Generation of infectious waste during the COVID-19 pandemic: The case of a Brazilian hospital

Coronavirus-19 disease (COVID-19) acquired pandemic status in March 2020. The new virus has caused serious implications in the healthcare services management, including several sectors, among them the generation of waste. Healthcare wastes (HCW) generation increased along pandemic representing a health problem due to potentially infected ones. From this perspective, the study sought to analyse the challenges and changes imposed by COVID-19 in the HCW management in a large public hospital from Brazil. For this purpose, data about the Contingency Plan prepared by the hospital and HCW generation from 2017 to 2020 were used, analysed by statistical methods. When dealing with the Contingency Plan, the Brazilian hospital adopted measures similar to other hospitals around the world as described by the literature, such as: adoption of new protocols, specific team assigned to manage actions and training of professionals and suspension of elective surgeries. Regarding the generation of HCW, there was a significant increase in the mass of biological waste with a high risk of infection. The waste of this group increased from March 2020, coinciding with the start of care for the patients infected by COVID-19. The contribution of this type of waste to total generation jumped from approximately 0.2% in previous years to almost 5% in 2020. In addition, a reduction in the average of total waste generated in kilogrammes per bed per day from 2017 to 2019 was indicated compared to the 2020. COVID-19 pandemic led to major challenges for hospitals that had to care for patients infected with the SARS-CoV-2 virus, including new protocols, changing the work shifts and training the teams in the new procedures. The biological waste with a high risk of infectiousness also increased 30 times.

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Interventional Pulmonology and COVID-19: Experience from a Malaysian Tertiary Hospital

Annals of the Academy of Medicine, Singapore ◽

10.47102/annals-acadmedsg.2020364 ◽

2020 ◽

Vol 49 (12) ◽

pp. 1013-1017

Author(s):

Nai-Chien Huan ◽

Khai Lip Ng ◽

Jeat Thong Tang ◽

Han Nee Kua ◽

Ummi Nadira Daut ◽

...

Keyword(s):

Medical Education ◽

High Risk ◽

Medical Practice ◽

Healthcare Workers ◽

Healthcare Services ◽

Tertiary Hospital ◽

Risk Of Infection ◽

Interventional Pulmonology ◽

Continue Medical ◽

Multiple Challenges

Abstract The ongoing pandemic of COVID-19 has presented multiple challenges to global healthcare services, dictating changes in almost every aspect of daily medical practice. Performing aerosol generating procedures (AGPs) in the field of interventional pulmonology can lead to profound formation of aerosols, leading to a high risk of infection among healthcare workers (HCWs). We share our experiences on performing AGPs in the midst of a COVID-19 pandemic by focusing on changes in AGP practices. In a pandemic, HCWs ought to adapt to the ever-changing situation and use available resources to provide the best possible healthcare to patients, ensure safety of staff, and continue medical education of future pulmonologists. Keywords: Bronchoscopy, infectious diseases, pulmonary, respiratory medicine

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Two Years after the Crisis: Do Risks of the Second Wave Become Stronger?

Voprosy Ekonomiki ◽

10.32609/0042-8736-2011-12-4-20 ◽

2011 ◽

pp. 4-20

Author(s):

M. Ershov

Keyword(s):

High Risk ◽

World Economy ◽

External Shocks ◽

Global Imbalances ◽

Russian Economy ◽

The World ◽

The Future ◽

Second Wave

With signs of normalization seemingly in place in the world economy, a number of problems show the possibility of aggravation in the future. The volume of derivatives in American banks grows significantly, high risk instruments are back in place and their use becomes more active, global imbalances increase. All of the above requires thorough approaches when creating mechanisms which can neutralize external shocks for the Russian economy and make it possible to develop in the new post-crisis environment.

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Policy Review: Dubai Health Authority’s COVID-19 Rapid Response

Medical & Clinical Research ◽

10.33140/mcr.05.001 ◽

2020 ◽

Vol 5 (Special) ◽

Keyword(s):

United Arab Emirates ◽

Well Being ◽

Healthcare Services ◽

Rapid Response ◽

Policy Implications ◽

World Health ◽

Healthcare Sector ◽

Services Delivery ◽

First Case ◽

The World

Dubai Health Authority (DHA) is the entity regulating the healthcare sector in the Emirate of Dubai, ensuring high quality and safe healthcare services delivery to the population. The World Health Organization (WHO) declared COVID-19 a pandemic on the 11th of March 2020, indicating to the world that further infection spread is very likely, and alerting countries that they should be ready for possible widespread community transmission. The first case of COVID-19 in the United Arab Emirates was confirmed on 29th of January 2020; since then, the number of cases has continued to grow exponentially. As of 8th of July 2020 (end of the day), 53,045 cases of coronavirus have been confirmed with a death toll of 327 cases. The UAE has conducted over 3,720,000 COVID-19 tests among UAE citizens and residents over the past four months, in line with the government’s plans to strengthen virus screening to contain the spread of COVID-19. There were vital UAE policies, laws, regulations, and decrees that have been announced for immediate implementation to limit the spread of COVID- 19, to prevent panic and to ensure the overall food, nutrition, and well-being are provided. The UAE is amongst the World’s Top 10 for COVID-19 Treatment Efficiency and in the World’s Top 20 for the implementation of COVID-19 Safety measures. The UAE’s mission is to work towards resuming life after COVID-19 and enter into the recovery phases. This policy research paper will discuss the Dubai Health Authority’s rapid response initiatives towards combating the control and spread of COVID-19 and future policy implications and recommendations. The underlying factors and policy options will be discussed in terms of governance, finance, and delivery.

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A review study of nasal endoscopy protocol during the COVID-19 pandemic

Iraqi National Journal of Medicine ◽

10.37319/iqnjm.2.csi.5 ◽

2020 ◽

Vol 2 (CSI) ◽

pp. 38-41

Author(s):

Rafid Jabbar

Keyword(s):

High Risk ◽

Health Services ◽

Paranasal Sinus ◽

Medical Staff ◽

Nasal Endoscopy ◽

Paranasal Sinus Diseases ◽

The World ◽

Major Procedure ◽

Risk Of Exposure ◽

Review Study

During ENT practice, we have to examine the nose and perform several nasal procedures in our clinics. Otolaryngologists are at a high risk of exposure to the COVID-19 virus. Nasal endoscopy is a major procedure for the diagnosis of the nasal and paranasal sinus diseases and introducing proper health services for our patients. In addition, the world is living the era of the COVID-19 pandemic, for which we have to protect ourselves, educate our medical staff, and work together against the spread of this severely contagious disease within our communities. The main purpose of this study is to review the protocol of nasal endoscopy in the ENT clinic and enhance the safest way to deal with patients during this pandemic.(1)

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Behavioral Emergencies and Crises

The Oxford Handbook of Clinical Psychology ◽

10.1093/oxfordhb/9780195366884.013.0033 ◽

2010 ◽

pp. 739-762

Author(s):

Phillip M. Kleespies ◽

Justin M. Hill

Keyword(s):

Mental Health ◽

Risk Factors ◽

High Risk ◽

Work Environment ◽

Emotional Impact ◽

High Risk Patients ◽

Risk Patients ◽

Life Threatening ◽

Behavioral Emergencies ◽

And Training

This chapter illustrates the mental health clinician’s relationship with behavioral emergencies. The chapter begins by distinguishing the terms behavioral emergency and behavioral crisis, and underlying themes among all behavioral emergencies are identified. Given that most clinicians will face a behavioral emergency in their careers, the importance of enhancing the process of educating and training practitioners for such situations far beyond the minimal training that currently exists is highlighted. The chapter continues by exploring various aspects of evaluating and managing high-risk patients (i.e., those who exhibit violent tendencies toward themselves or others, and those at risk for victimization). It includes a discussion of the benefits and limitations to estimating life-threatening risk factors and specific protective factors. The chapter concludes by discussing the emotional impact that working with high-risk patients has on clinicians, and an emphasis is placed on the importance of creating a supportive work environment.

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Sickle Cell Anemia Presenting with Vaso-Occlusive Pain: Should We Screen for COVID-19?

Dubai Medical Journal ◽

10.1159/000513232 ◽

2021 ◽

pp. 1-4

Author(s):

Mohammad Ali ◽

Lina Okar ◽

Nabil E. Omar ◽

Jabeed Parengal ◽

Ashraf Soliman ◽

...

Keyword(s):

High Risk ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Signs And Symptoms ◽

Risk Groups ◽

Position Statement ◽

Interesting Case ◽

International Federation ◽

Cell Disease ◽

The World

Despite the widespread of coronavirus disease-19 (COVID-19) infection around the world, there are very scarce reported literature about the care of patients with a known diagnosis of hemoglobin disorders such as sickle cell disease (SCD) or thalassemia and confirmed COVID-19 infection. Thalassemia International Federation issued a position statement to include patients with thalassemia and SCD among the high-risk groups of patients. Here, we present an interesting case of a 42-year-old patient know to have SCD presenting with Vaso-occlusive (VOC) pain episode in the absence of COVID-19 signs and symptoms, who tested positive for COVID-19 infection and had a smooth recovery. This case highlights the importance of screening SCD patients presenting with VOC-related events even in the absence of COVID-19 signs and symptoms.

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Clinical Differences between COVID-19 and a COVID-Like Syndrome

Journal of Clinical Medicine ◽

10.3390/jcm10112519 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2519

Author(s):

Pierpaolo Di Micco ◽

Giuseppe Camporese ◽

Vincenzo Russo ◽

Giuseppe Cardillo ◽

Egidio Imbalzano ◽

...

Keyword(s):

False Negative ◽

Nasopharyngeal Swab ◽

Similar Group ◽

Risk Of Infection ◽

Hospital Workers ◽

Serological Tests ◽

Clinical Presentations ◽

The World ◽

Lung Failure ◽

The Difference

COVID-19 is an infection due to SARS-CoV-2; this virus has been identified as the cause of the present pandemic. Several typical characteristics are present in this infection, in particular pneumonia with possible lung failure, but atypical clinical presentations are being described daily by physicians around the world. Ground-glass opacities with pneumonia are the most common and dangerous presentations of the COVID-19 disease, and they are usually associated with positive nasopharyngeal swab (NPS) tests with detectable SARS-CoV-2 viral RNA. Compared to the general population, hospital workers have been at a greater risk of infection ever since the first patients were hospitalized. However, hospital workers have also been reported as having COVID-like symptoms despite repeated negative swab tests but having tested positive for SARS-CoV-2 antibodies with serological tests. We can postulate that a COVID-like syndrome is possible, in particular in hospital workers, that is characterized by symptoms similar to those of COVID-19, but with repeated negative nasopharyngeal swabs. These repeated negative NSPs make the difference in daily clinical management with people that experienced a single false negative nasopharyngeal swab; furthermore, a clear clinical differentiation of these situations is still lacking in the literature. For this reason, here, we report our main findings from a cohort of patients with a COVID-like syndrome compared to a similar group affected by typical COVID-19.

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Vertebral Fractures in Ireland: A Sub-analysis of the DXA HIP Project

Calcified Tissue International ◽

10.1007/s00223-021-00868-7 ◽

2021 ◽

Author(s):

John J Carey ◽

Lan Yang ◽

E. Erjiang ◽

Tingyan Wang ◽

Kelly Gorham ◽

...

Keyword(s):

Hip Fracture ◽

High Risk ◽

Vertebral Fractures ◽

Fragility Fractures ◽

Vertebral Fracture Assessment ◽

International Studies ◽

Men And Women ◽

Women Subjects ◽

The World ◽

High Risk Populations

AbstractOsteoporosis is an important global health problem resulting in fragility fractures. The vertebrae are the commonest site of fracture resulting in extreme illness burden, and having the highest associated mortality. International studies show that vertebral fractures (VF) increase in prevalence with age, similarly in men and women, but differ across different regions of the world. Ireland has one of the highest rates of hip fracture in the world but data on vertebral fractures are limited. In this study we examined the prevalence of VF and associated major risk factors, using a sample of subjects who underwent vertebral fracture assessment (VFA) performed on 2 dual-energy X-ray absorptiometry (DXA) machines. A total of 1296 subjects aged 40 years and older had a valid VFA report and DXA information available, including 254 men and 1042 women. Subjects had a mean age of 70 years, 805 (62%) had prior fractures, mean spine T-score was − 1.4 and mean total hip T-scores was − 1.2, while mean FRAX scores were 15.4% and 4.8% for major osteoporotic fracture and hip fracture, respectively. Although 95 (7%) had a known VF prior to scanning, 283 (22%) patients had at least 1 VF on their scan: 161 had 1, 61 had 2, and 61 had 3 or more. The prevalence of VF increased with age from 11.5% in those aged 40–49 years to > 33% among those aged ≥ 80 years. Both men and women with VF had significantly lower BMD at each measured site, and significantly higher FRAX scores, P < 0.01. These data suggest VF are common in high risk populations, particularly older men and women with low BMD, previous fractures, and at high risk of fracture. Urgent attention is needed to examine effective ways to identify those at risk and to reduce the burden of VF.

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Global variability in orthopedic surgery training

Orthopedic Reviews ◽

10.4081/or.2019.8152 ◽

2019 ◽

Author(s):

Andrew D. Sobel ◽

Davis Hartnett ◽

David Hernandez ◽

Adam E. M. Eltorai ◽

Alan H. Daniels

Keyword(s):

United States ◽

Orthopedic Surgery ◽

Orthopaedic Surgery ◽

Educational Development ◽

The United States ◽

Surgery Training ◽

Orthopaedic Care ◽

The World ◽

Orthopaedic Training ◽

And Training

Medical and orthopaedic training varies throughout the world. The pathways to achieve competency in orthopaedic surgery in other countries differ greatly from those in the United States. This review summarizes international educational requirements and training pathways involved in the educational development of orthopaedic surgeons. Understanding the differences in training around the world offers comparative opportunities which may lead to the improvement in education, training, and competency of individuals providing orthopaedic care.

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