Impact of Middle East respiratory syndrome outbreak on the use of emergency medical resources in febrile patients

Jeong, Hyunho; Jeong, Sikyoung; Oh, Joo Suk; Woo, Seon Hee; So, Byung Hak; Wee, Jeong Hee; Kim, Ji Hoon; Im, Ji Yong; Choi, Seung Pill; Park, Kyoungnam; Cho, Byul Nim Hee; Hong, Sungyoup

doi:10.15441/ceem.16.166

Cited by 14 publications

(16 citation statements)

References 19 publications

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“…Healthcare utilization decreased in the 2003 SARS epidemic due to fear of nosocomial infection, whereas it explosively increased in the 2009 H1N1 influenza pandemic due to fear of influenza itself 23410. In the case of MERS, since the main transmission route was nosocomial transmission and the mortality rate was high, healthcare utilization decreased during the epidemic 1213. This effect was dramatic in the ER rather than other departments in hospitals, as most of the nosocomial infections occurred in a crowded ER 6.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have analyzed the impacts of SARS and influenza epidemics 2341011. However, although few small studies have investigated changes in healthcare utilization during the MERS epidemic in Korea,1213 no study has systematically evaluated the impact of the MERS epidemic on nationwide healthcare utilization. Furthermore, the impact of the reduction in emergency care utilization on health outcomes has not been explored.…”

Section: Introductionmentioning

confidence: 99%

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Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea

2019

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Purpose In May 2015, South Korea experienced an epidemic of Middle East respiratory syndrome (MERS). This study investigated the impacts of MERS epidemic on emergency care utilization and mortality in South Korea. Materials and Methods A natural experimental study was conducted using healthcare utilization and mortality data of the entire Korean population. The number of monthly emergency room (ER) visits was investigated to identify changes in emergency care utilization during the MERS epidemic; these trends were also examined according to patients' demographic factors, disease severity, and region. Deaths within 7 days after visiting an ER were analyzed to evaluate the impact of the reduction in ER visits on mortality. Results The number of ER visits during the peak of the MERS epidemic (June 2015) decreased by 33.1% compared to the average figures from June 2014 and June 2016. The decrease was observed in all age, sex, and income groups, and was more pronounced for low-acuity diseases (acute otitis media: 53.0%; upper respiratory infections: 45.2%) than for high-acuity diseases (myocardial infarctions: 14.0%; ischemic stroke: 16.6%). No substantial changes were detected for the highest-acuity diseases, with increases of 3.5% for cardiac arrest and 2.4% for hemorrhagic stroke. The number of deaths within 7 days of an ER visit did not change significantly. Conclusion During the MERS epidemic, the number of ER visits decreased in all age, sex, and socioeconomic groups, and decreased most sharply for low-acuity diseases. Nonetheless, there was no significant change in deaths after emergency care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea

2019

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“…Pathway and protocols need to be in place to ensure that rapid appropriate care is provided to suspected COVID-19 children, while avoiding delay in care of non-COVID-19 patients. 9 In addition, it will be paramount to ensure patients and staff are protected from the infection and with as little exposure as possible.10 It has also become recognised that children may present with conditions not linked to COVID-19 but some, when admitted for that condition, are found to have COVID-19 positive swabs as an incidental finding. This may be a feature with the more widespread dissemination of COVID-19 throughout the population.…”

Section: Importancementioning

confidence: 99%

Preparedness and response to Pediatric CoVID-19 in European Emergency Departments: a survey of the REPEM and PERUKI networks

Bressan

Buonsenso

Farrugia

et al. 2020

Preprint

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Study objective:We aimed to describe the preparedness and response to the COVID-19 pandemic in referral EDs caring for children across Europe. Methods: We did a cross-sectional point prevalence survey, which was developed and disseminated through the pediatric emergency medicine research networks for Europe (REPEM) and the United Kingdom and Ireland (PERUKI). We included a pre-determined number of centers based on each country population: five to ten EDs for countries with > 20 million inhabitants and one to five EDs for the other countries. ED directors or named delegates completed the survey between March 20th and 21st to report practice in use one month after the outbreak in Northern Italy. We used descriptive statistics to analyse data. Results: Overall 102 centers from 18 countries completed the survey: 34% did not have an ED contingency plan for pandemics and 36% had never had simulations for such events. Wide variation on PPE items was shown for recommended PPE use at pre-triage and for patient assessment, with 62% of centers experiencing shortage in one or more PPE items. COVID-19 positive ED staff was reported in 25% of centers. Only 17% of EDs had negative pressure isolation rooms. Conclusion:We identified variability and gaps in preparedness and response to the COVID-19 epidemic across European referral EDs for children. Early availability of a documented contingency plan, provision of simulation training, appropriate use of PPE, and appropriate isolation facilities emerged as key factors that should be optimized to improve preparedness and inform responses to future pandemics.

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“…Shifts in health-seeking behaviours also contribute, with an unwillingness to access healthcare driven by concerns about contagion in hospital settings [ 8 , 9 ]. Evidence from SARS and MERS epidemics have shown that risk preventative behaviours, such as hospital avoidance, were widely practised, with fear of infection associated with avoidance of healthcare facilities [ 10 , 11 , 12 , 13 , 14 ]. Of concern was an increase in cases triaged ‘very urgent/immediate’ among those admitted; however, without presenting complaint or diagnosis, this finding is difficult to interpret [ 1 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing the Impact of COVID-19 Public Health Stages on Paediatric Emergency Attendance

McDonnell

Nicholson

Conlon

et al. 2020

IJERPH

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This study outlines the impact of COVID-19 on paediatric emergency department (ED) utilisation and assesses the extent of healthcare avoidance during each stage of the public health response strategy. Records from five EDs and one urgent care centre in Ireland, representing approximately 48% of national annual public paediatric ED attendances, are analysed to determine changes in characteristics of attendance during the three month period following the first reported COVID-19 case in Ireland, with reference to specific national public health stages. ED attendance reduced by 27–62% across all categories of diagnosis in the Delay phase and remained significantly below prior year levels as the country began Phase One of Reopening, with an incident rate ratio (IRR) of 0.58. The decrease was predominantly attributable to reduced attendance for injury and viral/viral induced conditions resulting from changed living conditions imposed by the public health response. However, attendance for complex chronic conditions also reduced and had yet to return to pre-COVID levels as reopening began. Attendances referred by general practitioners (GPs) dropped by 13 percentage points in the Delay phase and remained at that level. While changes in living conditions explain much of the decrease in overall attendance and in GP referrals, reduced attendance for complex chronic conditions may indicate avoidance behaviour and continued surveillance is necessary.

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Impact of Middle East respiratory syndrome outbreak on the use of emergency medical resources in febrile patients

Cited by 14 publications

References 19 publications

Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea

Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea

Preparedness and response to Pediatric CoVID-19 in European Emergency Departments: a survey of the REPEM and PERUKI networks

Assessing the Impact of COVID-19 Public Health Stages on Paediatric Emergency Attendance

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