The immediate impact of COVID-19 on US dermatology practices.
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ABSTRACT:
SUBMITTER: Litchman GH
PROVIDER: S-EPMC7228885 | biostudies-literature | 2020 Aug
REPOSITORIES: biostudies-literature
Publications
The immediate impact of COVID-19 on US dermatology practices.
Litchman Graham H GH Rigel Darrell S DS
Journal of the American Academy of Dermatology 20200516 2
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Project description:COVID-19 continues to affect the delivery of healthcare services, as practices across North America gradually re-open with new safety measures and practice guidelines. Specifically in dermatology, clinical care is delivered in close physician-patient proximity through physical examination and the use of additional diagnostic and therapeutic procedures. We designed a 10-question survey to better understand how COVID-19 has impacted the delivery of care in North American dermatology practices. Survey questions explored themes including changes in patient volumes, the use of virtual visits/teledermatology, the frequency of aesthetic and surgical procedures, and other related topics. We invited 102 board-certified dermatologists working in a variety of medical, aesthetic, surgical, and mixed practices, to participate in our survey hosted through Qualtrics XM. These dermatologists were selected based on their geographic location and our ability to access their contact information. Each dermatologist received an individualized e-mail and survey link; however, all survey responses were anonymized. In 2.5 weeks after survey invitations were sent, the survey was viewed and completed by 71 and 54 dermatologists, respectively. The second wave of e-mails was sent to the remaining 48 dermatologists who had not yet completed the survey, after which 15 participants both viewed and completed the survey. In total, 69 responses were recorded with an overall response rate of 67.6%. We report decreased patient volume capacity, fewer aesthetic and surgical procedures, and an increase in the use of virtual medicine among board-certified North American dermatologists. However, this represents a reflection on perspectives at a single time point in a rapidly evolving situation. Understanding the full scope of the impact that COVID-19 continues to have on dermatologic care is paramount to effectively serve our patients.
| S-EPMC8661817 | biostudies-literature
Project description:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new coronavirus responsible for the pandemic named coronavirus disease 2019 (COVID-19). The disease causes SARS with a significant morbidity and mortality. We provide a review with a focus on COVID-19 in dermatology. We discuss triage of suspected infectious patients, protection of medical doctors and nurses. We discuss the available data on cutaneous symptoms, although disease-specific symptoms have yet not been observed. COVID-19 is a challenge for the treatment of dermatologic patients, either with severe inflammatory disorders or with skin cancer. The consequences for systemic treatment are obvious but it will be most important to collect the clinical data for a better decision process. Last but not least, education in dermatology for students will not be temporarily possible in the classical settings. COVID-19, although not a skin disease, by itself has an immense impact on dermatology.
| S-EPMC7235502 | biostudies-literature
Project description:Coronavirus 2019 (COVID 19) was first detected in December 2019 in China. It has become a pandemic. With concern about therapies that may decrease immunity and enhance the severity of an individual's COVID-19 infection, leading to a possibly fatal outcome, use of immunosuppressants has become an important concern. This work focuses on management of various skin diseases individuals lacking immunity to COVID-19 but requiring a systemic immunosuppressant, keeping in view the challenge of the COVID 19 pandemic and that our knowledge of this virus and its effects on the immune system are incomplete including knowledge as to an individual's immunity after COVID-19 infection.
| S-EPMC7435553 | biostudies-literature
Project description:The volume and value of fish catches by Indonesia's small-scale fisheries have declined significantly since national government restrictions on travel and social distancing were imposed in response to the COVID-19 pandemic. Using a digital data collection system (OurFish), that records purchases by fish traders from small-scale fishers, data was collected across 82 coastal communities in Southeast Sulawesi. We found that the number of active fishers and traders declined by more than 90% after the onset of the pandemic and the average weight of catch per fishing trip increased across fishers. Although the average price per kilogram of fish declined after the pandemic began, fishers that were able to maintain fishing had on average higher catches and therefore daily catch value was maintained. High value fisheries that usually enter export supply chains were more negatively impacted compared with lower value species that are commonly sold to local markets. We interviewed 185 small scale fishers and fish traders across 20 of the 82 communities in Southeast Sulawesi province, recording the perceived level of impact on local fisheries and the fish trade, causes of this impact and proposed coping strategies. Over 50% of both fishers and fish traders believed low demand for fish from traders and a decline in the price received for fish were disrupting their lives. Approximately 75% of both male and female fishers are coping by continuing to fish, highlighting that there were few alternative livelihoods available at the time of the interviews. Our results provide key insights into the vulnerability of small-scale fishing communities to impacts of the COVID-19 pandemic.
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Project description: Not available
| S-EPMC8652617 | biostudies-literature
Project description:The SARS-Cov-2 is a single-stranded RNA virus composed of 16 non-structural proteins (NSP 1-16) with specific roles in the replication of coronaviruses. NSP3 has the property to block host innate immune response and to promote cytokine expression. NSP5 can inhibit interferon (IFN) signalling and NSP16 prevents MAD5 recognition, depressing the innate immunity. Dendritic cells, monocytes, and macrophages are the first cell lineage against viruses' infections. The IFN type I is the danger signal for the human body during this clinical setting. Protective immune responses to viral infection are initiated by innate immune sensors that survey extracellular and intracellular space for foreign nucleic acids. In Covid-19 the pathogenesis is not yet fully understood, but viral and host factors seem to play a key role. Important points in severe Covid-19 are characterized by an upregulated innate immune response, hypercoagulopathy state, pulmonary tissue damage, neurological and/or gastrointestinal tract involvement, and fatal outcome in severe cases of macrophage activation syndrome, which produce a 'cytokine storm'. These systemic conditions share polymorphous cutaneous lesions where innate immune system is involved in the histopathological findings with acute respiratory distress syndrome, hypercoagulability, hyperferritinemia, increased serum levels of D-dimer, lactic dehydrogenase, reactive-C-protein and serum A amyloid. It is described that several polymorphous cutaneous lesions similar to erythema pernio, urticarial rashes, diffuse or disseminated erythema, livedo racemosa, blue toe syndrome, retiform purpura, vesicles lesions, and purpuric exanthema or exanthema with clinical aspects of symmetrical drug-related intertriginous and flexural exanthema. This review describes the complexity of Covid-19, its pathophysiological and clinical aspects.
| S-EPMC7404593 | biostudies-literature
Project description:Study objectivesThe COVID-19 pandemic required sleep centers to consider and implement infection control strategies to mitigate viral transmission to patients and staff. Our aim was to assess measures taken by sleep centers due to the COVID-19 pandemic and plans surrounding reinstatement of sleep services.MethodsWe distributed an anonymous online survey to health care providers in sleep medicine on April 29, 2020. From responders, we identified a subset of unique centers by region and demographic variables.ResultsWe obtained 379 individual responses, which represented 297 unique centers. A total of 93.6% of unique centers reported stopping all or nearly all sleep testing of at least one type, without significant differences between adult and pediatric labs, geographic region, or surrounding population density. By contrast, a greater proportion of respondents continued home sleep apnea testing services. A total of 60.3% reduced home sleep apnea testing volume by at least 90%, compared to 90.4% that reduced in-laboratory testing by at least 90%. Respondents acknowledged that they implemented a wide variety of mitigation strategies. While no respondents reported virtual visits to be ≥ 25% of clinical visits prior to the pandemic, more than half (51.9%) anticipated maintaining ≥ 25% virtual visits after the pandemic.ConclusionsAmong surveyed sleep centers, the vast majority reported near-cessation of in-laboratory sleep studies, while a smaller proportion reported reductions in home sleep apnea tests. A large increase in the use of telemedicine was reported, with the majority of respondents expecting the use of telehealth to endure in the future.
| S-EPMC7849634 | biostudies-literature
Project description:ContextThe COVID-19 pandemic has affected all sectors and human activities around the World.ObjectiveIn this article we present a first attempt to understand the immediate impact of COVID-19 and the sanitary measures taken by governments on farming systems in Central America and Mexico (CAM).MethodsThrough a review of information generated in these initial months of the COVID-19 pandemic (webinars, blogs, electronic publications, media) and 44 interviews with key informants across the region, we have identified the main impacts felt by different types of farming systems in the region.Results and conclusionsFrom corporate agricultural production systems, to small and medium scale entrepreneurs and smallholder subsistence farm households, all types of farming systems were impacted, more or less severely, by the different measures implemented by governments such as reduced mobility, closure of public and private venues and restrictions in borders. Larger corporate farming systems with vertical market integration and high level of control or coordination within the supply chain, and smallholder or subsistence farming systems with important focus on production for self-consumption and little external input use, were both relatively less impacted and showed greater adaptive capacity than the medium and small entrepreneurial farming systems dependent on agriculture as their primary income and with less control over the upstream and downstream parts of their supply chain. All types of farming systems implemented a series of mechanisms to cope with the COVID-19 pandemic including the development of alternative value chains, food and agricultural products delivery systems and the exponential use of digital means to communicate and maintain the viability of the different agricultural systems. Collective action and organization of farmers also proved to be an important coping mechanism that allowed some farmers to acquire inputs and deliver outputs in the context of restricted mobility, price volatility, and general uncertainty. Some features of the CAM region played an important role in mediating the impact of COVID-19 and associated sanitary measures. We identify as particularly relevant the nature of agricultural exports, the current structure of the agricultural sector, the diversified livelihood strategies of rural households, and the importance of mobility for rural livelihoods.SignificanceThe results presented focus only in the immediate effect of COVID-19 pandemic and the mechanisms implemented by farmers in the first months. Whether these impacts and response mechanisms will result in a transformation of the farming systems towards greater resilience and sustainability is still an open question.
| S-EPMC9759656 | biostudies-literature
Project description:PurposeThe coronavirus disease 2019 (COVID-19) pandemic affected radiology practices in many ways. The aim of this survey was to estimate declines in imaging volumes and financial impact across different practice settings during April 2020.MethodsThe survey, comprising 48 questions, was conducted among members of the ACR and the Radiology Business Management Association during May 2020. Survey questions focused on practice demographics, volumes, financials, personnel and staff adjustments, and anticipation of recovery.ResultsDuring April 2020, nearly all radiology practices reported substantial (56.4%-63.7%) declines in imaging volumes, with outpatient imaging volumes most severely affected. Mean gross charges declined by 50.1% to 54.8% and collections declined by 46.4% to 53.9%. Percentage reductions did not correlate with practice size. The majority of respondents believed that volumes would recover but not entirely (62%-88%) and anticipated a short-term recovery, with a surge likely in the short term due to postponement of elective imaging (52%-64%). About 16% of respondents reported that radiologists in their practices tested positive for COVID-19. More than half (52.3%) reported that availability of personal protective equipment had become an issue or was inadequate. A majority (62.3%) reported that their practices had existing remote reading or teleradiology capabilities in place before the pandemic, and 22.3% developed such capabilities in response to the pandemic.ConclusionsRadiology practices across different settings experienced substantial declines in imaging volumes and collections during the initial wave of the COVID-19 pandemic in April 2020. Most are actively engaged in both short- and long-term operational adjustments.
| S-EPMC7402108 | biostudies-literature
Project description:Due to COVID-19, horseracing was required to cease all activity in March 2020; however, little is known about the pandemic's impact on staff working practices. This study investigated the impact of COVID-19 on staff working practices during the initial lockdown phases. An online survey about working conditions during lockdown was answered by 287 participants. Chi-squared tests for independence and binary logistic regression (BLR) analysis was undertaken. A total of 53.7% (n = 154) of staff were working during lockdown. Pandemic-specific workplace changes were reported as effective by 87.8% (n = 115) of staff. Flat grooms reported workplace changes as less effective (χ2 (52, n = 131) = 92.996, p < 0.001). A total of 67.2% (n = 193) of staff were positive about job security. Trainers and grooms were significantly less likely to report jobs as secure (χ2 (52, n = 287) = 75.653, p < 0.05). The findings suggest that most of the racing industry positively received changes made by their employers to tackle the pandemic, and for staff still working during lockdown, their health and safety was prioritised. Continued development of employee support structures to promote job security and workforce stability is advised, which will minimise the disruption of staff changes on the care and welfare of the horses.
| S-EPMC7692747 | biostudies-literature