Effects of the COVID-19 pandemic on provision of electroconvulsive therapy

Aims and method COVID-19 has had a heavy impact on healthcare provision worldwide, including delivery of electroconvulsive therapy (ECT). A survey was completed in the UK and Republic of Ireland in April and July 2020 by 95 and 89 ECT clinics respectively. Results In April 2020, 53% of the clinics provided only emergency treatment and 24% had closed. Reasons included unavailability of anaesthetists, infection control measures and staff sickness. Restrictions persisted in July, with disruption to an estimated 437 individuals’ treatment and poor outcomes, including clinical deterioration and readmission. Clinical implications Risk stratification, longer clinic sessions, improvements in ventilation, regular virus testing, pragmatic staff rostering and availability of personal protective equipment will protect against service disruption in subsequent waves of the pandemic.

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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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An anaesthetic and intensive care perspective on infection control measures for the prevention of airborne transmission of SARS-CoV-2

British Journal of Hospital Medicine ◽

10.12968/hmed.2020.0538 ◽

2020 ◽

Vol 81 (9) ◽

pp. 1-9

Author(s):

Hazel R O'Mahony ◽

Daniel S Martin

Keyword(s):

Infection Control ◽

Personal Protective Equipment ◽

Scientific Evidence ◽

Respiratory Viruses ◽

Control Measures ◽

Protective Equipment ◽

Appropriate Use ◽

Airborne Transmission ◽

Infection Control Measures ◽

Current Guidance

Guidance regarding appropriate use of personal protective equipment in hospitals is in constant flux as research into SARS-COV-2 transmission continues to develop our understanding of the virus. The risk associated with procedures classed as ‘aerosol generating’ is under constant debate. Current guidance is largely based on pragmatic and cautious logic, as there is little scientific evidence of aerosolization and transmission of respiratory viruses associated with procedures. The physical properties of aerosol particles which may contain viable virus have implications for the safe use of personal protective equipment and infection control protocols. As elective work in the NHS is reinstated, it is important that the implications of the possibility of airborne transmission of the virus in hospitals are more widely understood. This will facilitate appropriate use of personal protective equipment and help direct further research into the true risks of aerosolization during these procedures to allow safe streamlining of services for staff and patients.

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Changes in Emergency Department Responses Between SARS and COVID-19 in Taiwan

10.21203/rs.3.rs-106038/v1 ◽

2020 ◽

Author(s):

Chia Wei Lin ◽

Kuan-Ho Lin ◽

Hong-Mo Shih ◽

Kai-Wei Yang ◽

Kao-Pin Hwang ◽

...

Keyword(s):

Emergency Department ◽

Rating Scale ◽

Early Stage ◽

Control Measures ◽

Protective Equipment ◽

Policy Reforms ◽

Policy Changes ◽

Hospital Level ◽

Fever Patient ◽

Infection Control Measures

Abstract Background: After SARS outbreak, infectious control polices had been reformed in Taiwan, but there was no evidence to prove its effectiveness. This study compared emergency department (ED) responses to the SARS and COVID-19 epidemics and investigate how policy changes affect infection prevention.Methods: A 2003 questionnaire regarding the responses of EDs to SARS was resent to EDs during the COVID-19 epidemic in 2020. The use of personal protective equipment (PPE), implementation of infection control measures (ICMs), and difficulties in performance were compared. Data collection included hospital level, different PPE types provided and ICMs implemented, timing for using PPE and ICMs, and a difficulty rating scale for ICM implementation.Results: In total, 100 EDs responded to the questionnaire in 2003 was reviewed and compared with 131 EDs in 2020. In COVID-19 epidemic, the use of basic PPEs and ICMs was mostly significantly improved, but the percentage of preparedness in high grade PPEs was still low. Quarantine of fever patients outside of EDs was less performed in small to medium sized hospitals (p=0.008 and 0.004). All of the additional ICMs were significantly less implemented in local hospitals. The timing to use PPE and implement ICMs were simultaneously and significantly performed at early stage. Instituting a fever triage ward and restricting fever patient admission became less necessary. The closure of EDs remained the most difficult to perform in both outbreaks. Conclusion: After the policy reforms, ED responses became earlier and more consistent. However, inadequate quarantine resources at EDs in low- and middle-grade hospitals may lead to breaches in future epidemics.

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Infection control measures for adult cardiac surgery in the UK—a survey of current practice

Journal of Hospital Infection ◽

10.1016/s0195-6701(03)00134-8 ◽

2003 ◽

Vol 54 (3) ◽

pp. 174-178 ◽

Cited By ~ 6

Author(s):

J.B. Kendall ◽

C.A. Hart ◽

S.H. Pennefather ◽

G.N. Russell

Keyword(s):

Cardiac Surgery ◽

Infection Control ◽

Current Practice ◽

Control Measures ◽

Infection Control Measures ◽

The Uk ◽

Adult Cardiac Surgery

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Awareness and knowledge of undergraduate dental students about the signs and symptoms of Corona viral infection (COVID-19), and the required infection control measures to prevent its spread

Bulletin of the National Research Centre ◽

10.1186/s42269-021-00494-1 ◽

2021 ◽

Vol 45 (1) ◽

Author(s):

Rasha F. Sharaf ◽

Nihal Kabel

Keyword(s):

Infection Control ◽

Personal Protective Equipment ◽

Dental Treatment ◽

Signs And Symptoms ◽

Dental Students ◽

Control Measures ◽

Protective Equipment ◽

Common Symptom ◽

Infection Control Measures ◽

High Level

Abstract Background Coronavirus disease (COVID-19) is considered a highly contagious disease with flu-like symptoms and causing relatively high level of death. It can be transmitted from a person to another through droplets and that makes the dentists at high risk of infection. Therefore, the aim of the current study was to assess the awareness and knowledge of dental students about the signs and symptoms of Coronavirus disease (COVID-19) and to evaluate their awareness about the required infection control measures during the dental treatment to control the spread of the disease. A questionnaire was formed using Google forms and distributed among dental students and interns in different universities in Cairo, Egypt. Questions were about signs and symptoms of COVID-19, attitude of the dentists toward dental treatment of suspected patients and the required personal protective equipment (PPE) and infection control measures at the dental clinic. Results The majority of the participants strongly agreed/agreed that COVID-19 is a highly dangerous disease, Participants reported that the most common symptom is difficulty in breathing (89.4%) followed by fever (84.4%). Face shield was the most recommended personal protective equipment (PPE) during dental treatment (98.6%) followed by disposable gown (96.3%). The majority of participants (84.8%) recommended using 70% ethyl alcohol as the first method to disinfect surfaces in between dental visits, followed by sodium hypochlorite. Conclusions Dental students and interns in Cairo, Egypt, have good knowledge and awareness about COVID-19 and the necessary precautions required to provide adequate dental treatment for the patients during the pandemic COVID-19; however, the importance of infection control should be highlighted for both clinical and preclinical dental students, to provide safe dental treatment to the patients as well as protection of the dentists and healthcare workers.

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Prevention of COVID-19 Infection with Personal Protective Equipment

Journal of Disaster Research ◽

10.20965/jdr.2021.p0061 ◽

2021 ◽

Vol 16 (1) ◽

pp. 61-69

Author(s):

Noriko Shimasaki ◽

Hideaki Morikawa ◽

◽

Keyword(s):

Infectious Disease ◽

Infection Control ◽

Personal Protective Equipment ◽

Control Measures ◽

Protective Equipment ◽

Modes Of Transmission ◽

Infection Control Measures ◽

Urban Disaster ◽

Asymptomatic Individuals ◽

Novel Coronavirus

A new infectious disease caused by a novel coronavirus (COVID-19) has spread rapidly worldwide in 2020. The COVID-19 pandemic in Japan can be viewed as an urban disaster because transmission of this respiratory disease tends to occur in densely populated areas. A scientific understanding of the pathogen itself, the cause of the disaster (infectious disease), as well as infection control measures, are important to implement robust and appropriate countermeasures. This review discribes the features, especially the modes of transmission, of COVID-19 and the principles by which infection control is possible using one of the most effective infection control measures – personal protective equipment (PPE). Because COVID-19 is often transmitted to others by asymptomatic individuals through droplets, even those who are unaware of their infection should wear masks to prevent the spread of droplets that may contain the virus and effectively control the spread of disease. However, given the worldwide competition for masks and the urgent requirement of effective controls, it is necessary to conduct further research to establish a system that can supply adequate numbers of masks to regions where many people are infected in the country, with no shortage of masks, in order to make the country more resilient to disasters caused by infectious diseases in the future.

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COVID-19 and ophthalmology- Challenges and mitigation of disease

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.058 ◽

2021 ◽

Vol 7 (2) ◽

pp. 284-288

Author(s):

Pravin M Bhat ◽

Sunil S Kewat

Keyword(s):

Infection Control ◽

Respiratory Illness ◽

Control Measures ◽

Protective Equipment ◽

Health Crisis ◽

Surface Disinfection ◽

Infection Control Measures ◽

Contagious Nature ◽

The World ◽

Respiratory Hygiene

The SARS-CoV-2 infection has become a global health crisis with an uprising trend of infection and death in the world. Considering the contagious nature and the human to human transmission of the disease, it is utmost important to follow the infection control measures in the ophthalmic practice. The pink eye or conjunctivitis is the associated symptom reported along with the respiratory illness and fever in patients of COVID-19. So the triage policy, using noncontact procedures, understanding the risk factors of the disease, postponement of routine ophthalmic patient’s visit, following respiratory hygiene, hand hygiene, using personal protective equipment (PPE) are some of the measures to keep the infection in control are explained in this article. The surface disinfection, equipment disinfection are also important considering the environmental contamination nature of the disease. So in order to minimize the infection every ophthalmologist should work as per the guidelines and measures and work with the local designated infection control authorities.

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Dental Students in Egypt: To What Extent Do They Perceive and Comply with Infection Control Measures?

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.15.4.77 ◽

2021 ◽

Author(s):

Basma A. Elawady ◽

Mona S. Mohamed ◽

Eman H. Elsebaie ◽

Essraa A. Hegazy ◽

Lamiaa A. Madkour

Keyword(s):

Hand Hygiene ◽

Infection Control ◽

Dental Students ◽

Control Measures ◽

Protective Equipment ◽

Infection Control Measures ◽

Communicative Strategies ◽

Control Procedures ◽

Knowledge And Practice ◽

Dental Schools

This study was carried out in the dental school of Ahram Canadian University in Egypt to investigate the knowledge and compliance of senior students and interns toward infection control practices. A self‑administered questionnaire was employed with questions pertinent to the participants’ knowledge of risks in the dental settings, the practice of hand hygiene, the use of protective equipment, and the management of sharp injuries, among others. Although the knowledge and practice of the 240 surveyed participants were good; they were not up to the coveted standards. Despite being an integral part of their curriculum, an alarming percentage (19.6%) of the participants denied receiving knowledge about infection control instructions. Meanwhile, only 72.5% were aware of being at risk in the dental settings, and 78.3% confirmed their practice of hand hygiene. On the other hand, 84.6% of the surveyed participants confirmed the availability of protective equipment and 94.2% of them expressed their willingness to apply infection control measures in the future. The defects in the knowledge and practice mandate corrective actions to promote and upgrade the students’ compliance. Meanwhile, other gaps can be rectified via developing state-of-the-art communicative strategies. Efforts are warranted to enhance the attitude and motivate the students to conform to the protective safety measures. With all the infection control procedures already established in dental schools, the challenge lies in improving the students’ compliance with these recommendations.

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Analysis of alternative Covid-19 mitigation measures in school classrooms: an agent-based model of SARS-CoV-2 transmission

10.1101/2021.08.30.21262826 ◽

2021 ◽

Author(s):

M. J. Woodhouse ◽

W. P. Aspinall ◽

R. S. J. Sparks ◽

Keyword(s):

Mitigation Strategies ◽

Control Measures ◽

Mitigation Measures ◽

New Wave ◽

Agent Based ◽

School Settings ◽

Infection Control Measures ◽

Large Numbers ◽

Beneficial Impact ◽

The Uk

1.AbstractThe SARS-CoV-2 epidemic has had major impacts on children’s education, with schools required to implement infection control measures that have led to long periods of absence and classroom closures. We develop an agent-based epidemiological model of SARS-CoV-2 transmission that is applied to model infection within school classrooms, with a contact model constructed using random networks informed by structured expert judgement. Mitigation strategies to control infection are modelled to allow analysis of their effectiveness in supressing infection outbreaks and in limiting pupil absence. The model is applied to re-examine Covid-19 in schools in the UK in autumn 2020, and to forecast infection levels in autumn 2021 when the more infectious Delta-variant is dominant and school transmission is likely to play a major role in a new wave of the epidemic. Our results indicate that testing-based surveillance of infections in the classroom population with isolation of positive cases is a more effective mitigation measure than bubble quarantine both for reducing transmission in schools and for avoiding pupil absence, even accounting for insensitivity of self-administered tests. Bubble quarantine results in large numbers of pupils absent from school, with only modest impact of classroom infection. However, maintaining a reduced contact rate within the classroom has a major beneficial impact for managing Covid-19 in school settings.

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