Experience of augmenting critical care capacity in Daegu during COVID-19 incident in South Korea

Kim, Je Hyeong; Hong, Suk Kyung; Kim, Young‐Hwan; Ryu, Ho Geol; Park, Chi Min; Lee, Young Seok; Hong, Sung Jin

doi:10.4266/acc.2020.00275

Cited by 9 publications

(8 citation statements)

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“…Tracking COVID-19 ICU demand may be useful to hospital administrators and health officials as they seek to implement interventions to optimize outcomes for patients with COVID-19. 8 COVID-19 ICU demand can be calculated only retrospectively (because the peak number of patients with COVID-19 in the ICU can be assessed only retrospectively). However, facilities can identify the peak surge caseload since the pandemic started, in March 2020, and prospectively monitor COVID-19 ICU demand.…”

Section: Discussionmentioning

confidence: 99%

Association of Intensive Care Unit Patient Load and Demand With Mortality Rates in US Department of Veterans Affairs Hospitals During the COVID-19 Pandemic

et al. 2021

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IMPORTANCE Although strain on hospital capacity has been associated with increased mortality in nonpandemic settings, studies are needed to examine the association between coronavirus disease 2019 critical care capacity and mortality. OBJECTIVE To examine whether COVID-19 mortality was associated with COVID-19 intensive care unit (ICU) strain. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted among veterans with COVID-19, as confirmed by polymerase chain reaction or antigen testing in the laboratory from March through August 2020, cared for at any Department of Veterans Affairs (VA) hospital with 10 or more patients with COVID-19 in the ICU. The follow-up period was through November 2020. Data were analyzed from March to November 2020. EXPOSURES Receiving treatment for COVID-19 in the ICU during a period of increased COVID-19 ICU load, with load defined as mean number of patients with COVID-19 in the ICU during the patient's hospital stay divided by the number of ICU beds at that facility, or increased COVID-19 ICU demand, with demand defined as mean number of patients with COVID-19 in the ICU during the patient's stay divided by the maximum number of patients with COVID-19 in the ICU. MAIN OUTCOMES AND MEASURES All-cause mortality was recorded through 30 days after discharge from the hospital. RESULTS Among 8516 patients with COVID-19 admitted to 88 VA hospitals, 8014 (94.1%) were men and mean (SD) age was 67.9 (14.2) years. Mortality varied over time, with 218 of 954 patients (22.9%) dying in March, 399 of 1594 patients (25.0%) dying in April, 143 of 920 patients (15.5%) dying in May, 179 of 1314 patients (13.6%) dying in June, 297 of 2373 patients (12.5%) dying in July, and 174 of 1361(12.8%) patients dying in August (P < .001). Patients with COVID-19 who were treated in the ICU during periods of increased COVID-19 ICU demand had increased risk of mortality compared with patients treated during periods of low COVID-19 ICU demand (ie, demand of Յ25%); the adjusted hazard ratio for all-cause mortality was 0.99 (95% CI, 0.81-1.22; P = .93) for patients treated when COVID-19 ICU demand was more than 25% to 50%, 1.19 (95% CI, 0.95-1.48; P = .13) when COVID-19 ICU demand was more than 50% to 75%, and 1.94 (95% CI, 1.46-2.59; P < .001) when COVID-19 ICU demand was more than 75% to 100%. No association between COVID-19 ICU demand and mortality was observed for patients with COVID-19 not in the ICU. The association between COVID-19 ICU load and mortality was not consistent over time (ie, early vs late in the pandemic). CONCLUSIONS AND RELEVANCEThis cohort study found that although facilities augmented ICU capacity during the pandemic, strains on critical care capacity were associated with increased (continued) Key Points Question Is greater coronavirus disease 2019 (COVID-19) intensive care unit (ICU) strain associated with increased COVID-19 mortality? Findings In this cohort study of 8516 patients with COVID-19 admitted to 88 US Veterans Affairs hospitals, strains on critical care capacity were assoc...

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Section: Discussionmentioning

confidence: 99%

Association of Intensive Care Unit Patient Load and Demand With Mortality Rates in US Department of Veterans Affairs Hospitals During the COVID-19 Pandemic

et al. 2021

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“…Data on the variables of age, sex, and indicators of underlying diseases, such as the CCI, were collected, and these variables were considered as confounders because they were reported to be associated with the risk of contracting COVID-19 and the risk of COVID-19 mortality [14]. The place of residence was recorded as an important confounder because there were major outbreaks of COVID-19 in Daegu and Gyeongsangbuk-do until June 4, 2020 [15], and this may have affected the results.…”

Section: Other Measurements As Confoundersmentioning

confidence: 99%

Socioeconomic disparity and the risk of contracting COVID-19 in South Korea: an NHIS-COVID-19 database cohort study

Choi

Song

2021

BMC Public Health

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Background The relationship between socioeconomic status and the risk of contracting coronavirus disease (COVID-19) remains controversial. We aimed to investigate whether socioeconomic status affected the risk of contracting COVID-19 in the South Korean population. Methods The NHIS-COVID-19 database cohort was used in this population-based study. We collected the data of COVID-19 patients who were diagnosed between January 1, 2020 and June 4, 2020 and those of the control population. The income levels of all individuals as of February 2020 were extracted, and study participants were classified into four groups based on quartiles: Q1 (the lowest) to Q4 (the highest). Data were statistically analyzed using multivariable logistic regression modeling. Results In total, 122,040 individuals—7669 and 114,371 individuals in the COVID-19 and control groups, respectively—were included in the final analysis. The multivariable logistic regression model showed that the Q1 group had a 1.19-fold higher risk of contracting COVID-19 than the Q4 group, whereas the Q2 and Q3 groups showed no significant differences. In the 20–39 years age group, compared with the Q4 group, the Q3 and Q2 groups showed 11 and 22% lower risks of contracting COVID-19, respectively. In the ≥60 years age group, compared with the Q4 group, the Q1, Q2, and Q3 groups showed a 1.39-, 1.29-, and 1.14-fold higher risks of COVID-19, respectively. Conclusions Lower socioeconomic status was associated with a higher risk of contracting COVID-19 in South Korea. This association was more evident in the older population (age ≥ 60 years), whereas both lower and higher socioeconomic statuses were associated with higher risks of contracting COVID-19 in the young adult population (in the 20–39 year age group). Strategies for the prevention of COVID-19 should focus on individuals of lower socioeconomic status and on young adults of higher and lower socioeconomic status.

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“…After the outbreak of the coronavirus virus disease 2019 (COVID-19) pandemic in January 2020, physicians and nurses have done their best to combat this novel viral disease in Korea. Starting in February 2020, there was a sharp increase in this viral infection in Daegu [ 1 , 2 ]. It was hard work for medical personnel to diagnose and care for the infected patients.…”

Section: The Korean Government’s Proposal To Increase the Quota Of Me...mentioning

confidence: 99%

What happened during the period from senior medical students’ withdrawal of their applications to take the Korean Medical Licensing Examination in August 2020 to their taking the licensing examination in February 2021

Huh¹

2022

J Educ Eval Health Prof

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Korean government's proposal to increase the quota of medical students and establishment of new medical school during the COVID-19 pandemic period After the break of the COVID-19 pandemic in January 2020, physicians and nurses have done their best to combat this novel viral disease in Korea. From February 2020, there was a sharp increase in this viral infection in Daegu [1, 2]. It has been hard work for medical personnel to diagnose and care the infected patients. They also had to protect themselves from the infection [3]. During the war against this novel coronavirus, the Korean government's Ministry of Health and Welfare and the ruling Democratic Party of Korea announced the plan to establish a new medical school. It is to rear physicians who should work in the public area at least 10 years after graduation on July 23, 2020, at the National Assembly [4]. Specific plans were as follows:-There will be an increase in the number of medical students by 4,000 over the next 10 years, and the medical students' quota will be returned to its current state in 2032.-The current capacity of 3,068 medical students quota a year will be increased by 400 from 2022 to 3,458 to resolve the shortage of medical personnel in provinces and the imbalance by the specialty subject.-A total of 4,000 additional medical students are trained for 10 years, 400 each year. Of the 4,000, 3,000 are obligated to serve in essential medical care in the provinces for 10 years.-In addition, by February 2021, the medical school quota screening for each university will be allocated, and new medical schools will be actively promoted in provinces without medical schools.

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Experience of augmenting critical care capacity in Daegu during COVID-19 incident in South Korea

Cited by 9 publications

References 1 publication

Association of Intensive Care Unit Patient Load and Demand With Mortality Rates in US Department of Veterans Affairs Hospitals During the COVID-19 Pandemic

Association of Intensive Care Unit Patient Load and Demand With Mortality Rates in US Department of Veterans Affairs Hospitals During the COVID-19 Pandemic

Socioeconomic disparity and the risk of contracting COVID-19 in South Korea: an NHIS-COVID-19 database cohort study

What happened during the period from senior medical students’ withdrawal of their applications to take the Korean Medical Licensing Examination in August 2020 to their taking the licensing examination in February 2021

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