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•The mental health burden during the COVID-19 crisis is heavy among healthcare workers.•This meta-analysis estimated high pooled prevalences of psychiatric conditions.•Anxiety, ...depression and sleep problems were respectively 300 %, 311 %, and 440 %.•Estimates of acute and post-traumatic stress were high (56.5 %, 20.2 %).•Support interventions are urgent for workers’ wellbeing and quality of care.
Healthcare workers have been facing the COVID-19 pandemic, with numerous critical patients and deaths, and high workloads. Quality of care is related to the mental status of healthcare workers. This PRISMA systematic review and meta-analysis, on Pubmed/Psycinfo up to October 8, 2020, estimates the prevalence of mental health problems among healthcare workers during this pandemic. The systematic review included 70 studies (101 017 participants) and only high-quality studies were included in the meta-analysis. The following pooled prevalences were estimated: 300 % of anxiety (95 %CI, 24.2–37.05); 311 % of depression (95 %CI, 25.7–36.8); 565 % of acute stress (95 %CI - 30.6–80.5); 20,2% of post-traumatic stress (95 %CI, 9.9–33.0); 44.0 % of sleep disorders (95 %CI, 24.6–64.5). The following factors were found to be sources of heterogeneity in subgroups and metaregressions analysis: proportion of female, nurses, and location. Targeted prevention and support strategies are needed now, and early in case of future health crises.
Coronavirus disease (COVID-19) symptoms can be mistaken for vaccine-related side effects during initial days after immunization. Among 4,081 vaccinated healthcare workers in Israel, 22 (0.54%) ...developed COVID-19 from 1-10 days (median 3.5 days) after immunization. Clinicians should not dismiss postvaccination symptoms as vaccine-related and should promptly test for COVID-19.
The disease caused by respiratory syndrome coronavirus 2 (SARS-CoV-2) called COVID-19 resulted in a pandemic that has demanded extraordinary physical and mental effort from healthcare workers. This ...review provides an overview of studies that have explored traumatic stress in healthcare workers and associated factors between January and May 2020. The focus is on the most relevant literature investigating the prevalence of trauma- and stressor-related symptoms. Articles were selected from PubMed and PsycINFO databases using the search terms, "healthcare workers," "COVID-19," and "posttraumatic stress" in different combinations and with various synonyms. Among the seven studies that fulfilled our criteria, five assessed traumatic stress response, one assessed acute stress symptoms, and one focused on vicarious traumatization. Overall, the available findings highlight the presence of trauma-related stress, with a prevalence ranging from 7.4 to 35%, particularly among women, nurses, frontline workers, and in workers who experienced physical symptoms. Future studies should clarify the long-term effects of the COVID-19 pandemic on the mental health of healthcare workers, with particular focus on posttraumatic stress disorder.
•Healthcare workers are at risk of occupational tuberculosis (TB).•Whole genome sequencing (WGS) is a highly precise tool for genotyping.•WGS for TB contact investigations among healthcare workers is ...sparsely described.•We describe using WGS for ascertaining occupational TB among healthcare workers.•WGS reduces the efforts required for epidemiological TB contact investigations.
In this case report, we present case reports for two nurses, both working in departments of respiratory medicine, who developed tuberculosis (TB). For each individual case, whole genome sequencing (WGS) revealed only one specific match within a genomic distance of <6 single-nucleotide polymorphisms. The subsequent epidemiological investigations confirmed that both nurses had relevant exposures to their corresponding match 1139 and 1704 days before presenting with TB symptoms, respectively. Twenty-two studies were identified that reported using genotyping to identify occupational transmission of Mycobacterium tuberculosis to healthcare workers. Only two studies applied WGS, both conducted in resource-rich countries, comparable to the present Danish investigation. When comparing the two WGS studies to the other studies that used older genotyping techniques, WGS provided a higher resolution and much more detailed information. Consequently, the epidemiological investigations were more straightforward. In conclusion, WGS is a powerful tool for determining whether M. tuberculosis transmission is occupational as demonstrated for the two cases in this study.
This study aimed to determine the impact of different types of masks on the voices of healthcare professionals who had to wear masks for an extended amount of time during the pandemic period and had ...a healthy voice.
Our research included 41 healthcare workers. The participants were separated into two groups: surgical (n = 21) and N95 mask users (n = 20). Healthcare workers evaluated masks before and after wearing them for at least 8 hours throughout the workday. All subjects had a videolaryngoscopic examination; the Voice Handicap Index-10 (VHI-10), GRBAS, acoustic voice analysis (F0, jitter%, shimmer%, noise/harmonic ratio, relative average perturbation RAP), aerodynamic measures (maximum phonation time, MPT), and blood oxygen saturation were evaluated.
Although both groups' VHI-10 scores increased after using the mask, this rise was not statistically significant in our research. According to the GRBAS classification, voice quality deterioration was identified in 9.6% (mild-moderate) of the group using surgical masks and 15% (mild) of the group wearing N95. Only the jitter and RAP values of individuals wearing both surgical and N95 masks were determined to be statistically significant. There was no significant change in MPT following mask wear in either group. Both the surgical and N95 mask-using groups showed a substantial drop in blood oxygen saturation before and after mask usage.
There was no change in voice quality between healthcare workers wearing surgical and N95 masks. It has been noticed that voice perception and quality are affected by the mask's barrier effect rather than the kind of mask.
Background
Coronavirus disease (COVID-19) pandemic has spread to 198 countries, with approximately 2.4 million confirmed cases and 150,000 deaths globally as of April 18. Frontline healthcare workers ...(HCWs) face a substantially higher risk of infection and death due to excessive COVID-19 exposure. This review aimed at summarizing the evidence of the physical and mental health impacts of COVID-19 pandemic on health-care workers (HCWs).
Methods
We used the Arksey O’Malley framework to conduct a scoping review. A systematic literature search was conducted using two databases: PubMed and Google Scholar. We found 154 studies, and out of which 10 met our criteria. We collected information on the date of publication, first author’s country, the title of the article, study design, study population, intervention and outcome, and key findings, and divided all research articles into two domains: physical and mental health impact.
Results
We reviewed a total of 154 articles from PubMed (126) and Google Scholar (28), of which 58 were found to be duplicate articles and were excluded. Of the remaining 96 articles, 82 were excluded after screening for eligibility, and 4 articles did not have available full texts. Ten full-text articles were reviewed and included in this study.
Our findings identified the following risk factors for COVID-19-related health impact: working in a high-risk department, diagnosed family member, inadequate hand hygiene, suboptimal hand hygiene before and after contact with patients, improper PPE use, close contact with patients (≥ 12 times/day), long daily contact hours (≥ 15 h), and unprotected exposure. The most common symptoms identified amongst HCWs were fever (85%), cough (70%), and weakness (70%). Prolonged PPE usage led to cutaneous manifestations and skin damage (97%), with the nasal bridge (83%) most commonly affected site. HCWs experienced high levels of depression, anxiety, insomnia, and distress. Female HCWs and nurses were disproportionately affected.
Conclusion
The frontline healthcare workers are at risk of physical and mental consequences directly as the result of providing care to patients with COVID-19. Even though there are few intervention studies, early data suggest implementation strategies to reduce the chances of infections, shorter shift lengths, and mechanisms for mental health support could reduce the morbidity and mortality amongst HCWs.
•Healthcare workers are at high risk of mental health problems during viral epidemic outbreaks.•This review of 117 studies offers pooled estimations of prevalence of acute stress disorder (40%), ...followed by anxiety (30%), burnout (28%), depression (24%), and post-traumatic stress disorder (13%).•It identifies a number of factors (sociodemographic, occupational and social) associated with mental health problems.•Interventional high-quality research is urgently needed to inform evidence-based policies for viral pandemics.
Background: This study aimed at examining the impact of providing healthcare during health emergencies caused by viral epidemic outbreaks on healthcare workers' (HCWs) mental health; to identify factors associated with worse impact, and; to assess the available evidence base regarding interventions to reduce such impact.
Method: Rapid systematic review. We searched MEDLINE, Embase, and PsycINFO (inception to August 2020). We pooled data using random-effects meta-analyses to estimate the prevalence of specific mental health problems, and used GRADE to ascertain the certainty of evidence.
Results: We included 117 studies. The pooled prevalence was higher for acute stress disorder (40% (95%CI 39 to 41%)), followed by anxiety (30%, (30 to 31%)), burnout (28% (26 to 31%)), depression (24% (24 to 25%)), and post-traumatic stress disorder (13% (13 to 14%)). We identified factors associated with the likelihood of developing those problems, including sociodemographic (younger age and female gender), social (lack of social support, stigmatization), and occupational (working in a high-risk environment, specific occupational roles, and lower levels of specialised training and job experience) factors. Four studies reported interventions for frontline HCW: two educational interventions increased confidence in pandemic self-efficacy and in interpersonal problems solving (very low certainty), whereas one multifaceted intervention improved anxiety, depression, and sleep quality (very low certainty).
Limitations: We only searched three databases, and the initial screening was undertaken by a single reviewer.
Conclusion: Given the very limited evidence regarding the impact of interventions to tackle mental health problems in HCWs, the risk factors identified represent important targets for future interventions.
Coronavirus (COVID-19) is highly infectious agent that causes fatal respiratory illnesses, which is of great global public health concern. Currently, there is no effective vaccine for tackling this ...COVID19 pandemic where disease countermeasures rely upon preventing or slowing person-to-person transmission. Specifically, there is increasing efforts to prevent or reduce transmission to front-line healthcare workers (HCW). However, there is growing international concern regarding the shortage in supply chain of critical one-time-use personal and protective equipment (PPE). PPE are heat sensitive and are not, by their manufacturer's design, intended for reprocessing. Most conventional sterilization technologies used in hospitals, or in terminal medical device sterilization providers, cannot effectively reprocess PPE due to the nature and severity of sterilization modalities. Contingency planning for PPE stock shortage is important. Solutions in the Republic of Ireland include use of smart communication channels to improve supply chain, bespoke production of PPE to meets gaps, along with least preferred option, use of sterilization or high-level disinfection for PPE reprocessing. Reprocessing PPE must consider material composition, functionality post treatment, along with appropriate disinfection. Following original manufacturer of PPE and regulatory guidance is important. Technologies deployed in the US, and for deployment in the Republic of Ireland, are eco-friendly, namely vaporised hydrogen peroxide (VH2O2), such as for filtering facepiece respirators and UV irradiation and High-level liquid disinfection (Actichlor+) is also been pursed in Ireland. Safeguarding supply chain of PPE will sustain vital healthcare provision and will help reduce mortality.
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•There is pressing need to find solutions for reprocessing of PPE for COVID19•Reprocessing of PPE is challenging as made for one-time-use•Most sterilization technologies are not suitable for PPE reprocessing•Use of vaporised hydrogen peroxide and UV irradiation may prove effective for PPE
Abstract
During major epidemic outbreaks, demand for healthcare workers (HCWs) grows even as the extreme pressures they face cause declining availability. We draw on Taiwan’s severe acute respiratory ...syndrome (SARS) experience to argue that a modified form of traffic control bundling (TCB) protects HCW safety and by extension strengthens overall coronavirus disease 2019 (COVID-19) epidemic control.
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