COVID-19 health care demand and mortality in Sweden in response to non-pharmaceutical (NPIs) mitigation and suppression scenarios
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99 Sjödin H, Johansson AF, Farooq Z, Brännström A, Kriit HK, Wilder-Smith A, et al. Covid-19 health care demand and mortality in Sweden in response to nonpharmaceutical (NPIs) mitigation and suppression scenarios. medRxiv. 2020;23(3):1-15. doi: 10.1101/2020.03.20.20039594
https://doi.org/10.1101/2020.03.20.20039...
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2020
USA |
Descriptive and quatitative study |
To estimate the impact of COVID-19 on the Swedish population, considering the demography and human mobility of the municipalities, in mitigation and suppression scenarios, taking into account: incidence schedules, hospitalization rates, intensive care unit (ICU) need and mortality in relation to the current ICU capacity and care costs. |
Scenarios where contact rates and social distance are reduced by 50% result in mitigation. For suppression it would be necessary to reduce by 75%. The need for ICU for the total population in Sweden varies from 6 to 30 times the ICU capacity at the peak of the outbreak, in the scenario where only isolation and quarantine are practiced. At a time when contact rates and social distance are very strong, the outbreak is suppressed but risks recovering when social distance stops. The results indicate that in scenarios with less strong reductions in contact and social distance rates increase the risks of large hospital and intensive care demands. |
Duty to Plan: Health Care, Crisis Standards of Care, and Novel Coronavirus SARS-CoV-2
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66 Hick JL, Hanfling D, Wynia MK, Pavia AT. 2020. Duty to Plan: Health Care, Crisis Standards of Care, and Novel Coronavirus SARS-CoV-2 - discussion paper. NAM Perspectives. 2020;5(3):1-13. doi: 10.31478/202003b
https://doi.org/10.31478/202003b...
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2020
USA |
Qualitative study |
Discuss the application of Crisis Standards of Care (CSC) principles to clinical care, including personal protective equipment (PPE), intensive care, and outpatient and emergency challenges posed by coronavirus or other major epidemic or pandemic events. |
The principles of crisis standards of care (CSC) are: justice; duty to care; duty to manage resources; transparency; consistency; proportionality; accountability. Strategies to consider when addressing a resource shortage situation are: anticipating challenges, developing plans, storing materials; implementing shortages supply conservation strategies; providing a drug or equivalent or near equivalent delivery device; adapting the use of equipment for alternative purposes (e.g., anesthesia machine as a ventilator); reusing a wide variety of materials after proper disinfection or sterilization; removing a resource from one area/patient and allocating it to another with greater likelihood of benefit. |
Fair Allocation of Scarce Medical Resources in the Time of COVID-19
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22 Emanuel EJ, Persad G, Upshur R, Thome B, Parker M, Glickman A, et al. Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med. 2020;1(3):1-7. doi: 10.1056/NEJMsb2005114
https://doi.org/10.1056/NEJMsb2005114...
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2020
USA |
Descriptive and quantitative study |
Analyze how medical resources can be fairly allocated during a COVID-19 pandemic. |
Ethical values - maximizing benefits, treating equally, promoting and rewarding instrumental value and giving priority to the poorest - produce six specific recommendations for allocating medical resources during the COVID-19 pandemic: maximize benefits; prioritize health professionals; do not allocate on a first-come, first-served basis; be sensitive to evidence; recognize research participation; and apply the same principles to all patients with or without COVID-19. |
Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand
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1010 Ferguson NM, Laydon D, Nedjati-Gilani G. Impact of non-pharmaceutical interventions (NPIs) to reduce Covid-19 mortality and healthcare demand. London: Imperial College London; 2020;16(3):1-20. doi: 10.25561/77482
https://doi.org/10.25561/77482...
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2020
United Kingdom |
Descriptive and quantitative study |
Show the impact of non-pharmaceutical interventions (NPIs) to reduce COVID 19 mortality and demand for health care. |
The results show that multiple interventions will need to be stratified, regardless of whether suppression or mitigation is the overarching policy objective. However, suppression will require the stratification of more intense and socially disruptive measures than mitigation. The choice of interventions ultimately depends on the relative feasibility of their implementation and their likely effectiveness in different social contexts. |
Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases
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1111 Ramanathan K, Antognini D, Combes A, Paden M, Zakhary B, Ogino M, et al. Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases. Lancet Respir Med. 2020;20(3):1-9. doi: 10.1016/S2213-2600(20)30121-1
https://doi.org/10.1016/S2213-2600(20)30...
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2020
United Kingdom |
Qualitative study |
Discuss and analyze health service planning and delivery regarding the use of extracorporeal membrane oxygenation (ECMO) for the treatment of patients with acute respiratory distress syndrome (ARDS) related to coronary heart disease 2019 (COVID-19) and the application in other emerging infectious disease outbreaks. |
The intensive care response should be part of a larger pandemic control plan to reduce transmission and prevent deaths. In addition, much needs to be done through global collaboration to contain the disease and prioritize vaccine production to change the pathogen's natural history. Real-time data collection and sharing, establishing global biobanks and promoting an international culture of collaborative research that removes geographic boundaries, are crucial to rapidly identify at-risk populations, patients who benefit from therapies such as ECMO and possible therapeutic targets. |
Strategies to Inform Allocation of Stockpiled Ventilators to Healthcare Facilities During a Pandemic(1212 Koonin LM, Pillai S, Kahn EB, Moulia D, Patel A. Strategies to inform allocation of stockpiled ventilators to healthcare facilities during a pandemic. Health Security. 2020;18(2):1-6. doi: 10.1089/hs.2020.0028
https://doi.org/10.1089/hs.2020.0028...
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2020
USA |
Qualitative study |
Determine the need for and allocation of fans during a public health emergency, focusing on strategies to help state and local planners allocate fans stored in health facilities during a pandemic by responding to critical factors in the facility. |
Using ethical principles to assess need, determine capacity to absorb additional fans, and ensure resources for the most vulnerable populations, state and local public health authorities can equitably allocate fans stored during a pandemic. Having early strategies for allocating scarce resources, such as fans, can improve decision making, with the understanding that plans will have to adapt to the realities presented during a response to the pandemic. |
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