scholarly journals Optimal allocation of resources to healthcare workers or the general populace: a modelling study

2021 ◽  
Vol 8 (11) ◽  
Author(s):  
MyVan Vo ◽  
Joshua A. Glasser ◽  
Zhilan Feng
Keyword(s):  
Healthcare Workers ◽  
Optimal Allocation ◽  
Protective Equipment ◽  
Allocation Of Resources ◽  
Final Size ◽  
Surge Capacity ◽  
Medical Resources ◽  
Population Immunity ◽  
Reproduction Numbers ◽  
General Community

We consider a model that distinguishes susceptible; infected, but not yet infectious; pre-symptomatic, symptomatic, asymptomatic, and hospitalized infectious; recovered and dead members of two groups: healthcare workers (HCW) and members of the community that they serve. Because of the frequency or duration of their exposures to SARS-CoV-2, a greater fraction of HCW would experience severe COVID-19 symptoms that require medical care, which reduces mortality rates, absent personal protective equipment (PPE). While N95 masks (and, possibly, other scarce medical resources) are available to members of both groups, they do not use them equally well (i.e. efficacy and compliance differ). We investigated the optimal allocation of potentially scarce medical resources between these groups to control the pandemic and reduce overall infections and mortality via derivation and analysis of expressions for the reproduction numbers and final size. We also simulated prevalence and cumulative incidence, quantities relevant to surge capacity and population immunity, respectively. We found that, under realistic conditions, the optimal allocation is virtually or entirely to HCW, but that allocation of surplus masks and other medical resources to members of the general community also reduces infections and deaths.

Wound care during the COVID-19 pandemic: improving outcomes through the integration of telemedicine

2021 ◽  
Vol 30 (Sup2) ◽  
pp. S12-S17
Author(s):  
Alisha Oropallo ◽  
John Lantis ◽  
Alexander Martin ◽  
Ammar Al Rubaiay ◽  
Na Wang
Keyword(s):  
High Risk ◽  
Healthcare System ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Wound Care ◽  
Protective Equipment ◽  
Medical Resources ◽  
Social Distancing ◽  
Vulnerable Patients ◽  
Rapid Spread

COVID-19 is highly contagious and its rapid spread burdens the healthcare system. As the number of confirmed cases goes up, the shortage of medical resources has become a challenge. To avoid the collapse of the healthcare system during the fight with COVID-19, all healthcare workers, including wound care practitioners, should adapt to new roles and use any appropriate methods available to slow the spread of the virus. Integrating telemedicine into wound care during the outbreak helps maintain social distancing, preserve personal protective equipment and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk healthcare workers.

Wound care during the COVID-19 pandemic: improving outcomes through the integration of telemedicine

2021 ◽  
Vol 3 (Sup4) ◽  
pp. S14-S20
Author(s):  
Alisha Oropallo ◽  
John Lantis ◽  
Alexander Martin ◽  
Ammar Al Rubaiay ◽  
Na Wang
Keyword(s):  
High Risk ◽  
Healthcare System ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Wound Care ◽  
Protective Equipment ◽  
Medical Resources ◽  
Social Distancing ◽  
Vulnerable Patients ◽  
Rapid Spread

COVID-19 is highly contagious and its rapid spread burdens the healthcare system. As the number of confirmed cases goes up, the shortage of medical resources has become a challenge. To avoid the collapse of the healthcare system during the fight with COVID-19, all healthcare workers, including wound care practitioners, should adapt to new roles and use any appropriate methods available to slow the spread of the virus. Integrating telemedicine into wound care during the outbreak helps maintain social distancing, preserve personal protective equipment and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk healthcare workers.

scholarly journals Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study

2020 ◽  
Author(s):  
Long H. Nguyen ◽  
David A. Drew ◽  
Amit D. Joshi ◽  
Chuan-Guo Guo ◽  
Wenjie Ma ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Personal Protective Equipment ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Positive Test ◽  
Protective Equipment ◽  
Increased Risk ◽  
Frontline Healthcare Workers ◽  
General Community

BackgroundData for frontline healthcare workers (HCWs) and risk of SARS-CoV-2 infection are limited and whether personal protective equipment (PPE) mitigates this risk is unknown. We evaluated risk for COVID-19 among frontline HCWs compared to the general community and the influence of PPE.MethodsWe performed a prospective cohort study of the general community, including frontline HCWs, who reported information through the COVID Symptom Study smartphone application beginning on March 24 (United Kingdom, U.K.) and March 29 (United States, U.S.) through April 23, 2020. We used Cox proportional hazards modeling to estimate multivariate-adjusted hazard ratios (aHRs) of a positive COVID-19 test.FindingsAmong 2,035,395 community individuals and 99,795 frontline HCWs, we documented 5,545 incident reports of a positive COVID-19 test over 34,435,272 person-days. Compared with the general community, frontline HCWs had an aHR of 11·6 (95% CI: 10·9 to 12·3) for reporting a positive test. The corresponding aHR was 3·40 (95% CI: 3·37 to 3·43) using an inverse probability weighted Cox model adjusting for the likelihood of receiving a test. A symptom-based classifier of predicted COVID-19 yielded similar risk estimates. Compared with HCWs reporting adequate PPE, the aHRs for reporting a positive test were 1·46 (95% CI: 1·21 to 1·76) for those reporting PPE reuse and 1·31 (95% CI: 1·10 to 1·56) for reporting inadequate PPE. Compared with HCWs reporting adequate PPE who did not care for COVID-19 patients, HCWs caring for patients with documented COVID-19 had aHRs for a positive test of 4·83 (95% CI: 3·99 to 5·85) if they had adequate PPE, 5·06 (95% CI: 3·90 to 6·57) for reused PPE, and 5·91 (95% CI: 4·53 to 7·71) for inadequate PPE.InterpretationFrontline HCWs had a significantly increased risk of COVID-19 infection, highest among HCWs who reused PPE or had inadequate access to PPE. However, adequate supplies of PPE did not completely mitigate high-risk exposures.FundingZoe Global Ltd., Wellcome Trust, EPSRC, NIHR, UK Research and Innovation, Alzheimer’s Society, NIH, NIOSH, Massachusetts Consortium on Pathogen ReadinessRESEARCH IN CONTEXTEvidence before this studyThe prolonged course of the coronavirus disease 2019 (COVID-19) pandemic, coupled with sustained challenges supplying adequate personal protective equipment (PPE) for frontline healthcare workers (HCW), have strained global healthcare systems in an unprecedented fashion. Despite growing awareness of this problem, there are few data to inform policy makers on the risk of COVID-19 among HCWs and the impact of PPE on their disease burden. Prior reports of HCW infections are based on cross sectional data with limited individual-level information on risk factors for infection. A PubMed search for articles published between January 1, 2020 and May 5, 2020 using the terms “covid-19”, “healthcare workers”, and “personal protective equipment,” yielded no population-scale investigations exploring this topic.Added value of this studyIn a prospective study of 2,135,190 individuals, frontline HCWs may have up to a 12-fold increased risk of reporting a positive COVID-19 test. Compared with those who reported adequate availability of PPE, frontline HCWs with inadequate PPE had a 31% increase in risk. However, adequate availability of PPE did not completely reduce risk among HCWs caring for COVID-19 patients.Implications of all the available evidenceBeyond ensuring adequate availability of PPE, additional efforts to protect HCWs from COVID-19 are needed, particularly as lockdown is lifted in many regions of the world.

A Review on Methods of Face Masks Sterilization for Reuse Owing To Crisis During COVID-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1240-1243
Author(s):  
Pradyuman Singh Rajput ◽  
Asish Kumar Saha ◽  
Insiya Gangardiwala ◽  
Anand Vijayakumar Palur Ramakrishnan
Keyword(s):  
Healthcare Workers ◽  
Health Hazard ◽  
Capital City ◽  
Limited Resources ◽  
Protective Equipment ◽  
First Line ◽  
Republic Of China ◽  
Enormous Amount ◽  
The Face ◽  
The Common

The COVID-19 pandemic initially started from the Wuhan capital city of Hubei Province in the People's Republic of China had now led to a severe public health hazard across the globe, the recorded death is approximately 958 thousand globally and counting. With the enormous amount of spread of the disease, a severe crisis for Personal Protective Equipment (PPE) is being noticed across the globe. Face masks being the first line of defence for all the healthcare workers as well for the common public. It became mandatory to wear face masks before entering the patient care area. The countries who are not manufacturing it locally had to depend on other countries for the procurement. As there is a severe supply chain disruption due to the lockdown measures taken by all the countries to contain the disease, so it had become difficult to procure the face masks from the manufacturing countries. The price for these PPEs is also rising at an alarming rate with the increase in the COVID-19 cases and the huge rate of consumption by the healthcare and other sectors. Therefore, with limited resources, the hospital has to run its services. The CDC, WHO and ICMR have released several guidelines from time to time for sterilization and reuse of face masks. This article will discuss the various methods that can be utilized to sterilize the face masks and reuse of it.

scholarly journals More for less: predicting and maximizing genomic variant discovery via Bayesian nonparametrics

Biometrika ◽  
2021 ◽  
Author(s):  
Lorenzo Masoero ◽  
Federico Camerlenghi ◽  
Stefano Favaro ◽  
Tamara Broderick
Keyword(s):  
Optimal Allocation ◽  
Bayesian Nonparametrics ◽  
Allocation Of Resources ◽  
Experimental Conditions ◽  
Follow Up Study ◽  
Variant Discovery ◽  
Fixed Budget ◽  
The Cost ◽  
Genomic Variant

Abstract While the cost of sequencing genomes has decreased dramatically in recent years, this expense often remains non-trivial. Under a fixed budget, scientists face a natural trade-off between quantity and quality: spending resources to sequence a greater number of genomes or spending resources to sequence genomes with increased accuracy. Our goal is to find the optimal allocation of resources between quantity and quality. Optimizing resource allocation promises to reveal as many new variations in the genome as possible. In this paper, we introduce a Bayesian nonparametric methodology to predict the number of new variants in a follow-up study based on a pilot study. When experimental conditions are kept constant between the pilot and follow-up, we find that our prediction is competitive with the best existing methods. Unlike current methods, though, our new method allows practitioners to change experimental conditions between the pilot and the follow-up. We demonstrate how this distinction allows our method to be used for more realistic predictions and for optimal allocation of a fixed budget between quality and quantity.

scholarly journals Stress and Associated Factors among Frontline Healthcare Workers in the COVID-19 Epicenter of Da Nang City, Vietnam

2021 ◽  
Vol 18 (14) ◽  
pp. 7378
Author(s):  
Nhan Phuc Thanh Nguyen ◽  
Duong Dinh Le ◽  
Robert Colebunders ◽  
Joseph Nelson Siewe Fodjo ◽  
Trung Dinh Tran ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Stress Component ◽  
Multivariable Analysis ◽  
Working Hours ◽  
Health Facilities ◽  
Protective Equipment ◽  
Laboratory Workers ◽  
Frontline Healthcare Workers ◽  
Second Wave

Frontline healthcare workers (HCWs) involved in the COVID-19 response have a higher risk of experiencing psychosocial distress amidst the pandemic. Between July and September 2020, a second wave of the COVID-19 pandemic appeared in Vietnam with Da Nang city being the epicenter. During the outbreak, HCWs were quarantined within the health facilities in a bid to limit the spread of COVID-19 to their respective communities. Using the stress component of the 21-item Depression, Anxiety and Stress Scale (DASS-21), we assessed the level of stress among HCWs in Da Nang city. Between 30 August and 15 September 2020, 746 frontline HCWs were recruited to fill in an online structured questionnaire. Overall, 44.6% of participants experienced increased stress and 18.9% severe or extremely severe stress. In multivariable analysis, increased stress was associated with longer working hours (OR = 1.012; 95% CI: 1.004–1.019), working in health facilities providing COVID-19 treatment (OR = 1.58, 95% CI: 1.04–2.39), having direct contact with patients or their bio-samples (physicians, nurses and laboratory workers; OR = 1.42, 95% CI: 1.02–1.99), low confidence in the available personal protective equipment (OR = 0.846; 95% CI: 0.744–0.962) and low knowledge on COVID-19 prevention and treatment (OR = 0.853; 95% CI: 0.739–0.986). In conclusion, many frontline HCWs experienced increased stress during the COVID-19 outbreak in Da Nang city. Reducing working time, providing essential personal protective equipment and enhancing the knowledge on COVID-19 will help to reduce this stress. Moreover, extra support is needed for HCWs who are directly exposed to COVID-19 patients.

scholarly journals Evaluating the contributions of strategies to prevent SARS-CoV-2 transmission in the healthcare setting: a modelling study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044644
Author(s):  
Xueting Qiu ◽  
Joel C Miller ◽  
Derek R MacFadden ◽  
William P Hanage
Keyword(s):  
Healthcare Workers ◽  
Healthcare Setting ◽  
Stochastic Simulations ◽  
Limited Resources ◽  
Base Case ◽  
Protective Equipment ◽  
Random Testing ◽  
Weekly Basis ◽  
Force Of Infection ◽  
Effective Use

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

scholarly journals The Healthcare Sector Employer’s Duty of Care: Implications for Worker Well-Being

2021 ◽  
Vol 18 (11) ◽  
pp. 6015
Author(s):  
Melissa McDiarmid ◽  
Marian Condon ◽  
Joanna Gaitens
Keyword(s):  
Middle East ◽  
Healthcare Workers ◽  
Care Program ◽  
Well Being ◽  
Middle East Respiratory Syndrome ◽  
Worker Safety ◽  
Healthcare Sector ◽  
Duty Of Care ◽  
Protective Equipment ◽  
Extreme Risk

Pandemic diseases of this century have differentially targeted healthcare workers globally. These infections include Severe Acute Respiratory Syndrome SARS, the Middle East respiratory syndrome coronavirus Middle East respiratory syndrome coronavirus (MERS-CoV) and Ebola. The COVID-19 pandemic has continued this pattern, putting healthcare workers at extreme risk. Just as healthcare workers have historically been committed to the service of their patients, providing needed care, termed their “duty of care”, so too do healthcare employers have a similar ethical duty to provide care toward their employees arising from historical common law requirements. This paper reports on results of a narrative review performed to assess COVID-19 exposure and disease development in healthcare workers as a function of employer duty of care program elements adopted in the workplace. Significant duty of care deficiencies reported early in the pandemic most commonly involved lack of personal protective equipment (PPE) availability. Beyond worker safety, we also provide evidence that an additional benefit of employer duty of care actions is a greater sense of employee well-being, thus aiding in the prevention of healthcare worker burnout.

Morphometric Registration of Cytotoxic Changes of Epithelial Cells In Vitro: A Methodological Study

1990 ◽  
Vol 17 (3) ◽  
pp. 174-176
Author(s):  
Lis Andersen ◽  
Dorthe Arenholt-Bindslev
Keyword(s):  
Culture System ◽  
Optimal Allocation ◽  
Volume Density ◽  
Cell Culture System ◽  
Allocation Of Resources ◽  
Methodological Study ◽  
Epithelial Cell Culture ◽  
Coefficients Of Variation ◽  
And Control

Quantification of toxicity-induced cytomorphological effects in an epithelial cell culture system is described. Estimates of volume density and star volume of mitochondria and lysosomes are given. Mean volumes (n = 5) and coefficients of variation of these parameters were equal in experimental (TPA-treatment) and control cultures. An optimal allocation of resources for estimating cytomorphometric parameters would be to increase the number of culture flasks.

Sign in / Sign up

Export Citation Format

Share Document