Clinical Presentation and course of SARS-CoV-2 infection in health care personnel working in dedicated Covid hospital during two pandemic waves in India

Introduction: Health care personnel (HCPs) are predisposed to infection during direct or indirect patient care as well as due to the community spread of the disease. Methods: We observed the clinical presentation and course of SARS-CoV-2 infection in HCPs working in a dedicated Covid care hospital during the first and the second wave. Results: A total of 100 and 223 HCPs were enrolled for the first wave and the second wave respectively. Cough, shortness of breath, sore throat, runny nose, and headache was seen in 40(40%) and 152 (68%) (p <0.01), 15(15%) and 64 (29%) (p = .006), 40 (40%) and 119 (53.3%) (p=0.03), 9 (9%) and 66 (30%) (p<0.01), 20 (20%) and 125 (56%) (p<0.01) respectively. Persistent symptoms at the time of joining back to work were seen in 31(31%) HCPs and 152(68%) HCPs respectively (p= <0.01). Reinfection was reported in 10 HCPs. Conclusions: Most of the HCPs had mild to moderate infections. Symptoms persist after joining back to work. Upgradation of home based care and tele consultation facilities for active disease and redressal of residual symptoms will be helpful.

Toward COVID-19 we all have our stories, this is mine

<p>My name is Alberto and I am starting the eighth semester of my Bachelor’s Degree in Agrogenomic Science in the ENES. The pandemic emphasized how scarcely updated in digital technologies professors are and also displayed the needs that many of us students have. These needs did not improve for everyone. Three days before the voluntary quarantine in Mexico due to COVID-19, I travelled abroad, to a work stay period in the Universidad Nacional Mayor de San Marcos, in Peru. Right before the trip, the borders of that country closed, and I could not carry out my exchange. Upon my return to Mexico, I saw a very different scenario than what I was used to seeing. I didn’t know what my educational situation would be like, and I had no idea if I would be set back a semester of if I would continue normally. Luckily, I was able to take the corresponding subjects, finishing my semester in a proper and timely manner. In terms of my subjects, I didn’t learn much. My professors weren’t prepared, and many didn’t even know much about certain virtual technologies. Only the teacher that gave us Biology of Systems generated a different strategy to the others, providing a space of adequate and proper learning. My seventh semester was not bad at all, and I even adapted quite well to the situation. I began with my social service and the subject of Investigation Work. I believe that my planning with my professor was key to not becoming overwhelmed with activities and giving the project the attention it needed. I was able to finish the semester with a thoroughly completed project, without any pressure and it was something I enjoyed quite a bit. I hope that this eighth semester, which is about to begin, is just as comforting and I learn plenty. Now, about the outside of the educational sphere, I am a boy with diverse activities and interests, such as participating in social projects in the state of Guanajuato. The pandemic forced all the events and activities I participated in to shut down. Being at home in lockdown after a life of movement, in which I travelled up and down the city, caused a bit of confusion, fatigue and anxiety. Although I continue with my activities at a distance, I can no longer enjoy being in touch with people, seeing children be happy, teaching, carrying out all these activities. I don’t feel the same through a computer. I feel highly unmotivated to do all those things I used to do. In my family, we have all been looking after ourselves as much as possible. My family runs a business, and I am the only child that studies, at the moment. As much as we would like to stay home, we can’t. For us there is no ‘Home Office’. If we don’t sell, we don’t eat. Unfortunately, for over five months we were unable to go out to work, since the government would have fined us and even sanctioned us in harsher ways. During those five months, there was no income and my father had to ask for several loans, which only sank us further into debt. After those five months we went back to work, but sales were scarce. We were not making enough to pay back our debts. Regarding health, we are a few of the lucky ones. We have not been infected and all our family members are healthy. Only my grandmother got infected, but it never went past a little flu. All the students, teachers and other people related to science have different stories. This is mine.</p>

The Effects of live- in rehabilitation on ARV adherence, abstinence from drugs and lifestyle modification in people who inject drugs (PWID) Living with HIV – A clinic review

Background & Objective: HIV/AIDS is mostly seen in people who inject recreational drugs (PWID). Adherence has to be optimum for its treatment to be effective. Compliance to HIV medication has been problematic in PWID making HIV control difficult. Many studies in the past have validated educational activities like rehabilitation programs beneficial in maintaining regularity in medication intake. This brought us to the question of looking at such programs and its effects on our population. This study was conducted to assess the impact of other perspectives of abstinence and adherence including family support and employment status on a person’s willingness for treatment continuation and avoidance of drugs. Methods: A retrospective chart review of 241 PWID was conducted to assess adherence to antiretroviral agents (ARVs) and abstinence from recreational drugs post visit to the rehabilitation center. Associations with family support, marital status, employment, income and back to work status were also assessed. Results: Adherence to ARVs had significant statistical association with marital status (p=0.025), starting work again (p=0.001), family support (p=0.009), employment status (p=0.009) and monthly income (p=0.025). While family support (p=0.033), employment status (p<0.0001), Going back to work (p<0.0001), mode of travel to Rehabilitation center (p<0.0001) and monthly income (p=0.004) were associated with abstinence from drugs. Duration of rehabilitation or age had no effect on adherence or abstinence in our patient population of PWID. Conclusion: Family and spousal support and employment promote optimal ARV compliance and should be encouraged when starting ARVs. Enrollment in a long-term complementing educational program would further enhance ARV intake and abstinence. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5780 How to cite this:Hussain A, Rahim A, Sheikh A, Jiwani A. The Effects of live- in rehabilitation on ARV adherence, abstinence from drugs and lifestyle modification in people who inject drugs (PWID) Living with HIV – A clinic review. Pak J Med Sci. 2022;38(2):411-416. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5780 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Healthcare - Where to from here?

In writing an editorial it is difficult to ignore the impact and ramifications of addressing the Covid Pandemic. In Australia, there is emerging political and media signals that are saying we must start to move on and get people back to work and living normally. At the same time our health bureaucracies are pointing to higher vaccination rates, new variants, the need for ‘booster shots’ and continued reticence in some about opening state and national borders....

A time to invest?

The pandemic, necessitating the need for most children to stay at home, served to highlight the complexities of caring, amusing, and educating our early years children. With life now getting back to normal and parents getting back to work, is this the right time to invest in the sector?

Can I go back to work? A case of persistent SARS-CoV-2 with advanced untreated HIV infection

We describe the case of a 30-year-old care home employee diagnosed with COVID-19 and acute untreated HIV-1. He was unable to return to work for 119 days due to concerns over transmission risk as his SARS-CoV-2 PCR remained detectable. This highlights the uncertainty in interpreting SARS-CoV-2 PCR results post-infection in acute untreated HIV.

Control and Prevention of SARS-CoV-2 Outbreaks among Healthcare Workers from 129 Healthcare Facilities in Mexico

Few reports have shared the workflows to reduce SARS-CoV-2 infections among risk groups, including healthcare workers (HCWs). This study describes an occupational health program implemented to reduce the incidence of COVID-19 and establishes a back-to-work algorithm in HCWs of 129 Salud Digna outpatient care clinics in Mexico. This program was composed of training plans, screening SARS-CoV-2 infections, the containment of infections, follow-up COVID-19 cases, and continuing supervision in addition to the steady supply and training for the correct use of PPE. From 16 April 2020 to 15 April 2021, 7376 individuals were enrolled, of which 423 were excluded because they did not meet the inclusion criteria or refused the follow-up. In the cohort studied, we found a COVID-19 incidence of 35.4% (2610 individuals), lower hospitalization (0.11%), ICU (0.04%) and lethality rate (0.04%). Additionally, 85.9% of COVID-19 cases tested negative for SARS-CoV-2 after 14 days of the first positive test with an average isolation time of 26–33 days. Finally, 99% of people received personal protective equipment and adequate training to use it. Our results show that the program implemented reduced the hospitalization ICU admission and lethality in HCWs; we consider this workflow to help other workplaces offer safe conditions for HCWs and patients.

The post-treatment return-to-work transition experience for breast cancer survivors under 50 years of age

The purpose of this study is to explore the experience of cancer survivors less than 50 years of age, as they transition back to work after the end of treatment. Eight survivors took part in this exploratory qualitative study. The results of the iterative content analysis suggest that these survivors want to put their illness-focused life behind them and resume a “normal” existence, of which a return to work is an integral part. The return-to-work transition is also influenced by various personal, family and societal factors that can facilitate or inhibit the experience. Lastly, a number of distinct challenges and a higher level of vulnerability must be taken into consideration by healthcare professionals to be able to better support these survivors transitioning back to work.