Experiencing COVID-19, home isolation and primary health care: A mixed-methods study

IntroductionIsolation strategies have been implemented in numerous countries worldwide during the ongoing community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, various countries and organizations have implemented their isolation measures at varying intensities, even during the same period. Therefore, we systematically reviewed the key information contained in currently available guidelines regarding the isolation of the general population, aiming to better identify the heterogeneity of the current isolation strategies.MethodsWe conducted searches in four evidence-based medicine (EBM) databases and five guideline websites to identify guidelines, guidance, protocols, and policy documents published by authoritative advisory bodies or healthcare organizations, which provided information on the implementation of isolation for general populations with COVID-19. One author extracted data using a standardized data extraction checklist, and a second author double-checked all extractions for completeness and correctness. Discrepancies were resolved through discussion. The information extracted from the included articles was summarized both narratively and using tables.ResultsWe included 15 articles that provided information on isolation measures recommended by nine different countries and organizations. The included articles consistently recommended isolating individuals with a positive COVID-19 test, regardless of the presence of symptoms. However, there were variations in the duration of isolation, and substantial differences also existed in the criteria for ending the isolation of COVID-19 patients.ConclusionDifferent countries and organizations have substantial differences in their isolation policies. This reminds us that scientifically sound guidelines on isolation that balance the risk of prematurely ending isolation with the burden of prolonged isolation are a crucial topic of discussion when faced with a pandemic.

Section: Where To Isolate?mentioning

confidence: 99%

How are countries responding differently to COVID-19: a systematic review of guidelines on isolation measures

Xie,

Wang,

Zhang

2023

“…The patient in this study was quarantined for 10 days after the detection of SARS-CoV-2 on the first date, similar to previous a systematic review that revealed several Asian, European, and American nations with home-isolation policies ( 37 ). In addition, the medical team conducts daily follow-up calls and questionnaires to monitor patient symptoms, including the occurrence of unexpected symptoms and the impact of physical ( 38 ), mental, and emotional quarantine ( 39–41 ). Furthermore, this study was strengthened by the large number and variety of Songkhla patients who underwent HI and CI in primary care.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the worsening of COVID-19 symptoms among cohorts in community- or home-isolation care in southern Thailand

Sila,

Suriyaamorn,

Toh

et al. 2024

IntroductionThis study aimed to investigate factors associated with time-to-referral due to worsening symptoms in patients with laboratory-confirmed COVID-19 in southern Thailand. While underlying diseases have been evaluated to assess COVID-19 severity, the influence of vaccinations and treatments is also crucial.MethodsA cohort of 8,638 patients quarantined in home or community isolation with laboratory-confirmed COVID-19 was analyzed. Survival analysis and the Cox proportional hazard ratio were employed to assess factors influencing time-toreferral.ResultsAge ≥ 60 years, neurologic disorders, cardiovascular disease, and human immunodeficiency virus infection were identified as significant risk factors for severe COVID-19 referral. Patients who received full- or booster-dose vaccinations had a lower risk of experiencing severe symptoms compared to unvaccinated patients. Notably, individuals vaccinated during the Omicron-dominant period had a substantially lower time-to-referral than those unvaccinated during the Delta-dominant period. Moreover, patients vaccinated between 1 and 6 months prior to infection had a significantly lower risk of time-to-referral than the reference group.DiscussionThese findings demonstrate early intervention in high-risk COVID-19 patients and the importance of vaccination efficacy to reduce symptom severity. The study provides valuable insights for guiding future epidemic management strategies and optimising patient care during infectious disease outbreaks.

“…We thus analyzed the qualitative telephone interviews in the sense of the new research question in addition to the survey data aiming to provide a holistic understanding of the burdening experience of HCAs during the pandemic in 2020. We compared the results of all three data sets within a triangulation protocol, using the same methodology as used in a similar study ( 22 ). We used methodological data and investigator triangulation to improve the validity of our results ( 23 ).…”

Section: Methodsmentioning

confidence: 99%

Stress experiences of healthcare assistants in family practice at the onset of the COVID-19 pandemic: a mixed methods study

Schrader,

Ruck,

Borgulya

et al. 2023

Self Cite

BackgroundAt the beginning of the pandemic in 2020, healthcare assistants in general practices were confronted with numerous new challenges. The aim of the study was to investigate the stress factors of healthcare assistants in March/April 2020 as well as in the further course of the pandemic in 2020.MethodsFrom August to December 2020, 6,300 randomly selected healthcare assistants in four German states were invited to participate in the study. We performed a mixed methods design using semi-structured telephone interviews and a cross-sectional survey with quantitative and open questions. The feeling of psychological burden was assessed on a 6-point likert-scale. We defined stress factors and categorized them in patient, non-patient and organizational stress factors. The results of the three data sets were compared within a triangulation protocol.ResultsOne thousand two hundred seventy-four surveys were analyzed and 28 interviews with 34 healthcare assistants were conducted. Of the participants, 29.5% reported experiences of a very high or high feeling of psychological burden in March/April 2020. Worries about the patients’ health and an uncertainty around the new disease were among the patient-related stress factors. Non-patient-related stress factors were problems with the compatibility of work and family, and the fear of infecting relatives with COVID-19. Organizational efforts and dissatisfaction with governmental pandemic management were reported as organizational stress factors. Support from the employer and team cohesion were considered as important resources.DiscussionIt is necessary to reduce stress among healthcare assistants by improving their working conditions and to strengthen their resilience to ensure primary healthcare delivery in future health crises.