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Impact of COVID-19 and containment measures on burn care: A qualitative exploratory study.

ABSTRACT: BACKGROUND:Burn care in India is limited by multiple constraints. The COVID-19 pandemic and the containment measures restricted access to non-COVID emergency conditions, including burns. The aim of this study was to explore the impact of the pandemic on burn care in India. METHODS:Using the qualitative exploratory methods, we conducted in-depth interviews (IDI) with plastic and general surgeons representing burn units from across India. Participants were selected purposively to ensure representation and diversity and the sample size was guided by thematic saturation. Thematic analysis was undertaken adopting an inductive coding using NVivo 12 Pro. RESULTS:19 participants from diverse geographic locations and provider types were interviewed. Three major emerging themes were, change in patient and burn injury characteristics; health system barriers, adaptation, and challenges; and lessons and emerging recommendations for policy and practice. There was change in patient load, risk factors, and distribution of burns. The emergency services were intermittently disrupted, the routine and surgical services were rationally curtailed, follow-up and rehabilitation services were most affected. Measures like telemedicine and decentralising burn services emerged as the most important lesson. CONCLUSIONS:The ongoing pandemic has compounded the challenges for burns care in India. Urgent action is required to prioritise targeted prevention, emergency transport, decentralise service delivery, and harnessing technology for ensuring resilience in burns services.

SUBMITTER: Keshri VR

PROVIDER: S-EPMC8595323 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Impact of COVID-19 on global burn care.

Project description:BackgroundWorldwide, different strategies have been chosen to face the COVID-19-patient surge, often affecting access to health care for other patients. This observational study aimed to investigate whether the standard of burn care changed globally during the pandemic, and whether country´s income, geographical location, COVID-19-transmission pattern, and levels of specialization of the burn units affected reallocation of resources and access to burn care.MethodsThe Burn Care Survey is a questionnaire developed to collect information on the capacity to provide burn care by burn units around the world, before and during the pandemic. The survey was distributed between September and October 2020. McNemar`s test analyzed differences between services provided before and during the pandemic, χ2 or Fisher's exact test differences between groups. Multivariable logistic regression analyzed the independent effect of different factors on keeping the burn units open during the pandemic.ResultsThe survey was completed by 234 burn units in 43 countries. During the pandemic, presence of burn surgeons did not change (p = 0.06), while that of anesthetists and dedicated nursing staff was reduced (<0.01), and so did the capacity to manage patients in all age groups (p = 0.04). Use of telemedicine was implemented (p < 0.01), collaboration between burn centers was not. Burn units in LMICs and LICs were more likely to be closed, after adjustment for other factors.ConclusionsDuring the pandemic, most burn units were open, although availability of standard resources diminished worldwide. The use of telemedicine increased, suggesting the implementation of new strategies to manage burns. Low income was independently associated with reduced access to burn care.

| S-EPMC8664090 | biostudies-literature

The impact of the COVID-19 pandemic on primary care physicians and nurses in Nova Scotia: a qualitative exploratory study.

Project description:BackgroundThe COVID-19 pandemic has brought immense disruption worldwide, dramatically altering the ways we live, work and learn on a day-to-day basis; however, few studies have investigated this from the perspective of primary care providers. In this study, we sought to explore the experiences of primary care providers in the province of Nova Scotia, with the intention of understanding the impact of the COVID-19 pandemic on primary care providers' ability to provide care, their information pathways, and the personal and professional impact of the pandemic.MethodsWe conducted an exploratory qualitative research study involving semistructured interviews conducted via Zoom videoconferencing or telephone with primary care providers (physicians, nurse practitioners and family practice nurses) who self-identified as working in primary health care in Nova Scotia from June 2020 to April 2021. We performed a thematic analysis involving coding and classifying data according to themes. Emergent themes were then interpreted by seeking commonalties, divergence, relationships and overarching patterns in the data.ResultsTwenty-four primary care providers were interviewed. Subsequent analysis identified 4 interrelated themes within the data: disruption to work-life balance, disruptions to "non-COVID-19" patient care, impact of provincial and centralized policies, and filtering and processing an influx of information.InterpretationOur findings showed that managing a crisis of this magnitude requires coordination and new ways of working, balancing professional and personal life, and adapting to already implemented changes (i.e., virtual care). A specific primary care pandemic response plan is essential to mitigate the impact of future health care crises.

| S-EPMC10035666 | biostudies-literature

Air pollution impacts of COVID-19-related containment measures.

Project description:Responses to the COVID-19 outbreak resulted in one of the largest short-term decreases in anthropogenic emissions in modern history. To date, there has been no comprehensive assessment of the impact of lockdowns on air quality and human health. Using global satellite observations and ground measurements from 36 countries in Europe, North America, and East Asia, we find that lockdowns led to reductions in NO2 concentrations globally, resulting in ~32,000 avoided premature mortalities, including ~21,000 in China. However, we do not find corresponding reductions in PM2.5 and ozone globally. Using satellite measurements, we show that the disconnect between NO2 and ozone changes stems from local chemical regimes. The COVID-related lockdowns demonstrate the need for targeted air quality policies to reduce the global burden of air pollution, especially related to secondary pollutants.

| S-EPMC8139585 | biostudies-literature

Effectiveness of Containment Measures Against COVID-19 in Singapore: Implications for Other National Containment Efforts.

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| S-EPMC7707159 | biostudies-literature

Understanding the psychological impact of the COVID-19 pandemic and containment measures: An empirical model of stress.

Project description:Epidemics such as COVID-19 and corresponding containment measures are assumed to cause psychological stress. In a survey during the lockdown in Switzerland (n = 1565), we found substantially increased levels of stress in the population. In particular, individuals who did not agree with the containment measures, as well as those who saw nothing positive in the crisis, experienced high levels of stress. In contrast, individuals who are part of a risk group or who are working in healthcare or in essential shops experienced similar stress levels as the general public. The psychological mechanisms that determine stress, caused by the COVID-19 pandemic and containment measures, are not yet clear. Thus, we conducted a path analysis to gain a deeper understanding of the psychological mechanisms that lead to stress. Experiencing fear of the disease is a key driver for being worried. Our model further shows that worries about the individual, social, and economic consequences of the crisis, strongly boost stress. The infection rate in the canton (i.e., state) of residence also contributes to stress. Positive thinking and perceived social, organizational, and governmental support mitigate worries and stress. Our findings indicate that containment measures increase worries and stress, especially for those who feel that these measures either are not sufficient or go too far. Thus, highlighting positive aspects of the crisis and convincing people of the effectiveness and necessity of mitigation measures can, not only promote compliance, but also reduce stress. Our model suggests that people who feel protected by the authorities have fewer worries, which can, in turn, limit the negative impact of the crisis on mental health.

| S-EPMC8320973 | biostudies-literature

Comparing containment measures among nations by epidemiological effects of COVID-19.

Project description: Not available

| S-EPMC7543445 | biostudies-literature

Containment measures limit environmental effects on COVID-19 early outbreak dynamics.

Project description:Environmental factors are well known to affect spatio-temporal patterns of infectious disease outbreaks, but whether the rapid spread of COVID-19 across the globe is related to local environmental conditions is highly debated. We assessed the impact of environmental factors (temperature, humidity and air pollution) on the global patterns of COVID-19 early outbreak dynamics during January-May 2020, controlling for several key socio-economic factors and airport connections. We showed that during the earliest phase of the global outbreak (January-March), COVID-19 growth rates were non-linearly related to climate, with fastest spread in regions with a mean temperature of ca. 5 °C, and in the most polluted regions. However, environmental effects faded almost completely when considering later outbreaks, in keeping with the progressive enforcement of containment actions. Accordingly, COVID-19 growth rates consistently decreased with stringent containment actions during both early and late outbreaks. Our findings indicate that environmental drivers may have played a role in explaining the early variation among regions in disease spread. With limited policy interventions, seasonal patterns of disease spread might emerge, with temperate regions of both hemispheres being most at risk of severe outbreaks during colder months. Nevertheless, containment measures play a much stronger role and overwhelm impacts of environmental variation, highlighting the key role for policy interventions in curbing COVID-19 diffusion within a given region. If the disease will become seasonal in the next years, information on environmental drivers of COVID-19 can be integrated with epidemiological models to inform forecasting of future outbreak risks and improve management plans.

| S-EPMC7744010 | biostudies-literature

The impact of one-year COVID-19 containment measures in patients with mesial temporal lobe epilepsy: A longitudinal survey-based study.

Project description:BackgroundWe assessed levels of depression, anxiety, stress, anhedonia, somatization, psychological distress, sleep, and life quality in patients with mesial temporal lobe epilepsy (MTLE) after one year of containment measures started in Italy to stem the COVID-19 pandemic.MethodsWe consecutively enrolled 51 patients with MTLE, administering an online survey that compared the year before and after the COVID-19 propagation. We analyzed clinical data (e.g., seizure frequency, life quality) and neuropsychological assessment through Somatic Symptom Scale-8 (SSS-8), Beck Depression Inventory (BDI-2), State-Trait Anxiety Inventory (STAI-Y), Depression, Anxiety and Stress Scale (DASS-21), Pittsburgh Sleep Quality Index (PSQI), Snaith-Hamilton Pleasure Scale (SHAPS), Impact of Event Scale-Revised (IES-R). The BDI-2 and STAI-Y scores were compared to those acquired in the same patients before the COVID-19 outbreak.ResultsComparing our population with MTLE before and after COVID-19 outbreak, we found a significant worsening in life quality (p = 0.03), SSS-8 (p = 0.001), BDI-2 (p = 0.032), and STAI-Y scores (p < 0.001). After one year of pandemic, 88.2% of patients obtained pathological scores at PSQI, 19.6% at SHAPS, 29.4% at IES-R. Reduction of life quality correlated with anxiety, depression, stress, and somatization. Higher levels of anhedonia correlated with stress, depression, and anxiety. Somatization correlated with depression, anxiety, and sleep quality. Distress levels correlated with anxiety, somatization, and depression.ConclusionsWe demonstrated a significant worsening of depression, anxiety, life quality, and somatization in patients with MTLE after one year of COVID-19 beginning. Concomitantly, results suggest that the pandemic had a negative impact on sleep quality, psychological distress, and anhedonia, but not on epilepsy itself.

| S-EPMC8801317 | biostudies-literature

Exploring the Impact of COVID-19 on Home Care Workers: A Qualitative Study.

Project description:This qualitative study aimed to gain insight into the impact of COVID-19 on Home Care Workers (HCWs). During COVID-19 HCWs provided a lifeline for home care clients to support older people remaining living in their own homes. With a high-risk client base, HCWs were one of the few (Health and Social Care Professional) HSCPs to continue providing home-based care throughout COVID-19. Despite these contributions HCWs provided for aging in place during COVID-19, a paucity of research exists in relation to the challenges and impact of the pandemic on HCWs. Three in-person focus groups were conducted (n = 23). Two main themes were produced guided by a Reflexive Thematic Analysis approach to enable the researchers to best represent the participants experiences: Challenges and concerns to the personal and private lives of HCWs and Navigating home-based complexities of HCWs workplace during COVID-19. health care challenges to minimize impact to HCWs issues to create a safe workplace for HCWs.

| S-EPMC10799579 | biostudies-literature

Impact of COVID-19 Containment Measures on Unemployment: A Multi-country Analysis Using a Difference-in-Differences Framework

Project description:Background: At the start of the coronavirus disease 2019 (COVID-19) pandemic, in the absence of pharmaceutical interventions, countries resorted to containment measures to stem the spread of the disease. In this paper, we have conducted a global study using a sample of 46 countries to evaluate whether these containment measures resulted in unemployment. Methods: We use a difference-in-differences (DID) specification with a heterogenous intervention to show the varying intensity effect of containment measures on unemployment, on a sample of 46 countries. We explain variations in unemployment from January-June 2020 using stringency of containment measures, controlling for gross domestic product (GDP) growth, inflation rate, exports, cases of COVID-19 per million, COVID-19-specific fiscal spending, time fixed effects, region fixed effects, and region trends. We conduct further subset analyses by COVID-cases quintiles and gross national income (GNI) per capita quintiles. Results: The median level of containment stringency in our sample was 43.7. Our model found that increasing stringency to this level would result in unemployment increasing by 1.87 percentage points (or 1.67 pp, after controlling for confounding). For countries with below median COVID-19 cases and below median GNI per capita, this effect is larger. Conclusion: Containment measures have a strong impact on unemployment. This effect is larger in poorer countries and countries with low COVID-19 cases. Given that unemployment has profound effects on mortality and morbidity, this consequence of containment measures may compound the adverse health effects of the pandemic for the most vulnerable groups. It is necessary for governments to consider this in future pandemic management, and to attempt to alleviate the impact of containment measures via effective fiscal spending.

| S-EPMC10125098 | biostudies-literature

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