INTRODUCTION: Teleophthalmology may assist the healthcare sector in adapting to limitations imposed on clinical practice by a viral pandemic. A scoping review is performed in this study to assess the current applications of teleophthalmology for its suitability to diagnose, monitor or manage ophthalmological conditions with accuracy. METHODS: A search of PubMed was conducted for teleophthalmology-related articles published from 1 January 2018 to 4 May 2020. Only articles that focused on the use of teleophthalmology in terms of diagnosis and management, as well as its benefits and detriments, were included. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included articles. RESULTS: A total of 38 articles were assessed at the full-text level. There were 2 qualitative studies and 1 quantitative randomised controlled trial, while the majority were either quantitative descriptive studies (19, 50.0%) or quantitative non-randomised studies (16, 42.1%). Overall, 8 studies described reducing manpower requirements, 4 described reducing direct patient-doctor contact, 17 described storage of medical imaging and clinical data, and 9 described real-time teleconferencing. The MMAT analysis revealed limitations in appropriate sampling strategy in both quantitative non-randomised studies (9 of 16, 56.3%) and quantitative descriptive studies (9 of 19, 47.4%). Cost-effectiveness of teleophthalmology was not performed in any included study. CONCLUSION This current review of the various aspects of teleophthalmology describes how it may potentially assist the healthcare sector to cope with the limitations imposed by a viral pandemic through technology. Further research is required to evaluate the cost-effectiveness of the various strategies.
COVID-19/transmission* ; Humans ; Ophthalmology/organization & administration* ; Telemedicine/organization & administration*

Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections/transmission* ; Humans ; Pandemics ; Pneumonia, Viral/transmission* ; Research ; SARS-CoV-2

COVID-19/transmission* ; COVID-19 Testing ; Humans ; Infection Control ; Infectious Disease Transmission, Patient-to-Professional/prevention & control* ; Intraoperative Care ; Pandemics ; Personal Protective Equipment ; Postoperative Care ; Preoperative Care ; Tracheostomy/methods*

COVID-19/transmission* ; Communicable Disease Control/organization & administration* ; Humans ; Thailand/epidemiology*

INTRODUCTION: Oropharyngeal swabs for diagnosis of COVID-19 often induce violent coughing, which can disperse infectious droplets onto providers. Incorrectly doffing personal protective equipment (PPE) increases the risk of transmission. A cheap, single-use variation of the face shield invented by a Singaporean team, SG Shield, aims to reduce this risk. This manikin study aimed to study the efficacy of the SG Shield in combination with standard PPE. METHODS: A person attired in full PPE whose face and chest was lined with grid paper stood in front of an airway manikin in an enclosed room. A small latex balloon containing ultraviolet fluorescent dye was placed in the oral cavity of the manikin and inflated until explosion to simulate a cough. Three study groups were tested: (a) control (no shield), (b) face shield and (c) SG Shield. The primary outcome was droplet dispersion, determined quantitatively by calculating the proportion of grid paper wall squares stained with fluorescent dye. The secondary outcome was the severity of provider contamination. RESULTS: The SG Shield significantly reduced droplet dispersion to 0% compared to the controls (99.0%, P = 0.001). The face shield also significantly reduced droplet contamination but to a lesser extent (80.0%) compared to the control group (P = 0.001). Although the qualitative severity of droplet contamination was significantly lower in both groups compared to the controls, the face shield group had more contamination of the provider's head and neck. CONCLUSION The manikin study showed that the SG Shield significantly reduces droplet dispersion to the swab provider's face and chest.
Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control* ; COVID-19 ; Fluorescent Dyes ; Personal Protective Equipment ; Cough

In this paper, we provide guidance to clinicians who care for infants born to mothers with suspected/confirmed COVID-19 during this current pandemic. We reviewed available literature and international guidelines based on the following themes: delivery room management; infection control and prevention strategies; neonatal severe acute respiratory syndrome coronavirus 2 testing; breastfeeding and breastmilk feeding; rooming-in of mother-infant; respiratory support precautions; visiting procedures; de-isolation and discharge of infant; outpatient clinic attendance; transport of infant; and training of healthcare staff. This guidance for clinical care was proposed and contextualised for the local setting via consensus by members of this workgroup and was based on evidence available as of 31 July 2020, and may change as new evidence emerges.
Infant, Newborn ; Pregnancy ; Female ; Humans ; Mothers ; COVID-19/epidemiology* ; Singapore/epidemiology* ; COVID-19 Testing ; Pandemics/prevention & control* ; Infectious Disease Transmission, Vertical/prevention & control* ; Pregnancy Complications, Infectious/prevention & control*

The ongoing pandemic of COVID-19 has presented multiple challenges to global healthcare services, dictating changes in almost every aspect of daily medical practice. Performing aerosol generating procedures (AGPs) in the field of interventional pulmonology can lead to profound formation of aerosols, leading to a high risk of infection among healthcare workers (HCWs). We share our experiences on performing AGPs in the midst of a COVID-19 pandemic by focusing on changes in AGP practices. In a pandemic, HCWs ought to adapt to the ever-changing situation and use available resources to provide the best possible healthcare to patients, ensure safety of staff, and continue medical education of future pulmonologists.
Aerosols ; Bronchoscopy/trends* ; COVID-19/transmission* ; COVID-19 Testing ; Humans ; Infection Control/trends* ; Infectious Disease Transmission, Patient-to-Professional/prevention & control* ; Malaysia ; Practice Patterns, Physicians'/trends* ; Tertiary Care Centers ; Thoracoscopy/trends*

COVID-19/epidemiology* ; Child ; Humans ; Infectious Disease Transmission, Vertical ; SARS-CoV-2 ; Singapore/epidemiology* ; Systemic Inflammatory Response Syndrome/virology*

Coronavirus disease 2019 (COVID-19) pandemic has caused a total of 55 928 327 confirmed cases and 1 344 003 deaths as of November 19, 2020. But so far the origin of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes this pandemic has remained undetermined. The purpose of this study is to review the current research of SARS-CoV-2 and the existing problems therein, which may provide inspiration for further researches. Existing evidence suggested that SARS-CoV-2 may be derived from bat coronavirus 40-70 years ago. During the evolution, this virus underwent extensive variations in the process of mutations and natural selection. Different genomic regions of SARS-CoV-2 may have different selection pressures, but all of which increase the difficulty of tracing the origin of this virus. A wide variety of animals have been considered as potential hosts of SARS-CoV-2, including cats, lions, tigers, dogs and minks. SARS-CoV-2 has a chance to transmit from humans to animals and can be transmitted among animals. Current research evidence has shown that China is not the original source of SARS-CoV-2. It is still unclear how the virus spreads to human, and efforts are still need to be made to explore the origin of SARS-CoV-2, its hosts and intermediate hosts, and the mechanism of its transmission across different species of animals.
Animals ; COVID-19/transmission* ; Cats ; China ; Chiroptera/virology* ; Disease Vectors ; Dogs ; Evolution, Molecular ; Humans ; SARS-CoV-2/classification*

COVID-19/transmission* ; Communicable Disease Control/organization & administration* ; Humans ; Remote Consultation/organization & administration* ; Singapore/epidemiology* ; Videoconferencing/organization & administration*