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Articles from 2020 In August


Point-of-care ultrasound and COVID-19

Article-Point-of-care ultrasound and COVID-19

The following article is available in full, including figures and data, on Cleveland Clinic Journal of Medicine June 2020 as part of its COVID-19 Curbside Consults.

Point-of-care ultrasound has an important role in the management of patients with COVID-19 infection. Because the utility of each application varies by setting, individual institutions should consider how they can best use ultrasound within their specific environments.

In general, procedural guidance and focused echocardiography are high yield. Lung ultrasound has the potential to aid the diagnosis and management of patients with COVID-19 infection. Lower extremity point-of-care ultrasound for deep vein thrombosis may help guide decision making regarding anticoagulation or undifferentiated shock.

It is of the utmost priority that ultrasound not spread infection, so point-of-care ultrasound must be used only when clinically indicated. Institutions should have protocols for machine disinfection.

Background

The highly infectious nature of the SARS-CoV-2 virus via respiratory droplets can lead to contamination of medical and radiologic devices during use.

The concern for nosocomial spread of the virus among healthcare workers and other hospitalized patients has led many societies and medical centers to recommend appropriately limiting exposure and imaging.

Point-of-care ultrasound is increasingly being used to diagnose, monitor, and manage patients in emergency departments and in those admitted to inpatient services.

In patients with COVID-19 infection it is an excellent tool for comprehensive examination given that ultrasound is already commonly used in patient care, handheld ultrasound devices are easy to clean, and the nature of the virus is critical and dynamic.

In this Curbside Consult, we present typical lung ultrasound findings in patients with COVID-19 infection and discuss other uses of point-of-care ultrasound in their care.

We also highlight key points about the disinfection of ultrasound machines and introduce a protocol that minimizes the time needed to assess infected patients for deep vein thrombosis as well as lung and cardiac abnormalities.

Typical findings of COVID-19

Description of findings

Typical lung patterns seen on ultrasonography in patients with COVID-19 infection include the following:

  • Pleural irregularity and thickening (early finding)
  • Subpleural consolidations
  • B lines may be seen, often derived from areas of irregular pleura; these become more confluent and diffuse as the disease progresses.
  • Spared areas (a pattern of normal lung interspersed between focal B lines) are usually present early in the disease
  • Nonlobar and translobar consolidation with air bronchograms
  • Small localized pleural effusions may be seen, but moderate or large basilar pleural effusions are rare

Findings are nonspecific

These lung ultrasound findings are not specific to COVID-19 and are seen in other pneumonias (viral and bacterial) and inflammatory pneumonitis. Severe cases of COVID-19 are similar in appearance to acute respiratory distress syndrome from other etiologies.

The findings differ from cardiogenic pulmonary edema, which is frequently characterized by bilateral lower-lobe-predominant B lines with smooth pleura. Alternatively, lack of lung ultrasound findings consistent with COVID-19 infection in acute respiratory failure may suggest an alternative etiology.

Read the full article.

Omnia Health Live Africa: Keeping the global healthcare industry connected virtually

Article-Omnia Health Live Africa: Keeping the global healthcare industry connected virtually

With COVID-19 impacting almost every aspect of day-to-day life, it may not be ‘business as usual’ as yet. However, if you are looking to stay up to date on the latest developments within the African healthcare industry and be connected with the healthcare community at this critical time, from 12 to 16 October log on to Omnia Health Live Africa – a five-day, free-to-attend virtual expo.

As the largest virtual healthcare tradeshow of its kind in the continent, Omnia Health Live (OHL) Africa’s mission is to connect buyers and sellers in a conducive business environment. The virtual event will unite the most innovative and knowledgeable minds from the African healthcare communities. It's a platform designed for attendees to engage, discover and learn from online tools and apps for seamless networking with suppliers.

OHL Africa has been built from the ground up to be a truly African event. Medical equipment manufacturers and healthcare solution providers from both Africa and the international community will congregate to develop new business ties and establish existing relationships with African hospital procurement teams, dealers, distributors, clinicians and healthcare professionals.

Moreover, the teams behind renowned expos such as Africa Health, North Africa Health, Medic East Africa and Medic West Africa have joined forces for the event, ensuring unrivalled access to all four corners of the continent. These four leading shows cater to an audience of over 125,000 healthcare and industry trade professionals.

Running for the last 10 years, Africa Health attracts more than 10,000 visitors delivering a hosted buyer programme including Ministers, Government Delegations and CEOs of leading hospitals from across sub-Saharan Africa. This has enabled deeper learning and fostering of relationships, which all leads to further collaboration, knowledge exchange and more business in Southern Africa.

On the other hand, Kenya’s ambitions for achieving widespread healthcare coverage has led to Medic East Africa being the biggest medical trade fair in Eastern Africa. This show has enabled health professionals to discover thousands of products and evaluate the latest competing solutions in healthcare across all product categories within the region. Medic East Africa has been bringing its healthcare community together for seven years attracting 4,000 visitors including top government officials and private sector executives.

While Nigeria’s rapidly developing healthcare sector has brought the latest innovations in healthcare in the spotlight for eight years through Medic West Africa. As the leading business event for healthcare product manufacturers and service providers under one roof, Medic West Africa connects more than 4,500 healthcare and medical laboratory professionals looking to source the latest healthcare equipment. The event has established itself as the leading healthcare business platform in the West African region.

Furthermore, for 13 years, North Africa Health has brought together more than 5,000 healthcare providers, medical practitioners, manufacturers, eHealth experts, key buyers, distributors, policymaker’s stakeholders from North Africa to meet, learn and do business. The show has an unparalleled level of access to education, distributors, hospitals and government in the north of Africa.

Educational sessions at Omnia Health Live Africa

OHL Africa will bring together policy drivers, thought leaders, expert clinicians and decision-makers in order to transform healthcare's most pressing challenges through collaboration and empowerment. Attendees will access over 30 clinical and business sessions that will feature more than 110 global speakers who will empower the virtual audience with access to the latest healthcare industry content. All the sessions are built to suit African time zones.

The event has adopted six pillars as the foundation for the knowledge-sharing sessions. These include Patient Safety, Leadership, Diagnostics, Infrastructure, Supply Chain and Evidence-Based Medicine. The pillars have been carefully curated to address African specific healthcare issues with topical and relevant information and education.

By collaborating with global thought leaders and innovators, OHL Africa intends to give back to the global community of healthcare professionals by providing Continuing Professional Development (CPD) resources and insights into the newest best practices, techniques and technologies to healthcare's toughest challenges.

The agenda for the event has been formulated for attendees to make the most of the sessions and have ample time to network and conduct meetings.

For more info visit live.omnia-health.com/Africa

What you need to know today about protective footwear and COVID-19

Article-What you need to know today about protective footwear and COVID-19

Low possibility of spreading COVID-19 through shoes

According to the World Health Organisation (WHO), the likelihood of COVID-19 being spread via footwear and infecting individuals is very low. As a precautionary measure, the WHO recommends leaving shoes at the entrance of home. This will prevent contact with dirt or any waste that could be carried on the soles of shoes.

A study from China showed that the soles of medical staff shoes might function as carriers. From 19 February through 2 March 2020, swab samples were collected from potentially contaminated objects in the ICU and GW at Huoshenshan Hospital in Wuhan, China. The researchers concluded that the coronavirus can be tracked all over the floor, as indicated by 100% rate of positivity from the floor in the pharmacy, where there were no patients. 

They added that half of the samples from the soles of ICU medical staff shoes tested positive, and recommended that the soles of footwear are disinfected before walking out of wards containing COVID-19 patients.

How to disinfect shoes

The CDC recommends sitting down on a “clean chair” before using Environmental Protection Agency-registered disinfectant wipes to thoroughly disinfect all surfaces of the shoe, moving from top to bottom and including the sole.

Disinfecting shoe mats have proved popular with consumers. SaniStride reported an increase in sales of their Shoe Sanitizer Dispensing Mats by more than 500 percent

Joseph Khabbaza, MD, a pulmonary and critical care specialist from Cleveland Clinic, said that while it won’t hurt to clean your shoes and avoid wearing them in the house, practicing regular hand sanitising, avoiding touching your face with unwashed hands, and social distancing are your best bets for avoiding infection.

A range of disinfectant devices can be found through our Omnia Health Marketplace. 

Protective footwear when cleaning and disinfecting environmental surfaces in the context of COVID-19

According to the WHO, disinfection practices are important to reduce the potential for COVID-19 virus contamination in non-healthcare settings, such as in the home, office, schools, gyms, publicly accessible buildings, faith-based community centres, markets, transportation and business settings or restaurants.

PPE for preparing or using disinfectants in health care settings includes closed work shoes, as well as uniforms with long-sleeves, gowns and/or impermeable aprons, rubber gloves, medical mask, and eye protection (preferably face shield).

The minimum recommended PPE furthermore in non-healthcares settings is closed shoes, rubber gloves and impermeable aprons. 

PPE does not include shoe covers

COVID-19 PPE for healthcare personnel includes goggles or disposable face shield, gown, pair of clean, non-sterile gloves - but no shoe or boot covers - as shown in the following CDC infographic

Similarly, official UK guidance (updated April 2020) does not make any recommendations for use of shoe protective equipment

A Centre for Evidence Based Medicine (CEBM) review from April 2020 stated that it had found no systematic reviews or randomised trials looking at the effectiveness of shoe covers as part of PPE, either in the context of COVID-19 or in other outbreaks. 

Convalescent plasma associated with reduced COVID-19 mortality in 35,000-plus hospitalized patients

Article-Convalescent plasma associated with reduced COVID-19 mortality in 35,000-plus hospitalized patients

Mayo Clinic and collaborators have published a preprint that identifies two main signals of efficacy that can inform future clinical trials on plasma therapy on COVID-19 patients. The data are extracted from the Mayo-led national Expanded Access Program (EAP) for convalescent plasma for the treatment of hospitalized patients with COVID-19.

The researchers report in “Effect of Convalescent Plasma on Hospitalized Patients with COVID-19: Initial Three-Month Experience” that the timing of plasma transfusions in a cohort of 35,322 patients were associated with lower mortality. The cohort included a high proportion of critically ill patients, with 52.3% in the intensive care unit (ICU) and 27.5% receiving mechanical ventilation at the time of plasma transfusion. They also report that in a subset of the cohort (3,082 patients), they found lower mortality associated with plasma transfusions that contained higher levels of antibodies against the virus that causes COVID-19. Specifically:

  • The seven-day mortality rate was reduced in patients transfused within three days of COVID-19 diagnosis compared with patients transfused four or more days after COVID-19 diagnosis. Similar trends were seen for 30-day mortality rate.
  • The use of convalescent plasma with higher antibody levels was associated with reduced seven-day and 30-day mortality.

The overall cohort included a diverse representation of participants by age, gender, weight, race and ethnicity. Study participants included approximately 40% females; 38% Hispanic/Latinos; 19% African American; and 4% Asian. This study includes adult participants enrolled in the U.S. Convalescent Plasma EAP program between April 4 and July 4 who were hospitalized with (or at risk of) severe or life-threatening acute COVID-19 respiratory syndrome.

It is important to note that the EAP is not and was not intended to be a clinical trial to determine the efficacy of convalescent plasma. It was established by the FDA as a program to increase access to plasma to help severely ill patients at the height of the pandemic and to determine the safety of plasma transfusions. The current observations might indicate factors that may impact effect of treatment and help direct the randomized clinical trials that are needed to establish efficacy. The intent was to offer a procedure that had a history of use at a time when there was no known treatment for this deadly condition.

Limits to the COVID-19 study

No data existed as to what dose might be appropriate. Inclusionary criteria were broad; exclusionary minimal. There was no standardized treatment protocol. Enrollment sites were very diverse, from university hospitals to community hospitals. Personnel training was minimal as was the fine detail of data reported.

This project has been funded in part with federal funds from the Biomedical Advanced Research and Development Authority, part of the Office of the Assistant Secretary for Preparedness and Response of the U.S. Department of Health and Human Services, among others. The study’s launch was followed by a national convalescent plasma donation campaign, The Fight Is In Us.

Egypt embraces digital transformation

Article-Egypt embraces digital transformation

With a population of reportedly 100 million, Egypt is making several key investments in the area of health technology to reduce costs and provide efficient care to its people. COVID-19 has further accelerated digital transformation in the country with the increased use of remote monitoring, telehealth platforms and Artificial Intelligence (AI)-enabled apps and devices.

Moreover, Egypt aims to have 7.7 per cent of its GDP derived through AI by 2030, according to a PwC report titled ‘The Potential Impact of AI in the Middle East’. The country has also developed a national AI strategy to integrate the technology in different sectors including healthcare.

The Egyptian government is driving digitisation across sectors and has been pushing for universal healthcare and cross-industry collaborations. This is evidenced in the recent partnership announced with British telecom operator Vodafone. According to reports, with the backing of the UK Department for International Trade, Vodafone won a £100m contract to help Egypt develop a new health insurance IT system on the lines of UK’s National Health Service (NHS).

The contract will introduce NHS-style universal healthcare for every citizen in Egypt. Vodafone will work with DXC Technology, a company providing IT infrastructure services across the NHS supply chain, to create a digital healthcare services platform to enable the launch of Egypt’s universal health insurance scheme. Reports said that the project will start off as a pilot in Port Said before it is introduced to four other governorates and then throughout the country.

Dr. Ahmed Nouh, Director, Digital Healthcare, Vodafone Egypt, told Omnia Health Insights: “The National Health Insurance System or the Universal Health Insurance, is a new system approved by the Egyptian Government in 2019. It makes healthcare insurance compulsory for all citizens. Vodafone’s role in this is that we will be doing the full automation and digitalisation of hospitals starting from information management systems, lab radiology systems integration, ERPs and financial management etc. These systems are still in the implementation stage and it is an on-going project, which will be realised in the next four years. Vodafone is putting a lot of effort to achieve this strategy.”

Empowering patients in Egypt

According to a report by start-up data platform Magnitt, Egypt has been ranked as one of the top countries with the most start-up investment deals closed in 2019 in the MENA. Egypt was second, after the UAE, attracting 14 per cent of the US$704m in total funding, in terms of deal values.

An app that has been making healthcare accessible for all in Egypt is Vezeeta. Its founder/CEO Amir Barsoum’s aim is to empower consumers to make more informed healthcare decisions. The app allows users to book online appointments, teleconsultations, doctors’ home visits and can also be used for online ordering and delivery of medications.  

Set up in 2012, Vezeeta connects users with 21,000 locally licensed doctors across 41 medical specialities. The company serves 4 million patients across six countries: Egypt, Saudi, Kenya, Nigeria (telehealth is available in these countries), Jordan and Lebanon.

Recently, Vezeeta partnered with Saudi Arabia’s leading telecom company STC to provide its employees with free telehealth services. In a statement, the company said that the partnership will enable STC’s employees in Saudi to book free phone calls and video calls through the app. The employees will also be able to schedule home visits from doctors.

Age of acceleration

Omnia Health Insights also spoke to Omar Shaker, a healthcare futurist, who has been instrumental in creating a network of Egyptian digital health leaders run and build a digital health ecosystem in the country via the Health 2.0 Egypt chapter, which is the official affiliate of the Health 2.0 Conference and Healthcare Information and Management Systems Society (HIMSS).

Currently, Shaker is the Advanced Analytics Director for the California Centre for Functional Medicine, which is a Bay Area clinic that focuses on lifestyle improvements via technology and has Functional Medicine certified doctors. “I do that remotely from Cairo while pushing to grow the impact of Health 2.0 Egypt on the ground,” he said.

Health 2.0 Egypt is a network whose purpose is to connect digital health stakeholders with both the local and global innovation community. The knowledge sharing and support that has been generated from its activities have created jobs, helped start-ups find clients and investors, and provided the digital health work in Egypt global exposure.

“This allowed us to attract funding from both local and global funders and have been able to connect over 3,000 people in 5 different governorates, brought 15 global speakers in our Cairo and Alexandria events, and ran multiple innovation competitions that coached over 20 local start-ups in 2019, many of which are now established larger local players,” he said. “Our network is now expanding beyond Egypt and with the large demand for online content, we have been able to attract just over 1,000 webinar viewers from 18 different countries. We are in the process of creating the new infrastructure that would be able to support the mission of building a road of innovation to connect the Middle East and Africa to the rest of the world.”

When asked about why he refers to himself a healthcare futurist, Shaker said: “I was first exposed to the term following Singularity University, which promotes the idea of how technology accelerates at an exponential rate that can be easily missed because our brains tend to think linearly. We can imagine 100 years as a long time but that is only going back 1920s. Futurists are people who dedicate their lives to exploring that edge of technology and how it can be implemented realistically. Done right, ideas can impact billions of people and solve real-world problems.”

According to Shaker, right now healthcare is going through its biggest change ever, and the capacity to scale genomic testing and analysis, processing power for AI, ability to build robots that can perform surgeries and manufacture using 3D printing are all accelerating at a pace that is faster than we know what to do with.

“In order to be a part of this age of acceleration, I realised I needed to spend a considerable amount of effort that is fuelled by curiosity in understanding these various forces and dedicate my life into finding the best way to leverage those to improve many of my frustrations with healthcare. It is exhausting because the road is not paved and you constantly need to be in a beginner's mindset, but especially in this day and age, your efforts will be rewarded,” he concluded.

The role of cardiac imaging in hospitalized COVID-19–positive patients

Article-The role of cardiac imaging in hospitalized COVID-19–positive patients

The following article is available in full, including figures and data, on Cleveland Clinic Journal of Medicine June 2020 as part of its COVID-19 Curbside Consults.

COVID-19 infection is associated with several cardiac complications with high rates of adverse outcomes. Cardiac imaging has different utility in different clinical scenarios, and the importance of minimizing healthcare worker exposure should be considered.

Cardiac imaging should only be ordered if its benefits outweigh its risks, with anticipated changes in acute treatment and outcomes, and no suitable alternative of sufficient adequacy is available. Indications for advanced cardiac imaging for COVID-19 patients in the acute phase are limited, although follow-up imaging in the convalescent stage may provide prognostic importance in recovered COVID-19 patients with positive troponin or decompensated heart failure.

Introduction

Since the initial cases in Wuhan, China in December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCoV), has rapidly become a global pandemic that has overwhelmed health systems, resulting in significant mortality.

Although COVID-19 primarily affects the lungs, a global inflammatory response involving multiple organs portends a poor prognosis. Cardiovascular complications of COVID-19 include acute myocardial injury in 12% to 28%, arrhythmias in 7% to 17%, and heart failure in about 20%, although whether they were caused by or exacerbated by COVID-19 remains unclear. Nevertheless, patients with a history of cardiovascular disease are at particularly high risk of adverse outcomes.

Previously, the decision to order cardiac imaging focused solely on balancing risks vs benefits at the patient level; however, the SARS-CoV-2 pandemic has resulted in an unprecedented impact on health-care delivery. Clinicians now must also consider the impact of potential exposure of healthcare workers, the concern for medical devices acting as fomites and causing nosocomial spread, and the feasibility of treatment options when determining diagnostic strategies for COVID-19 patients.

General recommendations

It is critically important to provide basic cardiorespiratory support to COVID-19 patients based on physical assessment with a thorough evaluation of risks and benefits before considering additional testing. Therefore, the following questions should be considered when ordering cardiac imaging:

  1. What is the specific clinical concern, and will the findings result in a substantial acute change in management?
  2. Will the benefits of cardiac imaging outweigh the risk of potential exposure of healthcare workers and nosocomial spread of virus?
  3. Are there alternative lower-risk options with sufficient accuracy to answer the clinical question?
  4. Can cardiac imaging be deferred until infectious risks have been mitigated or excluded?

Cardiac point-of-care ultrasonography (cPOCUS) should preferentially be performed in COVID-19 patients in the emergency room and intensive care unit by trained users when indicated. When there is uncertainty regarding the imaging findings, cPOCUS images should be reviewed with a certified cardiologist.

Images should be reviewed in conjunction with any past echocardiograms and recent chest computed tomography (CT) scans (for delineation of the presence of pericardial effusion, coronary artery calcification, and cardiac chamber sizes) to determine acute findings and need for focused/limited echocardiography.

Transthoracic echocardiography (TTE) examination protocols should be limited to decrease exposure time, but thorough enough to answer the clinical questions at hand and prevent need for repeat studies.

Advanced imaging techniques such as transesophageal echocardiography (TEE), cardiac computed tomography (CCT), or cardiac magnetic resonance imaging (CMR) have limited utility in the acute infectious phase for most hospitalized and acutely ill COVID-19 patients, since these are not likely to result in significant changes in acute management.

TEE carries a high aerosolization risk from patients gagging or coughing, and should be avoided unless absolutely critical for diagnosis. TTE with off-axis views, use of contrast agents, or CCT with contrast for left atrial appendage thrombus assessment may occasionally serve as adequate alternatives.

Infection-control precautions related to cardiac imaging should be followed with regard to equipment, personnel, protection, and location, which are outside the scope of this article.

Cardiac imaging should be delayed until outpatient follow-up of COVID-19 patients with suspected subacute clinical myocardial involvement. However, given the uncertainty regarding the duration of viral shedding, the development of strategic work-flow for outpatient cardiac imaging in convalescent COVID-19 patients should be considered and developed.

This commentary provides general recommendations for cardiac imaging by outlining 4 important clinical scenarios where cardiac imaging may be useful or controversial in hospitalized COVID-19 patients.

Read the full article.

Post-intensive care syndrome and COVID-19—Implications post pandemic

Article-Post-intensive care syndrome and COVID-19—Implications post pandemic

The following article is available in full, including figures and data, on Cleveland Clinic Journal of Medicine June 2020 as part of its COVID-19 Curbside Consults.

Post-intensive care syndrome (PICS) describes new or worsening physical, cognitive, or mental impairments in a patient following critical illness or intensive care. The COVID-19 pandemic will likely result in many more patients with PICS and its associated health and economic challenges. Screening and assessment tools done during hospitalization, at discharge, and post discharge should be utilized to facilitate services and strategies to improve PICS outcomes for patient and their families.

Background

Since the emergence of severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003 and the 21st century’s first pandemic, the 2009 H1N1 influenza, it has become clear that the effects of serious, life threatening illness extend beyond the hospital stay and can have long-term sequelae for patients.

PICS

Post-intensive care syndrome (PICS) refers to a patient with new or worsening impairment in any physical, cognitive, or mental domain after critical illness or intensive care. These impairments persist beyond the intensive care unit (ICU) hospitalization for as long as 5 to 15 years. The major risk factors for the development of PICS are acute respiratory distress syndrome (ARDS), sepsis, delirium, prolonged mechanical ventilation, and multiorgan failure.

Physical impairment in patients due to PICS is prevalent (up to 80%) and includes muscular weakness, fatigue, dyspnea, impaired pulmonary function, decreased exercise tolerance, sexual dysfunction, and respiratory failure that frequently lead to a reduction in activities of daily living and quality of life.

Mental health impairment occurs in 8% to 57% of patients with PICS and include anxiety, depression and posttraumatic stress disorder (PTSD) noted both in patients as well as their caregivers. Studies have noted a higher prevalence of post-ICU psychological sequelae in patients who are younger, female sex, have poor recall of ICU stay and longer duration of ICU sedation.

Finally, PICS cognitive impairment is noted in 30% to 80% of patients and includes memory loss and difficulty with concentration, comprehension, and critical thinking. This is reflected in a study of over 800 patients with respiratory failure or shock admitted to intensive care units. Scores on global cognition were 1.5 standard deviation lower than the population and similar to patients with traumatic brain injury with the duration of delirium as independently associated with worse global cognition at 3 months and 1 year.

PICS impairments often last more than a year and have a profound impact on patients’ quality of life, as well as that of their family members, known as PICS-F. Individuals with PICS-F are most commonly affected in the domain of mental health.

As many as 40% of patients with PICS are unable to return to their former level of function, resulting in job loss and financial difficulties that can further complicate access to healthcare. Iatrogenic complications from polypharmacy and fragmentation of care also impact patient recovery as there is often a mismatch between the support needed relative to the support provided.

The unrecognized needs of patients with PICS leads this vulnerable population to increased risk of subsequent hospitalization and emergency department and outpatient visits resulting in extraordinary healthcare-related costs. ARDS survivors are estimated to have a mean post-hospitalization cost of US$43,200 per person. The cost burden of COVID-19 survivors is expected to be higher.

PICS and COVID-19

Patients with severe illness due to COVID-19 often develop critical illness with hypoxemic respiratory failure, most commonly ARDS. Patients with COVID-19 treated in the ICU that survive may be at higher risk for developing PICS given the constraints on social support (restricted visitation), prolonged mechanical ventilation with exposure to higher amount of sedatives, and limited physical therapy during and after hospitalization given the risk of disease transmission.

Post-ICU care for patients in rehabilitation centers, skilled nursing facilities, and long-term acute care hospitals is also subject to imposed service limitations due to exposure restrictions, limited personal protective equipment, and risk of transmission to caregivers. Furthermore, limited visitation policies due to the risk of transmission may increase the risk of PIC-F.

The scale of the pandemic foreshadows an incredible burden of patients with PICs with over 3.6 million cases and greater than 140,000 deaths in the United States due to COVID-19. In a study from the post-SARS era, it was observed that patients develop long term fatigue, diffuse myalgia, weakness, depression, and sleep-disordered breathing.

We anticipate that not only will rehabilitation needs increase, but there will likely be higher rates of PTSD, depression, and substance abuse for patients, families, and health care workers which is something that has been seen in large scale disasters such as 9/11.

Read the full article.

DHA Director General tours Clemenceau Medical Center

Article-DHA Director General tours Clemenceau Medical Center

His Excellency Humaid Al Qutami, Director-General of the Dubai Health Authority (DHA) stressed that Dubai’s unique investment opportunities and incentives have made the city a favourable destination for medical investment as it provides an ideal environment for the development and success of international and multinational private hospitals.

Al Qutami made the statement during his visit to Clemenceau Medical Center, which began operating early this year, with a capacity of 100 beds offering several specialities and centres of excellence including heart; digestive disease; liver; mother and child; haematology and oncology; neuroscience and spine; and orthopaedic surgery.

Clemenceau Medical Center is the first hospital in Dubai Healthcare City Phase 2 and the free zone’s 4th general hospital.

Enhancing healthcare delivery

During his visit, Al Qutami stressed that the DHA considers the private healthcare sector to be its strategic partner and that the authority spares no effort in attracting more international specialised medical hospitals and centres to Dubai to enhance the healthcare system in the emirate and provide the public with a variety of health services that meet their needs.

During his hospital tour, Al Qutami met with high-level officials from the hospital and was accompanied by Jamal Abdulsalam, CEO of Dubai Healthcare City Authority. 

Jamal Abdulsalam, CEO, DHCA, said, “It makes us proud to add to the Dubai Healthcare City portfolio yet another globally-recognised name in the health industry. By choosing to set up in our free zone, Clemenceau, our first hospital in DHCC Phase 2, has demonstrated the trust that healthcare organisations around the world have in our standards and progressive regulations. We will continue to work towards enhancing healthcare delivery in the UAE.”

Phlebotomy home services to further safeguard vulnerable patients in UAE

Article-Phlebotomy home services to further safeguard vulnerable patients in UAE

Senior citizens and individuals with chronic illnesses in Abu Dhabi can now take advantage of phlebotomy (blood drawing) services from the comfort of their own home.

Imperial College London Diabetes Centre (ICLDC) and Amana Healthcare have partnered to expand home phlebotomy services for a larger population of patients with diabetes who are considered to be one of the most vulnerable groups of the community to infection and disease. It is estimated that more than 16 per cent of the UAE adult population has some form of diabetes, according to the International Diabetes Federation’s 2019 Diabetes Atlas.

Assisting vulnerable patients

Under the new partnership, which is in line with the Healthcare Programme for Senior Citizens and Individuals with Chronic Illnesses run by the Department of Health Abu Dhabi and Abu Dhabi Public Health Centre, up to 300 vulnerable patients can be visited daily.

Dr. Alya Saif Faris Ghanem Al Mazrouei, Acting Deputy Executive Director of ICLDC, explained: “It has been established that patients with poorly controlled blood-sugar have worse outcomes when exposed to any infectious illnesses. If they are elderly and have other comorbidities as well, it is vital that they avoid mingling with non-household members or taking public transport. However, they need to continue to have regular blood tests to manage their condition.

She added: “We are already offering the service in the cities of Abu Dhabi, Al Ain and Dubai to those who are aged 60 or over or have one of the following conditions: poorly controlled blood sugar, pregnancy, kidney disease (eGFR < 40), or unstable thyroid conditions,” she says

Patients who do not fall into these categories can make use of ICLDC’s appointment-only express phlebotomy facility, available at its Zayed Sports City and Al Ain branches. Here, the tests are completed in a separate, demarcated area, followed by a teleconsultation once the results are available.

Dr. Al Mazrouei said that the results of the blood tests are available within 24 hours, after which the ICLDC physicians will follow up with a teleconsultation and, if a prescription is necessary, instruct ICLDC’s home medication delivery service accordingly.

DHA and Indian health officials host webinar to discuss public and mental health

Article-DHA and Indian health officials host webinar to discuss public and mental health

The Dubai Health Authority (DHA) and Indian health officials held a webinar recently to discuss public and mental health, and to explore collaborative healthcare opportunities.

His Excellency Humaid Al Qutami, Director-General of the DHA said during his opening speech in the webinar that the UAE and India share a strong historical partnership and the two sides are keen to further strengthen as well as explore collaboration opportunities especially in specialised fields of healthcare.

High-level officials from the DHA including Dr. Younis Kazim, CEO of Dubai Healthcare Corporation and Farida Al Khaja, CEO of Clinical Support Services & Nursing Sector, participated in the webinar.

Exploring collaborative opportunities

In December 2019, a delegation headed by Al Qutami visited India on an official tour. The delegation visited several esteemed healthcare hospitals and institutions in India to explore collaborative opportunities in the healthcare sector.

Specific areas of collaboration included mental health, organ transplant, medical research, cancer care, cardiology, health innovation, mental health services and geriatric services.

Al Qutami said, “The aim of our visit and the continuation of dialogue is in line with our vision to collaborate with leading institutions in the world in the health sector to provide high-quality care to our patients and visitors. We are keen to share experiences and expertise with the aim to further bolster the health sector in Dubai and provide world-class patient-centred care.”

HE Dr. Aman Puri, Consul General of India to Dubai and the Northern Emirates said, “I would like to take this opportunity to congratulate the DHA and all governmental authorities in the UAE for providing exceptional support to all residents including the very large Indian community during this unprecedented crisis. The way UAE authorities have managed the pandemic is truly an example for the rest of the world. COVID-19 has brought healthcare to the centre stage and it is important for health systems around the world to build partnerships. UAE and India are strategic partners and it is important for them to continue to build a strong partnership in the field of healthcare.

“I am pleased to see the momentum and collaborative approach the two sides have in the health sector as it is one of the most important sectors.”

Discussing best practices

Her Excellency K.K. Shailaja Teacher, Minister of Health and Social Welfare, Government of Kerala said, “Firstly, I would like to congratulate the UAE government for their work in containing COVID-19. We have a large number of Keralites living in the UAE and I express my thanks to the UAE government. We have a robust partnership with the UAE and one that is historic. It is a relationship we truly value and appreciate. During the DHA’s visit last year, we discussed specific areas of collaboration with a focus on patient care. The recent pandemic has reinforced the spotlight on public health and its importance.

“While the work in Kerala is vigorous and ongoing, our scientific approach has worked so far to keep the numbers as low as we can. There is absolutely no doubt that public health is going to be at the forefront moving forward and that we need to constantly build and enhance the public health system.”

She also highlighted the role of mental health support and counselling and technologies such as telemedicine.

Dr. Rajeev Sadanandan, Advisor to the Chief Minister of Kerala, Former Health Secretary, Government of Kerala highlighted the role of data monitoring and technology from electronic patient record to hospital infrastructure. He also discussed the importance of capacity building and the need to continue to collaborate at an international level on health information.

While Dr. Mohammed Al Redha Director of Project Management Office, Informatics and Smart Health at the DHA and moderator of the webinar said, “During our trip to India we discussed specific areas of collaboration. In recent times, public health and mental health are extremely vital areas of healthcare. The webinar provided an opportunity for both sides to discuss best practises, challenges and further plans in the public and mental health field. At the end of the day, patient care, wellbeing and safety is a priority and it is important to discuss best-practises, facilitate knowledge transfer and collaborate with an aim to benefit patient care.”

The speakers included Dr. Hassan Shuri, Head of Section and Consultant, Medical Fitness Department at the DHA, Sandesh Cadabam, Managing Director and CEO, Cadabams Group, Dr. B.R. Madhukar, Medical Director Cadabams Hospitals and Dr. Khawla Ahmed, Consultant Medical Affairs Department, DHA.