Fangcang Shelter Hospital Research Articles

Psychological experience of Juvenile patients’ parents in Fangcang shelter hospital during the Omicron wave of COVID-19 pandemic in Shanghai, China: a qualitative study

ObjectiveTo explore the psychological experience of Juvenile patient’s parents in Fangcang shelter hospital during the Omicron wave of COVID-19 pandemic.MethodsA qualitative study was conducted by using a phenomenological research method. Sixteen parents of juvenile patients with COVID-19 were recruited from National Exhibition and Convention Center (Shanghai, China) Fangcang shelter hospital (FSH) using purposive sampling. Data were collected by face-to-face in-depth interviews over 27 days, from April 9 to May 6, 2022. The interview data were analyzed using Colaizzi seven-step analysis method.ResultsThe psychological experiences of the parents of juvenile patients in the Fangcang shelter hospital were summarized into three themes: "perception regarding the FSH", "worried about the unmet needs of juvenile patients ", and "the psychological burden after discharge". These themes were classified into 9 sub-themes, including the acceptance of FSH, adaptability to FSH, concerns about cross-infection in the FSH, special needs of infants and young children, psychological needs of preschool children, the learning demands of school-age children, concern about re-positive, fear of sequelae, worry about social acceptance.ConclusionJuvenile patients and their parents in the Fangcang shelter hospitals have both positive and negative experiences. It is suggested that facilities for minors should be planned in advance. Humanistic care for adolescent patients and health education for the public are also critical.

Contamination of personal protective equipment and environmental surfaces in Fangcang shelter hospitals

BackgroundFangcang shelter hospitals emerged as a new public health concept after COVID-19. Data regarding contamination of Fangcang shelter environments remains scarce. This study aims to investigate the extent of SARS-CoV-2 contamination on personal protective equipment and surfaces in Fangcang hospitals. MethodsBetween March and May 2022, during wave of omicron variant, a prospective study was conducted in 2 Fangcang hospitals in Shanghai, China. Swabs of personal protective equipment worn and environmental surfaces of contaminated areas, doffing rooms, and potentially contaminated areas were collected. SARS-CoV-2 RNA was detected by reverse transcription quantitative polymerase chain reaction. If viral RNA was detected, sampling was repeated after cleaning and disinfection. ResultsA total of 602 samples were collected. 13.3% of the personal protective equipment were contaminated. Positive rate was higher in the contaminated areas (48.4%) than in the doffing rooms (11.7%) and the potentially contaminated areas (0; P<.05). Contamination was highest in patient occupied areas (67.5%). After cleaning, samples taken at previously contaminated surfaces are all negative. ConclusionsSARS-CoV-2 RNA contamination is prevalent in Fangcang hospitals and healthcare workers are under risk of infection. Potentially contaminated areas and surfaces after cleaning and disinfection are negative, underlying the importance of infection control policy.

A PROMETHEE based outranking approach for the construction of Fangcang shelter hospital using spherical fuzzy sets

This study mainly aims to develop two effective and practical multi-criteria group decision-making approaches by taking advantage of the ground-breaking theory of PROMETHEE family of outranking methods. The presented variants of Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) method are acknowledged to address the complex decision-making problems carrying the ambiguous information, expressible in terms of yes, no, abstinence and refusal, owing to the preeminent condition and wider structure of spherical fuzzy sets. Both of the proposed approaches seek help from the Shannon’s entropy formula to evaluate the object weights of the decision criteria. The proposed techniques operate by taking into account the deviation between each pair of potential alternatives in accordance to different types of preference functions to determine the preference indices. The proposed technique of spherical fuzzy PROMETHEE I method carefully compares the positive and negative outranking flows of the alternative to get partial rankings. In contrast, the spherical fuzzy PROMETHEE II method has the edge to eliminate the incomparable pair by employing the net outranking flow to derive the final ranking. The application of proposed approaches is explained via a case study in the field of medical concerning the selection of appropriate site to establish Fangcang shelter hospital in Wuhan to treat COVID-19 patients. The convincing comparisons of the proposed methodologies with q-rung orthopair fuzzy PROMETHEE and spherical fuzzy TOPSIS methods are also included to verify the aptitude of the proposed methodology.

Adjusting intervention strategies for mental health of COVID-19 patients: A network analysis based on a survey in Omicron-infected patients.

The COVID-19 pandemic had a major impact on people's mental health. As the SAS-Cov-2 evolves to become less virulent, the number of asymptomatic patients increases. It remains unclear if the mild symptoms are associated with mild perceived stress and mental illness, and the interventions to improve the mental health of the patients are rarely reported. This cross-sectional study investigated the level of depression, anxiety and perceived stress of 1,305 COVID-19 patients who received treatment in the Fangcang shelter hospitals in Shanghai, China. Network analysis was used to explore the relationship among depression, anxiety and perceived stress. The prevalence of depression, anxiety and perceived stress in the patients with Omicron infection were 9.03, 4.60, and 17.03%, respectively, lower than the prevalence reported during the initial outbreak of COVID-19. "Restlessness (A5)," "Uncontrollable worry (A2)," "Trouble relaxing (A4)" and "Fatigue (D4)" had the highest expected influence values. "Irritability (A6)" and "Uncontrollable (S1)" were bridge symptoms in the network. Comparative analysis of the network identified differences in the network structures between symptomatic and asymptomatic patients. This study investigated the prevalence of depression, anxiety and perceived stress and the correlation among them in Omicron-infected patients in Fangcang shelter hospital, in Shanghai, China. The core symptoms identified in the study provide insight into targeted clinical prevention and intervention of mental health in non-severe Omicron-infected patients.

The impact of vaccination on patients with COVID-19 during the wave of Omicron in Shanghai.

The global health has been affected by the COVID-19 pandemic persistently, of which Omicron is currently the predominant variant. However, the impact of vaccination on Omicron remained uncertain. This study sought to explore the effect of vaccination on patients infected with Omicron. A retrospective observational cohort was conducted in the largest Fangcang shelter hospital in Shanghai from April 1 to May 30, 2022. The demographics, length of hospital stay, clinical symptoms, the comorbidities and vaccination status were recorded. Clinical outcomes of the vaccinated and non-vaccinated groups were compared and analyzed. Of the 3,119 patients who fulfilled the eligibility criteria and were enrolled in the study, 2,226 (71.4%) patients had received nCoV-19 vaccine while 893 (28.6%) patients had not received it before admission. Patients in the vaccinated group had significantly shorter length of hospital stay than those in the unvaccinated group (15.48 ± 2.708 vs. 15.85 ± 3.102, p < 0.001). More asymptomatic patients were observed in the vaccinated group than the non-vaccinated (70.4 vs. 64.5%, p < 0.001). Further subgroup analysis demonstrated that the older the age, the more significant the difference was (p < 0.005). Vaccination was associated with a significant reduction in the severity of Omicron infection compared with no vaccination. Vaccination appears to make Omicron-infected people with milder symptoms than unvaccinated people. This suggests the potential effectiveness of current vaccines against Omicron.

Using machine learning models to predict the duration of the recovery of COVID-19 patients hospitalized in Fangcang shelter hospital during the Omicron BA. 2.2 pandemic.

Factors that may influence the recovery of patients with confirmed SARS-CoV-2 infection hospitalized in the Fangcang shelter were explored, and machine learning models were constructed to predict the duration of recovery during the Omicron BA. 2.2 pandemic. A retrospective study was conducted at Hongqiao National Exhibition and Convention Center Fangcang shelter (Shanghai, China) from April 9, 2022 to April 25, 2022. The demographics, clinical data, inoculation history, and recovery information of the 13,162 enrolled participants were collected. A multivariable logistic regression model was used to identify independent factors associated with 7-day recovery and 14-day recovery. Machine learning algorithms (DT, SVM, RF, DT/AdaBoost, AdaBoost, SMOTEENN/DT, SMOTEENN/SVM, SMOTEENN/RF, SMOTEENN+DT/AdaBoost, and SMOTEENN/AdaBoost) were used to build models for predicting 7-day and 14-day recovery. Of the 13,162 patients in the study, the median duration of recovery was 8 days (interquartile range IQR, 6-10 d), 41.31% recovered within 7 days, and 94.83% recovered within 14 days. Univariate analysis showed that the administrative region, age, cough medicine, comorbidities, diabetes, coronary artery disease (CAD), hypertension, number of comorbidities, CT value of the ORF gene, CT value of the N gene, ratio of ORF/IC, and ratio of N/IC were associated with a duration of recovery within 7 days. Age, gender, vaccination dose, cough medicine, comorbidities, diabetes, CAD, hypertension, number of comorbidities, CT value of the ORF gene, CT value of the N gene, ratio of ORF/IC, and ratio of N/IC were related to a duration of recovery within 14 days. In the multivariable analysis, the receipt of two doses of the vaccination vs. unvaccinated (OR = 1.118, 95% CI = 1.003-1.248; p = 0.045), receipt of three doses of the vaccination vs. unvaccinated (OR = 1.114, 95% CI = 1.004-1.236; p = 0.043), diabetes (OR = 0.383, 95% CI = 0.194-0.749; p = 0.005), CAD (OR = 0.107, 95% CI = 0.016-0.421; p = 0.005), hypertension (OR = 0.371, 95% CI = 0.202-0.674; p = 0.001), and ratio of N/IC (OR = 3.686, 95% CI = 2.939-4.629; p < 0.001) were significantly and independently associated with a duration of recovery within 7 days. Gender (OR = 0.736, 95% CI = 0.63-0.861; p < 0.001), age (30-70) (OR = 0.738, 95% CI = 0.594-0.911; p < 0.001), age (>70) (OR = 0.38, 95% CI = 0292-0.494; p < 0.001), receipt of three doses of the vaccination vs. unvaccinated (OR = 1.391, 95% CI = 1.12-1.719; p = 0.0033), cough medicine (OR = 1.509, 95% CI = 1.075-2.19; p = 0.023), and symptoms (OR = 1.619, 95% CI = 1.306-2.028; p < 0.001) were significantly and independently associated with a duration of recovery within 14 days. The SMOTEEN/RF algorithm performed best, with an accuracy of 90.32%, sensitivity of 92.22%, specificity of 88.31%, F1 score of 90.71%, and AUC of 89.75% for the 7-day recovery prediction; and an accuracy of 93.81%, sensitivity of 93.40%, specificity of 93.81%, F1 score of 93.42%, and AUC of 93.53% for the 14-day recovery prediction. Age and vaccination dose were factors robustly associated with accelerated recovery both on day 7 and day 14 from the onset of disease during the Omicron BA. 2.2 wave. The results suggest that the SMOTEEN/RF-based model could be used to predict the probability of 7-day and 14-day recovery from the Omicron variant of SARS-CoV-2 infection for COVID-19 prevention and control policy in other regions or countries. This may also help to generate external validation for the model.

Mental health status of infected children between 7 to 12 years old in Fangcang Shelter Hospital during the COVID-19 Shanghai lockdown in 2022: a cross-section study.

There has been an increase in research on the potential adverse effects on children's mental health, especially depression and anxiety, during the coronavirus disease 2019 (COVID-19) pandemic over the past few months. Therefore, the aim of the present study was to investigate depression and anxiety symptoms among children in shelter hospitals during the 2022 Shanghai lockdown. A total of 98 infected children aged 7-12 years were enrolled in this study between April 19 and June 4, 2022. The Children's Depression Inventory (CDI), Anxiety Scale for Children-Autism Spectrum Disorder (ASC-ASD), and Anxiety Scale or Children-Autism Spectrum Disorder Parent Form (ASC-ADS-P) were used to assess children's depression and anxiety symptoms. Children's guardians completed the survey by verbally asking their child/children the questions. The guardians additionally completed the ASC-ASD-P. The prevalence of depression and anxiety was 12.2% and 13.3%, respectively. A total of 66 respondents reported no physical symptoms. Linear regression showed that myalgia [7.198, 95% confidence interval (CI): 3.163-11.232], headache (7.189, 95% CI: 3.842-10.535) coryza (5.362, 95% CI: 2.654-8.070), and number of quarantine days (4.378, 95% CI: 3.409-5.348) were significantly correlated with higher levels of depression, whereas chills (14.337, 95% CI: 9.799-18.875), coryza (9.309, 95% CI: 6.467-12.152), headache (7.193, 95% CI: 3.182-11.204), myalgia (5.571, 95% CI: 0.684-10.459), number of quarantine days (3.190, 95% CI: 1.796-4.584), and gender (male) (-4.137, 95% CI: -6.609 to 1.665) were associated with anxiety scores. Persistent fever was correlated with depression (P=0.007), whereas physical discomfort, such as persistent fever, cough, sore throat, headache, myalgia, and coryza were correlated with anxiety (all P<0.05). The findings of the present study indicated a moderate prevalence of depression and anxiety among infected children in a shelter hospital during the 2022 Shanghai lockdown. Therefore, the findings of this study could provide scientific basis for the development of targeted psychological intervention. It could be helpful for policy-makers to focus on psychological health among infected children and help to optimize future interventions.

Analysis on Related Factors of Hospitalization Days of Patients with Novel Coronavirus Pneumonia in Fangcang Shelter Hospitals

Objective: To study the factors influencing the length of stay in patients with COVID-19. Methods: The clinical data of 110 patients with COVID-19 who were infected with Omicron virus for more than 10 days from April to May 2022 were collected. Their gender, age, smoking status, clinical manifestations related to pneumonia, whether they were combined with other basic diseases and vaccination status were analyzed. The above influencing factors were analyzed by single factor regression analysis, followed by Cox regression model analysis. Results: The age of patients had an effect on the length of hospital stay. The median length of hospital stay of patients that are &lt; 50 years old, 50-64 years old and ? 65 years old were 14, 14, and 17 days respectively (?2 = 9.346, P = 0.009). The presence of coronavirus-related symptoms also affects the length of hospital stay (?2 = 4.840, P = 0.028). The results of multivariate regression model showed that age (?2 = 8.669, P = 0.006) and coronavirus-related symptoms (?2 = 5.424, P = 0.020) were independent factors affecting the length of hospital stay. Conclusion: During the development of COVID-19, the age of patients and whether they have coronavirus-related symptoms are positively correlated with the length of stay. Gender, habit of smoking, presence of other basic diseases and vaccination are not related to the length of stay.

Study on Application Effect of 6S Management Mode in Infection Control Management of Fangcang Shelter Hospital of National Exhibition and Convention Center

Objective: In 2022, a pneumonia caused by novel coronavirus broke out in Shanghai. A large number of medical personnel were deployed nationwide to support the Fangcang Shelter Hospital of National Exhibition and Convention Center (Shanghai). Because the of the underdeveloped infrastructure and the disorganized layout process, the phenomenon of infection among medical personnel was rampant given the highly contagious nature of the Omicron variant. This paper discusses the effect of 6S management in infection control management of Fangcang Shelter Hospital of National Exhibition and Convention Center (Shanghai). Methods: A series of 6S management practices were carried out based on the evaluation of the control management of Fangcang Shelter Hospital of National Exhibition and Convention Center (Shanghai) during the anti-epidemic period, and the effect of the implementation of 6S management was studied based on the rapport among team members and the overall control system process, the management of wearing and stripping channels, the time of wearing protective articles and the psychological and emotional changes of the team members. Results: After the implementation of 6S management mode, the management of dressing room, epidemic prevention materials, and occupational protection awareness and infection control safety were significantly improved. More than 95.5% of the team members believed that improving the working environment in the shelter increased the confidence of victory in the fight against the epidemic, reduced the preparations before entering and leaving the cabin, improved the work efficiency and ensured occupational safety. It ensures the realization of the goal of “zero infection” and is set as a benchmark of control work of Fangcang Shelter Hospital of National Exhibition and Convention Center (Shanghai). Conclusion: The application of 6S management mode to the shelter infection control management can create and maintain a good working environment in the shelter, promote the implementation effect of various systems and processes of infection control, reduce the potential infection risk in the shelter and improve the efficiency of infection control management.

A Comparative Study on Technical Standards for the Design of Emergency Medical Facilities in China in the Context of COVID-19

The technical standards for the design and construction of emergency medical facilities play an important role in guiding the conversion of Fangcang shelter hospitals and the construction of emergency infectious disease hospitals and temporary facilities for medical quarantine and observation. However, due to the imperfections and superficialness of the current version of the existing technical standards, further improvement and optimization on the maturity and systematism are necessary. This paper presents an in-depth analysis and comparison on the detailed regulations and terms between the existing 11 sets of technical standards issued by the National Health Commission (NHC) and the provincial competent authorities of Hubei, Zhejiang, Jiangsu, Hebei, Shandong and Beijing. The similarities, disparities and deficiencies of these technical standards are summarized. Then, the primary contents, including the site selection and architectural design, heating, ventilation and air conditioning (HVAC), structural design, electricity intelligence, water supply and drainage, operation and maintenance, environmental health and safety, and fire protection, are analyzed in-depth from the view of infectious disease control and health safety. Furthermore, some critical principles related to the detailed terms of the architectural design, HVAC, electricity and water supply are concluded. Finally, some essential suggestions are proposed for the improvement and revision of these technical standards for better applications.

Long-term outcomes in COVID-19 patients who recovered from the first wave of the pandemic.

This cross-sectional study evaluated the long-term health effects of coronavirus disease 2019 (COVID-19) in Jianghan District (Wuhan, China). The results showed that 61.4% of COVID-19 patients reported at least one symptom and 8.8% had depressive symptoms at the 17-month follow-up. The proportion of patients with chest radiographic abnormalities in Fangcang shelter hospitals and designated COVID-19 hospitals was 31.6% and 41.1%, respectively, and the proportion of patients with impaired pulmonary diffusion capacity in these hospitals was 52.8% and 60.9%, respectively. Female sex (odds ratio [OR]=1.48, 95% confidence interval [CI]: 1.16-1.88), severe disease (OR=1.46, 95% CI: 1.01-2.10) and a higher number of initial symptoms (OR=1.31, 95% CI: 1.23-1.40) were associated with the development of sequelae symptoms at 17months. This study involving community-dwelling COVID-19 adults may help determine the long-term effects of COVID-19 during the first pandemic wave. Nonetheless, larger follow-up studies are needed to characterize the post-COVID-19 condition.

Experiences of COVID-19 patients in a Fangcang shelter hospital in China during the first wave of the COVID-19 pandemic: a qualitative descriptive study

ObjectivesThis study aimed to examine COVID-19 patients’ experiences in a Fangcang shelter hospital in China, to provide insights into the effectiveness of this centralised isolation strategy as a novel solution...

Early Response to COVID-19

Early Response to COVID-19

Fear of progression in patients with mild or common type COVID-19.

AimTo investigate the current condition and degree of fear of disease progression and associated factors in patients with mild or common type COVID‐19.BackgroundAt the end of 2019, COVID‐19 spread from Wuhan in Hubei Province throughout China. Confirmed cases and deaths have since been reported in many countries around the world. However, fear of progression in these patients has been poorly explored.MethodsDuring February 2020, we recruited 114 patients with mild or common type COVID‐19 admitted to a Fangcang shelter hospital. We assessed patients' degree of fear using the simplified Fear of Progression Questionnaire (Chinese version). Multiple regression analysis was applied to explore potential factors.ResultsThe fear of disease progression scores of patients with mild or common COVID‐19 was at the low‐to‐moderate level. Current unemployment, disease duration of 28 days or more and not having a spouse diagnosed with COVID‐19 were factors potentially associated with fear of progression.ConclusionWith a high prevalence of fear of disease progression in patients with COVID‐19, the risk of psychological effects from the pandemic is significant and fear of progression is one of the manifestations. The need for psychological support services for patients should be included in all pandemic and disaster planning.

Study on the Localization of Fangcang Shelter Hospitals During Pandemic Outbreaks.

In the event of pandemic, it is essential for government authority to implement responses to control the pandemic and protect people's health with rapidity and efficicency. In this study, we first develop an evaluation framework consisting of the entropy weight method (EWM) and the technique for order preference by similarity to ideal solution (TOPSIS) to identify the preliminary selection of Fangcang shelter hospitals; next, we consider the timeliness of isolation and treatment of patients with different degrees of severity of the infectious disease, with the referral to and triage in Fangcang shelter hospitals characterized and two optimization models developed. The computational results of Model 1 and Model 2 are compared and analyzed. A case study in Xuzhou, Jiangsu Province, China, is used to demonstrate the real-life applicability of the proposed models. The two-stage localization method gives decision-makers more options in case of emergencies and can effectively designate the location. This article may give recommendations of and new insights into parameter settings in isolation hospital for governments and public health managers.

Modeling the effect of Fangcang shelter hospitals on the control of COVID-19 epidemic.

The ongoing COVID‐19 pandemic has posed a tremendous threat to the public and health authorities. Wuhan, as one of the cities experiencing the earliest COVID‐19 outbreak, has successfully tackled the epidemic finally. The main reason is the implementing of Fangcang shelter hospitals, which rapidly and massively scale the health system's capacity to treat COVID‐19 confirmed cases with mild symptoms. To give insights on what degree Fangcang shelter hospitals have contained COVID‐19 in Wuhan, we proposed a piecewise smooth model regarding the patient triage scheme and the bed capacities of Fangcang shelter hospitals and designated hospitals. We used data on the cumulative number of confirmed cases, recovered cases, deaths, and data on the number of hospitalized individuals in Fangcang shelter hospitals and designated hospitals in Wuhan to parameterize the targeted model. Our results showed that diminishing the bed capacity or delaying the opening time of Fangcang shelter hospitals, both would result in worsening the epidemic by increasing the total number of infectives and hospitalized individuals and the effective reproduction number Re(t). The findings demonstrated that Fangcang shelter hospitals avoided 17,013 critical infections and 17,823 total infections while it saved 7 days during the process of controlling the effective reproduction number Re(t)<1. Our study highlighted the critical role of Fangcang shelter hospitals in curbing and eventually stopping COVID‐19 outbreak in Wuhan, China. These findings may provide a valuable reference for decision‐makers in regarding ramping up the health system capacity to isolate groups of people with mild symptoms in areas of widespread infection.

A Study on the Effect of the Pre-Go-Live Training in Anxiety and Depression of Medical Staff Based on the Data of Wuhan Fangcang Shelter Hospital During COVID-19 in the Era of Big Data.

Coronavirus disease 2019 (COVID-19) broke out in 2019. In the past 4 years, China has adopted many measures to control the epidemic, including building Fangcang shelter hospitals to isolate confirmed positive cases. Therefore, we aim to explore the mental health status of medical staff in the Wuhan Fangcang shelter hospital and discuss the relevant factors that affect the medical staff's mental status. The subjects of the research were staff from several Fangcang shelter hospitals in Wuhan during the epidemic of COVID-19. Patient Health Questionnaire−9 items Scale (PHQ-9) was used to assess the severity of the participants' depressive symptoms, and Generalized Anxiety Disorder−7 items Scale (GAD-7) was used to evaluate the severity of the participants' anxiety symptoms. The demographic information and health adjustment methods were collected in a self-made questionnaire, and regression analysis on related factors that affect mental health was performed. The three most frequently used methods of psychological adjustment for the staff in the Fangcang shelter hospital are common recreational activities, such as reading, streaming videos, listening to music, and playing games. (93.8%), communicating with colleagues in the Fangcang shelter hospital (92.5%), and communicating with family members and friends (78.3%). Binary logistic regression analysis showed that developing depression symptoms has relation to 2 factors, which are having not participated in medical emergency rescue missions (odds ratio = 2.610; 95% confidence interval 1.398–4.872, P = 0.003) and inadequate training before entering the shelter hospital (odds ratio = 2.804, 95% confidence interval 1.293–6.08, P = 0.009). Compared with adequate pre-job training, insufficient training increases the risk of anxiety symptoms (odds ratio = 2.692; 95% confidence interval 1.3–5.575, P = 0.008). Lack of experience and inadequate training in medical emergency rescue missions exposed the medical staff to a higher risk of developing symptoms of depression and anxiety. Psychological adjustment methods that are helpful to adjust their mental state are most commonly used.

The prevalence and influencing factors for compassion fatigue among nurses in Fangcang shelter hospitals: A cross-sectional study.

We aim to investigate the prevalence and associated factors for compassion fatigue among nurses in Fangcang Shelter Hospitals in Wuhan. Studies have shown that compassion fatigue was more common among nurses than other health-care providers, and its predictors were also different. In recent years, most studies have investigated compassion fatigue in emergency and oncology nurses, whereas there is little information on compassion fatigue among nurses from the frontline of Fangcang Shelter Hospitals during the COVID-19 pandemic. A descriptive, cross-sectional design was used in this study. An online survey was conducted among nurses (n = 972) of five Fangcang Shelter Hospitals in Wuhan, Hubei province, China, from 6 March to 10 March 2020. A self-administered questionnaire including demographic information, work-related information, General Health Questionnaire, Perceived Stress Scale and Compassion Fatigue Scale was used. The prevalence of compassion fatigue among nurses in Fangcang Shelter Hospitals was moderate, and most cases were mild. There was a significant relationship between compassion fatigue and work-related factors, mental health and perceived stress among nurses working in Fangcang Shelter Hospitals. Various factors contribute to compassion fatigue, including lower job satisfaction and job adaptability, less praise from patients, more fear of infection and more perceived stress. A good working atmosphere, organizational support and psychological consultation are essential to alleviate nurses' compassion fatigue during the anti-epidemic period.

Dynamic Allocation of Medical Resources During the Outbreak of Epidemics

During the outbreak of epidemics such as coronavirus disease (COVID-19), the local hospitals often withstand a sharp increase of patient influx, which renders the healthcare system on the verge of collapse. To alleviate the situation, the effective allocation of scarce medical resources during the pandemic plays a vital role. The essence of the healthcare system in time of emergency is to stay functional, and to be able to diagnose and hospitalize as many patients as possible. Fangcang shelter hospital, as a novel way to temporarily increase the capacity of the local healthcare system, is proven to be effective against the COVID-19 pandemic. To improve the performance of the healthcare system with Fangcang, many practical factors need to be taken into account, such as the patient deterioration during waiting to be admitted, the referral mechanism according to the severity of the patients, and the selective admission regulations. To address the high volatility and time-varying feature of the COVID-19, a multistage and multi-type medical service network model is established, and a dynamic allocation strategy of the medical resources at each stage is proposed based on a stochastic optimization problem, which is then solved via the fluid queueing approximation. Combined with the real data collected from Wuhan, it is revealed that the proposed algorithm could help with the allocation of medical resources during the outbreak of epidemics. Even with limited medical resources available, the method could still maintain a guaranteed service level while keeping the healthcare system operational. Furthermore, the simulation analysis validates that our method can effectively allocate medical resources at each stage, so as to stabilize the system performance and fulfill the medical demand for multiple types of patients. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —To fend off the outbreak of epidemics, the lessons have to be learned from the past. The successful control of the spread of COVID-19 in Wuhan (China) is a classical example of applying modern medical practices and management tools. In the present article, the treating procedure of COVID-19 in Wuhan is modeled as a multistage decision problem, which includes the screening with nucleic acid testing, the further testing, the treatment of patients with mild/severe symptoms, or even critical patients. The introduction of Fangcang shelter hospital is crucial for winning the battle against COVID-19. The current study attempts to determine the timing of introducing the Fangcang shelter hospital during the outbreak of a major epidemic, and helps allocate the medical resources needed to contain the spread of the virus. It is discovered that the actual number of beds in the Fangcang shelter hospital is far more than what is necessary, and it would be better to have built the Fangcang some time in advance. In the meantime, the number of designated hospitals for COVID-19 is in line with the results obtained via the optimal staffing strategy proposed here, but it is also noticeable that these hospitals should be released of duty sooner to fight against not only COVID-19 but also other diseases in reality.

The Impact of Quarantine and Medical Resources on the Control of COVID-19 in Wuhan based on a Household Model

In order to understand how Wuhan curbed the COVID-19 outbreak in 2020, we build a network transmission model of 123 dimensions incorporating the impact of quarantine and medical resources as well as household transmission. Using our new model, the final infection size of Wuhan is predicted to be 50,662 (95%CI: 46,234, 55,493), and the epidemic would last until April 25 (95%CI: April 23, April 29), which are consistent with the actual situation. It is shown that quarantining close contacts greatly reduces the final size and shorten the epidemic duration. The opening of Fangcang shelter hospitals reduces the final size by about 17,000. Had the number of hospital beds been sufficient when the lockdown started, the number of deaths would have been reduced by at least 54.26%. We also investigate the distribution of infectious individuals in unquarantined households of different sizes. The high-risk households are those with size from two to four before the peak time, while the households with only one member have the highest risk after the peak time. Our findings provide a reference for the prevention, mitigation and control of COVID-19 in other cities of the world.