Mitigation Policies and Emergency Care Management in Europe's Ground Zero for COVID-19

Ciminelli, Gabriele; Garcia-Mandicó, Sílvia

doi:10.2139/ssrn.3604688

Cited by 12 publications

(13 citation statements)

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“…• EMS calls during COVID-19, 7,8,10-19 • Reduced EMS operator response time, 7 • Ambulance response delays, 14,20,21 • Collateral mortality and morbidity among non-COVID-19 cases, 14,17,19,[22][23][24][25][26][27][28][29]31 and • Total ambulance call time. 17,29,[33][34][35]…”

Section: Charting the Data And Synthesizing Resultsmentioning

confidence: 99%

“…16 The worst was in Lombardia, which was dubbed COVID-19 Ground Zero in Europe, where EMS calls swelled five times more than its EMSDC baseline. 17 In Greater Paris, the number of daily EMS calls increased from 2000 to 6500. 18 In Catalonia, Spain, EMS calls increased by 330% during the month of March, 2020, with unprecedented numbers reaching 40,000 EMS calls during three pandemic peak days.…”

Section: Ems Calls During Covid-19mentioning

confidence: 99%

See 1 more Smart Citation

Emergency Medical Services (EMS) Calls During COVID-19: Early Lessons Learned for Systems Planning (A Narrative Review)

Amiry¹,

Maguire²

2021

OAEM

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Background: Over the course of the COVID-19 progress, reports from many locations around the world indicated major increases in EMS call volume, which imposed great pressure on EMS dispatch centers (EMSDC) globally. No studies yet have been done to examine this phenomenon. Objective: This paper examines the interrelated effects of the unprecedented global increase of EMS call, the effect of the COVID-19 crisis on responding to non-COVID-19 emergencies, and the concurrent effects of having overwhelmed dispatch centers. It tries to explain the current evidence of the bottleneck of EMS calls during the early phase of the worldwide pandemic. Eligibility Criteria: We examine the numbers of EMS calls internationally between March and June 2020, derived from published literature and news media. Only articles in English were selected, with certain keywords related to EMS calls, ambulance delay, stroke and cardiac arrest. Source of Evidence: Google Scholar was the main searching source. Results: After applying the selection criteria, a total of 29 citations were chosen, and a pattern of knowledge resulted in the emergence of five themes: EMS calls during COVID-19, Reduced EMS operator response time, Ambulance response delays, Collateral mortality and morbidity among non-COVID-19 cases, and Total ambulance call time. Conclusion:Over the course of COVID-19 progress, there was a global phenomenon of exponential increases in EMS calls, which is expected to impose a great pressure on EMS dispatch centers. Several factors contributing to the bottleneck of EMS calls are identified and explained.

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Section: Charting the Data And Synthesizing Resultsmentioning

confidence: 99%

Section: Ems Calls During Covid-19mentioning

confidence: 99%

Emergency Medical Services (EMS) Calls During COVID-19: Early Lessons Learned for Systems Planning (A Narrative Review)

Amiry¹,

Maguire²

2021

OAEM

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“…Location in a highly densely populated area was the only factor associated with a reduced mortality rate, which might be related to improved access to hospitals with intensive care units in urban areas, as previously suggested. 20 The clustering of nursing homes according to their residents' profile and structural capacities provided a global perspective of the type of nursing homes that might be more susceptible to Covid-19 mortality in the advent of future outbreaks. Consistently with our regression analysis, clusters with greater mortality than the median (phenogroup numbers 1,4,7, and 8) were all located in neighborhoods with high incidence of Covid-19.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk factors for mortality of residents in nursing homes with Covid-19: a retrospective cohort study

Suñer

Ouchi

Mas

et al. 2020

Preprint

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BackgroundNursing homes have shown remarkably high Covid-19 incidence and mortality. We aimed to explore the contribution of structural factors of nursing home facilities and the surrounding district to all-cause and Covid-19-related deaths during a SARS-CoV-2 outbreak.MethodsIn this retrospective cohort study, we investigated the risk factors of Covid-19 mortality at the facility level in nursing homes in Catalonia (North-East Spain). The investigated factors included characteristics of the residents (age, gender, comorbidities, and complexity and/or advanced disease), structural features of the nursing home (total number of residents, residents who return home during the pandemic, and capacity for pandemic response, based on an ad hoc score of availability of twelve essential items for implementing preventive measures), and sociodemographic profile of the catchment district (household income, population density, and population incidence of Covid-19). Study endpoints included all-cause death and Covid-19-related death (either PCR-confirmed or clinical suspicion).FindingsThe analysis included 167 nursing homes that provide long-term care to 8,716 residents. Between March 1 and June 1, 2020, 1,629 deaths were reported in these nursing homes; 1,089 (66□9%) of them were Covid-19-confirmed. The multivariable regression showed a higher risk of death associated with a higher percentage of complex patients (HR 1□09; 95%CI 1□05-1□12 per 10% increase) or those with advanced diseases (1□13; 1□07-1□19), lower capacity for implementing preventive measures (1□08; 1□05-1□10 per 1-point increase), and districts with a higher incidence of Covid-19 (2□98; 2□53-3□50 per 1000 cases/100,000 population increase). A higher population density of the catchment area was a protective factor (0□60; 0□50-0□72 per log10 people/Km2 increase).InterpretationPresence of residents with complex/advance disease, low capacity for pandemic response and location in areas with high incidence of Covid-19 are risk factors for Covid-19 mortality in nursing homes and may help policymakers to prioritize preventative interventions for pandemic containment.FundingCrowdfunding campaign YoMeCorono (https://www.yomecorono.com/), and Generalitat de Catalunya.Research in contextEvidence before this studyWe searched PubMed for studies exploring the management of Covid-19 in long-term care settings. The search was performed on May 1, 2020, and included the keywords “Covid-19”, “nursing home”, “long term care”, and “skilled nursing facility” with no language restriction. In addition to descriptive reports of Covid-19 mortality in the long-term care setting, we found studies providing evidence on the influence of age and comorbidities to mortality at the individual level. Some authors reported comparisons in the incidence and mortality of Covid-19 between facilities and country areas, and suggested the characteristics of each area/facility that may explain differences in mortality. However, we found no published works specifically investigating the contribution of structural features of the facility and sociodemographic characteristics of the area to explaining differences in Covid-19 mortality among long-term care facilities.Added value of this studyThis is the first analysis of risk of mortality at a facility level of residents with Covid-19 in nursing homes. We enrolled up to 167 nursing homes providing long-term care to 8,716 residents and we actively identified risk factors for Covid-19 mortality at the facility level. We found that nursing homes with lower capacity for pandemic response, and located in districts with a higher incidence of Covid-19 had significantly higher risks of Covid-19 mortality. The percentage of complex and/or advanced disease patients was also a risk factor.Implications of all the available evidenceOur findings provide policymakers with critical information to prioritize long-term care facilities at higher risk when deploying preventative interventions to minimize mortality in this setting. The association between mortality within the nursing home and Covid-19 incidence in the catchment area reinforces the importance of preventing the entry of SARS-CoV-2 into facilities. Nursing homes with limited capacity to implement containment measures should be prioritized when deploying preventative interventions for minimizing Covid-19 mortality in long-term care facilities.

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“…At the societal level, closure of non-essential businesses has been shown to be effective in reducing Covid-19 mortality (Ciminelli and Garcia-Mandico 2020), but a lockdown of all non-essential workers is unlikely to be cost-effective for an extended period (Fischer 2020). Prior work has already shown that closure of non-essential businesses jeopardized almost a quarter of jobs in the U.S. and 4 reduced total wage income (del Rio-Chanona et al 2020), had a perverse effect on wage inequality (Schiavone 2020), and increased unemployment mostly among minorities (Fairlie, Couch, and Xu 2020).…”

Section: Introductionmentioning

confidence: 99%

The Impact of the Non-essential Business Closure Policy on Covid-19 Infection Rates

Song

McKenna²,

Chen

et al. 2021

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In response to the Covid-19 pandemic, many localities instituted non-essential business closure orders, keeping individuals categorized as essential workers at the frontlines while sending their non-essential counterparts home. We examine the extent to which being designated as an essential or non-essential worker impacts one's risk of being Covid-positive following the nonessential business closure order in Pennsylvania. We also assess the intrahousehold transmission risk experienced by their cohabiting family members and roommates. Using a difference-indifferences framework, we estimate that workers designated as essential have a 55% higher likelihood of being positive for Covid-19 than those classified as non-essential; in other words, non-essential workers experience a protective effect. While members of the health care and social assistance subsector contribute significantly to this overall effect, it is not completely driven by them. We also find evidence of intrahousehold transmission that differs in intensity by essential status. Dependents cohabiting with an essential worker have a 17% higher likelihood of being Covid-positive compared to those cohabiting with a non-essential worker. Roommates cohabiting with an essential worker experience a 38% increase in likelihood of being Covid-positive. Analysis of households with a Covid-positive member suggests that intrahousehold transmission is an important mechanism

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Mitigation Policies and Emergency Care Management in Europe's Ground Zero for COVID-19

Cited by 12 publications

References 0 publications

Emergency Medical Services (EMS) Calls During COVID-19: Early Lessons Learned for Systems Planning (A Narrative Review)

Emergency Medical Services (EMS) Calls During COVID-19: Early Lessons Learned for Systems Planning (A Narrative Review)

Risk factors for mortality of residents in nursing homes with Covid-19: a retrospective cohort study

The Impact of the Non-essential Business Closure Policy on Covid-19 Infection Rates

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