Clinical and ethical challenges for emergency departments during communicable disease outbreaks: Can lessons from Ebola Virus Disease be applied to the <scp>COVID</scp>‐19 pandemic?

Markwell, Alex; Mitchell, Rob; Wright, April; Brown, Anthony

doi:10.1111/1742-6723.13514

Cited by 26 publications

(24 citation statements)

References 16 publications

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“…As a communicable disease, and now a global public health emergency (PHE), COVID-19 places a unique challenge on our health and social care workforce that will disrupt not just their usual workplace duties but also their social context [ 62 ]. As we adjust to new ways of living and working, HSCWs are likely to continue to face challenges ahead.…”

Section: Discussionmentioning

confidence: 99%

A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being

et al. 2021

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Background Health and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and, in the challenge to control the virus, have directly faced its consequences. Supporting their psychological wellbeing continues, therefore, to be a priority. This rapid review was carried out to establish whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis. Methods We undertook a rapid review of the literature following guidelines by the WHO and the Cochrane Collaboration’s recommendations. We searched across 14 databases, executing the search at two different time points. We included published, observational and experimental studies that reported the psychological effects on HSCWs during the COVID-19 pandemic. Results The 24 studies included in this review reported data predominantly from China (18 out of 24 included studies) and most sampled urban hospital staff. Our study indicates that COVID-19 has a considerable impact on the psychological wellbeing of front-line hospital staff. Results suggest that nurses may be at higher risk of adverse mental health outcomes during this pandemic, but no studies compare this group with the primary care workforce. Furthermore, no studies investigated the psychological impact of the COVID-19 pandemic on social care staff. Other risk factors identified were underlying organic illness, gender (female), concern about family, fear of infection, lack of personal protective equipment (PPE) and close contact with COVID-19. Systemic support, adequate knowledge and resilience were identified as factors protecting against adverse mental health outcomes. Conclusions The evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from efforts aimed at supporting psychological well-being. However, inconsistencies in findings and a lack of data collected outside of hospital settings, suggest that we should not exclude any groups when addressing psychological well-being in health and social care workers. Whilst psychological interventions aimed at enhancing resilience in the individual may be of benefit, it is evident that to build a resilient workforce, occupational and environmental factors must be addressed. Further research including social care workers and analysis of wider societal structural factors is recommended.

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Section: Discussionmentioning

confidence: 99%

A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being

et al. 2021

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“…"I hope that our society and government pay more attention to lack of personal protective equipment' [42] Discussion As a communicable disease and now a global public health emergency (PHE), COVID-19 places a unique challenge on our health and social care workforce that will disrupt not just their usual workplace duties but also their social context. [46] As we adjust to new ways of living and working, HSCWs are likely to continue to face challenges ahead. Our review con rms that the psychological impact of COVID-19 on health care workers is considerable, with signi cant levels of anxiety, depression, insomnia and distress.…”

Section: Environmental Factorsmentioning

confidence: 99%

A rapid review of the impact of COVID-19 on the mental health of health and social care workers: implications for psychological interventions

Kock

Latham

Leslie

et al. 2020

Preprint

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BackgroundHealth and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and in the challenge to control the virus have directly faced its consequences. Supporting their psychological wellbeing continues therefore to be a priority. This rapid review was carried out to identify whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis. The review also sought to identify a participant population for the trial of a digital intervention to support HSCW’s psychological wellbeing during the pandemic. MethodsWe undertook a rapid review of the literature following guidelines by the WHO and the COVID-19 Cochrane Collaboration’s recommendations. We searched across 14 databases, executing the search at two different time points. We included published observational and experimental studies that reported the psychological effects on health and care workers during the COVID-19 pandemic. ResultsThe 24 studies included in this review reported data predominantly from China (18 out of 24 included studies) and most sampled urban hospital staff. Our study indicates that COVID-19 has a considerable impact on the psychological wellbeing of front line hospital staff. Results suggest that nurses may be at higher risk of adverse mental health outcomes during this pandemic, but no studies compare this group with the social care or primary care workforce. Other risk factors identified were underlying organic illness, gender (female), concern about family, fear of infection, lack of personal protective equipment (PPE) and close contact with COVID-19. Resilience was identified as a factor protecting against adverse mental health outcomes. ConclusionsThe evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from psychological interventions. However, inconsistencies in findings and a lack of data outside of hospital settings, suggest that we should not exclude any groups when addressing psychological wellbeing in health and social care workers. Psychological interventions aimed at enhancing psychological resilience and utilising innovative methods to personalise treatments without excluding groups may be of benefit.

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“…A registry for emergency care (REC), with the short‐term capacity to examine the impact of IPC processes on patient care, will have an essential role as a source of real‐time clinical data to guide emergency care delivery and public health response, especially in the setting of communicable disease outbreaks 15,16 . Tools of this nature may help offset the impact of public health emergencies on Australian EDs, 17 and help drive innovative approaches to managing the risks of nosocomial transmission 8 …”

Section: Discussionmentioning

confidence: 99%

Epidemiology and clinical features of emergency department patients with suspected COVID‐19: Results from the first month of the COVID‐19 Emergency Department Quality Improvement Project (COVED‐2)

O’Reilly

Mitchell

et al. 2020

Emerg Medicine Australasia

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Objective: The aim of the present study was to describe the epidemiological and clinical features of ED patients with suspected and confirmed COVID-19. Methods: The COVID-19 Emergency Department (COVED) Project is an ongoing prospective cohort study that includes all adult patients presenting to The Alfred Hospital ED who undergo testing for SARS-CoV-2. Current guidelines recommend testing for patients with fevers or chills, acute respiratory symptoms or a high-risk exposure history, as well as implementation of infection prevention and control precautions for all suspected and confirmed cases. Study outcomes include a positive SARS-CoV-2 test result and intensive respiratory support. Results: In the period 1-30 April 2020, 702 of 3453 ED patients (20%; 95% CI 19-22) were tested, with a significant increase during the study period (incident rate ratio 1.019; 95% confidence interval 1.017-1.021, P < 0.001). The primary outcome of a positive SARS-CoV-2 test was recorded in 14 patients (2%; 95% confidence interval 1-3). Shortness of breath (77%), fatigue (100%), myalgia (67%) and diarrhoea (67%) were common among positive cases, while close contact (9%), fever (0%) and healthcare occupation (0%) were not. No positive cases required intensive respiratory support in the ED. Conclusions: The volume of ED patients with suspected COVID-19 is increasing. Low numbers of positive cases precluded development of accurate predictive tools, but the COVED Project is fulfilling an important role in monitoring the burden of infection prevention and control requirements on the ED. The

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Clinical and ethical challenges for emergency departments during communicable disease outbreaks: Can lessons from Ebola Virus Disease be applied to the COVID‐19 pandemic?

Cited by 26 publications

References 16 publications

A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being

A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being

A rapid review of the impact of COVID-19 on the mental health of health and social care workers: implications for psychological interventions

Epidemiology and clinical features of emergency department patients with suspected COVID‐19: Results from the first month of the COVID‐19 Emergency Department Quality Improvement Project (COVED‐2)

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