Temporary Hospital Research Articles

Mental health needs of the COVID-19 patients and staff in the Fangcang shelter hospital: a qualitative research in Wuhan, China.

During the coronavirus disease 2019 (COVID-19) pandemic, Fangcang shelter hospitals were opened in Wuhan, China, to isolate and care for patients with mild or moderate symptoms. The patients and staff in the hospitals faced mental health challenges. This paper reports the experiences and mental health needs from them. Following the qualitative design, semi-structured interviews were conducted in the EastWest Lake Fangcang Shelter Hospital, Wuhan on March 2020. Data collection and analysis was based on grounded theory. Open coding was adapted and a structured codebook was developed through coding seminars. The themes and subthemes were then confirmed through thematic analysis. The findings were further explained and integrated in a theoretical framework. A total of 10 COVID-19 patients and 13 staff, including doctors, nurses, psychiatrists, and policemen participated in the interviews. They have common needs, as well as their own needs. The perspectives from the staff also did complement for needs of the patients. The mental health needs were generalized into four themes, that is, basic needs, information and communication, emotional needs, and social support, each with several subthemes. In addition, there were some external factors that regulated the internal needs, which were summarized in a theoretical framework. The study indicates the directions on hospital management, mental health services, policy making, and social work to meet the mental health needs of the inpatients and staff from temporary shelter hospitals like Fangcang in Wuhan during the COVID-19 pandemic.

Antimicrobial resistance and antimicrobial therapy modification during COVID19 pandemic in large tertiary hospital

Objective. assessment of the evolution of the microbiological landscape of the hospital for the period of operation in 2020 into a pandemic of a new coronavirus infection in various departments, including intensive care units; change depending on the results of antibacterial therapy regimens. Materials and Methods. In a retrospective study, conducted from June to December 2020, in a multidisciplinary hospital working with COVID-19 infection, the resistance of isolated strains of microorganisms was analyzed in patients of different age groups. Resistance was assessed with test points in June and November 2020; depending on this, proposals were made to correct the internal (local) protocols of antimicrobial therapy. Results. The need for frequent and regular microbiological monitoring was confirmed. Further, we understood that the territories of the main and temporary hospital of the City Clinical Hospital No. 40 are heterogeneous and there are obvious differences both in structure and in the level of sensitivity. “In practice, these are two different hospitals”. Within the territories, the branches also differ from each other. When analyzing resistance in ICUs, it was revealed that within each hospital in each department, albeit similar in structure and profile of patients, there is a different level of resistance of strains. Conclusions. The structure of sensitivity generally corresponds to the world data, but for some pathogens it differs significantly. Microbiological monitoring should be carried out not only inside the hospital, but also inside the department. The increase in consumption of carbapenems and protected cephalosporins requires a reassessment of the practice of using AMP in any covid hospital, due to the impact on the epidemic situation both in the ICUs and in the hospital.

БОРЬБА С «ГОЛОДНЫМ ТИФОМ» ЗЕМСКОГО МЕДИЦИНСКОГО ПЕРСОНАЛА ПЕРМСКОЙ ГУБЕРНИИ В 1908–1914 гг.

The paper describes sanitary-hygienic, epidemiological, medical and food measures against carried out by medics during the outbreaks of typhus in 1908–1914. As this infection became a hunger marker in Russia, the object of the study is an epidemic situation in three counties (“uezd”) of the Perm province — Ekaterinburgskiy, Kamyshlovskiy, Shadrinskiy — which population constantly suffered from a crop failure. Based on the materials of “The medical and sanitary chronicle of the Perm province”, (“Vrachebno-sanitarnaya hronika Permskoy gubernii”) containing publications describing epidemics of typhus, the author considers application of the achievements of biological and medical sciences for outlining rational strategy for measures against typhus (implementation of disinfection and disinsection procedures) and identifies two organizational innovations introduced in that time. The first epidemiological teams consisting of doctors, paramedics (“fel’dsher”) and nurses were organized and sent to the epidemic focuses. These units were intended to detect, isolate and treat typhus patients, carry out disinfection and disinfestation in special temporary anti-typhoid barracks. The population began to use temporary hospitals actively, disinfect their houses and property. However, the insufficient knowledge of a transmission pathway of infection (its causative agent — Rickettsia prowazekii — and the carrier — body lice) hampered the further development of effective anti-typhoid measures and, as a result, challenged the whole complex of proposed activities.

Hospital El Salvador: a novel paradigm of intensive care in response to COVID-19 in central America

Hospital El Salvador: a novel paradigm of intensive care in response to COVID-19 in central America

Establishment and Functioning of a Temporary 1000-Bed COVID-19 Hospital During the Initial Outbreak in Wuhan

Background: COVID-19 Emerged as a novel zoonotic disease in late 2019 and quickly spread across Wuhan before spreading to other parts of China and rest of the world. Due to the rapid spread of the disease, local hospitals were inundated with COVID-19 patients putting a strain on the healthcare system. Little was known about the transmission and potential clinical management of COVID-19 at that time.Methods: A temporary COVID-19 hospital was built within one week. The confirmed COVID-19 cases were either directly recruited to the hospital or were transferred from other hospitals. Patients were admitted for both quarantine and treatment, as required. Data were collected as part of standard clinical care and retrospectively analyzed.Findings: A total of 2,959 patients were recruited during the operation period of this hospital between February 4, 2020, and April 8, 2020. These patients included 838 severe patients of which 72 were classified as critical, and 66 patients died. No infection was reported among healthcare workers.Interpretation: Setting up a dedicated hospital for COVID-19 provided a critical resource during the peak of the pandemic in Wuhan by enabling both quarantine and treatment for the infected patients. The mortality in this hospital was comparable to other hospitals at the time. These data suggest that this approach may prove beneficial in controlling infectious disease spread and limit mortality and prevent strain on existing healthcare system to enable them to care for non-COVID-19 patients.Funding Statement: This study was supported by funding from Beijing Nova Program Interdisciplinary Cooperation Project (DC; No. Z191100001119021), Chinese PLA General Hospital Youth Project (DC; No.QNF19074), Beijing Nova Program Project (DC; No. Z171100001117012), and China 13th Five-year National Key Grant (LXX; No.2018ZX09201013).Declaration of Interests: The authors declare that there are no competing interests.Ethics Approval Statement: This study was approved by the ethics committee of the Chinese PLA General Hospital, with a waiver of informed consent.

COVID-19 emergencies around the globe: China's experience in controlling COVID-19 and lessons learned.

MotivationNations around the world have been significantly impacted during the COVID-19 pandemic. China’s strategies for controlling COVID-19 offer valuable lessons for the global community. By learning from China’s experience and lessons, other countries could also find appropriate methods to control the pandemic.Problem statementWhat measures has China taken to control the pandemic? What lessons has China learned through this pandemic?Approach/methodsThe literature on China’s lessons and experience in controlling the COVID-19 pandemic was searched and reviewed. Related newspapers and magazines were also searched.ResultsChina’s experience can be summed up as establishing temporary hospitals, strict isolation, experts with a knowledge of COVID-19, and measures that increase social distancing.ConclusionsBy learning from the experience of China, other countries in the world could eventually find the methods to control the COVID-19 pandemic. An emergency response system should be established in each country. Doctors and nurses are not alone in fighting COVID-19, and the entire world is helping them. With cooperation, current difficulties could be overcome.

Organization of infectious safety of a temporary infectious diseases hospital on the example of a clinical hospital

The article is devoted to the problems of ensuring the safety of infectious diseases hospital employees for the treatment of patients with COVID-2019. The authors describe in detail the system of organization of the hospital. At the same time, the authors consider the standardization of the activities of all hospital employees by creating and strictly observing a system of algorithms to be the leading principle of ensuring infectious safety.

A high-efficiency simulation method for analyzing the impact of exhausted air from temporary hospitals built for the treatment of novel coronavirus pneumonia

A high-efficiency simulation method for analyzing the impact of exhausted air from temporary hospitals built for the treatment of novel coronavirus pneumonia

‘The Dreaded Pneumonic Influenza Has Made Its Appearance Amongst Us’: The Influenza Pandemic of 1918–19 in Gippsland, Victoria

This article contributes to our understanding of the 1918–19 influenza pandemic from a regional perspective. It covers the Gippsland region in the southeast of Australia, which traverses the area from Melbourne to the New South Wales border, with a focus on detailing pandemic history at a finely-grained community level. While the public memory of the influenza pandemic is patchy I explore local and family histories to show a vernacular memory of its impact. I also argue that the capacity for Gippsland to respond to the crisis was based on mobilisation and activity carried out during World War I. The role of women in the voluntary sector was crucial in responding to this crisis, especially the Red Cross. At the same time the crisis revealed sometimes-hidden divisions, and I also consider examples of disagreement on issues such as the location of temporary hospitals or the impacts on border areas.

The effects of tocilizumab on clinical and laboratory features of patients with severe COVID-19: a single-center experience

Objective: Cytokine storm is considered as the immune hyperinflammatory process which may deteriorate the course of COVID-19. Interleukin (IL-6) inhibitors can be used in severe COVID-19 patients due to their anti-inflammatory and anti-immune effects. We aimed to assess the therapeutic effect of tocilizumab (Actemra) in patients with severe COVID-19 pneumonia. Methods: Overall, 1382 patients were admitted to a temporary hospital during July outbreak of COVID-19. Of these, 282 patients were hospitalized. Baseline clinical, radiological and laboratory data were collected from patient records. Laboratory markers prior to discharge were also collected. Wilcoxon rank sum test was conducted to show the significance of change of laboratory markers. Results: Eleven of the 282(3.9%) hospitalized patients who had severe pneumonia confirmed by either chest radiography (CXR) or computed tomography (CT) received tocilizumab (Actemra). Polymerase chain reaction (PCR) viral markers of COVID-19 were positive in three cases. Hypoxemia and surrogate markers of cytokine storm improved after the prescription of tocilizumab (p=0.003 in all laboratory parameters). Two of the patients who received tocilizumab have been transferred to reference centers. No mortality or adverse reactions case was registered. Conclusion: Our observational study demonstrated significant improvement in oxygen saturation, reduction in inflammatory markers - leukocytosis, CRP and D-dimers and 83% recovery without need for mechanical ventilation and no mortality in patients with COVID-19 with severe multilobar bilateral pneumonia and CT score 3-4 receiving tocilizumab in addition to standard treatment.

CHARITABLE ACTIVITIES OF ORTHODOX MONASTERIES IN SOUTHERN UKRAINE FROM THE SECOND HALF OF XIX CENTURY TILL 1917

The relevance of the study is due to the need for theoretical understanding of historical experience in the field of social assistance and its practical application in modern charitable activities of the Orthodox Church. The purpose of the article is a comprehensive analysis of the philanthropy of Orthodox monasteries in the Southern Ukrainian dioceses from the second half of the nineteenth century till 1917. The main methods used in the study are divided into theoretical (analysis, synthesis, comparison) and empirical (document analysis). The analysis of basic forms and methods of social assistance to the people in need is carried out. The method of comparison, made it possible to determine the common features and peculiarities of the charity of the Orthodox monasteries of Southern Ukraine. Reconstruction of events and processes, generalization of conclusions, formation of holistic knowledge about the research problem became possible due to the use of the synthesis method. Analysis of documents was used in working with economic and administrative documents of monasteries. In general, it is the quantitative data that allow more accurately and comprehensively identify trends and patterns, make generalizations and draw conclusions about the scope and effectiveness of charitable activities. The study found that the main forms of philanthropy of monasteries in Southern Ukraine were as follows: philanthropic activities, medical care, maintenance of schools, financial support of theological schools, personal participation of abbots in the activities of charities, the establishment of shelters for refugees and temporary hospitals for the wounded warriors. Church charity was an important complement to the private and public support of the people in need.

COVID-19 Surge Capacity Solutions: Our Experience of Converting a Concert Hall into a Temporary Hospital for Mild and Moderate COVID-19 Patients

The 2019 coronavirus disease (COVID-19) pandemic has stressed the health care system in Italy as well as around the world, with hospitals implementing their surge capacity to increase the number of available beds for patients positive to the virus.At the end of March, the Piemonte (Northern Italy) Government decided to build a temporary rapid-assembly emergency hospital for the treatment of mild and moderate COVID-19 patients, converting an existing concert hall in the city of Turin. The decision was prompted not only by the urgent need of hospital beds, but also by a forward-looking approach for the months immediately after the emergency, when it will be essential for conventional hospitals to return to a normal configuration.This paper documents the temporary hospital project, describing the site, the layout and the equipment, the idea behind structural choices, and the staff involved. The aim of the work is to share the experience and to provide some practical recommendations to other professionals who are fighting the COVID-19 pandemic worldwide.

Offsite Construction for Emergencies: A focus on Isolation Space Creation (ISC) measures for the COVID-19 pandemic

The outbreak of a pandemic of global concern, the Corona Virus Disease 2019 (COVID-19) has tested the capacity of healthcare facilities to the brim in many developed countries. In a minacious fashion of rapid spread and extreme transmission rate, COVID-19 has triggered a shortage of healthcare facilities such as hospital bed spaces and ventilators. Various strategies have been adopted by the worst-hit countries to slacken or halt the spread of the virus. Common Isolation Space Creation (ISC) measures for the COVID-19 pandemic containment includes self-isolation at home, isolation at regular hospitals, isolation at existing epidemic hospitals, isolation at retrofitted buildings for an emergency, isolation at Temporary Mobile Cabins (TMCs), isolation at newly constructed temporary hospitals for COVID-19. This study evaluates the ISC measures and proposes offsite and modular solutions for the construction industry and built environment to respond to emergencies. While this study has proposed a solution for creating emergency isolation spaces for effective containment of such pandemic, other critical COVID-19 challenges such as the shortage of healthcare staff and other facilities are not addressed in this study.

Fangcang shelter hospitals during the COVID-19 epidemic, Wuhan, China.

ObjectiveTo design models of the spread of coronavirus disease-2019 (COVID-19) in Wuhan and the effect of Fangcang shelter hospitals (rapidly-built temporary hospitals) on the control of the epidemic.MethodsWe used data on daily reported confirmed cases of COVID-19, recovered cases and deaths from the official website of the Wuhan Municipal Health Commission to build compartmental models for three phases of the COVID-19 epidemic. We incorporated the hospital-bed capacity of both designated and Fangcang shelter hospitals. We used the models to assess the success of the strategy adopted in Wuhan to control the COVID-19 epidemic.FindingsBased on the 13 348 Fangcang shelter hospitals beds used in practice, our models show that if the Fangcang shelter hospitals had been opened on 6 February (a day after their actual opening), the total number of COVID-19 cases would have reached 7 413 798 (instead of 50 844) with 1 396 017 deaths (instead of 5003), and the epidemic would have lasted for 179 days (instead of 71).ConclusionWhile the designated hospitals saved lives of patients with severe COVID-19, it was the increased hospital-bed capacity of the large number of Fangcang shelter hospitals that helped slow and eventually stop the COVID-19 epidemic in Wuhan. Given the current global pandemic of COVID-19, our study suggests that increasing hospital-bed capacity, especially through temporary hospitals such as Fangcang shelter hospitals, to isolate groups of people with mild symptoms within an affected region could help curb and eventually stop COVID-19 outbreaks in communities where effective household isolation is not possible.

Providing end-of-life care in a Nightingale hospital.

Lauren Oliver, formerly Clinical Nurse Advisor, NHS Nightingale North West, outlines the challenges faced by staff in providing good-quality end-of-life care for patients in a temporary hospital during the initial peak of the COVID-19 pandemic.

Psychiatric care organization and mental health disorders in people of countries affected by the COVID-19 pandemic 2020 (Review)

In the context of the COVID-19 pandemic, 50 patients and 30 medical personnel were infected in a psychiatric hospital in Wuhan (Hubei Province, China), which required the Ministry of Health of China to urgently analyze the situation and develop a set of measures aimed at containing the spread of the virus and organizing a full and safe psychiatric care.
 The reasons for this situation could be the lack of reserve beds for psychiatric patients, low awareness of psychiatrists in diagnosing and treating infectious diseases, the separation of the psychiatric care system between the two departments, and the cramped living conditions of patients in psychiatric hospitals.
 More than 500 psychiatrists from across the country were sent to Wuhan to fill staff. Psychiatric patients with mild to moderate COVID-19 were transferred to temporary psychiatric hospitals organized in gymnasiums and exhibition centers. Severely ill psychiatric patients COVID-19 were transferred to hospital infectious diseases. A single patient routing system was organized, a shift schedule for doctors was introduced. To reduce the burden on public transport, the outpatient unit of psychiatric care was taken to regional hospitals, which had previously dealt only with forensic psychiatry and the control of patients with addictive disorders.
 Based on the experience of Wuhan, psychiatric communities from different countries proposed a list of practical recommendations designed to reduce the risks of spreading the infection and optimize the work of psychiatric care.
 All hospitals should have a reserve bed capacity, which can be used for the rehabilitation and socialization of patients in quiet times. Hospitals must be provided with a sufficient number of tests, drugs, and personal protective equipment. Outpatients need to be fully provided with access to medical and psychotherapeutic therapy using telemedicine technologies to minimize the risk of infection. It is crucial to restructure the appointment of doctors by introducing work on a shift schedule: two weeks in two weeks, which will not only ensure a good rest but also allow doctors to be quarantined after each shift.

Resilient managed competition during pandemics: lessons from the Italian experience during COVID-19.

In the last decades, several European health systems have abandoned their vertically integrated health care in favour of some form of managed competition (MC), either in a centralised or decentralised format. However, during a pandemic, MC may put health systems under additional strain as they are designed to follow some form of 'organisational self-interest', and hence face reduced incentives for both provider coordination (e.g. temporary hospital close down, change in the case-mix), and information sharing. We illustrate our argument using evidence for the Covid-19 pandemic outbreak in Italy during March and April 2020, which calls for the development of 'coordination mechanisms' at times of a health emergency.

Special Report: America’s First Asylum for African Americans Marks 150th Anniversary

<i>Special Report:</i> America’s First Asylum for African Americans Marks 150th Anniversary

Fierce Advocates for Building All-Hazards Resurgence and Resilience: NYC Health + Hospitals' COVID-19 Experiences Applied.

Fierce Advocates for Building All-Hazards Resurgence and Resilience: NYC Health + Hospitals' COVID-19 Experiences Applied.

How New York City Health + Hospitals System-Wide Special Pathogens Program Responded to COVID-19.

How New York City Health + Hospitals System-Wide Special Pathogens Program Responded to COVID-19.