Query: COVID 19 Frontliners

title: A mathematical model of COVID 19 transmission between frontliners and the general public
abstract: The number of COVID 19 cases is continuously increasing in different countries (as of March 2020) including the Philippines. It is estimated that the basic reproductive number of COVID 19 is around 1.5 to 4. The basic reproductive number characterizes the average number of persons that a primary case can directly infect in a population full of susceptible individuals. However, there can be superspreaders that can infect more than this estimated basic reproductive number. In this study, we formulate a conceptual mathematical model on the transmission dynamics of COVID 19 between the frontliners and the general public. We assume that the general public has a reproductive number between 1.5 to 4, and frontliners (e.g. healthcare workers, customer service and retail personnel, food service crews, and transport or delivery workers) have a higher reproduction number. Our simulations show that both the frontliners and the general public should be protected or resilient against the disease. Protecting only the frontliners will not result in flattening the epidemic curve. Protecting only the general public may flatten the epidemic curve but the infection risk faced by the frontliners is still high, which may eventually affect their work. Our simple model does not consider all factors involved in COVID 19 transmission in a community, but the insights from our model results remind us of the importance of community effort in controlling the transmission of the disease. All in all, the take home message is that everyone in the community, whether a frontliner or not, should be protected or should implement preventive measures to avoid being infected.

title: The Preparation, Delivery and Outcome of COVID 19 Pandemic Training Program among the Emergency Healthcare Frontliners (EHFs) The Malaysian Teaching Hospital Experience
abstract: One of the strategies in strengthening the healthcare providers in mitigating the impact of COVID 19 pandemic is through training Safety and disease unfamiliarity with COVID 19 was the main reason for developing this dedicated specialized training modules in order to address the issue The training modules were developed based on three strategies that are learning from experience, design suitable dedicated module and identify weakness and vulnerability The training modules created were donning doffing of Personal Protective Equipment (PPE) airway management and cardiopulmonary resuscitation of suspected COVID 19 patients which were delivered through immersive life simulation technique A total of 178 Emergency Healthcare Frontliners (EHFs) were trained Each module was guided with a checklist that the participants found to be very useful None of the participants reported developing symptoms of infection after undergoing the face to face simulation training even after two weeks of post training periods Seven important steps were found to be crucial that contributed to these findings which included room space, participants number per group, COVID 19 screening, taking of temperature, hand sanitization, PPE, and equipment sanitization before and after training Hands on training with guided checklist was found to be very useful to the EHFs in managing an unfamiliar situation of COVID 19 In time constraint resource limited conditions, training modules should be focused on addressing the pressing problem at hand In conducting a face to face training, precautionary safety measures should be strictly adhered to prevent the spread of the disease

title: Innovative Face Shields Help Frontliners Face off COVID 19 Pandemic.
abstract: The COVID 19 outbreak has presented unique challenges1 and opportunities for innovations towards effective response and overcoming operational constraints. Personal protective equipment (PPE) is critical to mitigate the risk of infection faced by healthcare workers (HCWs)2,3 in care settings. Prolonged use of goggles can cause discomfort, pain and facial imprints. Moreover, the lenses tend to fog up, reducing visibility and even resulting in giddiness at times. In response to discomfort, HCWs may be compelled to adjust the goggles, inadvertently exposing themselves to the risk of contamination with blood, bodily fluids and other potentially infectious materials. Face shields may be a more comfortable alternative to these goggles. Acute shortages due to global supply chain disruptions in the early course of the pandemic presented our innovation team with an opportunity to swiftly design and develop an ideal face shield for HCWs, to provide robust protection with better fit and comfort. For ease of use and viability, disposability and low cost factors were noted. Expedited production would address the potential acute shortages. In response to this challenge, an interdisciplinary team consisting of a design team from the Centre for Healthcare Innovation (CHI) and clinical leads comprising infectious diseases physicians and infection control nurses from the National Centre for Infectious Diseases (NCID) and Tan Tock Seng Hospital (TTSH) came together to develop a low cost, robust and disposable face shield. Most importantly, the product should be desirable and usable.4 The project was initiated on 1 February 2020. The team conceptualised and produced 10 prototypes over a weekend. More than 100 iterations were generated in the subsequent 2 weeks. The team tested prototypes with our clinical leads while concurrently making the necessary iterations. The team conducted a literature review of face shields used in infection control and identified potential materials such as polycarbonate, polyvinyl chloride (PVC) and polyethylene terephthalate glycol (PETG)7 to prototype a face shield. After testing the possible plastics available, the team took reference from the design requirements (Table 1) and decided upon the optically clear biaxially oriented polyethylene terephthalate (BoPET) for the prototype's shield.  Singap 2020;49:1044 7

title: COVID 19: Tribute to the Frontliners and its Impact to Malaysia Political Security
abstract: The zoonotic disease called COVID 19 has been the world's number one enemy for nearly a year now. The first quarter of 2020 were kicked start with death exceeding 1 million people from early March to date, and, the number are expected to increase rapidly especially with the newly cases arising in the Americas and South East Asia region as reported in World Health Organisation (WHO) daily dashboard. In this trying time, leadership, competency, and communication have been the epicentre of all government in combating the spread of Covid 19. Malaysia is no exception in embarking into the war against the deadly invisible virus. A study on the dynamics of public service vis a vis political leadership is conducted to generate behavioural pattern of governance in handling pandemic crisis. This article explains in Malaysian context, how leadership of the public service has shaped the pandemic to become a better situation with excellent leadership, proper competency, and effective communication strategy in ensuring the curve for new cases are flatten in a shorter period. It goes further to re examine political security taking into aspect of political actors' with civil servants. The unique value of the paper stems from the fact that a new government establishment in the midst of COVID 19 pandemic. Given at the severity of the pandemic and unprecedented government's establishment (through political turmoil) contribute new perspectives for handling crisis in Malaysia. In doing so, existing framework and actors of disaster management are also examined, to search for a better synergy in the nation's effort undermining COVID 19. The discussion contributes as an added value to Malaysia's preparedness in weathering crisis in the near future. Contrary to perception on the less ability of the government to weather the crisis, the article highlighted on coordination strategy of all actors and institutions involved, which received international and local recognition. However in the long term, loopholes need to be identified in constructing a better framework for the future. Whether the public service in general is still rigidly structured for the new normal or vice versa, is to be discussed in this article.

title: Asymptomatic and Minimally Symptomatic COVID 19 in Medical Frontliners: A Case Series from National Cardiovascular Centre Harapan Kita Indonesia
abstract: COVID 19 has widely spread in Indonesia and threatened health care workers at the frontline. We reported 12 cases of COVID 19 via local transmission among cardiology residents in National Cardiovascular Centre Harapan Kita Indonesia. All cases were asymptomatic or minimally symptomatic. Universal precaution and standardized protective equipment have been used but still ineffective to prevent bacterial transmission. Improper doffing technique and unfitted protective equipment might be responsible for cross infection.

title: Psychosocial support for healthcare frontliners during COVID 19 pandemic in Malaysia

title: Knowledge, confidence, and perception of respiratory therapists as frontliners in managing COVID 19 cases A questionnaire survey
abstract: The deadly outbreak of coronavirus disease 2019 (COVID 19) has imposed many challenges to health care professionals (HCPs) The knowledge, confidence in performing clinical skills, and psychological impact have been studied among various HCP. Respiratory therapists (RTs) are the frontliners in handling critically ill COVID 19 victims. Although being an integral part, there are no studies on RTs in COVID 19. Hence, we aim to study the knowledge, confidence, and perception of RTs in managing COVID 19.  A cross sectional, questionnaire based survey conducted among RTs in India. The present study was conducted from July 15, 2020, to August 1, 2020. Descriptive analysis was used to describe demographics, mean knowledge, confidence levels, perception, and psychological impact on RTs.  A total of 68 RTs responded with a response rate of 70.8% Of them, 60% (41) had good knowledge, 96% (65) had higher confidence in performing required clinical skills, 98.5% (67) had a perception that RTs plays an essential role in COVID 19 care, and 98.5% (67) had a negative psychological impact. Reliability of the questionnaire was found to be in acceptable range.  This study found that RTs in general had good knowledge and higher level confidence in performing procedure related to COVID 19. RTs perceive that the role of RT in COVID 19 is important.

title: Exploration of Frontliners' Experience Wearing PPE during the Covid 19 Outbreak
abstract: Safety health issues are at the forefront of dealing with infectious diseases during the Covid 19 crisis. In the context of this critical pandemic event, this study focuses on discovering frontliners experiences with Personal Protective Equipment (PPE) during the crisis. A thematic analysis has been used to identify themes and subthemes for this study. Researchers interviewed individuals to understand the experiences and reactions of frontliners dressed in PPE while on duty. The dominant themes documented in the study are as follows; physical discomfort, mental strength, the call of nature, dehydration and sweating, and communication interruption. Idealistic sacrifice and resistance working in difficult times during Covid 19 while serving the country ought to be appreciated and acknowledged by the nation

title: A mathematical model of COVID 19 transmission between frontliners and the general public
abstract: The number of COVID 19 cases is continuously increasing in different countries including the Philippines. It is estimated that the basic reproduction number of COVID 19 is around 1.5 4 (as of May 2020) The basic reproduction number characterizes the average number of persons that a primary case can directly infect in a population full of susceptible individuals. However, there can be superspreaders that can infect more than this estimated basic reproduction number. In this study, we formulate a conceptual mathematical model on the transmission dynamics of COVID 19 between the frontliners and the general public. We assume that the general public has a reproduction number between 1.5 and 4, and frontliners (e.g. healthcare workers, customer service and retail personnel, food service crews, and transport or delivery workers) have a higher reproduction number. Our simulations show that both the frontliners and the general public should be protected against the disease. Protecting only the frontliners will not result in flattening the epidemic curve. Protecting only the general public may flatten the epidemic curve but the infection risk faced by the frontliners is still high, which may eventually affect their work. The insights from our model remind us of the importance of community effort in controlling the transmission of the disease.

title: COVID 19 outbreak in Malaysia: Actions taken by the Malaysian government
abstract: 19, a novel pneumonia disease originated from Wuhan, was confirmed by World Health Organization on 12th January 2020 before becoming an outbreak in all countries. Outbreak situation A stringent screening process in all airports had been enforced after the first case outside China was reported in Thailand. Up to 14th April 2020, Malaysia reported two waves of COVID 19 cases, which the first wave was successfully ended in less than two months. In early March 2020, the second wave arose with worrying situations. Actions taken Malaysia government enforced the Movement Control Order starting from 18th March 2020 to seriously break the chain of COVID 19. Media actively spread the hashtag #stayhome. Non governmental organizations including prison inmates were the earliest to sew personal protective equipment to frontliners. Various organizations hosted fund raising to provide essentials mainly to hospitals. Provisional hospital was set up, collaborations with healthcare service providers were granted while additional laboratories were assigned in enhancing the proficiency of Ministry of Health. Economic downturn Initial financial stimulus amount RM 20.0 billion was released in February 2020 before the highlighted PRIHATIN package, amount RM 250 billion was announced. The PRIHATIN package was an all inclusive support from the government to society in various backgrounds from students, families to business owners.