scholarly journals Telemedicine: A cornerstone of healthcare assistance during the recent pandemic outbreak of COVID-19 but also a great opportunity for the future. A pilot experience in the largest Teaching Hospital in Southern Italy.

2020 ◽  
Author(s):  
MD; Tartaglia Edoardo ◽  
Vozzella Emilia Anna ◽  
LLD Iervolino Anna ◽  
Egidio Rosanna ◽  
Buonocore Gaetano ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Defense Mechanism ◽  
Health Care Systems ◽  
Waiting Times ◽  
Economic Loss ◽  
System Capacity ◽  
Telemedicine Service ◽  
Great Opportunity ◽  
Care Systems ◽  
Novel Coronavirus

Abstract Background: At the end of 2019, Wuhan, China, experienced an outbreak of a novel coronavirus. The epidemiologic burden of COVID-19 is constantly evolving, with numbers of infected persons, hospital admissions and deaths growing near exponentially. The recent pandemic outbreak of COVID-19 worldwide caught the health care systems in every country around the world by storm and without a proper defense mechanism to cope and control such a pandemic. In fact, this outbreak is causing an overwhelming burden of illnesses that stresses health system capacity and adverse effects on healthcare workers including the risk of infection. In this context, telemedicine has been promoted and scaled up to reduce the risk of transmission. In this paper the Authors reports their own experience with Telemedicine. Methods: During the “lockdown”, the AOU“Federico II” was forced to create peculiar pathways to ensure the safety of the patients and medical staff, and to keep an appropriate medical assistance, therefore it was introduced the telemedicine, wherever possible, by modifying the Information Technology (IT) related to the waiting times, rescheduling all booked visits and identifying several outpatient’s clinics suitable for telemedicine activities. Besides, safe pathways were properly studied to screening all patients who had a medical consult in person.Results: Since the introduction of telemedicine service, 953 consultations were provided in this way, about 13 % of all medical consults delivered by AOU “Federico II” in this period; 97,38% of them were follow-up visits, that otherwise would have been missed during the current pandemic, so an economic loss has been avoided. In addition, it has been calculated that, using Telemedicine visits vs a face-to-face consultation, about 65-70% of direct costs were spared by our Healthcare Company.Conclusions: Telemedicine has been the keystone that has allowed a rapid, appropriate response of whole overloaded healthcare systems to current Pandemic, and, as reported by Ohannessian et al., all stakeholders are encouraged to address the challenges and collaborate to promote the safe and evidence-based use of telemedicine during the current pandemic and future outbreaks, and the COVID-19 pandemic is a call to adopt the necessary regulatory changes supporting wide adoption of telemedicine.

scholarly journals A Comprehensive Study of Artificial Intelligence and Machine Learning Approaches in Confronting the Coronavirus (COVID-19) Pandemic

2021 ◽  
pp. 002073142110174
Author(s):  
Md Mijanur Rahman ◽  
Fatema Khatun ◽  
Ashik Uzzaman ◽  
Sadia Islam Sami ◽  
Md Al-Amin Bhuiyan ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Health Care ◽  
Language Processing ◽  
Probabilistic Models ◽  
Health Care Systems ◽  
Learning Approaches ◽  
Care Systems ◽  
Novel Coronavirus ◽  
Comprehensive Study

The novel coronavirus disease (COVID-19) has spread over 219 countries of the globe as a pandemic, creating alarming impacts on health care, socioeconomic environments, and international relationships. The principal objective of the study is to provide the current technological aspects of artificial intelligence (AI) and other relevant technologies and their implications for confronting COVID-19 and preventing the pandemic’s dreadful effects. This article presents AI approaches that have significant contributions in the fields of health care, then highlights and categorizes their applications in confronting COVID-19, such as detection and diagnosis, data analysis and treatment procedures, research and drug development, social control and services, and the prediction of outbreaks. The study addresses the link between the technologies and the epidemics as well as the potential impacts of technology in health care with the introduction of machine learning and natural language processing tools. It is expected that this comprehensive study will support researchers in modeling health care systems and drive further studies in advanced technologies. Finally, we propose future directions in research and conclude that persuasive AI strategies, probabilistic models, and supervised learning are required to tackle future pandemic challenges.

scholarly journals Contributory role of SARS-CoV-2 genomic variations and life expectancy in COVID-19 transmission and low fatality rate in Africa

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Olabode E. Omotoso
Keyword(s):  
Mutational Analysis ◽  
Health Care Systems ◽  
Selective Advantage ◽  
African Population ◽  
Young Generation ◽  
Regulatory Policies ◽  
Recurrent Mutations ◽  
Mutational Hotspots ◽  
Care Systems ◽  
Novel Coronavirus

Abstract Background The novel coronavirus disease (COVID-19) has claimed lots of lives, posing a dire threat to global health. It was predicted that the coronavirus outbreak in the African population would be very lethal and result to economic devastation owing to the prevalence of immune-compromised population, poverty, low lifespan, fragile health care systems, poor economy, and lifestyle factors. Accumulation of mutations gives virus selective advantage for host invasion and adaptation, higher transmissibility of more virulent strains, and drug resistance. The present study determined the severe acute respiratory syndrome-2 (SARS-CoV-2) genomic variability and the contributory factors to the low COVID-19 fatality in Africa. To assess the SARS-CoV-2 mutational landscape, 924 viral sequences from the Africa region with their sociobiological characteristics mined from the Global Initiative on Sharing All Influenza Data (GISAID) database were analyzed. Results Mutational analysis of the SARS-CoV-2 sequences revealed highly recurrent mutations in the SARS-CoV-2 spike glycoprotein D614G (97.2%), concurrent R203K, and G204R (65.2%) in the nucleocapsid phosphoprotein, and P4715L (97.2%) in the RNA-dependent RNA polymerase flagging these regions as SARS-CoV-2 mutational hotspots in the African population. COVID-19 is more severe in older people (> 65 years); Africa has a low percentage of people within this age group (4.36%). The average age of the infected patients observed in this study is 46 years with only 47 infected patients (5.1%) above 65 years in Africa in comparison to 13.12% in countries in other continents with the highest prevalence of COVID-19. Conclusions Africa’s young generation, the late incidence of the disease, and adherence to public health guidelines are important indicators that may have contributed to the observed low COVID-19 deaths in Africa. However, with the easing of lockdown and regulatory policies, daily increasing incidence in most countries, and low testing and sequencing rate, the epidemiology and the true impact of the pandemic in Africa remain to be unraveled.

scholarly journals Potential impact of seasonal forcing on a SARS-CoV-2 pandemic

2020 ◽  
Author(s):  
Richard A. Neher ◽  
Robert Dyrdak ◽  
Valentin Druelle ◽  
Emma B. Hodcroft ◽  
Jan Albert
Keyword(s):  
Seasonal Variation ◽  
Infection Control ◽  
Transmission Rate ◽  
Health Care Systems ◽  
Control Measures ◽  
Rate Variation ◽  
Small Peak ◽  
Infection Control Measures ◽  
Care Systems ◽  
Novel Coronavirus

A novel coronavirus (SARS-CoV-2) first detected in Wuhan, China, has spread rapidly since December 2019, causing more than 80,000 confirmed infections and 2,700 fatalities (as of Feb 27, 2020). Imported cases and transmission clusters of various sizes have been reported globally suggesting a pandemic is likely.Here, we explore how seasonal variation in transmissibility could modulate a SARS-CoV-2 pandemic. Data from routine diagnostics show a strong and consistent seasonal variation of the four endemic coronaviruses (229E, HKU1, NL63, OC43) and we parameterize our model for SARS-CoV-2 using these data. The model allows for many subpopulations of different size with variable parameters. Simulations of different scenarios show that plausible parameters result in a small peak in early 2020 in temperate regions of the Northern Hemisphere and a larger peak in winter 2020/2021. Variation in transmission and migration rates can result in substantial variation in prevalence between regions.While the uncertainty in parameters is large, the scenarios we explore show that transient reductions in the incidence rate might be due to a combination of seasonal variation and infection control efforts but do not necessarily mean the epidemic is contained. Seasonal forcing on SARS-CoV-2 should thus be taken into account in the further monitoring of the global transmission. The likely aggregated effect of seasonal variation, infection control measures, and transmission rate variation is a prolonged pandemic wave with lower prevalence at any given time, thereby providing a window of opportunity for better preparation of health care systems.

scholarly journals Nurse Leaders’ Reflections and Difficulties Fighting the NCP Epidemic： A Qualitative Study

2021 ◽  
Author(s):  
Jing Wang ◽  
Lihua Tang ◽  
Huanyuan Da ◽  
Huan Lu ◽  
Xinping Shi ◽  
...  
Keyword(s):  
Interpersonal Relationships ◽  
Health Care Systems ◽  
Nurse Leaders ◽  
Fear Learning ◽  
Survival Strategies ◽  
Internal Conflicts ◽  
The Future ◽  
Care Systems ◽  
Novel Coronavirus ◽  
Outstanding Leadership

Abstract Objective. To understand the difficulties and survival strategies in nursing during NCP outbreak, and to reflect and summarize the experience. Background. Since December 2019, the highly infectious novel coronavirus pneumonia overwhelmed health care systems and medical workers who had to provide care in situations involving high personal risk and stress, some becoming infected and dying. Nurse leaders had to develop new strategies for nursing care. Methods. Using the phenomenological research method in qualitative research, 8 head nurses who participated in NCP treatment were interviewed in-depth, and then Colaizzi 7-step analysis method was used to summarize.Results. Working under great pressure, nursing leaders led the team through a period of crisis: shock and fear, learning in chaos, supporting nurses, and rewarding nurses. Conclusion. As important intervention performers in the crisis, nurse leaders need to have their own outstanding leadership to effectively manage internal conflicts and interpersonal relationships, strengthen teamwork training and establish supportive system so as to better deal with the management of similar public health events in the future. Relevance to clinical practice. Findings will assist nurse leaders to prepare themselves in the outbreak. It is hoped that the results of this study will contribute to disaster management in similar infectious outbreaks in the future.

scholarly journals Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US

2020 ◽  
Vol 180 (10) ◽  
pp. 1328 ◽  
Author(s):  
Molly M. Jeffery ◽  
Gail D’Onofrio ◽  
Hyung Paek ◽  
Timothy F. Platts-Mills ◽  
William E. Soares ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Health Care Systems ◽  
Emergency Department Visits ◽  
The Us ◽  
Care Systems

Dancing With Death in the Dust of Coronavirus: The Lived Experience of Iranian Nurses

2020 ◽  
Vol 26 (4) ◽  
pp. e82-e89
Author(s):  
Fatemeh Bahramnezhad ◽  
Parvaneh Asgari
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Phenomenological Approach ◽  
Care Providers ◽  
Care Systems ◽  
Interpretative Phenomenological Approach ◽  
Communication Challenges ◽  
Novel Coronavirus

The novel coronavirus disease (COVID-19) pandemic as a public health emergency poses dramatic challenges for health-care systems. The experiences of health-care workers are important in planning for future outbreaks of infectious diseases. This study explored the lived experiences of 14 nurses in Tehran, Iran caring for coronavirus patients using an interpretative phenomenological approach as described by Van Manen. In-depth interviews were audio-recorded between March 10 and May 5, 2020. The essence of the nurses' experiences caring for patients with COVID-19 was categorized as three themes and eight subthemes: (a) Strong pressure because of coronavirus: initial fear, loneliness, communication challenges, exhaustion. (b) Turn threats into opportunities: improvement of nursing image, professional development. (c) Nurses' expectations: expectations of people, expectations of government. The findings of this study showed that identifying the challenges and needs of health-care providers is necessary to create a safe health-care system and to prepare nurses and expand their knowledge and attitudes to care for patients in new crises in the future.

scholarly journals Hospitalization for ischemic stroke was affected more in independent cases than in dependent cases during the COVID-19 pandemic: An interrupted time series analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261587
Author(s):  
Hiroyuki Nagano ◽  
Jung-ho Shin ◽  
Tetsuji Morishita ◽  
Daisuke Takada ◽  
Susumu Kunisawa ◽  
...  
Keyword(s):  
Time Series ◽  
Ischemic Stroke ◽  
Hospital Admissions ◽  
Health Care Systems ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
State Of Emergency ◽  
Its Analysis ◽  
Care Systems ◽  
The Impact

Background The pandemic of the coronavirus disease 2019 (COVID-19) has affected health care systems globally. The aim of our study is to assess the impact of the COVID-19 pandemic on the number of hospital admissions for ischemic stroke by severity in Japan. Methods We analysed administrative (Diagnosis Procedure Combination—DPC) data for cases of inpatients aged 18 years and older who were diagnosed with ischemic stroke and admitted during the period April 1 2018 to June 27 2020. Levels of change of the weekly number of inpatient cases with ischemic stroke diagnosis after the declaration of state of emergency were assessed using interrupted time-series (ITS) analysis. The numbers of patients with various characteristics and treatment approaches were compared. We also performed an ITS analysis for each group (“independent” or “dependent”) divided based on components of activities of daily living (ADL) and level of consciousness at hospital admission. Results A total of 170,294 cases in 567 hospitals were included. The ITS analysis showed a significant decrease in the weekly number of ischemic stroke cases hospitalized (estimated decrease: −156 cases; 95% confidence interval (CI): −209 to −104), which corresponds to −10.4% (95% CI: −13.6 to −7.1). The proportion of decline in the independent group (−21.3%; 95% CI: −26.0 to −16.2) was larger than that in the dependent group (−8.6%; 95% CI: −11.7 to −5.4). Conclusions Our results show a marked reduction in hospital admissions due to ischemic stroke after the declaration of the state of emergency for the COVID-19 pandemic. The independent cases were affected more in proportion than dependent cases.

scholarly journals Forecasting the COVID-19 Outbreak: An Application of Arima and Fuzzy Time Series Models

2020 ◽  
Author(s):  
Prashant Verma ◽  
Mukti Khetan ◽  
Shikha Dwivedi ◽  
Shweta Dixit
Keyword(s):  
Time Series ◽  
Health Care Systems ◽  
Medical Personnel ◽  
Fuzzy Time Series ◽  
Time Series Models ◽  
Data Set ◽  
Care Systems ◽  
Novel Coronavirus ◽  
Time Series Methodology ◽  
Near Future

Abstract Purpose: The whole world is surfaced with an inordinate challenge of mankind due to COVID-19, caused by 2019 novel coronavirus (SARS-CoV-2). After taking hundreds of thousands of lives, millions of people are still in the substantial grasp of this virus. This virus is highly contagious with reproduction number R0, as high as 6.5 worldwide and between 1.5 to 2.6 in India. So, the number of total infections and the number of deaths will get a day-to-day hike until the curve flattens. Under the current circumstances, it becomes inevitable to develop a model, which can anticipate future morbidities, recoveries, and deaths. Methods: We have developed some models based on ARIMA and FUZZY time series methodology for the forecasting of COVID-19 infections, mortalities and recoveries in India and Maharashtra explicitly, which is the most affected state in India, following the COVID-19 statistics till “Lockdown 3.0” (17th May 2020). Results: Both models suggest that there will be an exponential uplift in COVID-19 cases in the near future. We have forecasted the COVID-19 data set for next seven days. The forecasted values are in good agreement with real ones for all six COVID-19 scenarios for Maharashtra and India as a whole as well.Conclusion: The forecasts for the ARIMA and FUZZY time series models will be useful for the policymakers of the health care systems so that the system and the medical personnel can be prepared to combat the pandemic.

scholarly journals Implementation of the Integrated Care of Older People (ICOPE) App in Primary Care: New Technologies in Geriatric Care during Quarantine of COVID-19 and Beyond

2020 ◽  
pp. 1-2
Author(s):  
D. Sanchez-Rodriguez ◽  
C. Annweiler ◽  
S. Gillain ◽  
B. Vellas
Keyword(s):  
New Technologies ◽  
Health Care Systems ◽  
Action Plan ◽  
Credible Interval ◽  
Therapeutic Interventions ◽  
World Health ◽  
Global Priority ◽  
Care Systems ◽  
Novel Coronavirus ◽  
Health Organization

The COVID-19 pandemic due to a novel coronavirus (SARS-CoV-2) in December 2019 has rapidly spread worldwide. The mortality rate is about 2.3% in general population, with high human-to-human transmission of 0.41 (credible interval [0.27, 0.55]), and nasopharyngeal asymptomatic carriers act as vectors within the population (1). The World Health Organization (WHO) declared the pandemic on March 2020, and established objectives and action plan. First, WHO aimed at limiting the transmission of SARS-CoV-2, which required large isolation actions (country borders lockdown and individual quarantine). Second, WHO aimed at guiding and supporting the different health care systems across countries. Finally, developing therapeutic interventions appeared as a global priority as available evidence were still scarce (1). More than 860 clinical trials are ongoing worldwide.

scholarly journals Social distancing and dangers of access block to health care services during COVID-19 pandemic

2020 ◽  
Vol 16 (2) ◽  
Author(s):  
Mor Saban ◽  
Tal Shachar
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Care Systems ◽  
Chronically Ill ◽  
Access To Health Services ◽  
Isolated Populations ◽  
Social Distancing ◽  
Care Services ◽  
Care Systems ◽  
Novel Coronavirus

An outbreak of the novel coronavirus (COVID-19) that started in Wuhan, China, has spread quickly, with cases confirmed in 180 countries with broad impact on all health care systems. Currently, the absence of a COVID-19 vaccine or any definitive medication has led to increased use of non-pharmaceutical interventions, aimed at reducing contact rates in the population and thereby transmission of the virus, especially social distancing. These social distancing guidelines indirectly create two isolated populations at high-risk: the chronically ill and voluntary isolated persons who had contact with a verified patient or person returning from abroad. In this concept paper we describe the potential risk of these populations leading to an 80% reduction in total Emergency Department (ED) visits, including patients with an acute condition. In conclusion, alternative medical examination solutions so far do not provide adequate response to the at-risk population. The healthcare system must develop and offer complementary solutions that will enable access to health services even during these difficult times.

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