 to October 31, 2019 was performed. Demographics, mechanism and distribution of injuries, interventions, and outcomes were evaluated. Injuries were classified using a wound-focused classification comprised of four zones: 1) areas closest to blast epicenter that had total or near-total tissue loss from the blast; 2) adjacent areas with thermal and chemical burns; 3) distant sites with shrapnel-related wounds; 4) injuries arising from barotrauma. Results We identified 64 patients who were mostly male (84%), averaging 38 ± 14 years old. Injury mechanisms included fireworks (19%), industrial accidents (16%), volatile fuels and drug labs (45%), and others including can, battery, lighter explosions (20%). All mechanisms had equivalent frequency of Zone 2 injuries with an average TBSA of 17 ± 18%. Drug-related blasts caused the highest TBSA (34 ± 23%) and the most full-thickness burns (33% vs average 23%). Fireworks had over five times (17% vs. 3%) more Zone 3 and three times (25% vs 8%) more Zone 4 injuries compared to the other mechanisms. Upper extremities were involved at twice the rate of other body regions (43% vs 19%). Patients presenting to our burn team over 24 hours after initial injury had infections in 50% of cases – a four-fold increase compared to non-delayed presentations (50% vs 13%). Overall, 45% required surgery (32% grafting, 3% flaps) but 100% of the drug-related blasts needed surgical intervention. Some patients (58%) required ICU admission with the highest rate (83%) in the drug-related group. Conclusions Blast injuries most often required admission for management of the Zone 2 component. Each blast mechanism resulted in distinct distributions of injury although fireworks had the greatest number of Zone 1, 3, and 4 injuries. Firework blasts were often less severe and more likely to present delayed with infectious complications. Larger blast mechanisms including drug-related lab explosions as well as industrial blasts had the highest rates of ICU admission, TBSA, full thickness depth, upper extremity involvement, and need for surgical intervention.

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