3
views
0
recommends
+1 Recommend
2 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Propuesta de un índice que resume las medidas preventivas no farmacológicas adoptadas frente al SARS-CoV-2 en las empresas: el caso del Parc de Salut Mar (Barcelona) Translated title: A proposal for a summary index of nonpharmacological preventive measures adopted against SARS-CoV-2 in companies: the case of Parc de Salut Mar (Barcelona)

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Resumen Introducción: Proponer la construcción de un índice numérico con las medidas preventivas no farmacológicas frente a SARS-CoV-2 a partir de la experiencia de una institución sanitaria en Barcelona, el Parc de Salut Mar (PSMar). Método: La construcción del índice se ha realizado en tres fases. La identificación y selección de las variables a incluir a partir de entrevistas semiestructuradas a informantes clave y la revisión documental. La definición de las dimensiones (constituidas a partir de una o más variables) y, finalmente la operatividad del índice a partir de dichas dimensiones. Se ha estimado el índice en el PSMar, y en sus dos principales centros, el Hospital del Mar y el Hospital de la Esperanza. Resultados: Se identificaron y categorizaron 21 variables, clasificadas en 5 dimensiones: equipos de protección individual, medidas organizativas individuales, medidas organizativas colectivas, medidas de vigilancia epidemiológica y actividades formativas. Además, De forma complementaria se añadió si existía un protocolo de actuación. Durante la primera ola, el índice en el Hospital del Mar se mantuvo por encima del valor obtenido en el Hospital de la Esperanza, mientras que en la segunda ola ambos índices presentaron valores similares hasta la semana 36, cuando el del hospital del Mar comenzó a presentar valores superiores. Estas oscilaciones se debieron principalmente a las dimensiones equipos de protección individual y actividades formativas. Conclusiones: El índice propuesto pone de manifiesto las dificultades para aplicar las diversas medidas preventivas no farmacológicas en las primeras semanas de la pandemia. Esta herramienta puede ser útil para evaluar las actividades desarrolladas frente a la pandemia por parte de los Servicios de Prevención de Riesgos Laborales, con las oportunas adaptaciones a la realidad de cada empresa.

          Translated abstract

          Abstract Introduction: We propose the construction of a numerical index of nonpharmacological preventive measures against SARS-CoV-2 based on the experience of Parc de Salut Mar (PSMar), a healthcare institution in Barcelona. Method: The construction of the index was carried out in three phases. First, we identified and selected the variables to be included based on semi-structured interviews with key informants and a review of relevant documents. Second, we defined the dimensions (consisting of one or more variables) and, as a final step, operationalised the index based on these dimensions. The index was then applied to generate estimates for the PSMar, and in its two main centres, the Hospital del Mar and the Hospital de la Esperanza. Results: Twenty-one variables were identified and categorised into five dimensions: personal protective equipment, individual organisational measures, collective organisational measures, epidemiological surveillance measures, and training activities. We also developed an action protocol. During the first SARS-CoV-2 wave, the index at the Hospital del Mar remained above that estimated for the Hospital de la Esperanza, whereas in the second wave both indices showed similar values until week 36, when the Hospital del Mar index began to show higher values. These oscillations were mainly due to the dimensions of personal protective equipment and training activities. Conclusions: The proposed index identified the difficulties in implementing the various non-pharmacological preventive measures during the first weeks of the pandemic. This tool can be useful for evaluating the activities carried out by the occupational risk prevention services during the pandemic, followed by appropriate adaptations to the realities of each individual company.

          Related collections

          Most cited references7

          • Record: found
          • Abstract: found
          • Article: not found

          A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker)

          COVID-19 has prompted unprecedented government action around the world. We introduce the Oxford COVID-19 Government Response Tracker (OxCGRT), a dataset that addresses the need for continuously updated, readily usable and comparable information on policy measures. From 1 January 2020, the data capture government policies related to closure and containment, health and economic policy for more than 180 countries, plus several countries' subnational jurisdictions. Policy responses are recorded on ordinal or continuous scales for 19 policy areas, capturing variation in degree of response. We present two motivating applications of the data, highlighting patterns in the timing of policy adoption and subsequent policy easing and reimposition, and illustrating how the data can be combined with behavioural and epidemiological indicators. This database enables researchers and policymakers to explore the empirical effects of policy responses on the spread of COVID-19 cases and deaths, as well as on economic and social welfare.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis

            Objective To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. Design Systematic review and meta-analysis. Data sources Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints). Eligibility criteria for study selection Observational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. Main outcome measures The main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality. Data synthesis DerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran’s Q test and the I 2 metrics, with two tailed P values. Results 72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a “package of interventions.” Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I 2 =12%), mask wearing (0.47, 0.29 to 0.75, I 2 =84%), and physical distancing (0.75, 0.59 to 0.95, I 2 =87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively. Conclusions This systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination. Systematic review registration PROSPERO CRD42020178692.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Global shortage of personal protective equipment

              The COVID-19 pandemic has unearthed lack of coordination and equal access to personal protective equipment around the world. Talha Burki reports. On May 28, 2020, Médecins Sans Frontìres (MSF) issued a press release calling for the market in personal protective equipment (PPE) to be regulated. “The COVID-19 pandemic has caused shortages and price rises in PPE, especially those needed to protect frontline health workers”, noted MSF. “The situation has thrown into danger not only healthcare workers, but the ability of providers like MSF to respond to other vital healthcare needs. Regulation to ensure that personal protective equipment is distributed in an equitable and transparent manner during the COVID-19 pandemic must be put in place.” By some distance, the world's largest manufacturer of PPE is China. Before the pandemic, China was responsible for half the world's supply of surgical masks and was the only place capable of mass producing clinical gowns. So the severe shortages that characterised the early stages of the pandemic were probably unavoidable. Supply was already disrupted by the Chinese New Year, which typically interrupts production for 10–14 days. This year's festivities coincided with an explosion of cases of COVID-19 within China. The public health policies that were introduced in response to the emergence of severe acute respiratory syndrome coronavirus 2 prevented a lot of workers from returning to their factory jobs. Alongside the constricted supply came a surge in domestic demand for PPE. China imposed export restrictions. Other countries, including several in Europe, would subsequently enact similar measures, with reports emerging in April that USAID had informed the recipients of its grants that they were not to use any of these funds to buy surgical masks, N95 respirators, or surgical gloves. International travel restrictions compounded the problem. In early March, WHO noted that since the start of the pandemic, the price of surgical masks had increased sixfold, the price of N95 respirators had trebled, and the price of surgical gowns had doubled. They urged industry to raise its production of PPE by 40%. Countries issued contingency plans for stock-outs. Nations such as the UK and the USA reported dangerously low supplies of PPE. In Italy, the shortages contributed to the high burden of infection and death among hospital staff. As prices continued to rise, countries competed for PPE on the open market. There were even reports of US states bidding against one another. At the end of March, WHO Director-General Tedros Adhanom Ghebreyesus stated that “the chronic global shortage of personal protective equipment is now one of the most urgent threats to our collective ability to save lives”. The initial disruption appears to have stabilised now. China now produces at least 110 million surgical masks every day; before the pandemic hit, production stood at 20 million masks per day. Chinese billionaire Jack Ma has made a series of PPE donations to Africa, through his charitable foundations, and the United Arab Emirates has pledged three aircrafts to deliver essential cargo and personnel until the end of the year. “Things are certainly better”, said Paul Molinaro, Chief of Operations Support and Logistics at WHO. “The market did eventually respond, we have seen some new manufacturers come online and the surge in demand has somewhat subsided; but I would not say that the issues have been necessarily resolved, there are still constraints on the market.” There are continuing shortages of particular raw materials and not all manufacturers have returned to pre-pandemic levels of production. Moreover, some companies that diverted their production facilities to making PPE may stop making the products as the pandemic runs its course. UNICEF reckons that by the end of 2020, demand for surgical masks could reach 2·2 billion, demand for gloves could reach 1·1 billion, and demand for face shields could reach 8·8 million. All of which means that PPE will remain a sellers' market for the foreseeable future. Buyers have to offer a firm financial commitment in advance of the sale. If they are unable to do so, or act too slowly, chances are the vendor will look elsewhere. This puts low income countries at a disadvantage. “In every country we work with, there is not enough PPE either to set up the COVID-19 centre to take in and confirm patients, or to protect the general hospital and to ensure the continuity of medical services”, explains Isabelle Defourny, director of operations at MSF. “In different countries, we are seeing more and more staff get sick.” She points out that when hospitals start to act as a setting actively amplifying an infectious disease outbreak, because of a lack of PPE, they eventually have to be closed. The situation in war-torn Yemen is particularly concerning. “There is some PPE for treating COVID-19 patients, but nowhere near enough to protect the staff in different hospitals and health centres”, said Defourny. “It is building into a disaster; the number of severe cases of COVID-19 are increasing at the same time as medical staff are becoming infected and are unable to work.” She worries that even as the pandemic eases in the developed world, the global shortages of PPE will continue as countries build up their stock of PPE in expectation of a second wave of cases. WHO and several partners, including MSF, have established a supply portal through which countries can order PPE. “The idea is to co-ordinate an approach to the market so that parties are not competing against each other”, Molinaro told The Lancet Infectious Diseases. “The portal is really trying to resolve the issue of the fragmented demand.” The European Union and the African Union have established their own collaborative procurement processes. Individual countries decide for themselves what to do with their supplies of PPE. In the early stages of pandemic in England, the National Health Service was prioritised over care homes, for example. Members of the consortium behind the WHO supply portal can advise on prioritisation between countries, but there is no formal global mechanism for assigning PPE to the places most in need. MSF believes that this needs to change. “It is extraordinarily important to have some kind of criteria to decide what happens when there is a shortage, otherwise you risk a situation where many countries will not be able to access the PPE they desperately need, while other countries may have a surplus”, said Defourny. Andrew Lakoff (University of Southern California, Los Angeles, USA) points out that over the past decade or so there has been a great deal of discussion over how best to ensure equitable access to vaccines, drugs, and diagnostics, but there has not been the same kind of attention paid to PPE. “MSF's intervention is important”, he said. “We certainly need some kind of internationally agreed way of keeping global supply chains moving through times of pandemic; I would imagine WHO would be very well placed to try to coordinate that.” Molinaro stresses the importance of flexibility. It is much easier to forecast demand for a vaccine, for example, than for PPE. The COVID-19 pandemic saw demand for some protective items surge by several thousand percent. “During a pandemic, the epidemiology changes from week to week; we have to be responsive to that”, adds Molinaro. “In the longer-term, we will have to figure out what happens if there is a large second wave of cases, or indeed a different pandemic. There is a limit to how much we can stockpile.” © 2020 Flickr – ECDC 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
                Bookmark

                Author and article information

                Journal
                aprl
                Archivos de Prevención de Riesgos Laborales
                Arch Prev Riesgos Labor
                Societat Catalana de Salut Laboral y Asociación de Medicina del Trabajo de la Comunidad Valenciana (Barcelona, Barcelona, Spain )
                1578-2549
                September 2022
                : 25
                : 3
                : 300-309
                Affiliations
                [3] Barcelona orgnameInstitut Hospital del Mar d'Investigacions Mèdiques Spain
                [4] Barcelona orgnameParc de Salut Mar orgdiv1Servicio de Salud Laboral España
                [2] Barcelona orgnameCIBER de Epidemiología y Salud Pública (CIBERESP) España
                [1] Barcelona Cataluña orgnameUniversitat Pompeu Fabra orgdiv1Centro de Investigación en Salud Laboral (CISAL) Spain
                Article
                S1578-25492022000300300 S1578-2549(22)02500300300
                10.12961/aprl.2022.25.03.06
                3e462448-d583-4728-83b1-6ae940356fca

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 22 February 2022
                : 28 April 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 7, Pages: 10
                Product

                SciELO Spain

                Categories
                Originales

                personal sanitario,medidas preventivas,COVID-19,equipo de protección individual,preventive measures,health personnel,personal protective equipment

                Comments

                Comment on this article