Hospital Capacity during an Influenza Pandemic—Buenos Aires, Argentina, 2009

Meites, Elissa; Farias, Daniel Rodrigues de; Raffo, L Eduardo; Albalak, Rachel; Carlino, Oreste Luis; McDonald, L. Clifford; Widdowson, Marc‐Alain

doi:10.1086/657667

Cited by 5 publications

(9 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Critically ill patients occasionally received mechanical ventilation outside the ICU, at the emergency department or special facilities [40], [41]. In most patients, ARDS with respiratory failure was the leading cause of death.…”

Section: Discussionmentioning

confidence: 99%

An Analysis of 332 Fatalities Infected with Pandemic 2009 Influenza A (H1N1) in Argentina

et al. 2012

Self Cite

View full text Add to dashboard Cite

BackgroundThe apparent high number of deaths in Argentina during the 2009 pandemic led to concern that the influenza A H1N1pdm disease was different there. We report the characteristics and risk factors for influenza A H1N1pdm fatalities.MethodsWe identified laboratory-confirmed influenza A H1N1pdm fatalities occurring during June-July 2009. Physicians abstracted data on age, sex, time of onset of illness, medical history, clinical presentation at admission, laboratory, treatment, and outcomes using standardize questionnaires. We explored the characteristics of fatalities according to their age and risk group.ResultsOf 332 influenza A H1N1pdm fatalities, 226 (68%) were among persons aged <50 years. Acute respiratory failure was the leading cause of death. Of all cases, 249 (75%) had at least one comorbidity as defined by Advisory Committee on Immunization Practices. Obesity was reported in 32% with data and chronic pulmonary disease in 28%. Among the 40 deaths in children aged <5 years, chronic pulmonary disease (42%) and neonatal pathologies (35%) were the most common co-morbidities. Twenty (6%) fatalities were among pregnant or postpartum women of which only 47% had diagnosed co-morbidities. Only 13% of patients received antiviral treatment within 48 hours of symptom onset. None of children aged <5 years or the pregnant women received antivirals within 48 h of symptom onset. As the pandemic progressed, the time from symptom-onset to medical care and to antiviral treatment decreased significantly among case-patients who subsequently died (p<0.001).ConclusionPersons with co-morbidities, pregnant and who received antivirals late were over-represented among influenza A H1N1pdm deaths in Argentina, though timeliness of antiviral treatment improved during the pandemic.

show abstract

Section: Discussionmentioning

confidence: 99%

An Analysis of 332 Fatalities Infected with Pandemic 2009 Influenza A (H1N1) in Argentina

et al. 2012

Self Cite

View full text Add to dashboard Cite

show abstract

“…Following the PICOS framework, the characteristics of the 16 studies included in the narrative analysis are described in Table 2. The studies can be grouped into three categories: those focussing on a simulated influenza outbreak (eight articles, mostly published before 2011) [25][26][27][28][29][30][31][32] ; those assessing temporal effects of the H1N1 pandemic (three articles published between 2011 and 2015) [33][34][35] ; and those assessing effects at the early stages of the COVID-19 pandemic (five articles published in the first half of 2020). [36][37][38][39][40] Three-quarters (75%) of the retained articles covered high-income countries in Europe (five studies), North America (4), and Oceania (3); two (13%) studies covered upper-middle-income countries in South America; one (6%) covered a high-income economy in Asia; and one (6%) used a model population.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…33 Workforce planning involved the need to accommodate a national policy to furlough workers with high-risk medical conditions; in the study setting, data revealed that 6% of hospital nurses accepted six weeks of paid leave over three months. 33 While overall nursing absences were found to be similar to prepandemic periods, unscheduled absences increased, reaching a peak of 43% of nurses scheduled for duty on a given day. Nursing surge capacity was managed through temporary hiring, cancellation of vacations and other scheduled absences, and shifting to higher acuity care areas (given fewer hospitalized patients attributable to postponed surgeries).…”

Section: Factors Considered To Affect Hrh Surge Capacity During the H1n1 Pandemicmentioning

confidence: 99%

“…The authors noted that a 43% nursing staff absenteeism rate during the pandemic was not unusually high, as baseline rates up to 46% had been observed before the pandemic in other South American hospitals. 33 In Norway, physician registry data were analysed to enhance understanding of pressures from the H1N1 pandemic on the delivery of primary care medical services. 34 Simonsen and colleagues reported that the majority of medical consultations for influenza-like illness took place in day-time general practices (characterized by mostly pre-booked appointments with limited availability for acute illnesses every day).…”

Section: Factors Considered To Affect Hrh Surge Capacity During the H1n1 Pandemicmentioning

confidence: 99%

See 1 more Smart Citation

Health workforce surge capacity during the COVID‐19 pandemic and other global respiratory disease outbreaks: A systematic review of health system requirements and responses

Gupta

Balcom

Gulliver

et al. 2021

Health Planning & Management

View full text Add to dashboard Cite

Health system decision‐makers need comprehensive evidence to mitigate surges in the demand for human resources for health (HRH) during infectious disease outbreaks. This study aimed to assess the state of the evidence on policy and planning responses to HRH surge capacity during the coronavirus disease (COVID‐19) pandemic and other viral respiratory disease outbreaks of global significance in the 21st century. We systematically searched eight bibliographic databases to extract primary research articles published between January 2000 and June 2020 capturing temporal changes in health workforce requirements and responses surrounding respiratory virus pandemics. Following the Preferred Reporting Items for Systematic Reviews and Meta‐analyses standard, 16 studies met our inclusion criteria. Five focused on COVID‐19, three on H1N1, and eight modelled a hypothetical pandemic. Investigations of different training, mobilization, and redeployment options to address pandemic‐time health system capacity were reviewed; however, few scenarios drew on observational HRH data, and heterogeneity of study approaches and outcomes generally precluded comparability across contexts. Notable evidence gaps included occupational and psychosocial factors affecting healthcare workers' absenteeism and risk of burnout, gendered considerations of HRH capacity, evaluations in low‐ and lower‐middle income countries, and policy‐actionable assessments to inform post‐pandemic recovery and sustainability of services for noncommunicable disease management.

show abstract

“…A key factor that may limit achieving this goal is the availability of ventilators, requiring anesthesia machines and regional stockpiles to be used. 41 Crisis care (200% beyond usual capacity or three times the usual ICU beds) will most likely require access to outside resources, such as strategic national stockpiles, and will likely require 48 to 72 h to achieve. Th e facility should identify what spaces would be used and what supplemental supplies (monitors, beds, and ventilators) would be required to minimize delays if occasion warrants.…”

mentioning

confidence: 99%