Quarantine and isolation facility: A State Health Department’s response to the COVID-19 pandemic

2021 ◽  
Vol 16 (3) ◽  
pp. 203-205
Author(s):  
Appathurai Balamurugan, MD, DrPH ◽  
William Greenfield, MD ◽  
Michael Knox, DrPH ◽  
Greg Brown, NRP
Keyword(s):  
Vulnerable Populations ◽  
Vulnerable Population ◽  
Lessons Learned ◽  
State Health ◽  
Multigenerational Families ◽  
Department Of Health ◽  
Increased Risk ◽  
Isolation Requirements ◽  
Background State ◽  
Isolation Facility

Background: State Health Departments are at the helm of addressing the myriad needs during the COVID-19 pandemic, including those of vulnerable populations who do not have a place to self-isolate or quarantine to prevent the spread. An estimated 5,000 Arkansas residents face homelessness and are at increased risk of contracting and spreading COVID-19. Additionally, those living in multigenerational families face similar challenges.Objective: We share our experiences and lessons learned in planning, executing, and maintaining a quarantine and isolation facility for vulnerable population during the COVID-19 pandemic.Setting and patients: A 29-bed quarantine and isolation facility was instituted and maintained by the Arkansas Department of Health to meet the quarantine and isolation needs of vulnerable populations. Outcomes and conclusions: As the COVID-19 pandemic persists, need for a facility to meet quarantine and isolation requirements of vulnerable population is not just a critical mitigation strategy but is an ethical imperative.

scholarly journals Transmission Dynamics of SARS-CoV-2 during an Outbreak in a Roma Community in Thessaly, Greece—Control Measures and Lessons Learned

2021 ◽  
Vol 18 (6) ◽  
pp. 2878
Author(s):  
Michalis Koureas ◽  
Matthaios Speletas ◽  
Zacharoula Bogogiannidou ◽  
Dimitris Babalis ◽  
Vassilios Pinakas ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Lessons Learned ◽  
Control Measures ◽  
Disease Spread ◽  
Contact Tracing ◽  
Chi Square ◽  
Increased Risk ◽  
Hospital Visits ◽  
Index Cases ◽  
Isolation Facility

A COVID-19 outbreak occurred among residents of a Roma settlement in Greece (8 April–4 June 2020). The aim of this study was to identify factors associated with an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to evaluate the effectiveness of control measures implemented. Data were analyzed from individuals that were tested for SARS-CoV-2 during contact tracing, population screening or hospital visits. RT-PCR was used for the detection of SARS-CoV-2 in oropharyngeal samples. Risk factors for household secondary attack rates (SAR) and hospitalization with COVID-19 were examined using chi-square tests, Fisher’s exact tests and logistic regression analyses. During the outbreak, 142 cases, 20 hospitalizations and 1 death were recorded, with a total of 2273 individuals tested. The risk of hospitalization was associated with age (OR: 1.04, 95% CI: 1.02–1.07) and Cycle threshold (Ct) values (OR for a decrease in Ct values by 1: 1.18, 95% CI: 1.07–1.31). Household SAR was estimated at 38.62% (95% CI: 32.50–45.01%). After the designation of an isolation facility for cases, household SAR declined from 74.42% to 31.03%. Household size was associated with the risk of infection (OR: 2.65, 95% CI: 1.00–7.07). The presence of COVID-19 symptoms among index cases was correlated with higher transmission (OR: 23.68, 95% CI 2.21–253.74) in multivariate analysis, while age was found to be associated with SAR only in univariate analysis. Roma communities can be particularly vulnerable to the spread of SARS-CoV-2. In similar settings, symptomatic cases are more important transmitters of SARS-CoV-2. Within these communities, immediate measures should be implemented to mitigate disease spread.

scholarly journals Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

2021 ◽  
Vol 6 (6) ◽  
pp. e005833
Author(s):  
Leena N Patel ◽  
Samantha Kozikott ◽  
Rodrigue Ilboudo ◽  
Moreen Kamateeka ◽  
Mohammed Lamorde ◽  
...  
Keyword(s):  
Health Facility ◽  
Healthcare Workers ◽  
National Level ◽  
Lessons Learned ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Health Facility Level ◽  
Ensure Patient Safety ◽  
Increased Risk ◽  
Facility Level

Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.

scholarly journals Older Adults and Opioid Education: Lessons Learned From Experiences in Rural Arkansas

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Robin McAtee ◽  
Leah Tobey ◽  
Corey Hayes ◽  
Laura Spradley ◽  
Sajni Kumpuris
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
Rural Areas ◽  
Term Treatment ◽  
Lessons Learned ◽  
Opioid Use ◽  
Farm Bureau ◽  
Department Of Health ◽  
Long Term Treatment ◽  
Agricultural Areas

Abstract Nearly one-third of all Medicare participants were prescribed an opioid by their physician in 2015 (AARP, 2017) and in 2017, Arkansas had the 2nd highest opioid prescribing rate in the nation (CDC, 2019). Approaching older adults (OA) about opioids and pain management can be a sensitive topic. Educating and altering long-term treatment with opioids is especially challenging in rural areas where literacy, especially health literacy, is suboptimal. The Arkansas Geriatric Education Collaborative (AGEC) is a HRSA Geriatric Workforce Enhancement Program with an objective to improve health outcomes including an emphasis to decrease the misuse and abuse of opioids among older Arkansans. To address this crisis, the AGEC partnered with local leaders such as the AR Drug Director, academia, Department of Health and Human Services, and multiple community based organizations to create age-tailored educational programs. Unique aspects of approaching and educating rural OA about opioids and pain management will be reviewed. Outcomes will be discussed such as their lack of knowledge about: what is an opioid, why they were prescribed, and what are viable alternatives. Also discussed will be lessons learned that resulted in more effective methods of reaching and teaching rural OA. Partnering with the AR Farm Bureau helped the AGEC reach 100’s of farmers in the extremely rural and mostly agricultural areas. Learning to not use the word opioid resulted in more participants and in a more positive attitude and outlook on attempts to change the culture of opioid use, misuse and abuse among older Arkansans.

scholarly journals The ACHIEVE Trial: Lessons Learned From Nesting a Randomized Controlled Trial Within an Observational Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 811-811
Author(s):  
Jennifer Deal ◽  
Nicholas Reed ◽  
David Couper ◽  
Kathleen Hayden ◽  
Thomas Mosley ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Observational Study ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Randomized Controlled ◽  
Study Staff ◽  
Increased Risk

Abstract Hearing impairment in older adults is linked to accelerated cognitive decline and a 94% increased risk of incident dementia in population-based observational studies. Whether hearing treatment can delay cognitive decline is unknown but could have substantial clinical and public health impact. The NIH-funded ACHIEVE randomized controlled trial of 977 older adults aged 70-84 years with untreated mild-to-moderate hearing loss, is testing the efficacy of hearing treatment versus health education on cognitive decline over 3 years in community-dwelling older adults (Clinicaltrials.gov Identifier: NCT03243422.) This presentation will describe lessons learned from ACHIEVE’s unique study design. ACHIEVE is nested within a large, well-characterized multicenter observational study, the Atherosclerosis Risk in Communities Study. Such nesting within an observational study maximizes both operational and scientific efficiency. With trial results expected in 2022, this presentation will focus on the benefits gained in design and recruitment/retention, including dedicated study staff, well-established protocols, and established study staff-participant relationships. Part of a symposium sponsored by Sensory Health Interest Group.

Nightingale Theory and Intentional Comfort Touch in Management of Tinea Pedis in Vulnerable Populations

2010 ◽  
Vol 28 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Maeve Howett ◽  
Ann Connor ◽  
Elizabeth Downes
Keyword(s):  
Vulnerable Populations ◽  
Access To Health Care ◽  
Fungal Growth ◽  
Foot Care ◽  
Limited Access ◽  
Clinical Encounters ◽  
Secondary Infections ◽  
Increased Risk ◽  
Migrant Farm ◽  
Working And Living Conditions

Vulnerable populations, specifically migrant farm workers and persons experiencing homelessness, are often at an increased risk for foot infections. This risk is related to their working and living conditions, socioeconomic status, limited access to health care, frequent exposure to wet environments, limited access to clean and dry socks and shoes, bathing or laundry facilities, and daily routines that requires them to be on their feet for long periods of time. After years of caring for these populations and hundreds of clinical encounters, an evidence-based, effective method of foot care that incorporates intentional comfort touch has been developed. This article describes methods for mitigating the severity of fungal growth, decreasing the risk of secondary infections, and improving skin integrity by manipulating the micro-environment of the patients’ feet. This includes fundamental aspects of hygiene as described by Florence Nightingale’s Environmental Theory that suggests that direct sunlight, fresh air, and cleanliness improves health.

Outbreak of Escherichia coli O157:H7 Infections Associated with Nonintact Blade-Tenderized Frozen Steaks Sold by Door-to-Door Vendors

2005 ◽  
Vol 68 (6) ◽  
pp. 1198-1202 ◽  
Author(s):  
ELLEN SWANSON LAINE ◽  
JONI M. SCHEFTEL ◽  
DAVID J. BOXRUD ◽  
KEVIN J. VOUGHT ◽  
RICHARD N. DANILA ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Single Case ◽  
Escherichia Coli O157 ◽  
Processing Methods ◽  
Safety Issues ◽  
The Public ◽  
Department Of Health ◽  
Increased Risk ◽  
Beef Products ◽  
Uremic Syndrome

Steaks have not been recognized as an important vehicle of Escherichia coli O157:H7 infection. During 11 to 27 June 2003, the Minnesota Department of Health (MDH) identified four O157 infection cases with the same pulsed-field gel electrophoresis (PFGE) subtype. All four case patients consumed brand A vacuum packed frozen steaks sold by door-to-door vendors. The steaks were blade tenderized and injected with marinade (i.e., nonintact). Information from single case patients in Michigan and Kansas identified through PulseNet confirmed the outbreak. The MDH issued a press release on 27 June to warn consumers, prompting a nationwide recall of 739,000 lb (335,506 kg) of frozen beef products. The outbreak resulted in six culture-confirmed cases (including one with hemolytic uremic syndrome) and two probable cases in Minnesota and single confirmed cases in four other states. The outbreak PFGE subtype of O157 was isolated from unopened brand A bacon-wrapped fillets from five affected Minnesota households. A fillet from one affected household was partially cooked in the laboratory, and the same O157 subtype was isolated from the uncooked interior. The tenderizing and injection processes likely transferred O157 from the surface to the interior of the steaks. These processing methods create new challenges for prevention of O157 infection. Food regulatory officials should reevaluate safety issues presented by nonintact steak products, such as microbiologic hazards of processing methods, possible labeling to distinguish intact from nonintact steaks, and education of the public and commercial food establishments on the increased risk associated with undercooked nonintact steaks. Information on single cases of O157 infection in individual states identified through PulseNet can be critical in solving multistate outbreaks in a timely manner.

scholarly journals Towards 'men who have sex with menappropriate' health services in South Africa

2013 ◽  
Vol 14 (2) ◽  
pp. 52-57 ◽  
Author(s):  
Kevin Brian Rebe ◽  
Glenn De Swardt ◽  
Helen Elizabeth Struthers ◽  
James Alisdair McIntyre
Keyword(s):  
South Africa ◽  
International Development ◽  
Healthcare Services ◽  
Lessons Learned ◽  
Health Clinic ◽  
Emergency Plan ◽  
State Sector ◽  
Department Of Health ◽  
Sex With Men ◽  
Hiv Acquisition

Health programming for men who have sex with men (MSM) in South Africa has been ignored or absent until fairly recently, despite this population being at high risk for HIV acquisition and transmission. Anova Health Institute, with support from the US President's Emergency Plan for AIDS Relief (PEPFAR)/United States Agency for International Development (USAID) and in collaboration with the South African National Department of Health, launched the first state sector MSM-targeted sexual health clinic in 2010. The clinic has been successful in attracting and retaining MSM in care, and lessons learned are described in this article. Components contributing to the creation of MSM-appropriate healthcare services are discussed.

scholarly journals Protecting the vulnerable during COVID-19: Treating and preventing chronic disease disparities

2020 ◽  
Vol 4 ◽  
pp. 125
Author(s):  
Linda M. Mobula ◽  
David J. Heller ◽  
Yvonne Commodore-Mensah ◽  
Vanessa Walker Harris ◽  
Lisa A. Cooper
Keyword(s):  
Vulnerable Populations ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Socioeconomic Groups ◽  
Policy Interventions ◽  
Vulnerable Patients ◽  
Increased Risk ◽  
Care Models ◽  
Key Policy ◽  
Poor Outcomes

The coronavirus disease 2019 (COVID-19) pandemic has exacerbated health disparities across ethnic and socioeconomic groups. Non-communicable diseases (NCDs) - such as hypertension, diabetes, and obstructive lung diseases – are key drivers of this widening gap, because they disproportionately afflict vulnerable populations. Vulnerable populations with non-communicable diseases, in turn, are disproportionately affected by COVID-19 itself – but also at increased risk of poor outcomes from those underlying conditions. Proven strategies for NCD control must be adapted to help vulnerable patients react to these dual threats. We detail six key policy interventions – task shifting, workforce protection, telehealth and mobile services, insurance restructuring and increased funding for NCDs, prescription policies for NCDs and community partnerships - to bridge this care gap. Long-term integration of these care models post-COVID-19 may prevent care shocks during future pandemics, bolstering emerging universal primary care models.

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