ObjectivesHealthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty.SettingOur tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless.ParticipantsWe recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone.ResultsBetween 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment.ConclusionA multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.
Available online xxxKeywords: H1N1 Economic Social Morbidity Expenditure a b s t r a c t Background & aim: : Recent outbreak of H1N1 influenza leads to increased morbidity and mortality. High infection rate and virulence created panic among masses and huge health care burden. Socio-economic impact of H1N1 influenza has been underestimated. We describe socio-economic impact of H1N1 by taking hospitalization expenditure model. Method: In a prospective observational study at tertiary care centre in Northern India hospitalization costs were collected from 1st January 2015 to 31st March 2015. Real time reverse transcriptase polymerase chain reaction (RT-PCR) testing on nasopharyngeal swabs was used to confirm diagnosis. Result: Data of 209 patients were analyzed. Age of the patients ranged from 3 months to 85 years. The mean and median age of the patients was 41.5 and 45 years respectively. Female patients constituted 46% of all patients admitted. Hospital stay duration ranged from 1 day to 41 days. Minimum and maximum expenditure was 164 USD and 32548 USD respectively.Mean expenditure was 3326 USD. Mean room rent was 940 USD, investigation cost À457 USD, medicines cost e 808 USD, doctors' consultation-468USD and miscellaneous cost of 653 USD. Mean expenditure in H1N1 ward was 17 times(1983 USD), whereas in isolated single room it was 22 times(2554 USD) and in ICU mean expenditure was 62 times(7172 USD) the monthly per capita income. Expenditure increased with increasing age (P ¼ 0.004) with highest expenditure was seen in age group more than 60 years and lowest among age group less than 20 years. Apart from these direct effects, H1N1 influenza had huge indirect impact on the socio-economic framework in terms of absenteeism, decreased manpower causing economic slowdown, low tourism increased workload and anxiety among healthcare workers. Conclusion: H1N1 influenza outbreak severely affected the socio-economic framework of the country. Isolation wards seem to be cost effective and expenditure has got direct linear association with age. ScienceDirect jo urnal homepage: www .e lsev ie r. co m/ lo cate/ cmrp c u r r e n t m e d i c i n e r e s e a r c h a n d p r a c t i c e x x x ( 2 0 1 5 ) 1 e5 http://dx.Please cite this article in press as: Kumar P, et al., Socioeconomic impact of the recent outbreak of H1N1, Current Medicine Research and Practice (2015), http://dx.
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