1.COVID-19: Weighing the Endeavors of Nations, with Time to Event Analysis
Shine STEPHEN ; Alwin ISSAC ; Jaison JACOB ; VR VIJAY ; Rakesh Vadakkethil RADHAKRISHNAN ; Nadiya KRISHNAN
Osong Public Health and Research Perspectives 2020;11(4):149-157
The cataclysmic COVID-19 pandemic erupted silently causing colossal impact worldwide, the repercussions of which indicated a lackadaisical vigilance in preparation for such a pandemic. This review assessed the measures taken by nations to contain this pandemic. A literature review was conducted using Medline, Google Scholar, Science Direct, Scopus, and WHO website. There were 8 nations (selected from the GHS index list) appraised for containment strategies. This was achieved by using mortality rate (per million) as the primary endpoint. The nations which were proactive, initiated scientific strategies earlier with rigor, appeared to have succeeded in containing the pandemic, although it is still too early to arbitrate a verdict. The so called “pandemic war” mandates international, interdisciplinary, and interdepartmental collaboration. Furthermore, building trust and confidence between the government and the public, having transparent communication, information sharing, use of advanced research-technology, and plentiful resources are required in the fight against COVID-19.
2.The Pandemic League of COVID-19: Korea Versus the United States, With Lessons for the Entire World
Alwin ISSAC ; Shine STEPHEN ; Jaison JACOB ; Vijay VR ; Rakesh Vadakkethil RADHAKRISHNAN ; Nadiya KRISHNAN ; Manju DHANDAPANI
Journal of Preventive Medicine and Public Health 2020;53(4):228-232
Coronavirus disease 2019 (COVID-19) is inflicting a brutal blow on humankind, and no corner of the world has been exempted from its wrath. This study analyzes the chief control measures and the distinctive features of the responses implemented by Korea and the United States to contain COVID-19 with the goal of extracting lessons that can be applied globally. Even though both nations reported their index cases on the same day, Korea succeeded in flattening the curve, with 10 752 cases as of April 28, 2020, whereas the outbreak skyrocketed in the United States, which had more than 1 million cases at the same time. The prudent and timely execution of control strategies enabled Korea to tame the spread of the virus, whereas the United States paid a major price for its delay, although it is too early to render a conclusive verdict. Information pertaining to the number of people infected with the virus and measures instituted by the government to control the spread of COVID-19 was retrieved from the United States Centers for Disease Control and Prevention and the Korea Centers for Disease Control and Prevention websites and press releases. Drawing lessons from both nations, it is evident that the resolution to the COVID-19 pandemic lies in the prudent usage of available resources, proactive strategic planning, public participation, transparency in information sharing, abiding by the regulations that are put into place, and how well the plan of action is implemented.
3.Scrutiny of COVID-19 response strategies among severely affected European nations
Shine STEPHEN ; Alwin ISSAC ; Rakesh Vadakkethil RADHAKRISHNAN ; Jaison JACOB ; VR VIJAY ; Sam JOSE ; SM AZHAR ; Anoop S. NAIR ; Nadiya KRISHNAN ; Rakesh SHARMA ; Manju DHANDAPANI
Osong Public Health and Research Perspectives 2021;12(4):203-214
Although the health care systems in Europe are considered the global benchmark, European nations were severely affected by the coronavirus disease 2019 (COVID-19) pandemic. This manuscript aimed to examine the strategies implemented to combat the COVID-19 pandemic by France, the United Kingdom, Spain, Italy, Germany, and Russia and their outcomes in terms of the number of cases, testing, and deaths. This is the first review of its kind that extensively analyzes the preparedness, mitigation, and response strategies against the COVID-19 pandemic adopted by these nations. This paper further suggests a strategic preparedness model for future pandemics. From the analysis, we found that a decentralized approach, prompt decision-making and timely execution, coordination between local health authorities, and public participation in the implementation of strategies could substantially reduce the case fatality rate. Nations with a high percentage of gross domestic product invested in the health sector, as well as more nurses, physicians, hospital beds, intensive care unit beds, and ventilators, better managed the pandemic. Instead, nations that postponed their pandemic response by delaying tracking, tracing, testing, quarantine, and lockdown were badly affected. The lessons learned from the present pandemic could be used as a guide to prepare for further pandemics.
4.Scrutiny of COVID-19 response strategies among severely affected European nations
Shine STEPHEN ; Alwin ISSAC ; Rakesh Vadakkethil RADHAKRISHNAN ; Jaison JACOB ; VR VIJAY ; Sam JOSE ; SM AZHAR ; Anoop S. NAIR ; Nadiya KRISHNAN ; Rakesh SHARMA ; Manju DHANDAPANI
Osong Public Health and Research Perspectives 2021;12(4):203-214
Although the health care systems in Europe are considered the global benchmark, European nations were severely affected by the coronavirus disease 2019 (COVID-19) pandemic. This manuscript aimed to examine the strategies implemented to combat the COVID-19 pandemic by France, the United Kingdom, Spain, Italy, Germany, and Russia and their outcomes in terms of the number of cases, testing, and deaths. This is the first review of its kind that extensively analyzes the preparedness, mitigation, and response strategies against the COVID-19 pandemic adopted by these nations. This paper further suggests a strategic preparedness model for future pandemics. From the analysis, we found that a decentralized approach, prompt decision-making and timely execution, coordination between local health authorities, and public participation in the implementation of strategies could substantially reduce the case fatality rate. Nations with a high percentage of gross domestic product invested in the health sector, as well as more nurses, physicians, hospital beds, intensive care unit beds, and ventilators, better managed the pandemic. Instead, nations that postponed their pandemic response by delaying tracking, tracing, testing, quarantine, and lockdown were badly affected. The lessons learned from the present pandemic could be used as a guide to prepare for further pandemics.
5.Tropical cyclone Fani-perspective from the trauma and emergency department of an affected tertiary hospital.
Chitta Ranjan MOHANTY ; Mantu JAIN ; Rakesh Vadakkethil RADHAKRISHNAN ; Prabeer CHANDRA MOHANTY ; RITESH PANDA
Chinese Journal of Traumatology 2020;23(4):243-248
PURPOSE:
To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster.
METHODS:
A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated.
RESULTS:
Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7-53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14-28), 7.84 (7.841-7.841), and 97.4 (91.6-98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure.
CONCLUSION
In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims.
Adolescent
;
Adult
;
Child
;
Cyclonic Storms
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Disaster Planning
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Disaster Victims
;
statistics & numerical data
;
Emergency Service, Hospital
;
Female
;
Humans
;
Male
;
Middle Aged
;
Multiple Trauma
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epidemiology
;
etiology
;
Retrospective Studies
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Tertiary Care Centers
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Trauma Centers
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Trauma Severity Indices
;
Young Adult
6.Pattern of injuries due to wild animal attack among patients presenting to the emergency department: A retrospective observational study.
Pradeep Kumar SINGH ; S Manwar ALI ; Rakesh Vadakkethil RADHAKRISHNAN ; Chitta Ranjan MOHANTY ; Manas Ranjan SAHU ; Bishnu Prasad PATRO ; Ijas MS ; Susant Kumar PANDA
Chinese Journal of Traumatology 2021;24(6):383-388
PURPOSE:
The human-wildlife conflicts (HWCs) causing nuisances and injuries are becoming a growing public health concern over recent years worldwide. We aimed to study the demographic profile, mode of injury, pattern of injury, and outcome of wild animal attack victims presented to the emergency department.
METHODS:
This retrospective cross-sectional study was conducted in the emergency department of a tertiary-care hospital in Eastern India. Data were retrieved from the medical records from May 2017 to May 2021. Patients of all ages and genders attacked by wild animals and secondary injuries were included in this study. Patients with incomplete data, injuries due to the attack of stray and domestic animals and trauma due to other causes were excluded. Demographic profile, mode of injury, the pattern of injury, injury severity score (ISS), radiological pattern, and outcome were recorded. Statistical analysis with R (version 3.6.1.) was conducted.
RESULTS:
A total of 411 wild animal attack victims were studied, of which 374 (90.9%) were snakebite injuries and 37 (9.1%) were wild mammalian (WM) attack injuries. The mean age of WM attack victims was 46 years, and the male-to-female ratio was 4:1. Elephant attack injury (40.5%) was the most common WM attack injury reported. Most WM attacks (43.2%) occurred between 4:00 a.m. to 8:00 a.m. The median ISS was 18.5 (13-28), where 54.2% of patients had polytrauma (ISS>15). Elephant attack was associated with a higher ISS, but the difference was not significant compared to other animal types (p = 0.2). Blunt trauma was common pattern of injury in the elephant attack injury cases. Lacerations and soft tissue injuries were common patterns in other animal attacks. Among snakebites, neurotoxic was the most common type (55.4%), and lower extremity was the most common site involved.
CONCLUSION
The young male population is the major victim of HWCs; and elephant is the most common animal involved. There is a need to design scientifically sound preventive strategies for HWCs and to strengthen the preparedness in health establishments to manage victims effectively.
Animals
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Animals, Wild
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Cross-Sectional Studies
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Emergency Service, Hospital
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Female
;
Humans
;
Injury Severity Score
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Male
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Middle Aged
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Retrospective Studies