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Introduction Coronavirus disease 2019 (COVID-19) has substantially impacted the healthcare delivery system in Tehran, Iran. The country’s first confirmed positive test for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was on February 18, 2020. Since then, the number of cases has steadily increased in Iran and worldwide. Emergency medical services (EMS) quickly adapted its operations to accommodate a greater number of patients, and it worked to decrease the risk of COVID-19 spread among EMS personnel, given the disease’s high transmissibility. Methods We evaluated the chief complaint as well as the pattern and number of EMS calls and dispatches during the 28-day intervals before and after the February 18, 2020, COVID-19 outbreak in Iran. Results EMS calls increased from 355,241 in the pre-outbreak period to 1,589,346 in the post-outbreak period, a 347% increase (p<0.001). EMS dispatches rose more modestly from 82,282 to 99,926, a 21% increase (p<0.001). The average time on telephone hold decreased from 10.6 ± 12.7 seconds pre-outbreak to 9.8 ± 11.8 seconds post-outbreak, a 7% decrease (p<0.001). The average length of call also decreased from 1.32 ± 1.42 minutes pre-outbreak to 1.06 ± 1.28 minutes post-outbreak, a 20% decrease (p<0.001). The highest number of daily dispatches occurred during the second and third weeks of the four-week post-outbreak period, peaking at 4557 dispatches/day. After the first reported case of SARS-CoV-2, there were significant increases in chief complaints of fever (211% increase, p<0.001) and respiratory symptoms (245% increase, p<0.001). Conclusion The number of EMS calls and dispatches in Tehran increased 347% and 20%, respectively, after the outbreak of COVID-19. Despite this, the time on hold for EMS response decreased. The Tehran EMS system accomplished this by increasing personnel hours, expanding call-center resources, and implementing COVID-19-specific training.

Cathodic electrochemical deposition (CED) is introduced as an efficient and effective method for synthesis and surface coating of superparamagnetic iron oxide nanoparticles (SPIONs). In this way, bare Fe3O4 nanoparticles were electrosynthesized through CED method from aqueous solution Fe3+ : Fe2+ chloride (molar ratio of 2 : 1). In the next step, the surface of NPs was coated with polyethyleneimine (PEI) and polyethylene glycol (PEG) during the CED procedure, and PEG/PEI coated SPIONs were obtained. The prepared NPs were evaluated by powder X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), dynamic light scattering (DLS), vibrating sample magnetometer (VSM), and field-emission scanning electron microscopy (FE-SEM). The pure magnetite phase and nanosize (about 15 nm) of the prepared NPs were confirmed by XRD and FE-SEM. The presence of two coats (i.e., PEG and PEI) on the surface of electrosynthesized NPs was proved via FTIR results. The percentage of polymer coat (37.5%) on the NPs surface was provided by TGA analysis. The high magnetization value, negligible coercivity, and remanence measured by VSM indicate the superparamagnetic nature of both prepared NPs. The obtained results confirmed that the prepared Fe3O4 nanoparticles have suitable physicochemical and magnetic properties for biomedical applications.

Objective: Identification of hospital preparedness challenges against biological events such as COVID-19 is essential to improve dynamics, quality and business continuity confidence in the health system. Accordingly, the purpose of the present study is to evaluate the challenges of hospital preparedness in biological events. Methods: This study employed a qualitative method using content analysis in which 20 healthcare managers and experts who are experienced in biological events were selected through purposeful sampling. The data collection was done through semi-structured interviews, which continued until data saturation. The data were analyzed using qualitative content analysis as well as the Landman and Graneheim Approach. Results: Six main concepts (training and practice, resource management, safety and health, patient management, risk communication, and laboratory and surveillance) and 14 sub-concepts were extracted on hospital preparedness challenges in biological events through analyzing interviews. Conclusions: The present study indicated that the health system of the country faces many challenges in response to biological events and threats. Moreover, study participants indicated that Iranian hospitals were not prepared for biological events. It is recommended to design preparedness plans of hospitals based on preparedness standards for biological events. In addition, comprehensive measures are required to enhance their capacity to respond to biological emergencies.

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