Protect Healthcare Workers Research Articles

Knowing the Antibody Status may influence compliance of health care workers to COVID-19 booster dose

Abstract Background Previous studies showed that the fourth SARS-CoV-2 vaccine dose has a protective effect against infection, as well as against severe disease and death. This study aimed to examine whether knowledge of a high level antibody after the 3rd dose may reduce compliance to the 4th booster dose among health care workers. Methods We conducted a prospective cohort study among health care workers vaccinated with the first three doses at Rambam Healthcare Campus, a tertiary hospital in northern Israel. Participants underwent a serological test before the 4th booster vaccine was offered to all of them, with results provided to participants. The population was divided into two groups: those with antibody below 955 AU/ml, and those with 955 AU/ml and higher, a cutoff found protective in a previous study. Multiple logistic regression was carried out to compare the compliance to the 4th booster between the two groups, adjusted for demographic and clinical variables. Results After adjusting for the confounding variables, the compliance was higher in those with antibody levels below 955 AU/ml (OR = 1.41, P = 0.05, 95% CI 1.10-1.96). In addition, male sex, and age of 60 years and above were also associated with higher vaccination rate (OR = 2.28, P < 0.001, 95% CI 1.64 - 3.17), (OR = 1.14, P = 0.043, 95% CI 1.06 - 1.75), respectively. Conclusions Knowledge of the antibody status may affect compliance with the booster dose. Considering waning immunity over time, reduced compliance may affect the protection of health care workers who declined the 4th dose. Key messages • Knowing the antibody status may affect compliance of health care workers with the booster dose. • Reduced compliance of health care workers may affect their protection.

The Decontamination of N95 Masks as an Occupational Safety Strategy

Objective: This study aimed to monitor the use of a short-wave ultraviolet (UV-C) decontamination device for N95 masks at the João de Barros Barreto University Hospital, Belém, Pará, Brazil. The research investigated the reuse of masks, storage methods, and the perception of healthcare professionals regarding the decontamination protocol using UV-C after each work shift. Theoretical Framework: The research is based on theories related to biosafety and occupational health, focusing on the importance of decontamination processes in hospital settings to enhance the protection of healthcare workers and reduce infection risks. Method: A cross-sectional study was conducted with 295 nursing professionals, including nurses, technicians, and assistants. Data were collected through a questionnaire addressing the reuse of N95 masks, storage between uses, and opinions on the use of the UV-C device for decontamination. Results and Discussion: All participants (n=295) agreed that UV-C decontamination improves biosafety by reducing the handling of potentially contaminated masks. The acceptance of the device was unanimous, confirming its feasibility both in high-demand scenarios, such as the Covid-19 pandemic, and in routine hospital practices. Research Implications: This study demonstrates that implementing UV-C decontamination systems is a practical and effective solution for hospitals, with the potential to increase occupational safety and reduce infectious waste generation. Originality/Value: The study contributes to the literature by highlighting the feasibility and benefits of reusing N95 masks with UV-C decontamination, promoting greater safety in hospital environments.

Comparison of Three Tracheal Intubation Procedures Using Personal Protective Equipment, Direct and Video Laryngoscopes: An Open, Randomized, Parallel Clinical Trial

Background: During the COVID-19 pandemic, severe respiratory failure is a life-threatening condition, and life-saving tracheal intubation is a high-risk aerosol- and droplet-generating procedure. It is crucial to protect healthcare workers without compromising patient safety during intubation. The use of personal protective equipment (PPE) and different types of laryngoscopes are measures to reduce the risk of infectious transmission that might impact the intubation process. Objectives: This study aimed to evaluate the effects of different levels of PPE and types of laryngoscopes on the duration of the intubation process and its success rate. Methods: We conducted an open, randomized, parallel clinical trial on non-COVID-19 adult patients scheduled for elective and emergency surgeries under general anesthesia from November 2021 to May 2022. Patients were divided into three groups: Group 1 was intubated using a video-guided laryngoscope with operators wearing level three PPE; group 2 was intubated using a direct laryngoscope with operators wearing level three PPE; and group 3 was intubated using a direct laryngoscope with operators wearing level two PPE. Intubation was performed by 2nd- and 3rd-year anesthesia residents. Results: The duration of intubation varied significantly among the groups, with Group 1 taking the longest time (P = 0.046). Group 3 had a higher success rate for first-attempt intubation (P = 0.056). Conclusions: The use of PPE and video-guided laryngoscopy had varying effects on the intubation procedure, with the most notable impact being on the overall length of intubation. Further research with a larger sample size is needed to validate these findings.

Mental Health Disorders of Bulgarian Healthcare Professionals during a Recurring Wave of the COVID-19 Pandemic

Introduction: During the COVID-19 pandemic, health hazards for medical professionals are associated not only with the high risk of infection, but also with poor working conditions, a stressful psychosocial environment and several socio-demographic factors. Objectives: The study aims to gain insight into possible mental health disorders among healthcare professionals working in the Bulgarian healthcare system and to determine which professional and socio-demographic categories are most significantly affected. Methods: This cross-sectional study was conducted in October 2022 in healthcare facilities from seven regions in Southern Bulgaria. A total of 665 workers from hospitals, emergency centers, general and specialized medical practices, and medical laboratories filled out the self-assessment mental health questionnaire DASS-21 (Depression, Anxiety and Stress Scale), as well as a survey about their occupational and socio-demographic characteristics. Suitable statistical methods were used to assess the scientific hypothesis. Results: 40% of all surveyed healthcare workers had some type of self-reported mental health disorder, with 27% having more than one. 13% had simultaneous signs of depression, anxiety and stress. The rates of depression, anxiety and stress were highest among those working in COVID wards and emergency care centers, among young workers under 26 years of age, and among workers with disabilities and frequently ill workers. Conclusions: Protecting healthcare workers’ physical and mental health and work ability is a matter of primary importance, particularly under challenging working conditions such as the COVID-19 epidemic.

Effectively protecting health care workers as clade 1 mpox epidemic complexifies: a call for vaccine and antivirals deployment.

Effectively protecting health care workers as clade 1 mpox epidemic complexifies: a call for vaccine and antivirals deployment.

Reliability and Safety Testing of a Ventilator Remote Control System Against Communication Failures and Network Disruptions.

The need for remote ventilator control has been highlighted by the COVID-19 Public Health Emergency. Remote ventilator control from outside a patient's room can improve response time to patient needs, protect health care workers, and reduce personal protective equipment (PPE) consumption. Extending remote control to distant locations can expand the capabilities of frontline health care workers by delivering specialized clinical expertise to the point of care, which is much needed in diverse health care settings, such as tele-critical care and military medicine. However, the safety and effectiveness of remote ventilator control can be affected by many risk factors, including communication failures and network disruptions. Consensus safety requirements and test methods are needed to assess the resilience and safety of remote ventilator control under communication failures and network disruptions. We designed two test methods to assess the robustness, usability, and safety of a remote ventilator control prototype system jointly developed by Nihon Kohden OrangeMed, Inc. and DocBox, Inc. ("the NK-DocBox system") to control the operation of an NKV-550 critical care ventilator under communication failures and network disruptions. First, the robustness of the NKV-550 ventilator was tested using a remote-control application developed on OpenICE - an open-source medical device interoperability platform - to transmit customized high-frequency and erroneous remote-control commands that could be caused by communication failures in a real-world environment. The second method utilized a network emulator to create different types and severity of network quality of service (QoS) degradation, including bandwidth throttling, network delay and jitter, packet drop and reordering, and bit errors, in the NKV-DocBox system to quantitatively assess the impact on system usability and safety. The NKV-550 ventilator operated as expected when remote-control commands arrived as fast as once per second. It ignored erroneous commands attempting to adjust invalid ventilation parameters. When facing commands that set the ventilation mode and parameters to invalid values, it reset the ventilation mode or parameters to default values, the safety implication of which may merit further evaluation. When any network QoS attribute (except for packet reordering) started to degrade, the NK-DocBox System experienced interference to its remote-control function, such as delays in the transmission of ventilator data and remote-control commands within the system. When the network QoS was worse than 500 ms network delay, 100 ms network jitter, 1% data drop rate, 12Mbps minimal bandwidth, or 1e-6 bit error rate, the system became unsafe to use. For example, ventilator waveforms visualized on the remote-control application demonstrated freezes, out-of-synchronization, and moving backwards; and the connection between the ventilator and the remote-control application became unstable. The presented test methods confirmed the robustness of the NKV-550 ventilator against high-frequency and erroneous remote control, quantified the impact of network disruptions on the usability, reliability, and safety of the NK-DocBox system and identified the minimum network QoS requirements for it to function safely. These generalizable test methods can be customized to evaluate other remote ventilator control technologies and remote control of other types of medical devices against communication failures and network disruptions.

The relationship between union membership and self-rated health among racially diverse U.S. healthcare workers: The role of control over work schedules and locations

BackgroundLabor unions are associated with better wages, improved working conditions, and greater worker empowerment, which may result in better health. However, less is known about the relationship between unionization and health among U.S. healthcare workers, whether the relationship differs among racially diverse workers, and how much control over workplace schedules and location mediates the relationship. MethodsWe analyzed a cross-sectional survey of a nationally representative sample of 3000 U.S. healthcare workers collected from March 14 through April 5, 2023. Using ordinal logistic regression, we evaluated whether unionized healthcare workers had better self-rated health (SRH) than their nonunionized counterparts and examined potential differences between White and racially minoritized respondents. We quantified the mediation percentage explained by control over one's schedule and workplace location in the total and stratified samples using Karlson, Holm, and Breen decomposition analysis. ResultsOver a third (36.1%) of racially minoritized respondents were unionized, compared to 22.3% of White respondents. Among racially minoritized workers, a greater share of unionized workers reported excellent health (40.6% vs. 21.8%) than their nonunionized counterparts. In confounder-adjusted ordinal logistic regression analyses, labor union membership was associated with better SRH overall, with a stronger association for racially minoritized workers. Among White healthcare workers, control over workplace arrangements explained 68.1% of the union membership and SRH relationship. For racially minoritized workers, control over workplace arrangements partially mediated the relationship, explaining 17.4% of the variation, suggesting that labor unions may impact health through additional pathways for these workers. ConclusionsThis study provides empirical evidence of the relationship between labor union membership and health among U.S. healthcare workers. We demonstrate that control over schedules and location is an important mechanism by which unionization may protect healthcare workers’ health. Among racially diverse healthcare workers, labor unions may play an important role in health through various pathways beyond workplace control.

Energy-efficient ventilation strategies at hospital front desks for minimizing infectious particle dispersion: Considering patient postures and airflow optimization

This research presents a novel examination of infectious particle dispersion at hospital front desks, analysing the impact of different patient postures on particle dynamics. It evaluates the efficacy of various ventilation strategies in mitigating particle spread within this high-risk area. Specifically, this study innovatively assesses particle dispersion associated with three common patient postures: upright standing, sitting in a wheelchair, and lying on a mobile bed. Results showed the baseline ventilation that considers the upright standing patient has the highest particles (34) adhered on the nurse. Particle adherence decreases with the sitting (29 particles) and lying postures (20 particles), underscoring the significant influence of human posture on particle distribution. The key contribution of this study is the identification of an optimized ventilation strategy which installs low-level wall-mounted air supply diffusers and ceiling-mounted exhaust grilles, as demonstrated in Case 3. This strategy effectively reduces particle deposition on the nurses and visitors by 52.9 % and 40 %, respectively. These findings advocate for practical infection control measures, like barriers between nurses and patients, to better protect healthcare workers. The study also suggests that future research should account for more crowded environments and occupant movement to better reflect real-world conditions at hospital front desks.

The impact of the COVID-19 pandemic on conflict and health system–related violent events in Libya: An interrupted time series analysis

As a response to the COVID-19 pandemic, the United Nations Security Council passed resolution S/RES2532 (2020), requesting the cessation of hostilities. Despite ceasefire initiatives, evidence suggests that both conflict and violent events remained unabated—and, in some cases, escalated during the first months of the pandemic. This study uses interrupted time series analyses to examine the impact of the pandemic on violent and non-violent political events—including health system-related violence—in Libya, which has been experiencing a protracted conflict since 2014. We find a reduction of approximately 21 battles (p < 0.001) only during the first month of the pandemic. However, overall, throughout the pandemic, there was an increase of roughly one battle per month (p < 0.001). The violence that affected healthcare workers decreased during the first year of the pandemic (p < 0.001); but by the second year the reduction in healthcare worker–related violence had dissipated. While the pandemic seems to have mitigated the level of violence experience by healthcare workers, the overall pattern of violence is a troubling one, particularly since they were observed while there is an international agreement for a ceasefire in place and a specific peace agreement occurring in Libya. The pattern suggests that policy to protect healthcare workers may need to be enhanced even more during crisis settings.

Knowledge of the Serological Response to the Third BNT162b2 Vaccination May Influence Compliance of Healthcare Workers to Booster Dose.

Previous studies showed that the fourth SARS-CoV-2 vaccine dose has a protective effect against infection, as well as against severe disease and death. This study aimed to examine whether knowledge of a high-level antibody after the third dose may reduce compliance to the fourth booster dose among healthcare workers (HCWs). We conducted a prospective cohort study among HCWs vaccinated with the first three doses at Rambam Healthcare Campus, a tertiary hospital in northern Israel. Participants underwent a serological test before the fourth booster vaccine was offered to all of them, with results provided to participants. The population was divided into two groups, namely those with antibodies below 955 AU/mL and those with 955 AU/mL and higher, a cutoff found protective in a previous study. Multiple logistic regression was carried out to compare the compliance to the fourth booster between the two groups, adjusted for demographic and clinical variables. After adjusting for the confounding variables, the compliance was higher in those with antibody levels below 955 AU/mL (OR = 1.41, p = 0.05, 95% CI 1.10-1.96). In addition, male sex and age of 60 years and above were also associated with higher vaccination rates (OR = 2.28, p < 0.001, 95% CI 1.64-3.17), (OR = 1.14, p = 0.043, 95% CI 1.06-1.75), respectively. Knowledge of the antibody status may affect compliance with the booster dose. Considering waning immunity over time, reduced compliance may affect the protection of HCWs who declined the fourth dose.

The San Francisco Health Systems Collaborative: Public Health and Health Care Delivery Systems’ Response to the Covid-19 Pandemic

The Covid-19 pandemic challenged health care delivery systems worldwide. Many acute care hospitals in communities that experienced surges in cases and hospitalizations had to make decisions such as rationing scarce resources. Hospitals serving low-income communities, communities of color, and those in other historically marginalized or vulnerable groups reported the greatest operational impacts of surges. However, cross-institutional collaborations within jurisdictions offer unique opportunities to prevent or mitigate health disparities in resource utilization and access to care. In January 2020, in response to the emerging coronavirus epidemic, the San Francisco Department of Public Health (SFDPH) and local hospital and health systems partners convened to align and coordinate medical surge planning and response. Adopting a governance structure of mutual accountability and transparency, the San Francisco Health Systems Collaborative guided local medical and public health response in the areas of medical surge, vaccination administration, testing, and therapeutics. Four principles guided the collaborative response: (1) shared priorities, (2) clear governance and accountability, (3) data transparency, and (4) operational coordination. High-level priorities established included protecting vulnerable people, protecting health care workers, and maintaining health system capacity. The governance structure consisted of three layers: local hospital and health systems’ CEOs coordinating with SFDPH executives; hospital chief medical and nursing officers coordinating high-level surge capacity assessments and mitigation plans; and local clinical operational managers working with public health response operational leaders to coordinate scarce resource utilization. Fluctuating with the tempo of the disease indicators and medical surge, governance and coordination were maintained through a tiered meeting and reporting system. Data visibility and transparency were key principles facilitating operational decision-making and executive-level coordination of resources, including identifying additional surge bed capacity for use systemwide, as well as ensuring efficient and equitable vaccine distribution through implementation of five mass-vaccination sites with prioritized access for vulnerable communities. Applying these four principles of shared priorities, accountability, transparency, and operational coordination and pragmatism helped the public health and individual hospital systems make contributions to the overall response that were aligned with their unique strengths and resources. Publication here represents the first official public use of the name San Francisco Health Systems Collaborative (which had served as the term used internally to refer to the group) and the first time codifying this structure. Through this coordination, San Francisco achieved one of the lowest Covid-19 death rates and had one of the highest vaccination and booster rates, compared with rates across California or the United States. Similar principles and implementation methods can be adopted by other health jurisdictions for future emergency outbreak response.

The Effect of Coronavirus (COVID-19) on Job Satisfaction, Work Stress and Burnout of Healthcare Workers: A Systematic Review and Meta-Analysis.

We aimed to examine the job satisfaction (JS), work stress (WS) and burnout (B) levels of healthcare workers (HCWs), who are at the forefront of the fight against the coronavirus (COVID-19) epidemic process, which negatively affects the whole world, by meta-analysis. Articles, theses and papers in the literature before the COVID-19 (2014-2019) and during COVID-19 (2020-2022) were systematically reviewed. The sample size of 54 studies conducted from 13 countries was 49.139. Data analysis was performed with the Comprehensive Meta-analysis (CMA) 3.0 Version program. According to the random effect model analysis result, a negative, significant and low-level relationship was found between WS and JS, before and during COVID-19. There was a negative, significant and medium level relationship between JS and B. It was found positive, significant and high-level relationship between WS and B. Human development level (HDL) has a moderating effect on WS and B. In addition, sample size has moderating effect on WS and JS. During the prolonged COVID-19 pandemic, HCWs have experienced more burnout due to strict isolation, working conditions requiring overtime, fatigue, insomnia and concerns about virus transmission. Intense work tempo, inadequate health equipment, patient deaths, and low wages are the factors that decrease JS and increase WS and B. It is recommended to improve working conditions globally and provide financial support and mental health protection for HCWs.

Epidemiological characteristics of first-time SARS-CoV-2 Omicron infection among hospital staff in Chengdu, China

BackgroundAfter China ended its ‘dynamic zero-COVID policy’ on 7 December 2022, a large-scale outbreak of SARS-CoV-2 Omicron infections emerged across the country. We conducted a hospital-wide prospective study to document the epidemiological characteristics of the outbreak among healthcare workers in a hospital of Chengdu, where no previous staff SARS-CoV-2 infections were detected.MethodsAll hospital staff members were invited to complete an online questionnaire on COVID-19 in January 2023, and SARS-CoV-2 infection cases were followed up by telephone in June 2023 to collect data on long COVID. Univariable and multivariable logistic regression analyses were performed to evaluate factors associated with SARS-CoV-2 infection.ResultsA total of 2,899 hospital staff (93.5%) completed the online questionnaire, and 86.4% were infected with SARS-CoV-2 Omicron. The clinical manifestations of these patients were characterized by a high incidence of systemic symptoms. Cough (83.4%), fatigue (79.8%) and fever (74.3%) were the most frequently reported symptoms. Multivariable logistic analysis revealed that females [adjusted odds ratio (aOR): 1.42, 95% confidence interval (CI): 1.07–1.88] and clinical practitioners (aOR: 10.32, 95% CI: 6.57–16.20) were associated with an increased risk of SARS-CoV-2 infection, whereas advanced age ≥ 60 years (aOR: 0.30, 95% CI: 0.19–0.49) and a three-dose COVID-19 vaccination with the most recent dose administered within 3 months before 7 December 2022 (aOR: 0.44, 95% CI: 0.23–0.87 for within 1 month; aOR: 0.46, 95% CI: 0.22–0.97 for within 1–3 months) were associated with reduced risk. Among the cases, 4.27% experienced long COVID of fatigue, brain fog or both, with the majority reporting minor symptoms.ConclusionOur findings provide a snapshot of the epidemiological situation of SARS-CoV-2 infection among healthcare workers in Chengdu after China’s deregulation of COVID-19 control. Data in the study can aid in the development and implementation of effective measures to protect healthcare workers and maintain the integrity of healthcare systems during challenging times such as a rapid and widespread Omicron outbreak.

Analysis and visualization of the research progress on surgical smoke

BackgroundWith the advancement of medical technology, tools such as electrosurgical equipment, laser knives, and ultrasonic scalpels have made modern medical procedures more convenient and effective. However, the generation of surgical smoke during these procedures poses significant health risks to medical personnel. Despite this, only a few studies have examined the literature systematically in this area. By analyzing bibliometric data on surgical smoke, we can gain insights into current research hotspots and forecast future trends. MethodsThis study included literature related to surgical smoke from the Web of Science and China National Knowledge Infrastructure (CNKI) databases, covering the period from 2000 to 2024. We used VOSviewer, CiteSpace, and BioBERT to visualize research trends and hotspots. ResultsIn the early stages of research, the focus was mainly on the composition, generation mechanisms, and susceptible populations related to surgical smoke. In recent years, with the development of laparoscopic surgery and the global COVID-19 pandemic, research interests have shifted towards occupational protection of healthcare workers and public health. Currently, the research in this field primarily explores the promoting effects of surgical smoke on conditions such as inflammation and tumors, as well as occupational protection and health education for healthcare workers. Disease research focuses heavily on Smoke Inhalation Injury, Infections, Neoplasms, Postoperative Complications, and Inflammation. ConclusionWe explored future research directions in the field of surgical smoke using VOSviewer, CiteSpace, and BioBERT. Our findings indicate that current research focuses on investigating the promoting effects of surgical smoke on conditions such as inflammation and tumors, as well as on occupational protection and health education for healthcare workers. We summarized existing preventive measures, aiming to facilitate further research advancements and the translation of research outcomes into clinical results. These efforts provide new insights for advancing research in occupational protection of healthcare workers.

On the issues of additional public support of workers involved in medical care support during period of COVID-19

The article considers issues of organizational and legal progress of social protection of workers involved in medical care during period of COVID-19. The purpose of the study is to analyze regulatory legal documents that define state guarantees that provide social protection for persons involved in the provision of medical care during COVID-19. The attempt was made to analyze international and national information on relevant morbidity, mortality and disability of health care workers, but respective data was not readily available in open admission. The analysis of international documents (the WHO, CDC, JHU reports), public documents of the Russian Federation, information from official websites of the President of the Russian Federation and the executive authorities of the Russian Federation (state reports on sanitary and epidemiological well-being of the population in the Russian Federation in 2020-2022) demonstrated the following. The whole world faced with the problem of protecting health care workers from contamination with new corona-virus infection. In the Russian Federation, unprecedented measures were taken to ensure social protection for this category of workers, including provision of additional social benefits.

Reduced protein levels in latex gloves may play an alternative approach to lowering latex sensitization risks among health workers; a cross-sectional analytical study

BackgroundLatex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand.MethodsA cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI.ResultsDemographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44).ConclusionsThis study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices.

The psychological impact of the COVID-19 epidemic among healthcare workers at the grassroots level in Vietnam

The COVID-19 pandemic has significantly affected the mental health of healthcare workers (HCWs). Therefore, an immediate priority is to monitor rates of mental health issues to understand related factors and inform interventions. The main purpose of this study was to evaluate the psychological and mental health impact of COVID-19 and some related factors among HCWs at the grassroots level in Vietnam. A cross-sectional study was conducted on 675 HCWs working at health facilities through questionnaires. The finding showed the rate of HCWs who were psychologically affected by the COVID-19 pandemic was 37.2%, of which 64.1% of HCWs were afraid to tell their families about the risk of exposure to COVID-19 at work. The 31.0% of HCWs had difficulty sleeping deeply/insomnia due to the COVID-19 epidemic. No statistically significant differences were found in the psychological impact of COVID-19 between HCW groups by age, gender, seniority, and professional qualifications. Some groups of HCWs were found to have poor psychological health. Our research suggests that during the COVID-19 pandemic, HCWs working in healthcare facilities experienced an increased psychological burden; psychological interventions for those at high risk and with common mental disorders should be included to reduce this burden and protect HCWs' mental health.

Ventilation improvement for effective protection of healthcare workers in negative pressure airborne infectious isolation room from viral aerosols

A negative pressure airborne infectious isolation room (AIIR) is the primary healthcare air contamination control system used for the treatment of severe respiratory infectious patients. Effects of the ventilation system configuration and conditions on airflow pattern, aerosol distribution and ventilation performance were investigated using computational fluid dynamics (CFD). The field measurement by SARS-CoV-2 environmental surface test was also conducted. The cycle threshold values from transcription polymerase chain reaction (RT-PCR) method showed inverse relation to the simulated number of particles trapped on the surfaces indicating a good agreement. Modification of the present AIIR to have alignment between air inlet and outlet where the aspect ratio of the air outlet, Width (W): Height (H) = 1:1 (Improved case: IC#1) showed a 78 % reduction of aerosol concentration in healthcare workers (HCWs) zones. Aerosol concentrations were increased when the openings of the air outlet were enlarged. Addition of air outlet led to large swirling air, resulting in more aerosols being trapped and suspended in the air. Results suggested that AIIR with alignment air inlet on the ceiling and air outlet at the wall over the patient's head with W:H = 1:1 be the most suitable configuration to maximize the ventilation performance and minimize exposure risk to aerosolized viral infection for HCWs. Air change rate plays a more important role than the differential pressure on the removal efficiency. The differential pressure value should be at least −2.5 Pa and the air supply rate 12 ACH for effective protection of HCWs in the negative pressure AIIR.

Status of infection prevention and control programs in 25 facilities of Rwanda: Results from the WHO infection prevention and control assessment framework

AbstractBackgroundInfection prevention and control (IPC) is important in ensuring patient safety, protecting healthcare workers, and reducing healthcare‐associated costs. The World Health Organization (WHO)‐validated Infection Prevention and Control Assessment Framework (IPCAF) was used to evaluate IPC practices in Rwandan healthcare facilities.MethodologyIn this cross‐sectional study, we assessed 25 health facilities across Rwanda, including district and referral hospitals. Using the IPCAF tool, we assessed eight core components (CCs) of IPC programs. We calculated median scores and interquartile ranges to determine the levels of implementation of IPC practices.FindingsAmong the 25 facilities, all showed some degree of IPCAF implementation, with an overall median IPCAF score of 545.0, reflecting an intermediate level. Three facilities (12%) were at a basic level, 16 (64%) at an intermediate level, and 6 (24%) at an advanced level of IPC practices. The presence of IPC guidelines scored the highest among CCs (median: 87.5). About 96% of facilities did not have a dedicated full‐time IPC staff, 64% of facilities did not offer IPC training to new staff, and 84% did not have protocols for multidrug‐resistant pathogens.ConclusionsThis initial IPCAF assessment in Rwanda reveals critical IPC strengths and gaps. These findings highlight the necessity for targeted interventions, such as appointing dedicated IPC staff, strengthening IPC committees, and enhancing IPC training and resources.

A mini-review on safeguarding global health amidst a "Pandemic" of armed conflicts.

The year 2022 witnessed an alarming surge in state-based armed conflicts globally, reaching a staggering 56, with major hostilities in Ukraine, Myanmar, and Nigeria resulting in over 10,000 estimated conflict-related deaths. This trend continued with the onset of a significant conflict between Israel and Hamas in October 2023. The escalating frequency of armed conflicts, reaching the highest number since 1946, poses a critical threat to global health. This paper explores the multifaceted health impacts of armed conflicts, encompassing physical injuries, infectious diseases, malnutrition, and profound mental health consequences. Healthcare systems in conflict zones face severe strain, and achieving Sustainable Development Goals by 2030 becomes increasingly challenging. The surge in armed conflicts globally is characterized as a "pandemic," justifying urgent attention. The paper identifies and discusses strategies to safeguard public health in conflict zones, emphasizing humanitarian response, protecting healthcare workers and infrastructure, building preparedness and resilience, and promoting mental health support. In navigating this "pandemic" of armed conflicts, comprehensive strategies are imperative to address the intricate challenges and secure a healthier global future.