Epidemic Emergency Research Articles

New problems and countermeasures in the prevention and control of COVID-19

New problems and countermeasures in the prevention and control of COVID-19

The trend of fracture distribution in the SARS-CoV-2 era: organization and resource allocation in a level I trauma care center

Purpose: This study analyzes changes in the epidemiology of fractures during the SARS-CoV-2 era. Its aim was to better understand the workload of the orthopedic department, as well as the management of healthcare professionals, in this situation, with a view to ensuring optimal resource allocation in the event of any future epidemic emergency. Methods: Admissions to the orthopedic emergency room for trauma care were analyzed with reference to the period January 2019 to April 2020. The rate of hospitalized patients (group A) and the rate of patients discharged pending delayed surgery (group B) were recorded. Furthermore, distribution of the various fracture types, and of different trauma dynamics, was also evaluated. Results: The data show a reduction in the number of total admissions (from an average of 70.92/day to 21.15/day during the COVID period). In the pre-COVID era, patients requiring hospitalization accounted for 7.01% of all admissions; this rate increased to 12.47% in March 2020 and 15.67% in April 2020. No increase was found in the rate of patients assigned to delayed surgery: 1.31% in the pre COVID-era, 1.11% in March 2020, and 0.70% in April 2020. The frequency of proximal femoral fractures remained stable (53.71/month in the pre-COVID era, 47.5/month in the COVID era), while high-energy fractures decreased during the outbreak. Conclusion: During epidemics such as the SARS-CoV-2 outbreak, trauma services must be guaranteed in order to treat fractures and orthopedic emergencies, while elective procedures should be discontinued to preserve resources and allow conversion of professionals in order to meet ICU needs. The epidemiology of fractures can change, but orthopedists must still ensure high quality of care and, at the same time, protect themselves and their patients from the risk of viral infection.

Consideraciones bioéticas para la toma de decisiones médicas en situación de pandemia y emergencia sanitaria. Aprendiendo de la pandemia por SARS-COV-2.

The health crisis suffered during the 2020 SARS-CoV-2 pandemic caused healthcare professionals to face an unprecedented ethical conflict. The massive and short-term consumption of life support means meant that in many cases, these treatments could not be offered, at least in due course, when under normal conditions they would have been. This situation makes the importance of uniform, consensual and fair prioritization protocols in situations of epidemic and health emergency clear. The objective of this document is to address the bioethic criteria that should guide the elaboration of the prioritization protocols, which bodies should assume the maximum responsibility in such elaboration and how they should be applied. The resource allocation model must be a mixed model in which the possibility of survival is the fundamental pillar and the first criterion and equity and the protection of vulnerability are also guaranteed. Both prejudices against older people or people with disabilities and criteria of social utility and utilitarian approaches, which subordinate individual rights to the common good or the total number of lives saved, must be avoided. The main responsibility for the preparation, organization and protection of the prioritization protocols must be assumed by the highest legal and political authorities since this inevitable prioritization could implies the denial of a fundamental right included in the Spanish Constitution as is the protection of the health of each individual.

Bridges and Mediation in Higher Distance Education: HELMeTO 2020 Report

In this paper, we report the scientific experience of HELMeTO 2020, the second edition of the International Workshop on Higher Education Learning Methodologies and Technologies Online, held virtually in Bari (Italy) in September 2020 because of the COVID-19 pandemic. The call received 59 proposals from nine countries, 39 papers were accepted to the virtual workshop and 26 full papers were finally selected to be published in the proceedings. The workshop illustrated a fast-developing scenario in which the epidemic emergency accelerated the dissemination and consolidation of online learning in higher education. A specific focus of the workshop can be identified as students’ learning experience, with studies on tutoring and active learning approaches, personalized solutions supported by data analysis, virtual reality and an in-depth analysis of human–computer interactions.

Information fusion for future COVID-19 prevention: continuous mechanism of big data intelligent innovation for the emergency management of a public epidemic outbreak

Information fusion is very effective and necessary to respond to a public epidemic outbreak such as COVID-19. Big data intelligent, as a product of information fusion, plays an important role in the prevention and control of COVID-19. The continuous mechanism of big data intelligent innovation (BDII) is fundamental to effectively prevent and control a public epidemic outbreak. In this study, the continuous mechanism of BDII was fused into a complex network, and a three-dimensional collaborative epidemic prevention model was constructed. Furthermore, adiabatic elimination principle was applied to explore the order parameter of the continuous mechanism. Finally, empirical analysis was conducted based on three-stage epidemic prevention strategies to reveal the effect of continuous epidemic prevention under different big data intelligent emergency management policy levels. The results of this study are as follows. Through the mutual influence and coupling of the subsystems, the continuous mechanism of BDII can be realized to manage a public epidemic outbreak emergency. The big data intelligent subsystem is integrated into the subsystems of public epidemic outbreak management and science and technology innovation. The big data intelligent emergency management policies play a positive role in the overall BDII for the continuous epidemic prevention of a public epidemic outbreak. The convention of BDII transformation is the continuous mechanism of BDII as the order parameter of a public epidemic outbreak. In the early stage of epidemic prevention, the convention is excessively pursued, while the neglect of BDII configuration is not conducive to the long-term collaborative governance of a public epidemic outbreak. The study provides practical guidelines for the formulation of fusion innovation policies, application of big data intelligent, and theoretical basis for the emergency management of a public epidemic outbreak in the medical field.

COVID-19流行期の緊急事態宣言・外出自粛が慢性運動器疾患患者に与える影響

COVID-19流行期の緊急事態宣言・外出自粛が慢性運動器疾患患者に与える影響

Formation of emotional stability in patients over 65 years old in the context of COVID-19 pandemic (part 1)

To date, when using the following search terms: «65+”, «elderly person», and «emotional resilience» in titles and abstracts (as well as in combination with medical thematic heading terms), the PUBMED, Scopus and EMBASE databases present 4,500 papers devoted to mental health problems of age 65+ associated with complex epidemic situations; at the same time, there is still not enough research aimed at studying mental health issues during the COVID-19 pandemic. The current situation with the COVID-19 pandemic poses many questions for the psychology community regarding how to get out of an epidemic emergency without losing mental health, how to effectively overcome the problems and further improve social policy in relation to people aged 65+ in the post-pandemic period.

Modelling that shaped the early COVID-19 pandemic response in the UK.

Infectious disease modelling has played an integral part of the scientific evidence used to guide the response to the COVID-19 pandemic. In the UK, modelling evidence used for policy is reported to the Scientific Advisory Group for Emergencies (SAGE) modelling subgroup, SPI-M-O (Scientific Pandemic Influenza Group on Modelling-Operational). This Special Issue contains 20 articles detailing evidence that underpinned advice to the UK government during the SARS-CoV-2 pandemic in the UK between January 2020 and July 2020. Here, we introduce the UK scientific advisory system and how it operates in practice, and discuss how infectious disease modelling can be useful in policy making. We examine the drawbacks of current publishing practices and academic credit and highlight the importance of transparency and reproducibility during an epidemic emergency.This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.

COVID-19 impact on nurses in Spain: a considered opinion survey.

AimTo survey nurses' opinions about their work conditions at the onset of the COVID‐19 pandemic in Spain.BackgroundFor the Spanish General Council of Nursing (the Consejo General de Enfermería de España), it was essential to have information on nursing workforce conditions and nurses' preparedness to wear protective measures at the pandemic's onset. The coronavirus outbreak was believed to have started in China and rapidly spread as a global pandemic requiring policies and actions for planning emergency healthcare delivery.MethodsA cross‐sectional survey was conducted online. Data were collected during April 2020 and covered social demography, working conditions, training, availability of personal protective equipment, and nurses' health conditions, including the impact of COVID‐19.FindingsFrom all national territories in Spain, 11 560 registered nurses from different services completed the questionnaire. Findings indicated that the lack of personal protective equipment was a crucial issue, as well as service planning and organization, and 80.2% reported high or very high psychological impact of COVID‐19. Alarmingly, 29.5% of the nurses reported COVID‐19 symptoms. Of these 23.3% had been tested, and 30.2% were confirmed as being positive to the virus. The nurses deemed proper preparedness for emergencies and disasters as a significant concern.ConclusionNurses’ responses showed evidence of health services deficiencies as a source of damage to their capacity to provide safe patient care and protect themselves and their families' health. The working conditions of the nurses are at critical levels and are unacceptable. The study results provide evidence regarding the necessity of suitable planning and actions being taken to enable safe patient care and safety for nurses.Implications for Nursing and Health PolicyOur survey gathered nurses' views at the pandemic's onset. The evidence gathered is being used to advise policymakers and nursing organizations to take actions to control public health risks to populations. It is necessary that more investment in growing nursing workforce expertise and health infrastructure for pandemic and epidemic emergencies is provided.

Ethics in an Epidemic: Nine Issues to Consider

Abstract This article addresses nine ethical concerns facing school social workers during an epidemic and other emergency situations when they must rely on electronic communication platforms, such as Doxy.me, Skype, or Zoom. These issues of concern are use of appropriate terminology, client self-determination, technological competence, informed consent, confidentiality, boundary issues, social justice, record keeping, and professional self-care. The article combines research on the psychosocial effects of quarantine on students and their families and data about the effectiveness of telemental health. It provides legal expectations from the Family Educational Rights and Privacy Act as well as ethical guidance from the American Telemedicine Association and the National Association of Social Workers’ Code of Ethics to provide practical strategies about how to help students and their families during a time of prolonged stress. The article takes a strengths-based approach to crisis intervention by indicating both the advantages and the disadvantages of using electronic communication tools to provide continuity of care to clients.

Prenatal exposure to the SARS epidemic emergency and risk of cognitive impairment in toddlers

Prenatal exposure to the SARS epidemic emergency and risk of cognitive impairment in toddlers

Global health Initiatives as a ‘Drunken Boat’: The Meningitis Vaccines Project Case Study

Based on an analysis of the Meningitis Vaccine Project (MVP), a public-private partnership (PPP) set up to introduce the MenAfriVac® vaccine in African countries, this article examines the failures of an accelerated disease control programme that targeted a highly infectious disease. I argue that the integration of MenAfriVac® into the World Health Organization’s (WHO) Expanded Programme on Immunisation had the effect of reinforcing inequalities in access, in particular during epidemic emergencies. I will also show how vaccine shortages during an outbreak in Niger led to political tensions and to the emergence of a parallel and unregulated ‘black market’ of vaccines.

Anti-Epidemic Emergency Regimes under Polish Law in Comparative, Historical and Jurisprudential Perspective

The SARS-CoV-2 crisis of 2020 triggered a number of unprecedented reactions of European states, in particular in the form of either constitutional emergency measures or statutory anti-epidemic emergency measures. Poland chose to deal with the crisis by delegating powers to the executive by ordinary legislative means and declared a nationwide state of epidemic emergency on 13 March 2020 and a week later a state of epidemic on the basis of the Act of 5 December 2008 on preventing and combating infections and infectious diseases. For a century, Poland has been dealing with epidemics by delegating powers to the executive by ordinary legislative means. Anti-epidemic emergency measures were developed under the relevant acts of 1919, 1935, 1963, 2001, 2008 and now form an autonomous normative model authorised directly by Article 68 (4) of the Constitution of the Republic of Poland of 2 April 1997. The Constitution of 2 April 1997 authorises also extraordinary measures in situations of particular danger, "if ordinary constitutional measures are inadequate". This article analyses anti-epidemic emergency regimes under Polish law in a comparative, historical and jurisprudential perspective.

An Overview of Thermal Infrared Imaging-Based Screenings during Pandemic Emergencies.

Infrared thermal imaging (IRI) is a contact-less technology able to monitor human skin temperature for biomedical applications and in real-life contexts. Its capacity to detect fever was exploited for mass screening during past epidemic emergencies as well as for the current COVID-19 pandemic. However, the only assessment of fever may not be selective for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Hence, novel approaches for IRI data analysis have been investigated. The present review aims to describe how IRI have been employed during the last epidemics, highlighting the potentialities and the limitations of this technology to contain the contagions. Specifically, the methods employed for automatic face recognition and fever assessment and IRI’s performances in mass screening at airports and hospitals are reviewed. Moreover, an overview of novel machine learning methods for IRI data analysis, aimed to identify respiratory diseases, is provided. In addition, IRI-based smart technologies developed to support the healthcare during the COVID-19 pandemic are described. Finally, relevant guidelines to fully exploit IRI for COVID-19 identification are defined, to improve the effectiveness of IRI in the detection of the SARS-CoV-2 infection.

Community mobilization during epidemic emergencies: Insights from Kerala

The present paper describes the strategy to mitigate and control epidemic contingencies in the backdrop of Kerala’s Covid-19 containment plan. I have purposefully selected Kerala, the southernmost state of India, because of its globally acclaimed experience in efficiently managing the cases of coronavirus that were reported. Even tackling the Nipah and Zika virus cases in the pasts, makes it an exemplary unit of study. Moreover, the past experience of the state points to the fact that the containment strategy adopted is the result of an evolved practical approach. I came across certain innovative strategies implicating community mobilization like community kitchens, social surveillance, large scale production of face masks etc. by utilizing the hidden productive capacity of communities that extended from women self-help groups, youth clubs and even prison inmates. Moreover, the state’s controlling and containing measures were mentioned by international media and agencies like the BBC and the World Health Organization (WHO).

Second ethical comments towards COVID-19 (one year later)

At the beginning of COVID-19 development, when social vulnerability in the face of the global infectious threat became obvious, we presented target information on a key civilizational issue — the role of ethics in epidemic emergencies. The compliance of RF legislation and the world ethical standards analyzed on based on the study of the humanitarian heritage of pandemic management and a review of existing international documents. Today, one year later, it is time to practically evaluate the effectiveness of the ideology of ethical commitment and objectively comprehend the conflicts that have arisen, their causes and consequences. It should be emphasized that this work is not a so-called “moral lesson learned from COVID-19”, but representation of a real picture of how the centuries-old experience of former epidemics and pandemics was taken into account and the unique truth of the ethical content of management decisions and actions was accepted. It is particularly important to have a possibility to present this article as a continuation of our research topic on the bioethics of pandemics, on the pages of such an authoritative, specialized journal, which fully allows us to preserve the integrity of ideas about the humanitarian essence of anti-epidemic measures. This humanitarian parallel starts from the moment of managing a particular patient with infectious pathology until large-scale measures for eradication vaccine-preventable diseases. A comprehensive and dynamic look at the need to find ways and the nature of overcoming ethical conflicts during the ongoing pandemic of the new coronavirus infection could determine the ethical approach of longterm recommendations in the field of public health protection and ensure the stability of social trust in the future.

Digital Contact Tracing Based on a Graph Database Algorithm for Emergency Management During the COVID-19 Epidemic: Case Study.

BackgroundThe COVID-19 epidemic is still spreading globally. Contact tracing is a vital strategy in epidemic emergency management; however, traditional contact tracing faces many limitations in practice. The application of digital technology provides an opportunity for local governments to trace the contacts of individuals with COVID-19 more comprehensively, efficiently, and precisely.ObjectiveOur research aimed to provide new solutions to overcome the limitations of traditional contact tracing by introducing the organizational process, technical process, and main achievements of digital contact tracing in Hainan Province.MethodsA graph database algorithm, which can efficiently process complex relational networks, was applied in Hainan Province; this algorithm relies on a governmental big data platform to analyze multisource COVID-19 epidemic data and build networks of relationships among high-risk infected individuals, the general population, vehicles, and public places to identify and trace contacts. We summarized the organizational and technical process of digital contact tracing in Hainan Province based on interviews and data analyses.ResultsAn integrated emergency management command system and a multi-agency coordination mechanism were formed during the emergency management of the COVID-19 epidemic in Hainan Province. The collection, storage, analysis, and application of multisource epidemic data were realized based on the government’s big data platform using a centralized model. The graph database algorithm is compatible with this platform and can analyze multisource and heterogeneous big data related to the epidemic. These practices were used to quickly and accurately identify and trace 10,871 contacts among hundreds of thousands of epidemic data records; 378 closest contacts and a number of public places with high risk of infection were identified. A confirmed patient was found after quarantine measures were implemented by all contacts.ConclusionsDuring the emergency management of the COVID-19 epidemic, Hainan Province used a graph database algorithm to trace contacts in a centralized model, which can identify infected individuals and high-risk public places more quickly and accurately. This practice can provide support to government agencies to implement precise, agile, and evidence-based emergency management measures and improve the responsiveness of the public health emergency response system. Strengthening data security, improving tracing accuracy, enabling intelligent data collection, and improving data-sharing mechanisms and technologies are directions for optimizing digital contact tracing.

Don't stop walking: the in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic.

We studied the outcomes of peripheral artery disease (PAD) patients enrolled in a structured in-home walking program right before the lockdown due to the SARS-CoV-2 epidemic emergency, to determine whether this intervention ensured the maintenance of mobility even in the case of movement restrictions.We selectively studied 83 patients (age 72 ± 11, males n = 65) enrolled in the program within 9-month before the lockdown. The usual intervention was based on two daily 8-min sessions of slow intermittent in-home walking prescribed in circa-monthly hospital visits. During the lockdown, the program was updated by phone. Six-minute (6MWD) and pain-free walking distance (PFWD) were measured pre- and post-lockdown as well as body weight (BW), blood pressure (BP), and ankle-brachial index (ABI). Sixty-six patients were measured 117 ± 23 days after their previous visit. A safe, pain-free execution of the prescribed sessions was reported (median distance: 74 km). Overall, the 6MWD was stable, while PFWD improved (p < 0.001). The improvement was not related to age/gender, comorbidities, type of home but to the time of enrollment before lockdown. The new-entry subjects (≤ 3 months; n = 35) obtained significant improvements post-lockdown for 6MWD and PFWD, while those previously enrolled (> 3 months; n = 31) were stable. Decreased BW with stable BP and ABI values were also recorded, with better outcomes for new-entry subjects. In PAD patients, a structured walking program performed inside home and purposely guided by phone was adhered to by patients and favored mobility and risk factor control during the COVID-19 pandemic, regardless of walking ability, type of home and external conditions.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11739-020-02598-4.

An evaluation method of urban epidemic emergency response capability based on fuzzy logic

In 2020, the outbreak of COVID-19 seriously threatened many people's life and it had brought unexpected impacts upon the global economy. In order to understand the emergency response ability of cities with similar backgrounds, an evaluation method based on fuzzy comprehensive evaluation was proposed. First, we established the evaluation index system of urban epidemic response capability. Meantime, a combination way to calculate the index weights of the evaluation system was developed based on analytic hierarchy process. Finally, we have an empirical analysis on the evaluation activity of epidemic emergency management in area H, J province. The evaluation results can be used as the basis for selecting advanced cities. At the same time, it is of great importance for area H to improve urban resource allocation and emergency response capability.

Comparative study on prevention and control policies of major animal epidemics in China—Quantitative analysis of policy texts from 1972-2019

The matching of central and provincial governments' policy themes and the correspondence between them are important for measuring the accurate delivery of policies. Such measurement can directly reflect policy connections between the central and provincial governments and is helpful in understanding the strength and effect of policy implementation. In this study of animal epidemic prevention and control policy texts issued by central and provincial government departments from 1972 to 2019, the themes of the texts were determined by the segmentation of high- and low-frequency keywords, and the quantitative analysis was carried out in four dimensions: the year, number, subject and theme of each policy. The findings indicate that the central government takes the initiative in preventing and controlling animal epidemics and adjusts prevention and control measures through feedback, mostly using restrictive tools. The provincial governments’ prevention and control of animal epidemics are a combination of active and passive types, and the tools used basically have the same characteristics as those used by the central government. The central government has formed an animal epidemic prevention and control emergency management decision-making group with the Ministry of Agriculture and Rural Affairs of the People’s Republic of China and the State Administration for Market Supervision and Administration as the core. The policy text themes of provincial governments and agricultural animal disease prevention and control management departments match more closely than those of the central government. The study suggests that the central government's animal epidemic prevention and control policy themes can increase coverage and promote the implementation of provincial government prevention and control management measures. Provincial governments can form decision-making groups for the emergency management of animal epidemics, mobilize enthusiasm for animal epidemic prevention and control and receive feedback information, and enhance their ability to actively intervene in epidemic prevention and control.