scholarly journals Health services availability and readiness for COVID-19 case surge in hospitals of Nepal

2020 ◽  
Author(s):  
Suraj Bhattarai ◽  
Jaya Dhungana ◽  
Tim Ensor ◽  
Uttam Babu Shrestha
Keyword(s):  
Throat Swab ◽  
Face Mask ◽  
Medical Community ◽  
Web Based ◽  
Electronic Survey ◽  
Viral Transport ◽  
Pandemic Response ◽  
Hospital Readiness ◽  
N95 Respirators ◽  
Public Health Strategies

Abstract Background As with other coronavirus-affected countries, Nepal’s medical community also expressed concerns regarding the government’s public health strategies and hospital readiness in response to increasing COVID-19 case surge. To gauge such response, we assessed service availability and readiness status in hospitals situated across seven provinces. Methods A web-based observational study was conducted between March 24 and April 07 in 110 hospitals, all of which were later designated as COVID-19 clinics or hospitals by Nepal Government. An electronic survey link was sent out to the clinicians working at the frontline in those hospitals. One response per hospital was analyzed. Hospitals were divided into small, medium, and large based on the total number of beds (small:15 or less; medium:16–50; large:>50), and further categorized into public, private, and mixed based on the ownership. Results Out of 110 hospitals, 81% (22/27) of small, 39% (11/28) of medium, and 33% (18/55) of large hospitals had not allocated isolation beds for COVID-19 suspects or cases. Majority of medium (89%; 25/28), and 38% of large hospitals did not have a functional intensive care unit (ICU) at the time of study. Nasopharyngeal (NP)/throat swab kits were available in one-third (35/110), whereas viral transport media (VTM), portable fridge box, and refrigerator were available in one-fifth (20%) of the hospitals. Only one hospital (large/tertiary) had a functional PCR machine. Except for General practitioners, other health cadres—crucial during pandemics, were low in number. On IPC measures, the supplies of simple face mask, gloves and hand sanitizers were adequate in the majority of hospitals, however, N95-respirators and PPE-suits were grossly lacking. Government’s COVID-19 support was unevenly distributed across provinces; health facilities in provinces 2, 4, and 5 received fewer resources than others. Conclusions Our findings alerted the Nepalese and other governments to act early and proactively during health emergencies and not wait until the disease disrupts their health systems. Other countries with similar economy levels may undertake similar surveys to measure and improve their pandemic response.

scholarly journals Assessment of service availability and Infection prevention measures in hospitals of Nepal during the transition phase of COVID-19 case surge

2020 ◽  
Author(s):  
Suraj Bhattarai ◽  
Jaya Dhungana ◽  
Tim Ensor ◽  
Uttam Babu Shrestha
Keyword(s):  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Service Availability ◽  
Prevention Measures ◽  
Electronic Survey ◽  
Viral Transport ◽  
Hospital Readiness ◽  
N95 Respirators ◽  
And Control ◽  
Public Health Strategies

As with other coronavirus-affected countries, Nepalese medical fraternity also expressed concerns regarding public health strategies of government and hospital readiness in response to upgoing case surge. To gauge such response, we assessed service availability and Infection prevention and control (IPC) status in 110 hospitals situated across seven provinces. An electronic survey was sent out to the frontline clinicians working on those hospitals between 24th March and 7th April 2020; one response per hospital was analyzed. Hospitals were divided into small, medium, and large based on the total number of beds (small:<=15; medium:16-50; large:>50), and further categorized into public, private, and mixed based on the ownership. Out of 110 hospitals, 81% (22/27) of small, 39% (11/28) of medium, and 33% (18/55) of large hospitals had not allocated isolation beds for COVID-19 suspects. All small, majority of medium (89%; 25/28), and 50% of large hospitals did not have a functional intensive care unit (ICU) at the time of study. Nasopharyngeal (NP)/throat swab kits were available in one-third (35/110), whereas viral transport media (VTM), portable fridge box, and refrigerator were available in one-fifth (20%) of hospitals. Only one hospital (large/tertiary) had a functional PCR machine. Except for General practitioners, other health cadres- crucial during pandemics, were low in number. On IPC measures, the supplies of simple face masks, gloves, and hand sanitizers were adequate in the majority of hospitals, however, N95-respirators, Filter masks, and PPE-suits were grossly lacking. Government COVID-19 support was unevenly distributed across provinces; health facilities in Province 2, Gandaki, and Province 5 received fewer resources than others. Our findings alert the Nepalese and other governments to act early and proactively during health emergencies and not wait until the disease disrupts their health systems. Other countries of similar economic levels may undertake similar surveys to measure and improve their pandemic response.

scholarly journals Cost of Personal Protective Equipment During the First Wave of COVID-19

2021 ◽  
Vol 1 (S1) ◽  
pp. s49-s49
Author(s):  
Alfredo Mena Lora ◽  
Mirza Ali ◽  
Sherrie Spencer ◽  
Eden Takhsh ◽  
Candice Krill ◽  
...  
Keyword(s):  
Supply Chains ◽  
Personal Protective Equipment ◽  
Face Mask ◽  
Protective Equipment ◽  
Market Prices ◽  
Maximum Cost ◽  
Pandemic Response ◽  
The Difference ◽  
N95 Respirators ◽  
The Impact

Background: As the world prepared for and responded to the COVID-19 pandemic in early 2020, a rapid increase in demand for personal protective equipment (PPE) led to severe shortages worldwide. Acquisition of PPE in the general market was an integral part of pandemic response, along with the safeguarding of hospital supplies. We seek to quantify the difference in cost per unit (CPU) of PPE during the first wave of COVID-19 compared to prepandemic prices. Methods: We performed a retrospective review of market prices for PPE during the first surge of the pandemic in Chicago. Cost of PPE was tabulated and compared with prepandemic prices. The maximum cost per unit (CPU) of PPE was tabulated for each week, and the average cost throughout the pandemic was calculated. Disposable gowns, washable gowns, N95 respirators, face masks, and gloves were included in our analysis. Results: PPE prices were significantly higher during the pandemic compared to prepandemic prices (Figure 1). Disposable gown CPU peaked at $12 during the first week of March, 13.7 times higher than prepandemic prices, and the average gown CPU was 7.5 times higher than prepandemic prices. N95 respirators had a peak CPU of $12, and average CPU was 8 times higher than prepandemic prices. Face-mask CPU peaked at $0.55, 11 times higher, and averaged 9 times higher the regular price. Gloves averaged 2.5 times higher than the prepandemic CPU. Conclusions: Market prices for PPE were significantly elevated during the first weeks of the pandemic and remained high throughout the first wave of COVID-19. Multiple factors likely contributed to high prices, including demand shock, disrupted supply chains, and a rush to acquisition by healthcare systems and the general population alike. The impact of COVID-19 on prices highlights the importance of supply chains and national stockpiles for pandemic preparedness.Funding: NoDisclosures: None

Software Tools for Systematic Literature Review in Medicine: A Review and Feature Analysis (Preprint)

2021 ◽  
Author(s):  
Kathryn Cowie ◽  
Asad Rahmatullah ◽  
Nicole Hardy ◽  
Karl Holub ◽  
Kevin Kallmes
Keyword(s):  
Best Practices ◽  
Software Tools ◽  
Observer Agreement ◽  
Medical Community ◽  
Feature Analysis ◽  
Data Abstraction ◽  
Statistical Software ◽  
Web Based ◽  
Knowledge Support ◽  
Dual Extraction

BACKGROUND Systematic reviews (SRs) are central to evaluating therapies but have high costs in terms of both time and money. Many software tools exist to assist with SRs, but most tools do not support the full process, and transparency and replicability of SR depends on performing and presenting evidence according to established best practices. OBJECTIVE In order to provide a basis for comparing and selecting between software tools that support SR, we performed a feature-by-feature comparison of SR tools. METHODS We searched for SR tools by reviewing any such tool listed the Systematic Review Toolbox, previous reviews of SR tools, and qualitative Google searching. We included all SR tools that were currently functional, and require no coding and excluded reference managers, desktop applications, and statistical software. The list of features to assess was populated by combining all features assessed in four previous reviews of SR tools; we also added five features (Manual Addition, Screening Automation, Dual Extraction, Living review, Public outputs) that were independently noted as best practices or enhancements of transparency/replicability. Then, two reviewers assigned binary “present/absent” assessments to all SR tools with respect to all features, and a third reviewer adjudicated all disagreements. RESULTS Of 49 SR tools found, 27 were excluded, leaving 22 for assessment. Twenty-eight features were assessed across 6 classes, and the inter-observer agreement was 86.46%. DistillerSR, EPPI-Reviewer Web, and Nested Knowledge support the most features (24/28, 86%), followed by Covidence, SRDB.PRO, SysRev (20/28, 71%). Six tools support fewer than half of all features assessed: SyRF, Data Abstraction Assistant, SWIFT-review, SR-Accelerator, RobotReviewer, and COVID-NMA. Notably, only 9 of 22 tools (41%) support direct search, only four (18%) offer dual extraction, and only 9 (41%) offer living/updatable reviews. CONCLUSIONS DistillerSR, EPPI-Reviewer Web, and Nested Knowledge each offer a high density of SR-focused web-based tools. By transparent comparison and discussion regarding SR tool functionality, the medical community can both choose among existing software offerings and note the areas of growth needed, most notably in the support of living reviews.

Leading by virtual interaction: an application of cultural-historical activity theory

BMJ Leader ◽  
2021 ◽  
pp. leader-2021-000485
Author(s):  
Ana Sjaus ◽  
Krista Corinne Ritchie
Keyword(s):  
Activity Theory ◽  
Team Leadership ◽  
Cultural Historical Activity Theory ◽  
Human Interaction ◽  
Medical Community ◽  
Activity Systems ◽  
Group Activities ◽  
Pandemic Response ◽  
Historical Activity ◽  
Cultural Historical Activity

Introduction The pandemic spread of SARS-CoV-2, a novel, highly contagious and easily transmissible pathogen, has profoundly affected all aspects of human interaction. Guided by the need to reduce face-to-face contacts, medical organisations have rapidly shifted group activities to virtual platforms. Over 1 year into the pandemic, the necessity to maintain public health restrictions ensures that virtual meetings will be the norm for the foreseeable future.It has yet to be understood how virtual technologies shape healthcare and academic cultures, affect interactions, or influence strategic decisions and policies within these systems.Conclusion In this article, the authors reflect on the move from historically situated activity systems of team leadership in healthcare to ones that now exist in virtual formats. Cultural-historical activity theory (CHAT) is a framework that explains complex human actions, and how they unfold over time through interaction with mediational tools (eg, technology) and various people representing their own communities, roles and perceived divisions of labour. The authors use the lens of CHAT as a framework to understand the shifting dynamics at play and offer strategies for leaders to co-establish activity systems with team members to make goals of group activities explicit and to deliberately work toward them. Five specific strategies proposed are: (1) use software platforms that fit your needs and give voice to all attendees with technical support present in meetings; (2) converse explicitly about roles and emerging role fluidity during times of change and pandemic response; (3) co-construct something new intentionally; (4) engage in implementation science at this time; and (5) lead intentionally while honouring cultural norms and values. It is imperative that any changes, even the ones that are a part of the pandemic response, are made consistent with the core shared values of the medical community as this necessary new way of coming together is embraced with collective wisdom.

scholarly journals The Value of Artificial Intelligence in Laboratory Medicine

2020 ◽  
Author(s):  
Ketan Paranjape ◽  
Michiel Schinkel ◽  
Richard D Hammer ◽  
Bo Schouten ◽  
R S Nannan Panday ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Laboratory Medicine ◽  
Medical Community ◽  
Barriers To Adoption ◽  
Web Based ◽  
Medical Practitioners ◽  
Privacy Concerns ◽  
Key Stakeholders ◽  
Clinical Benefits ◽  
High Investment

Abstract Objectives As laboratory medicine continues to undergo digitalization and automation, clinical laboratorians will likely be confronted with the challenges associated with artificial intelligence (AI). Understanding what AI is good for, how to evaluate it, what are its limitations, and how it can be implemented are not well understood. With a survey, we aimed to evaluate the thoughts of stakeholders in laboratory medicine on the value of AI in the diagnostics space and identify anticipated challenges and solutions to introducing AI. Methods We conducted a web-based survey on the use of AI with participants from Roche’s Strategic Advisory Network that included key stakeholders in laboratory medicine. Results In total, 128 of 302 stakeholders responded to the survey. Most of the participants were medical practitioners (26%) or laboratory managers (22%). AI is currently used in the organizations of 15.6%, while 66.4% felt they might use it in the future. Most had an unsure attitude on what they would need to adopt AI in the diagnostics space. High investment costs, lack of proven clinical benefits, number of decision makers, and privacy concerns were identified as barriers to adoption. Education in the value of AI, streamlined implementation and integration into existing workflows, and research to prove clinical utility were identified as solutions needed to mainstream AI in laboratory medicine. Conclusions This survey demonstrates that specific knowledge of AI in the medical community is poor and that AI education is much needed. One strategy could be to implement new AI tools alongside existing tools.

scholarly journals Use of face mask in COVID-19 pandemic-a review

2021 ◽  
Vol 9 (12) ◽  
pp. 3750
Author(s):  
Santosh Kumar Swain ◽  
Pragnya Paramita Jena
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Virus Disease ◽  
Minimum Cost ◽  
Face Mask ◽  
Medical Community ◽  
Care Workers ◽  
Surgical Masks ◽  
The World ◽  
The Face

The current novel corona virus disease 2019 (COVID-19) is a highly infectious disease of the respiratory tract and rapidly spreading all over the world in short span of time. In current COVID-19 pandemic, use of the face mask is becoming usual and ubiquitous for both health care workers and public individuals. Wearing face mask is one of the non-pharmaceutical interventions which need minimum cost and provide dramatic response for preventing the COVID-19 infection. Limited availability of the vaccine and inadequate supply of therapeutic options, face mask use is an important part for public health measures for restricting the COVID-19 spread. Regardless of the debate among medical community regarding global face mask production shortage, a greater number of countries in the world are moving ahead with recommendations or mandates for using face mask in public. As currently global shortage of N95/FFP2 respirators and surgical masks for use by health care workers in the hospitals, simple cloth masks will act as a pragmatic solution for the use of the public. General public often use the surgical mask or even filtering facepiece (FFP) masks irrespective of their need, resulting unnecessary shortage for needy individuals those are exposed to the patients or those are health care workers. So, this review article will clarify the indication of the different types of masks and their rational use in the current COVID-19 pandemic.

scholarly journals Knowledge, perceptions and practices of Bangladeshi population regarding the novel coronavirus disease

2020 ◽  
Vol 6 (9) ◽  
pp. 353
Author(s):  
Asif Mahmud ◽  
Mohammad M. Rahman ◽  
Pratul D. Somadder
Keyword(s):  
Hand Hygiene ◽  
Face Mask ◽  
Cross Sectional ◽  
Web Based ◽  
Mass Gatherings ◽  
Bangladeshi Population ◽  
Novel Coronavirus ◽  
Prevention And Cure ◽  
Age Range ◽  
Preventive Methods

<p class="abstract"><strong>Background:</strong> Novel coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thorough knowledge about its spread and symptoms, perceptions towards disease and practices to prevent its occurrence are essential. The goal of this study is to assess the knowledge, perceptions and practices of the Bangladeshi residents towards the COVID-19.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional, web-based, pre-tested questionnaire was designed emphasized on the demographic profile, knowledge and perceptions about cause, transmission, prevention and cure of COVID-19. The questionnaires were distributed to 8 districts of Bangladesh only. The survey consists of close ended questions and took approximately 15 minutes to complete during the period of 20th March to 20th April 2020.  </p><p class="abstract"><strong>Results:</strong> A total of 320 completed the study questionnaire, including (67.5%) men and (32.5%) women, and most of them are age range 31-50 years (80.00%). 87.19% people knew cause of COVID-19 is viral and 48.75% knew it spreads through coughs. 77.81% people correctly knew about symptoms of COVID-19. 70.00% mentioned all the correct preventive methods as wearing face mask, vaccination, avoid mass gatherings and maintaining hand hygiene. In reality, only 40.00% people exclusively practicing hand hygiene. </p><strong>Conclusions:</strong> In general, Bangladeshi population participating in our survey had good knowledge about COVID-19, and a positive attitude towards using protective measures, which is important to limit the spread of the disease.

scholarly journals The Rebooting in Sports and Physical Activities After COVID-19 Italian Lockdown: An Exploratory Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Marco Guicciardi ◽  
Riccardo Pazzona
Keyword(s):  
Self Efficacy ◽  
Exploratory Study ◽  
Sleep Disturbances ◽  
Face Mask ◽  
Physical Activities ◽  
Mental Toughness ◽  
Web Based ◽  
Outdoor Activities ◽  
Life Orientation ◽  
Design Variables

The lockdown imposed in Italy to reduce the spread of COVID-19 posited unusual challenges to people practicing sports and physical activities. The rebooting of activities highlighted the need to cope with new behaviors and routines, such as wearing a face mask while exercising. We conducted a web-based survey in Italy at the start of physical activities’ rebooting, to investigate how people reacted to the new norms. Participants completed the questionnaires assessing insomnia, regulatory self-efficacy, optimism, mood states, and mental toughness. Age, gender, and environment were assumed as design variables. Results showed that in outdoor activities, the younger females as compared to the older manifest less regulatory self-efficacy, while the younger males manifest more regulatory self-efficacy than the older. In indoor activities, a reversed pattern of regulatory-self-efficacy was observed. Regarding life orientation, younger participants showed less optimism and positive expectation for the future and seem to be more exposed to the unexpected effects of the restrictions: they showed more sleep disturbances, confusion, depression, anger, and fatigue and less vigor and mental toughness than older participants. An understanding of the psychological implications of the rebooting phase can support the enactment of more appropriate behaviors to practice sports and physical activities when living at the time of the coronavirus.

scholarly journals A survey of US hospitals’ criteria for the allocation of remdesivir to treat COVID-19

2020 ◽  
Author(s):  
Frederick Mun ◽  
Cory M Hale ◽  
Eileen F Hennrikus
Keyword(s):  
Citizen Participation ◽  
Clinical Course ◽  
The United States ◽  
Research Network ◽  
Medical Community ◽  
Patient Identification ◽  
Treatment Allocation ◽  
Electronic Survey ◽  
Medical Centers ◽  
Allocation Criteria

Abstract Purpose To determine how hospitals across the United States determined allocation criteria for remdesivir, approved in May 2020 for treatment of coronavirus disease 2019 (COVID-19) through an emergency use authorization, while maintaining fair and ethical distribution when patient needs exceeded supply. Methods A electronic survey inquiring as to how institutions determined remdesivir allocation was developed. On June 17, 2020, an invitation with a link to the survey was posted on the Vizient Pharmacy Network Community pages and via email to the American College of Clinical Pharmacy’s Infectious Disease Practice and Research Network listserver. Results 66 institutions representing 28 states responded to the survey. The results showed that 98% of surveyed institutions used a multidisciplinary team to develop remdesivir allocation criteria. A majority of those teams included clinical pharmacists (indicated by 97% of respondents), adult infectious diseases physicians (94%), and/or adult intensivists (69%). Many teams included adult hospitalists (49.2%) and/or ethicists (35.4%). Of the surveyed institutions, 59% indicated that all patients with COVID-19 were evaluated for treatment, and 50% delegated initial patient identification for potential remdesivir use to treating physicians. Prioritization of remdesivir allocation was often determined on a “first come, first served” basis (47% of respondents), according to a patient’s respiratory status (28.8%) and/or clinical course (24.2%), and/or by random lottery (22.7%). Laboratory parameters (10.6%), comorbidities (4.5%), and essential worker status (4.5%) were rarely included in allocation criteria; no respondents reported consideration of socioeconomic disadvantage or use of a validated scoring system. Conclusion The COVID-19 pandemic has exposed the inconsistencies of US medical centers’ methods for allocating a limited pharmacotherapy resource that required rapid, fair, ethical and equitable distribution. The medical community, with citizen participation, needs to develop systems to continuously reevaluate criteria for treatment allocation as additional guidance and data emerge.

scholarly journals Acceptance of a COVID-19 Vaccine and its Related Determinants among the General Adult Population in Kuwait

2021 ◽  
Author(s):  
Yosor Alqudeimat ◽  
Deema Alenezi ◽  
Bedour AlHajri ◽  
Heba Alfouzan ◽  
Zain Almokhaizeem ◽  
...  
Keyword(s):  
Adult Population ◽  
Preventive Measure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Web Based ◽  
General Adult Population ◽  
Health Related ◽  
Study Participants ◽  
Public Health Strategies ◽  
Prevalence Ratios

Objective: To determine the acceptance of a potential coronavirus disease 2019 (COVID-19) vaccine among the general adult population in Kuwait and assess its determinants. Subjects and Methods: A web-based cross-sectional study was conducted by enrolling adults living in Kuwait (n = 2368; aged ≥21 years). Acceptance of a COVID-19 vaccine was inferred if participants indicated that they “definitely or probably will accept vaccination against COVID-19 once a vaccine is available.” Associations were explored by applying a modified Poisson regression to estimate and infer adjusted prevalence ratios (aPR) and their 95% confidence intervals (CI). Results: In total, 53.1% (1257/2368) of the participants were willing to accept a COVID-19 vaccine once available. Male subjects were more willing to accept a COVID-19 vaccine than females (58.3% vs. 50.9%, P < 0.001). Subjects who viewed vaccines in general to have health-related risks were less willing to accept vaccination (aPR = 0.39, 95% CI: 0.35-0.44). Moreover, participants who previously received an influenza vaccine were more likely to accept a COVID-19 vaccine (aPR = 1.44, 95% CI: 1.31-1.58). Willingness to get vaccinated against COVID-19 increased as the self-perceived chances of contracting the infection increased (P < 0.001). Conclusion: Overall, 53.1% of the study participants demonstrated willingness to get vaccinated against COVID-19. We found several factors influencing the level of acceptance. Since vaccination appears to be an essential preventive measure that can halt the COVID-19 pandemic, factors relating to low vaccine acceptance need to be urgently addressed by public health strategies.

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