Disaster medicine and public health preparedness
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Disaster Med Public Health Prep · Dec 2020
Adaptation of the National Plan for the Prevention and Fight Against Pandemic Influenza to the 2020 COVID-19 Epidemic in France.
On Tuesday, March 17, 2020, at noon, France became the third European country to impose a nationwide containment policy in the fight against epidemic coronavirus disease 2019 (COVID-19) viral infection. Announcing that the country was at "war," President Macron called upon all to play a role in mitigating against further development of contagion. This extreme measure never seen before during peace time was the result of adapting not only the French Pandemic Influenza Plan (PIP) being applied to the national context but also real-time clinical, epidemiological, and scientific information about the evolution of COVID-19 infection in the country. ⋯ As a result, decisive and immediate action was taken by the State for the national public health interest. This report from the field details the timely events that contributed to this extreme policy decision taken by France. A policy decision that other Western democracies have since applied as the pandemic disseminated across the globe.
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Disaster Med Public Health Prep · Dec 2020
Impact of Fundamental Diseases on Patients With COVID-19.
In December 2019, a new type of coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), appeared in Wuhan, China. Serious outbreaks of coronavirus disease 2019 (COVID-19), related to the SARS-CoV-2 virus, have occurred throughout China and the world. Therefore, we intend to shed light on its potential clinical and epidemiological characteristics. ⋯ In our study, we found that most of the deaths were elderly men with chronic fundamental diseases, and their COVID-19 progression to death time was shorter. At the same time, we demonstrated that older men are more likely to become infected with COVID-19, and the risk of death is positively correlated with age.
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Disaster Med Public Health Prep · Dec 2020
Clinical and Ethical Considerations in Allocation of Ventilators in an Influenza Pandemic or Other Public Health Disaster: A Comparison of the 2007 and 2015 New York State Ventilator Allocation Guidelines.
During an influenza or coronavirus disease 2019 (COVID-19) pandemic that results in acute respiratory distress, the number of available ventilators will not meet demand. In 2007, the New York State Task Force on Life and the Law and Department of Health released draft Guidelines for ethical allocation of ventilators for adults. In 2015, updated guidelines were released to ensure that: (1) revisions reflect the public's values and (2) the triage protocol is substantiated by evidence-based clinical data. We summarize the development and content of the 2015 Guidelines compared with the 2007 version, emphasizing new/revised aspects of the ethical considerations and clinical protocol. ⋯ The 2015 Guidelines reflect advances in medicine and societal values and provide an evidenced-based framework to save the most lives. The framework could be adapted in other emergencies, such as the COVID-19 pandemic, that require ventilators.
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Disaster Med Public Health Prep · Dec 2020
How to Reorganize the Radiology Departments to Face the 2019 Coronavirus Disease Outbreak.
Radiology departments have been directly involved from the beginning of the novel coronavirus disease (COVID-19) emergency to provide imaging lung assessment of suspected and positive patients while ensuring the execution of other routine and emergency examinations for non-COVID-19 patients. To limit the risk of the infection spread, radiology departments should be reconfigured. We propose the example of the reorganization of the Radiology Department of our hospital, in the center of Milan, in Northern Italy, which consisted of the creation of 2 completely distinct pathways and distinct radiological machines for COVID-19 positive or suspected positive and for non-COVID-19 patients.