Risk Of COVID-19 Exposure Research Articles

Healthcare Professionals Providing Direct Care to the COVID-19 Patients: A Descriptive Cross-sectional Study.

COVID-19 highly contagious viruses that have reached every corner of the world. Despite the heroic efforts to control the pandemic, health care professional risk for COVID-19 exposure was an important measure to identify due to lack of personal protective equipment. The objective of the study was to find out the prevalence of healthcare professionals providing direct care to the COVID-19 patient. A descriptive cross-sectional was conducted through online questionnaire from June 2020 to August 2020. Ethical approval was obtained from the Ethical Review Board of Nepal Health Research Council (Reference number: 363/2020 P). World Health Organization risk assessment protocol questionnaire was used for COVID-19 and distributed among 300 health care workers of Nepal involved in the management of COVID-19 hospitals. Convenience sampling was used. The KoBo toolbox was used for online data collection. Data analysis was done using Statistical Package for the Social Sciences version 23. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Among 300 study participants, 109 (36.33%), (30.85-41.74 at 95% Confidence Interval) of participants provide direct care to infected patients. With total respondents, 41 (37.61%) were registered nurses, medical doctors 28 (25.68%) and paramedics 36 (33.02%). Health care workers who provide direct care to the COVID-19 patient were similar to other studies done in similar settings. About half of the participants were exposed to COVID-19 virus from the hospital setting rather than from community setting which is similar to the study done in similar setting which might be due to lack of follow of protocols during COVID-19 patient care.

A Prospective, Longitudinal Evaluation of SARS-CoV-2 COVID-19 Exposure, Use of Protective Equipment and Social Distancing in a Group of Community Physicians.

Introduction: Healthcare workers experience a significant risk of exposure to and infection from SARS-CoV-2, COVID-19. Nonetheless, little research has focused on physicians’ use of personal protective equipment (PPE), their concerns about becoming infected and their social distancing maneuvers. Methods: All staff physicians at Advocate Lutheran General Hospital were invited to participate. Their COVID-19 IgG antibody level was measured and an online questionnaire was completed. The questionnaire assessed the risk of COVID-19 exposure, PPE usage, concern for contracting COVID-19, the performance of high-risk procedures, work in high-risk settings, and social distancing practices. Testing was performed in September (T0), and December 2020 (T1) at the height of the global pandemic. Results: A total of 481 (26.7%) of 1800 AGLH physicians were enrolled at T0 and 458 (95% of the original group) at T1. A total of 21 (4.3%) and 39 (8.5%) participants had antibodies at T0 and T1. A total of 63 (13.8%) worked in high-risk settings and 111 (24.2%) performed high-risk procedures. Participants working in high-risk settings had increased exposure to COVID-19 infected patients (OR = 4.464 CI = 2.522–8.459, p < 0.001). Participants were highly adherent to the use of PPE and social distancing practices including mask-wearing in public (86%, 82.1%), avoiding crowds (85.1%, 85.6%), six feet distancing (83.8%, 83.4%), and avoiding public transportation (78%, 83.8%). A total of 251 (55.4%) participants expressed moderate to extreme concern about becoming infected with COVID-19. Conclusions and Relevance: Among a group of community physicians, consistent PPE use and social distancing practices were common. These practices were associated with a low level of initial acquisition of COVID-19 infections and a relatively low longitudinal risk of infection.

Making virtual health care accessible to the deaf community: Findings from the telehealth survey

Introduction To reduce COVID-19 exposure risk, virtual visits became widely adopted as a common form of healthcare delivery for the general population. It is unknown how this affected the deaf population, a sociolinguistic minority group that continues to face communication and healthcare barriers. The survey's objective was to describe the deaf participants’ experiences with telehealth visits. Methods A 28-item online survey, available in American Sign Language and English, was developed and disseminated between November 2020 and January 2021. Ninety-nine deaf participants responded. Descriptive statistics were performed to assess the participant's virtual health care use, experiences, and communication approaches. Results Seventy-five percent of respondents used telehealth at least once in the past 12 months (n = 74; age = 37.6 ± 14.5 years). Of those who used telehealth, nearly two-thirds experienced communication challenges (65.3%; n = 49). Half of the participants reported having to connect via a video relay service that employs interpreters who maintain general certification instead of a remote interpreter with specialized health care interpreting certifications for video visits with their health care providers (n = 37) and a third of participants reported needing to use their residual hearing to communicate with their providers (n = 25). Conclusion Standard protocols for health care systems and providers are needed to minimize the burden of access on deaf patients and ensure virtual visits are equitable. It is recommended these visits be offered on Health Insurance Portability and Accountability Act-compliant platforms and include multi-way video to allow for the inclusion of remote medical interpreters and/or real-time captionists to ensure effective communication between the provider and the deaf patient occurs.

Social Group Differences in the Exposure Risk of COVID-19: A Case Study in Beijing, China.

Taking Beijing as a case, this paper conducted a survey to collect the characteristics of residents’ daily activities, including the mode of frequency and duration of travel, the type and environment of activities, and the duration and frequency of activities. We calculated the COVID-19 exposure risk of residents in different activities based on the exposure risk formula; the influencing factors of residents’ exposure risk were analyzed by regression analysis. The variance of residents’ COVID-19 exposure risk was calculated by coefficient of variation. The main conclusions are as follows: (1) There are differences in activity types of COVID-19 exposure risk, which are survival activity, daily activity and leisure activity from high to low. (2) There are differences in populations of COVID-19 exposure risk. Education level, occupation and income are the main factors affecting residents’ COVID-19 exposure risk. (3) There is internal inequity in the risk of COVID-19 exposure. The exposure risk was higher on work days than on rest days. Health inequities at work are highest on both work days and rest days. Among the different population characteristics, male, 31–40 years old, married, with a high school education, income level of 20,001–25,000 yuan, with a non-local rural hukou, rental housing, farmers, three generations or more living together have a greater degree of COVID-19 exposure risk.

A Mobile App for Wound and Symptom Surveillance After Colorectal Surgery: Protocol for a Feasibility Randomized Controlled Trial.

BackgroundSurgical site infections (SSIs) are the most common nosocomial infection and occur in 16.3% of patients undergoing colorectal surgery at our institution (The Ottawa Hospital), the majority of which are identified after discharge from hospital. Patients who suspect having an SSI generally present to the emergency department or surgery clinic. Both options for in-person interaction are costly to the health care system and patients. A mobile app, how2trak, has proven to be beneficial for patients with complex wounds at our institution by facilitating at-home monitoring and virtual consultations.ObjectiveThis study aims to assess the feasibility of a randomized controlled trial to assess if how2trak can improve patients’ experience and increase detection of SSIs after colorectal surgery while reducing patients’ risk of COVID-19 exposure.MethodsIn this single-center prospective feasibility trial, eligible patients undergoing colorectal surgery will be randomized to either standard care or how2trak postoperative monitoring of their incision, symptoms, and ostomy function. Patient self-assessments will be monitored by a nurse specialized in wound and ostomy care who will follow-up with patients with a suspected SSI. The primary outcome is feasibility as measured by enrollment, randomization, app usability, data extraction, and resource capacity.ResultsThis study was approved by our institution’s ethics board on February 26, 2021, and received support from The Ottawa Hospital Innovation and Care Funding on November 12, 2021. Recruitment started June 3, 2021, and 29 were patients enrolled as of September 2021. We expect to publish results in spring 2022.ConclusionsThis study will determine the feasibility of using a mobile app to monitor patients’ wounds and detect SSIs after colorectal surgery. If feasible, we plan to assess if this mobile app facilitates SSI detection, enhances patient experience, and optimizes their care.Trial RegistrationClinicalTrials.gov NCT04869774; https://clinicaltrials.gov/ct2/show/NCT04869774International Registered Report Identifier (IRRID)DERR1-10.2196/26717

Hospitalizations for COVID-19 Among US People Experiencing Incarceration or Homelessness

People experiencing incarceration (PEI) and people experiencing homelessness (PEH) have an increased risk of COVID-19 exposure from congregate living, but data on their hospitalization course compared with that of the general population are limited. To compare COVID-19 hospitalizations for PEI and PEH with hospitalizations among the general population. This cross-sectional analysis used data from the Premier Healthcare Database on 3415 PEI and 9434 PEH who were evaluated in the emergency department or were hospitalized in more than 800 US hospitals for COVID-19 from April 1, 2020, to June 30, 2021. Incarceration or homelessness. Hospitalization proportions were calculated. and outcomes (intensive care unit admission, invasive mechanical ventilation [IMV], mortality, length of stay, and readmissions) among PEI and PEH were compared with outcomes for all patients with COVID-19 (not PEI or PEH). Multivariable regression was used to adjust for potential confounders. In total, 3415 PEI (2952 men [86.4%]; mean [SD] age, 50.8 [15.7] years) and 9434 PEH (6776 men [71.8%]; mean [SD] age, 50.1 [14.5] years) were evaluated in the emergency department for COVID-19 and were hospitalized more often (2170 of 3415 [63.5%] PEI; 6088 of 9434 [64.5%] PEH) than the general population (624 470 of 1 257 250 [49.7%]) (P < .001). Both PEI and PEH hospitalized for COVID-19 were more likely to be younger, male, and non-Hispanic Black than the general population. Hospitalized PEI had a higher frequency of IMV (410 [18.9%]; adjusted risk ratio [aRR], 1.16; 95% CI, 1.04-1.30) and mortality (308 [14.2%]; aRR, 1.28; 95% CI, 1.11-1.47) than the general population (IMV, 88 897 [14.2%]; mortality, 84 725 [13.6%]). Hospitalized PEH had a lower frequency of IMV (606 [10.0%]; aRR, 0.64; 95% CI, 0.58-0.70) and mortality (330 [5.4%]; aRR, 0.53; 95% CI, 0.47-0.59) than the general population. Both PEI and PEH had longer mean (SD) lengths of stay (PEI, 9 [10] days; PEH, 11 [26] days) and a higher frequency of readmission (PEI, 128 [5.9%]; PEH, 519 [8.5%]) than the general population (mean [SD] length of stay, 8 [10] days; readmission, 28 493 [4.6%]). In this cross-sectional study, a higher frequency of COVID-19 hospitalizations for PEI and PEH underscored the importance of adhering to recommended prevention measures. Expanding medical respite may reduce hospitalizations in these disproportionately affected populations.

Impacts of COVID-19 on Electric Vehicle Charging Behavior: Data Analytics, Visualization, and Clustering

COVID-19 pandemic has infected millions and led to a catastrophic loss of lives globally. It has also significantly disrupted the movement of people, businesses, and industries. Additionally, electric vehicle (EV) users have faced challenges in charging their vehicles in public charging locations where there is a risk of COVID-19 exposure. However, a case study of EV charging behavior and its impacts during the SARS-CoV-2 is not addressed in the existing literature. This paper investigates the impacts of COVID-19 on EV charging behavior by analyzing the charging activity during the pandemic using a dataset from a public charging facility in the USA. Data visualization of charging behavior alongside significant timelines of the pandemic was utilized for analysis. Moreover, a cluster analysis using k-means, hierarchical clustering, and Gaussian mixture models was performed to identify common groups of charging behavior based on the vehicle arrival and departure times. Although the number of vehicles using the charging station was reduced significantly due to lockdown restrictions, the charging activity started to pick up again since May 2021 due to an increase in vaccination and easing of public restrictions. However, the charging activity currently still remains around half of the activity pre-pandemic. A noticeable decline in charging session length and an increase in energy consumption can be observed as well. Clustering algorithms identified three groups of charging behavior during the pandemic and their analysis and performance comparison using internal validation measures were also presented.

Evolving perceptions regarding receiving orthopaedic care during the Coronavirus 2019 (COVID-19) pandemic: a follow-up survey.

Background:As the Coronavirus 2019 (COVID-19) pandemic evolves, it is critical to understand how patients’ feelings and perceptions have changed. The aim of this study was to understand current feelings and concerns about seeking and receiving orthopaedic care 9 mo into the global pandemic.Methods:Utilizing a survey developed to evaluate the attitudes and beliefs from healthcare respondents about receiving care during the COVID-19 pandemic, an updated and revised version, evaluating changes in perception of respondents 9 mo into the pandemic, was distributed to a group of panelists by email.Results:Out of 1200 individuals, 197 (16%) completed the survey. A majority of respondents reported high level of comfort in the immediate or near-term receiving care in an orthopaedic clinic, urgent care clinic specifically for orthopaedics, or in an emergency room. Six percent of respondents reported a delay in seeking orthopaedic care despite COVID-19 concerns that occurred between studies. Respondents reported their primary reason for delaying care was because of concerns for risk of COVID-19 exposure from other patients (83%). More than 75% of respondents stated they are “extremely” or “very” likely to get the COVID-19 vaccine when it becomes available to the public. Respondents had a generally negative outlook on pandemic efforts locally to globally.Conclusions:Despite dismal overall perceptions regarding the outlook of the pandemic; consumers are becoming increasingly comfortable obtaining orthopaedic care. The ability of healthcare providers and practices to adherence to safety protocols will remain essential to maintaining consumer trust and confidence.Level of Evidence:Level IV.

Assessing Occupational Stress and Preparedness Among Campus Safety Officers and Dental School Employees at an Academic Medical Center During COVID-19

Job stress can lead to adverse physical and emotional health effects in employees. It is worse during an emergency or pandemic. This cross-sectional study looked at Campus Safety Officers and Dental School employees, who’s work puts them at risk for COVID-19 exposure. We hypothesized that Campus Safety Officers and Dental School employees who felt adequately trained to conduct COVID-19 related work would not feel more stressed during the COVID-19 pandemic than they did before the pandemic. We provided a self-administered questionnaire to 148 employees between April and July 2020. Of the 148 questionnaires, 147 were included in our study. There were 42 Campus Safety Officers (28.6%) and 105 Dental School employees (71.4%). Most study participants were younger than 40 years of age (51.1%), and male (52.4%). Forty-four had over 20 years of work experience. We found a significant association between employee perception of stress, perception of adequate training to conduct pandemic work (p≤0.0001), and gender (p=0.022). Although most study participants felt adequately trained to conduct work relating to COVID-19 (60.9%), they still felt more stressed during the pandemic than before (47.6%). Mental health support is critical to reduce the impact of stress.

Of COVID-19 and Chickens: The Ethics of One Workplace Safety Policy Early in the Pandemic

The emergence of the COVID-19 pandemic created considerable challenges for the food supply chain. One of the industries hardest hit was the agricultural and agri-foods industry. This industry has long faced worker shortages and regularly relied on temporary foreign workers. In this case, Roosters, a chicken processing and production company in Vancouver, British Columbia, Canada, had just come off a very costly 12-day closure following a COVID-19 exposure risk in two of its processing plants. With the company back in operation a new safety policy has been implemented to limit future virus exposure and shutdown risks. The policy, however, targets a small group of temporary foreign workers, one of whom is challenging the lengths the company can go in the name of protecting employees from the virus and the company from losses due to closure.

Impact of Pharmacist Intervention on Anticoagulation Management and Risk for Potential COVID-19 Exposure During the COVID-19 Pandemic

Impact of Pharmacist Intervention on Anticoagulation Management and Risk for Potential COVID-19 Exposure During the COVID-19 Pandemic

A media surveillance analysis of COVID-19 workplace outbreaks in Canada and the United States

A media surveillance analysis was conducted to identify COVID-19 workplace outbreaks and associated transmission risk for new and emerging occupations. We identified 1,111 unique COVID-19 workplace outbreaks using the Factiva database. Occupations identified in the media articles were coded to the 2016 National Occupational Classification (V1.3) and were compared and contrasted with the same occupation in the Vancouver School of Economics (VSE) COVID Risk/Reward Assessment Tool by risk rating. After nurse aides, orderlies, and patient service associates ( n = 109, very high risk), industrial butchers and meat cutters, and poultry preparers and related workers had the most workplace outbreaks reported in the media ( n = 79) but were rated as medium risk for COVID-19 transmission in the VSE COVID Risk Tool. Outbreaks were also reported among material handlers ( n = 61) and general farm workers ( n = 28), but these occupations were rated medium–low risk and low risk, respectively. Food and beverage services ( n = 72) and cashiers ( n = 60) were identified as high-risk occupations in the VSE COVID Risk Tool. Differences between the media results and the risk tool point to key determinants of health that compound the risk of COVID-19 exposure in the workplace for some occupations and highlight the importance of collecting occupation data during a pandemic.

Evaluation of a new emergency department avoidance model of care, the Cancer Urgent Assessment Clinic, in response to the COVID-19 pandemic

IntroductionThe Cancer Urgent Assessment Clinic (CUAC) was an emergency department (ED) avoidance/unscheduled model of care implemented in response to the COVID-19 pandemic. The aim was to reduce the risk of COVID-19 exposure and infection by providing an alternative to ED for cancer patients while undergoing anticancer treatments.MethodsThe clinic incorporated a telephone triage process and face-to-face appointments 8am to 8pm, 7 days per week. CUAC operated between 23 March '20 and 31 July '20, led by a nurse practitioner candidate, oncology registrars, cancer nurse specialists, and overseen by oncology consultants. Evaluation followed a mixed-methods approach through (1) analysis of CUAC patient data, (2) comparison of ED cancer patient presentation data from a previous period (23 March 2019–31 July 2019), and (3) a patient survey.ResultsIn total, 400 patients were telephone triaged via CUAC, with 166 recorded as having avoided ED. There was a reduction in the number of cancer patient admissions to the ED short stay unit during the clinic period compared with the same time-period in 2019: 130 vs. 234, associated with 615 fewer hours. Patient satisfaction was positive particularly regarding ease of access, time to treatment, confidence in assessment and treatment of cancer-related concerns, and likelihood of presenting to hospital when unwell during the pandemic.DiscussionWhile initially being implemented to reduce the risk of COVID-19 exposure, this evaluation demonstrated the CUAC model was an efficient and potentially cost-saving model of care for the management of cancer patients with mild to moderate severity of disease and treatment-related concerns.

Role of Telemedicine in Kidney Transplant Recipient in COVID 19 Era

Introduction: Telemedicine represents an innovative but untested approach to maintain patient care and reduce the risk of COVID-19 exposure to patients, health-care workers, and the public. In this study, we evaluated the applicability and efficacy of telemedicine in a kidney transplant recipient (KTR) cohort in COVID 19 era. Materials and Methods: An observational cohort study was conducted at a tertiary-care public-sector kidney disease institute in western India between March and September 2020. We evaluated the reasons, modes, and outcomes of patient contacts by telemedicine in the KTR cohort. We also evaluated the utility of telemedicine across three age groups. Results: Of 840 participants, whose mean age was 38.78 ± 12.39 years, male to female ratio was 4:1. The most common mode of communication was WhatsApp (653, 77.7%) followed by in-person surrogates (126, 15%). Acceptability of telemedicine was significantly better in younger and middle-age groups (P &lt; 0.00001) compared to the elderly. Request for drug delivery (n = 756) was the most common reason for contact overall and managed through postal parcels. KTRs (n = 200) and donors (n = 75) were evaluated for medical illnesses. The most common medical reasons for contact were for febrile illness (n = 120) and graft dysfunction (n = 60). COVID-19-related disease was diagnosed and managed in 80 KTRs and 2 donors. COVID-19 updates were given to all contacts. Conclusion: Telemedicine is underutilized in the care of the KTR cohort. Telemedicine can be used across all ages although it's best suited for young and middle age groups. The impact of telemedicine on short- and long-term patient outcomes is unclear and warrants further study.

ASTRO: Reducing COVID-19 Exposure through Contact Prediction and Avoidance

The fight against the COVID-19 pandemic has highlighted the importance and benefits of recommending paths that reduce the exposure to and the spread of the SARS-CoV-2 coronavirus by avoiding crowded indoor or outdoor areas. Existing path discovery techniques are inadequate for coping with such dynamic and heterogeneous (indoor and outdoor) environments—they typically find an optimal path assuming a homogeneous and/or static graph, and hence they cannot be used to support contact avoidance. In this article, we pose the need for Mobile Contact Avoidance Navigation and propose ASTRO ( A ccessible S patio- T emporal R oute O ptimization), a novel graph-based path discovering algorithm that can reduce the risk of COVID-19 exposure by taking into consideration the congestion in indoor spaces. ASTRO operates in an A * manner to find the most promising path for safe movement within and across multiple buildings without constructing the full graph. For its path finding, ASTRO requires predicting congestion in corridors and hallways. Consequently, we propose a new grid-based partitioning scheme combined with a hash-based two-level structure to store congestion models, called CM-Structure , which enables on-the-fly forecasting of congestion in corridors and hallways. We demonstrate the effectiveness of ASTRO and the accuracy of CM-Structure ’s congestion models empirically with realistic datasets, showing up to one order of magnitude reduction in COVID-19 exposure.

Expanding Virtual Health Capabilities Into Trainee Health.

ABSTRACTVirtual health and secure messaging gained newfound relevance in medicine during the coronavirus disease (COVID)-19 pandemic. For a military trainee health care clinic located on Joint Base San Antonio, the McWethy Troop Medical Clinic (TMC), implementation of virtual health and secure messaging services meant decreased risk of COVID-19 exposure for trainees and clinical staff. Through ongoing utilization, these services also made impacts to reduce loss of instruction time and improve access to care for the McWethy TMC trainee population. In defining the challenges, successes, and future implications for virtual health and secure messaging at the McWethy TMC, key lessons emerge for other military trainee clinics. The key concepts explored in this article are virtual health and secure messaging.

Boomerang Kids in the Pandemic: How High-Income Families Are Their Own Safety Net

In this Economic Commentary, we use the Current Population Survey to identify and examine the influx of young adults who moved in with their parents during the COVID-19 pandemic—the so-called boomerang kids—and how being in their family home influences their labor market decisions and sensitivity to occupational risk relative to that of other young adults. We find that most boomerang kids come from high-income families that can financially support them through nonemployment spells that are, on average, longer than those of young adults not living with their parents. Young adults living with their parents are also more responsive to the risk of COVID-19 exposure in the workplace and are less likely to work in occupations with high exposure risk.

Addressing COVID-19 Barriers to Clinical Trial Enrollment and Implementation in the PHARM-DC Study

Recent hospitalization puts older adults at higher risk of experiencing adverse drug events (ADEs) that are a common cause of hospital readmission. Yet, most ADEs are preventable. The PHARMacist Discharge Care (PHARM-DC) study is a multi-site randomized controlled trial that seeks to evaluate the effect of pharmacist-led peri- and post-discharge interventions on 30-day hospital readmissions among older adults taking ≥10 medications or ≥3 high-risk medications. The PHARM-DC intervention includes pharmacist-led patient counseling, medication reconciliation at discharge, and a follow-up phone call post-discharge. We will highlight study protocol adaptations undertaken during the COVID-19 pandemic to address challenges to enrollment and to minimize risk of COVID-19 exposure for study participants and research personnel. Additionally, we will share insights from focus groups and semi-structured interviews with pharmacist interventionists and pharmacy leaders on barriers and facilitators to implementation due to the pandemic and strategies for future clinical trials to overcome barriers.

Impacts of the Pandemic on Older Adults’ Social Isolation

The risk of COVID-19 exposure and likelihood of severe illness have been critical concerns among older adults during the pandemic. Meanwhile, social distancing has worsened social isolation, with severe impacts on connectedness among seniors. Effects of the pandemic may lead to an extended crisis, with impacts on health outcomes. Our primary purpose was to summarize emerging research describing impacts of the pandemic on social isolation and related health outcomes among older adults. A streamlined search was conducted to fit the scope of this review, with key terms determined to identify relevant publications. Common research databases and mainstream resources were utilized. We focused on research published or released since the start of 2020, primarily rapidly reviewed studies, to align with the timing of the pandemic. Early research suggests that the pandemic has worsened social isolation among older adults. Social isolation is now more urgent, as many seniors lost their usual connections due to social distancing. While these measures help to prevent virus exposure, this approach must be balanced with maintaining social connectedness. Thus, a “COVID-19 paradox” has emerged: safety protocols protect older adults but concurrently place them at risk of social isolation. Adapted approaches are urgently needed to safely address the consequences of a potential long-term social recession.

Virtual Visitation and Microethical Decision-making in the Intensive Care Unit During COVID-19.

Virtual Visitation and Microethical Decision-making in the Intensive Care Unit During COVID-19.