Lockdown During COVID-19: The Greek Success

Moris, Demetrios; Schizas, Dimitrios

doi:10.21873/invivo.11963

Cited by 62 publications

(55 citation statements)

References 19 publications

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“…The source for mortality and testing data we selected is publicly available, 7 has been repeatedly archived, 11 contains links to the source government reports for each country, agrees with other coronavirus aggregator sites, 89 and has been used in other scholarly works. 85,[90][91][92][93][94][95][96] We presented the per-capita mortality data in Supplemental Table A2. One might question whether any of these data sites or governments provide a complete and accurate picture of coronavirus mortality.…”

Section: Coronavirus Epidemiologymentioning

confidence: 99%

Association of Country-wide Coronavirus Mortality with Demographics, Testing, Lockdowns, and Public Wearing of Masks

Leffler

Ing

Lykins

et al. 2020

The American Journal of Tropical Medicine and Hygiene

172

220

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We studied sources of variation between countries in per-capita mortality from COVID-19 (caused by the SARS-CoV-2 virus). Potential predictors of per-capita coronavirus-related mortality in 200 countries by May 9, 2020 were examined, including age, gender, obesity prevalence, temperature, urbanization, smoking, duration of the outbreak, lockdowns, viral testing, contact-tracing policies, and public mask-wearing norms and policies. Multivariable linear regression analysis was performed. In univariate analysis, the prevalence of smoking, per-capita gross domestic product, urbanization, and colder average country temperature was positively associated with coronavirus-related mortality. In a multivariable analysis of 196 countries, the duration of the outbreak in the country, and the proportion of the population aged 60 years or older were positively associated with per-capita mortality, whereas duration of mask-wearing by the public was negatively associated with mortality (all P < 0.001). Obesity and less stringent international travel restrictions were independently associated with mortality in a model which controlled for testing policy. Viral testing policies and levels were not associated with mortality. Internal lockdown was associated with a nonsignificant 2.4% reduction in mortality each week (P = 0.83). The association of contact-tracing policy with mortality was not statistically significant (P = 0.06). In countries with cultural norms or government policies supporting public mask-wearing, per-capita coronavirus mortality increased on average by just 16.2% each week, as compared with 61.9% each week in remaining countries. Societal norms and government policies supporting the wearing of masks by the public, as well as international travel controls, are independently associated with lower per-capita mortality from COVID-19.

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Section: Coronavirus Epidemiologymentioning

confidence: 99%

Association of Country-wide Coronavirus Mortality with Demographics, Testing, Lockdowns, and Public Wearing of Masks

Leffler

Ing

Lykins

et al. 2020

The American Journal of Tropical Medicine and Hygiene

172

220

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“…To interpret the observed differences in clinical outcomes, at least two general and/or local factors should be taken into account. Firstly and primarily, in our study all critically ill patients with COVID-19 were admitted to the ICU in time, because overwhelming stress on the healthcare system did not occur in our country (11). All these patients were admitted to preexisting multidisciplinary ICUs, were cared for by critical care teams with experience in the management of patients with severe acute respiratory failure at standard sta ng ratios, and received full intensive care support, including renal replacement therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Ιn Greece, the number of patients with con rmed COVID-19 and those who required hospital and ICU admission was rather limited, thus not overwhelming hospital resources (11). Therefore, we considered pertinent to investigate the outcome of critically ill patients with COVID-19 admitted to the general ICUs of a big referral for COVID-19 tertiary-care hospital with adequate resources.…”

Section: Introductionmentioning

confidence: 99%

Mortality rate among critically ill patients with COVID-19 in a medical system with adequate hospital resources: a prospective observational study

Routsi

Magira

Kokkoris³

et al. 2020

Preprint

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Background: For critically ill patients with coronavirus disease 2019 (COVID-19) who require intensive care unit (ICU) admission, mortality rates vary widely depending on many factors, among which hospital resources and clinical setting seem important. We sought to determine the outcome of critically ill patients admitted in the usual multidisciplinary ICUs of a big referral for COVID-19 tertiary-care hospital with adequate resources.Methods: We performed a prospective observational study of all adult patients with COVID-19 consecutively admitted to four COVID-designated ICUs at Evangelismos Hospital, Athens, Greece, from March 11 to April 27, 2020.Results: Among 50 critically ill patients, ICU and hospital mortality for the entire cohort was 32% (16/50), whereas 66% (33/50) of patients were discharged alive from the ICU and 2% (1/50) were still treated in the ICU until June 16, 2020. ICU and hospital mortality for those who received invasive mechanical ventilation was 39% (16/41). Patients who eventually died had already increased risk of death on ICU admission, as suggested by the high values of the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, the presence of current malignancy and occurrence of cardiac arrest in 44% (7/16) of patients, and the general need for circulatory support by noradrenaline. Median PaO2/FiO2 on ICU admission for the entire cohort was 121 mmHg [interquartile range (IQR), 86-171 mmHg] and most patients had moderate and severe acute respiratory distress syndrome (ARDS) according to the Berlin Definition. The primary cause of death of all patients was multi-organ failure, most commonly due to sepsis, whereas none died from refractory hypoxemia, neurologic dysfunction or withdrawal of life support. Hospital stay was long in patients who survived [median 24 days (IQR, 15-35 days)] and was frequently complicated by bacteremias [36% (12/33)].Conclusion: Severely ill COVID-19 patients with moderate and severe ARDS may have equal or even lower mortality rates compared to ARDS due to other causes, when they are admitted in general ICUs with experienced and adequate staff without limitations in hospital resources, where established ARDS therapies are used.

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“…Vaccines against COVID-19,which are considered as the most promising measure to contain the pandemic, are still under development [1]. Lockdown is an effective public health measure to eliminate the coronavirus infection or atten the outbreak curve [2,3] andmany countries signi cantly affected by the pandemichas been enforced to issue a stay-at-home order [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Resumption of the Treatment for Non-COVID-19 Gynecologic Patients after Lifting Lock down: Experiences from Wuhan

Dong

Gao

Cai

et al. 2020

Preprint

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Background: To share our experiences of resumption of the treatment for gynecologic patients after lifting lockdown in a hotspot area of the Corona Virus Disease 2019 (COVID-19)pandemic.Methods: The triage process used to resume the medical activities for gynecologic patients at the Wuhan Union Hospital after a 76-day lockdown of the city is described and its effectiveness to avoid COVID-19 nosocomial transmission is shown.Results:The non-emergency patients are pre-triaged by contact history and body temperature at outpatient clinic and negative COVID-19 screening tests are required for an admissionin the buffering rooms at the gynecologic department. The buffering lastsfor at least three days for symptom monitoring and a second round of COVID-19 tests before they can be transferred to the regular gynecologic wards. For patients who need emergency surgery, the first screening should be completed at the quarantine wards after the surgery, followed by buffering at the gynecologic department. We received 19298 outpatient visits, admitted 326 patients, and performed 223 operations in the first two months after the lockdown was lifted, andno single COVID-19 case occurredin the hospitalized patients while the proportion of potentially high-risk patients with cancer and severe anemia were increased in comparison with the same period in 2019 and the latest two months before the lockdown.Conclusions:We provide an effective triage system with buffering at two levels to guarantee safe and timely treatment for non-COVID-19 gynecologic patients in a post-lockdown phase.

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Lockdown During COVID-19: The Greek Success

Cited by 62 publications

References 19 publications

Association of Country-wide Coronavirus Mortality with Demographics, Testing, Lockdowns, and Public Wearing of Masks

Association of Country-wide Coronavirus Mortality with Demographics, Testing, Lockdowns, and Public Wearing of Masks

Mortality rate among critically ill patients with COVID-19 in a medical system with adequate hospital resources: a prospective observational study

Resumption of the Treatment for Non-COVID-19 Gynecologic Patients after Lifting Lock down: Experiences from Wuhan

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