High incidence of heat illness and the potential burden on the health care system during the COVID-19 pandemic

Nakahara, Shinji; Kanda, Jun; Miyake, Yoshihiro; Sakamoto, Tetsuya

doi:10.1016/j.lanwpc.2020.100070

Cited by 6 publications

(7 citation statements)

References 5 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At the very least, this should be done during public health emergencies, especially in cases with surging numbers of patients. We must absolutely alter the current approach to emergency medical services, in which ambulance crews are tasked with searching for entry points ( 13 – 15 ). Given that medical resources are dispersed across a large number of small- and medium-sized hospitals, there are significant variations in the abilities of individual emergency departments.…”

Section: Discussion: Propositions For Improvementmentioning

confidence: 99%

“…Upon selection, crews must determine whether their patients will be accepted by sending an inquiry to the hospital ( 12 ), which may decline the patient based on its treatment abilities and bed vacancies. In the pandemic context, the number of cases requiring long inquiry processes greatly increased ( 12 , 13 ). While emergency departments in other countries tended to experience overcrowding when large numbers of COVID-19 patients were transported by ambulance, patients in Japan had to remain at the scene for long periods of time while ambulance crews looked for appropriate hospital destinations.…”

Section: Access To Hospitalized Care For Covid-19 Patientsmentioning

confidence: 99%

“…At the beginning of the pandemic, many hospitals and clinics declined febrile patients because their facilities were not appropriate entry points, meaning that patients should have instead chosen locations that better fit their needs ( 21 ). Although conditions are improving, many hospitals continue to decline febrile patients who are being transferred by ambulance, especially during surges of COVID-19 patients ( 5 , 13 ). In such cases, the patients themselves or ambulance crews must identify facilities that will provide care to febrile patients.…”

Section: Identifying the Problemsmentioning

confidence: 99%

See 2 more Smart Citations

Japan's Slow Response to Improve Access to Inpatient Care for COVID-19 Patients

Nakahara

Inada

Ichikawa

et al. 2022

Front. Public Health

Self Cite

View full text Add to dashboard Cite

The coronavirus disease 2019 (COVID-19) pandemic has exposed various weaknesses in national healthcare systems across the globe. In Japan, this includes the inability to promptly mobilize the resources needed to provide inpatient care in response to the rapidly increasing number of patients. Combined with unclear entry points to healthcare, particularly in emergency cases, this has led to a situation in which access to healthcare is rapidly deteriorating. This study examined problems in Japan's healthcare delivery system. While Japan's healthcare resources (e.g., hospital beds and medical personnel) are comparable to those found in other high-income countries, progress has been slow in securing beds for COVID-19 patients. In addition, the number of beds has only recently reached the levels seen in Western countries. Factors related to slow resource allocation include dispersed existing medical resources (mainly in the private sector), the lack of collaboration mechanisms among private-dominant healthcare providers and public health agencies, an inadequate legal framework for resource mobilization, the insufficient quantification of existing resources, and undesignated entry points to healthcare systems. To better prepare for future disasters, including the next wave of COVID-19, Japan urgently needs to restructure its legal framework to promptly mobilize resources, accurately quantify existing resources, introduce coordination mechanisms with functional differentiations among all community stakeholders, and clearly designate entry points to healthcare.

show abstract

Section: Discussion: Propositions For Improvementmentioning

confidence: 99%

Section: Access To Hospitalized Care For Covid-19 Patientsmentioning

confidence: 99%

Section: Identifying the Problemsmentioning

confidence: 99%

See 1 more Smart Citation

Japan's Slow Response to Improve Access to Inpatient Care for COVID-19 Patients

Nakahara

Inada

Ichikawa

et al. 2022

Front. Public Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…There is limited research on diagnosing and managing heat emergencies in hospitals. As a result, standard protocols and algorithms are scarce to diagnose and manage heat emergencies in a hospital setting [6,18,19]. In addition, local endemic and tropical infections in summer months presenting with fever, headache, or generalized weakness often overlap with the symptoms of heat emergencies, which makes the diagnosis further challenging for healthcare providers [20,21].…”

Section: Introductionmentioning

confidence: 99%

Improvement in the diagnosis and practices of emergency healthcare providers for heat emergencies after HEAT (heat emergency awareness & treatment) an educational intervention: a multicenter quasi-experimental study

Khan¹,

Khan²,

Ahmed³

et al. 2023

BMC Emerg Med

View full text Add to dashboard Cite

Background The incidence of heat emergencies, including heat stroke and heat exhaustion, have increased recently due to climate change. This has affected global health and has become an issue of consideration for human health and well-being. Due to overlapping clinical manifestations with other diseases, and most of these emergencies occurring in an elderly patient, patients with a comorbid condition, or patients on poly medicine, diagnosing and managing them in the emergency department can be challenging. This study assessed whether an educational training on heat emergencies, defined as heat intervention in our study, could improve the diagnosis and management practices of ED healthcare providers in the ED setting. Methods A quasi-experimental study was conducted in the EDs of four hospitals in Karachi, Pakistan. Eight thousand two hundred three (8203) patients were enrolled at the ED triage based on symptoms of heat emergencies. The pre-intervention data were collected from May to July 2017, while the post-intervention data were collected from May to July 2018. The HEAT intervention, consisting of educational activities targeted toward ED healthcare providers, was implemented in April 2018. The outcomes assessed were improved recognition—measured by increased frequency of diagnosing heat emergencies and improved management—measured by increased temperature monitoring, external cooling measures, and intravenous fluids in the post-intervention period compared to pre-intervention. Results Four thousand one hundred eighty-two patients were enrolled in the pre-intervention period and 4022 in the post-intervention period, with at least one symptom falling under the criteria for diagnosis of a heat emergency. The diagnosis rate improved from 3% (n = 125/4181) to 7.5% (n = 7.5/4022) (p-value < 0.001), temperature monitoring improved from 0.9% (n = 41/4181) to 13% (n = 496/4022) (p-value < 0.001) and external cooling measure (water sponging) improved from 1.3% (n = 89/4181) to 3.4% (n = 210/4022) (p-value < 0.001) after the administration of the HEAT intervention. Conclusion The HEAT intervention in our study improved ED healthcare providers' approach towards diagnosis and management practices of patients presenting with health emergencies (heat stroke or heat exhaustion) in the ED setting. The findings support the case of training ED healthcare providers to address emerging health issues due to rising temperatures/ climate change using standardized treatment algorithms.

show abstract

“…However, at the beginning of the COVID-19 pandemic, many health care providers in clinics and general hospitals were reluctant to examine patients with fever or common cold symptoms, mainly due to difficulties in ensuring proper infection control measures, such as distancing of outpatients or the lack of personal protective equipment (PPE) for health care providers. This placed an additional burden on emergency departments (EDs) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in the proportion and severity of patients with fever or common cold symptoms utilizing an after-hours house call medical service during the COVID-19 pandemic in Tokyo, Japan: a retrospective cohort study

et al. 2021

View full text Add to dashboard Cite

Background Trends in the characteristics and disease severity of patients using an after-hours house call (AHHC) medical service changed during the coronavirus disease (COVID-19) pandemic. However, there have been no reports on this issue since the start of the COVID-19 pandemic. This study aimed to investigate patients’ tendencies to utilize an AHHC medical service for fever or common cold symptoms during the COVID-19 pandemic. Methods This retrospective cohort study compared the characteristics and disease severity of patients with fever or common cold symptoms utilizing an AHHC medical service offered by a single large company between the control period (December 1, 2018 to April 30, 2019) and the COVID-19 pandemic exposure period (December 1, 2019 to April 30, 2020). We also assessed the proportion of these patients in relation to all patients calling the service for any reason. Results During the control and COVID-19 pandemic exposure periods, a total of 6462 and 10,003 patients consulted the AHHC medical service, respectively. Of these, 5335 (82.6%) and 7423 (74.2%) patients had fever and common cold symptoms, respectively, during the control and COVID-19 pandemic exposure periods (P < 0.001). The corresponding median (interquartile range) ages were 8 (3–11) and 10 (4–33) years, respectively. The distribution of disease severity differed between the groups. The proportions of patients with mild, moderate, and severe illness were 71.1, 28.7, and 0.2% in the control period and 42.3, 56.7, and 0.9% in the COVID-19 pandemic exposure period, respectively (P < 0.001). Conclusions During the COVID-19 pandemic, the proportion of patients with fever or common cold symptoms was lower than that in the control period, but disease severity was significantly higher.

show abstract

High incidence of heat illness and the potential burden on the health care system during the COVID-19 pandemic

Cited by 6 publications

References 5 publications

Japan's Slow Response to Improve Access to Inpatient Care for COVID-19 Patients

Japan's Slow Response to Improve Access to Inpatient Care for COVID-19 Patients

Improvement in the diagnosis and practices of emergency healthcare providers for heat emergencies after HEAT (heat emergency awareness & treatment) an educational intervention: a multicenter quasi-experimental study

Changes in the proportion and severity of patients with fever or common cold symptoms utilizing an after-hours house call medical service during the COVID-19 pandemic in Tokyo, Japan: a retrospective cohort study

Contact Info

Product

Resources

About