Protecting healthcare workers in the COVID-19 pandemic: respirator shortages and health policy responses in South America

Blair, Kevin J.; Martínez-Vernaza, Samuel; Segura, Eddy R.; Barrientos, José Luis Gallardo; Garber, Kent; Gualtero-Trujillo, Sandra; Juillard, Catherine; Castro, Rodolfo

doi:10.1590/0102-311x00227520

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…Outcome measures are shown in Table 1. The overall median burnout scores were high in the emotional exhaustion and personal accomplishment dimensions (16 [interquartile range (IQR), 8-24] and 40 [IQR, [33][34][35][36][37][38][39][40][41][42][43][44], respectively) whereas low in the depersonalization one (2 [IQR, 0-5]), with a burnout prevalence of 24%. The aggregate median psychologic distress score was 11 (IQR, [6][7][8][9][10][11][12][13][14][15][16][17].…”

Section: Resultsmentioning

confidence: 99%

“…The increased levels of burnout and PTSD found in professionals from public institutions might reflect the massive socioeconomic inequalities in Brazil. Public health institutions are responsible for the healthcare of two-thirds of the Brazilian population and have a chronic shortage of resources and workforce ( 39 , 40 ). Patients treated in public units usually have less access to adequate treatments and arrive more severely ill at ICUs, culminating in a much greater workload and stress for the PICU staff.…”

Section: Discussionmentioning

confidence: 99%

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Mental Health and Emotional Disorders During the COVID-19 Pandemics: Prevalence and Extent in PICU Staff*

Lima‐Setta

Moraes

Silami

et al. 2022

Pediatric Critical Care Medicine

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OBJECTIVES: To assess the prevalence of burnout, anxiety and depression symptoms, and posttraumatic stress disorder (PTSD) in PICU workers in Brazil during the first peak of the COVID-19 pandemic. To compare the results of subgroups stratified by age, gender, professional category, health system, and previous mental health disorders. DESIGN: Multicenter, cross-sectional study using an electronic survey. SETTING: Twenty-nine public and private Brazilian PICUs. SUBJECTS: Multidisciplinary PICU workers. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Self-reported questionnaires were used to measure burnout (Maslach Burnout Inventory), anxiety and depression (Hospital Anxiety and Depression Scale), and PTSD (Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [PCL-5]) in 1,084 respondents. Subjects were mainly young (37.1 ± 8.4 yr old) and females (85%), with a median workload of 50 hours per week. The prevalence of anxiety and depression was 33% and 19%, respectively, whereas PTSD was 13%. The overall median burnout scores were high in the emotional exhaustion and personal accomplishment dimensions (16 [interquartile range (IQR), 8–24] and 40 [IQR, 33–44], respectively) whereas low in the depersonalization one (2 [IQR, 0–5]), suggesting a profile of overextended professionals, with a burnout prevalence of 24%. Professionals reporting prior mental health disorders had higher prevalence of burnout (30% vs 22%; p = 0.02), anxiety (51% vs 29%; p < 0.001), and depression symptoms (32.5% vs 15%; p < 0.001), with superior PCL-5 scores for PTSD ( p < 0.001). Public hospital workers presented more burnout (29% vs 18.6%, p < 0.001) and more PTSD levels (14.8% vs 10%, p = 0.03). Younger professionals were also more burned out ( p < 0.05 in all three dimensions). CONCLUSIONS: The prevalence of mental health disorders in Brazilian PICU workers during the first 2020 peak of COVID-19 was as high as those described in adult ICU workers. Some subgroups, particularly those reporting previous mental disorders and younger professionals, should receive special attention to prevent future crises.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mental Health and Emotional Disorders During the COVID-19 Pandemics: Prevalence and Extent in PICU Staff*

Lima‐Setta

Moraes

Silami

et al. 2022

Pediatric Critical Care Medicine

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“…In the early phase of the COVID-19 pandemic in 2020, several clinical guidelines recommended early intubation to protect healthcare workers from aerosols containing SARS-CoV-2 [7][8][9][10]. However, along with the global spread of COVID-19, ventilator shortage was reported to be a serious bottleneck in some regions [11]. Actually, the clinical guidelines for COVID -19 in Italy proposed directing crucial resources, such as intensive care beds and ventilators, to only limited patients who could receive maximal bene t from the treatments [12].…”

Section: Introductionmentioning

confidence: 99%

High-flow Nasal Cannula Oxygen Therapy as Initial Respiratory Management for Severe COVID-19-induced Respiratory Failure: a Single-center Observational Study

Nakai

Umemura

Nishida

et al. 2022

Preprint

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Background: The efficacy and safety of high-flow nasal cannula (HFNC) oxygen therapy in severe respiratory failure, especially induced by COVID-19, has not been fully elucidated. We aimed to examine the usefulness of HFNC compared to invasive mechanical ventilation (IMV) as initial respiratory management for severe COVID-19-induced respiratory failure.Methods: In this retrospective observational study, we enrolled and categorized the patients with COVID-19-induced severe respiratory failure who were intolerant of conventional oxygen therapy into two groups: 1) patients who initially received HFNC (HFNC group) and 2) patients who initially underwent IMV (IMV group). The primary outcome was in-hospital mortality. The secondary outcomes were ventilator-free days within 28 days, intensive care unit (ICU)-free days within 28 days, and respiratory failure days defined as the length from day 1 to achieving successful weaning from both HFNC and IMV.Results: We analyzed 182 patients (HFNC group, n=81; IMV group, n=101). There was no difference in in-hospital mortality between the two groups (19% in the HFNC group vs. 25% in the IMV group, p=0.37). Initial use of HFNC was not associated with mortality in the univariate analysis (OR, 0.69; CI, 0.34–1.42; p=0.31) and inverse probability of treatment weighting analysis using propensity scoring (OR, 1.01; CI, 0.37–2.77; p=0.984). Ventilator-free days within 28 days were significantly longer in the HFNC group than those in the IMV group (median, 22 days [interquartile range (IQR), 2–28 days] vs. median, 14 days [IQR, 0–20 days], p<0.001). ICU-free days within 28 days were significantly longer in the HFNC group than those in the IMV group (median, 23 days [IQR, 0–28 days] vs. median, 15 days [IQR, 0–20 days], p<0.001). Respiratory failure days were relatively shorter in the HFNC group, but the difference was not statistically significant (p=0.071).Conclusions: Among patients with severe COVID-19-induced respiratory failure, HFNC compared to IMV resulted in a statistically significant increase in ventilator-free and ICU-free days within 28 days without increasing in-hospital mortality. This study showed the potential for HFNC to be an effective alternative to IMV as initial respiratory management for severe COVID-19-induced respiratory failure.

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“…Um "desastre" se trata de uma situação de ruptura ou mudança violenta no funcionamento normal de um sistema ou comunidade, que cause impactos indesejáveis 1 Faculdade de Administração e Ciências Contábeis(UFF)  e de grande magnitude em seres humanos, instalações, serviços ou meio ambiente. O desastre caracteriza-se por exceder a capacidade de resposta do sistema em ações de contenção, resgate, reparação de danos, recuperação de bens e serviços e, sobretudo, de prestar assistência médica, alojamento temporário, água e alimentação à população afetada.…”

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Impactos da inteligência artificial na evolução da logística humanitária em pandemias – uma revisão de literatura

Camara

2024

rsc

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O objetivo do estudo é realizar uma revisão de literatura acerca dos impactos da inteligência artificial na evolução da logística humanitária por ocasião de combate a pandemias, a partir da ótica da pandemia covid-19. Trata-se de uma revisão sistemática de literatura (RSL), com busca nas bases de dados ResearchGate, Science@Direct e Scopus, em outubro de 2023. O emprego da inteligência artificial no gerenciamento da cadeia de suprimentos contribuiu para seu robustecimento e aumento da resiliência. Como resultado, foram identificadas quatro categorias de ações estratégicas no enfrentamento à pandemia, sob a ótica da cadeia de suprimentos: digitalização e automatização; diversificação de fornecedores; elevação dos níveis de estoque e fabricação local; e robustecimento da gestão de riscos. Recomennda-se a inclusão do emprego da inteligência artificial nas propostas de aperfeiçoamento do gerenciamento da cadeia de suprimentos em situações de logística humanitária em razão de suas potencialidades, algumas, ainda, talvez inexploradas.

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Protecting healthcare workers in the COVID-19 pandemic: respirator shortages and health policy responses in South America

Cited by 4 publications

References 6 publications

Mental Health and Emotional Disorders During the COVID-19 Pandemics: Prevalence and Extent in PICU Staff*

Mental Health and Emotional Disorders During the COVID-19 Pandemics: Prevalence and Extent in PICU Staff*

High-flow Nasal Cannula Oxygen Therapy as Initial Respiratory Management for Severe COVID-19-induced Respiratory Failure: a Single-center Observational Study

Impactos da inteligência artificial na evolução da logística humanitária em pandemias – uma revisão de literatura

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