Early Lessons From World War COVID Reinventing Our Stroke Systems of Care

Sheth, Sunil A; Wu, Tzu Ching; Sharrief, Anjail; Ankrom, Christy; Grotta, James C.; Fisher, Marc; Savitz, Sean I

doi:10.1161/strokeaha.120.030154

Cited by 17 publications

(20 citation statements)

References 17 publications

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“…Lessons must be learned from this rapidly evolving situation to ensure that stroke care continues to be provided at present and during future crises. 13 In Kobe City, continued cooperation between facilities was crucial to maintaining high quality stroke care. Stroke care will remain an important element of medical services after the epidemic and efforts are required to ensure the uninterrupted functioning of stroke care systems.…”

Section: Resultsmentioning

confidence: 99%

Stroke Systems of Care During the COVID-19 Epidemic in Kobe City

Ohara

Imamura

Adachi

et al. 2020

Journal of Stroke and Cerebrovascular Diseases

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Background: The novel coronavirus disease 2019 (COVID-19) outbreak raised concerns over healthcare systems' ability to provide suitable care to stroke patients. In the present study, we examined the provision of stroke care in Kobe City during the COVID-19 epidemic, where some major stroke centers ceased to provide emergency care. Methods: This was a cross-sectional study. The Kobe Stroke Network surveyed the number of stroke patients admitted to all primary stroke centers (PSCs) in the city between March 1 and May 23, 2020, and between March 3 and May 25, 2019. In addition, online meetings between all PSC directors were held regularly to share information. The survey items included emergency response system characteristics, number of patients with stroke hospitalized within 7 days of onset, administered treatment types (IV rt-PA, mechanical thrombectomy, surgery, and endovascular therapy), and stroke patients with confirmed COVID-19. Results: During the period of interest in 2020, the number of stroke patients hospitalized across 13 PSCs was 813, which was 15.5% lower than that during the same period of 2019 (p = 0.285). The number of patients admitted with cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage decreased by 15.4% (p = 0.245), 16.1% (p = 0.659), and 14.0% (p = 0.715), respectively. However, the rates of mechanical thrombectomy and surgery for intracerebral hemorrhage were

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Section: Resultsmentioning

confidence: 99%

Stroke Systems of Care During the COVID-19 Epidemic in Kobe City

Ohara

Imamura

Adachi

et al. 2020

Journal of Stroke and Cerebrovascular Diseases

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“…These guidelines have introduced measures such as COVID-19 screening and personal protective equipment into stroke triage to ensure the safety of patients and the stroke team while emphasizing the importance of preventing delays in care. The optimization of telemedicine and other virtual clinician guidance tools has become essential to triage patients appropriately and provide education and prevention (17).…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center

et al. 2020

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Background: COVID-19 has impacted healthcare in many ways, including presentation of acute stroke. Since time-sensitive thrombolysis is essential for reducing morbidity and mortality in acute stroke, any delays due to the pandemic can have serious consequences. Methods: We retrospectively reviewed the electronic medical records for patients presenting with acute ischemic stroke at a comprehensive stroke center in March-April 2020 (the early months of COVID-19) and compared to the same time period in 2019. Stroke metrics such as incidence, time to arrival, and immediate outcomes were assessed. Results: There were 48 acute ischemic strokes (of which 7 were transfers) in March-April 2020 compared to 64 (of which 12 were transfers) in 2019. The average last known well to arrival time (±SD) for stroke codes was 1,041 (±1682.1) min in 2020 and 554 (±604.9) min in 2019. Of the patients presenting directly to the ED with a known last known well time, 27.8% (10/36) presented in the first 4.5 h in 2020, in contrast to 40.5% (15/37) in 2019. Patients who died comprised 10.4% of the stroke cohort in 2020 (5/48) compared to 6.3% in 2019 (4/64). Conclusions: During the first 2 months of COVID-19, there were fewer overall stroke cases who presented to our hospital, and of these cases, there was delayed presentation in comparison to the same time period in 2019. Recognizing how stroke presentation may be affected by COVID-19 would allow for optimization of established stroke triage algorithms in order to ensure safe and timely delivery of stroke care during a pandemic.

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“…While humankind has faced different pandemics in the last century, COVID-19 is one of the most influential human-driven disasters that caused deaths and unprecedented disruptions in urban life [20,27]. This challenge has come to a situation that some have called World War COVID to explain the destruction level of the pandemic [85]. Specifically, as COVID-19 has affected all aspects of human life, governments have been forced to impose restrictions to mitigate the negative externalities of the pandemic.…”

Section: Deployment Of Technology In Cities During Covid-19mentioning

confidence: 99%

Smart City and Crisis Management: Lessons for the COVID-19 Pandemic

Hassankhani

Alidadi

Sharifi

et al. 2021

IJERPH

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COVID-19 shocked cities around the world and revealed the vulnerability of urban lives and functions. Most cities experienced a catastrophic disturbance that has lasted for a long time. Planning plays a critical role in responding efficiently to this crisis and enabling rapid functional recovery in the post-disaster era. Cities that have implemented digitalization initiatives and programs are likely to have more capacity to react appropriately. Specifically, digitalized cities could ensure the well-being of their residents and maintain continuity of urban functions. This research aims to analyze the role of technology in crisis management in the last two decades and provide appropriate policy recommendations for dealing with the COVID-19 pandemic. Systematic literature review and subjective content analysis are employed to investigate the effects of technology on community well-being and making cities more resilient in past crises. This study shows that different technology-driven policies and actions enable crisis management, enhance community well-being, and increase urban resilience. Technology has enhanced coping and recovery capacities by increasing participation and social connectedness, enhancing physical and mental health and maintaining the functionality of education and economic systems. These have been achieved through various solutions and technologies such as social media, telehealth, tracking and monitoring systems, sensors and locational applications, teleworking systems, etc. These solutions and technologies have also been used during the COVID-19 pandemic to enhance community well-being and sustain urban functions. However, technology deployment might have adverse effects such as social exclusion, digital divide, privacy and confidentiality violation, political bias and misinformation dissemination, and inefficient remote working and education. It is suggested that to mitigate these side effects, policymakers should liberate the process of digitalization, increase the accessibility to digital services, and enhance digital literacy.

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Early Lessons From World War COVID Reinventing Our Stroke Systems of Care

Cited by 17 publications

References 17 publications

Stroke Systems of Care During the COVID-19 Epidemic in Kobe City

Stroke Systems of Care During the COVID-19 Epidemic in Kobe City

Impact of COVID-19 on Acute Stroke Presentation at a Comprehensive Stroke Center

Smart City and Crisis Management: Lessons for the COVID-19 Pandemic

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