Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal...ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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Interim guidance. 12 May 2021. The Continuity of essential health services: Facility Assessment Tool can be used by countries to rapidly assess the capacity of health facilities to maintain the provision of essential health services during the COVID-19 pandemic. It can help to alert the authorities ...and other stakeholders about where service delivery and utilization may require modification and/or investment. This assessment tool covers the following aspects of essential health services:
health workforce (numbers, absences, COVID-19 infections, health workforce management, training and support);
financial management and barriers;
service delivery and utilization (facility closures, changes in service delivery, community communication campaigns, changes in service utilization and catch-up strategies);
IPC capacities (protocols, safety measures, guidelines and the availability of personal protective equipment (PPE) for staff);
availability of therapeutics, diagnostics and supplies, and vaccine readiness; and
provision of COVID-19 primary care services.
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The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin...gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
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Snakebite envenoming affects millions of people worldwide annually and is a significant source of mortality. Preventing and treating the problem is complex and requires collaboration among the fields of public health, medicine, ecology, and laboratory science. After being removed from the category A... neglected tropical disease (NTD) list in 2013, snakebite envenoming was reinstated in 2017 in response to antivenom shortages and advocacy from researchers and international NGOs. In 2019, the World Health Organization (WHO) set a target to halve the number of deaths and cases of snakebite envenoming by 2030.
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Emerg Infect Dis. 2020 Jul [date cited]. https://doi.org/10.3201/eid2607.200915
Infection control instructions call for use of alcohol-based hand rub solutions to inactivate severe acute respiratory syndrome coronavirus 2. We determined the virucidal activity of World Health Organization–recommen...ded hand rub formulations, at full strength and multiple dilutions, and of the active ingredients. All disinfectants demonstrated efficient virus inactivation.
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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr...ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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A Global Inventory of Alternative Medical Waste Treatment Technologies
Cognitive deficits in schizophrenia can massively impact functionality and quality of life, furthering the importance of cognitive training. Despite the development of the field in Europe and in the United States, no programmes have been developed and tested in developing countries. Different cultur...al backgrounds, budget restrictions, and other difficulties may render treatment packages created in high income countries difficult for adoption by developing nations. We performed a pilot double-blind, randomized, controlled trial in order to investigate the efficacy and feasibility of an attention and memory training programme specially created in
a developing nation. The intervention used simple, widely available materials, required minimal infrastructure, and was conducted in groups.The sample included seventeen stable Brazilians with schizophrenia. Sessions were conducted weekly during five months. The cognitive training group showed significant improvements in inhibitory control and set-shifting over time. Both groups showed improvements in symptoms, processing speed, selective attention, executive function, and long-term visual memory. Improvements were found in the control group in long-term verbal memory and concentration. Our findings reinforce the idea that cognitive training in schizophrenia can be constructed using simple resources and infrastructure, facilitating its adoption by developing countries, and it may improve cognition.
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This helpdesk report seeks to establish what lessons have been learnt from the current and previous Ebola outbreaks. It recommends good practice and makes suggestions based on the evidence for good practice and preparedness to reduce transmission and prevent further risk and exposure in affected cou...ntries.
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