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      Analyses on ICU and non-ICU capacity of government hospitals during the COVID-19 outbreak via multi-objective linear programming: An evidence from Istanbul

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          Abstract

          The current infectious disease outbreak, a novel acute respiratory syndrome [SARS]-CoV-2, is one of the greatest public health concerns that the humanity has been struggling since the end of 2019. Although, dedicating the majority of hospital-based resources is an effective method to deal with the upsurge in the number of infected individuals, its drastic impact on routine healthcare services cannot be underestimated. In this study, the proposed multi-objective, multi-period linear programming model optimizes the distribution decision of infected patients and the evacuation rate of non-infected patients simultaneously. Moreover, the presented model determines the number of new COVID-19 intensive care units, which are established by using existing hospital-based resources. Three objectives are considered: (1) minimization of total distance travelled by infected patients, (2) minimization of the maximum evacuation rate of non-infected patients and (3) minimization of the infectious risk of healthcare professionals. A case study is performed for the European side of Istanbul, Turkey. The effect of the uncertain length of the stay of infected patients is demonstrated via sensitivity analyses.

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          Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

          In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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            Elective surgery cancellations due to the COVID ‐19 pandemic: global predictive modelling to inform surgical recovery plans

            Background The COVID‐19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID‐19. Methods A global expert‐response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian beta‐regression model was used to estimate 12‐week cancellation rates for 190 countries. Elective surgical case‐mix data, stratified by specialty and indication (cancer versus benign surgery), was determined. This case‐mix was applied to country‐level surgical volumes. The 12‐week cancellation rates were then applied to these figures to calculate total cancelled operations. Results The best estimate was that 28,404,603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID‐19 (2,367,050 operations per week). Most would be operations for benign disease (90.2%, 25,638,922/28,404,603). The overall 12‐week cancellation rate would be 72.3%. Globally, 81.7% (25,638,921/31,378,062) of benign surgery, 37.7% (2,324,069/6,162,311) of cancer surgery, and 25.4% (441,611/1,735,483) of elective Caesarean sections would be cancelled or postponed. If countries increase their normal surgical volume by 20% post‐pandemic, it would take a median 45 weeks to clear the backlog of operations resulting from COVID‐19 disruption. Conclusions A very large number of operations will be cancelled or postponed due to disruption caused by COVID‐19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to safely restore surgical activity. This article is protected by copyright. All rights reserved.
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              Immediate and long‐term impact of the COVID ‐19 pandemic on delivery of surgical services

              Background The ongoing pandemic is having a collateral health effect on delivery of surgical care to millions of patients. Very little is known about pandemic management and effects on other services, including delivery of surgery. Methods This was a scoping review of all available literature pertaining to COVID‐19 and surgery, using electronic databases, society websites, webinars and preprint repositories. Results Several perioperative guidelines have been issued within a short time. Many suggestions are contradictory and based on anecdotal data at best. As regions with the highest volume of operations per capita are being hit, an unprecedented number of operations are being cancelled or deferred. No major stakeholder seems to have considered how a pandemic deprives patients with a surgical condition of resources, with patients disproportionally affected owing to the nature of treatment (use of anaesthesia, operating rooms, protective equipment, physical invasion and need for perioperative care). No recommendations exist regarding how to reopen surgical delivery. The postpandemic evaluation and future planning should involve surgical services as an essential part to maintain appropriate surgical care for the population during an outbreak. Surgical delivery, owing to its cross‐cutting nature and synergistic effects on health systems at large, needs to be built into the WHO agenda for national health planning. Conclusion Patients are being deprived of surgical access, with uncertain loss of function and risk of adverse prognosis as a collateral effect of the pandemic. Surgical services need a contingency plan for maintaining surgical care in an ongoing or postpandemic phase.
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                Author and article information

                Journal
                Comput Biol Med
                Comput Biol Med
                Computers in Biology and Medicine
                Elsevier Ltd.
                0010-4825
                1879-0534
                6 May 2022
                July 2022
                6 May 2022
                : 146
                : 105562
                Affiliations
                [a ]Department of Industrial Engineering, Yildiz Technical University, Besiktas, 34349, Istanbul, Turkey
                [b ]Turkish Airlines, 34149, Yesilkoy, İstanbul, Turkey
                Author notes
                []Corresponding author. Turkish Airlines 34149, Yesilkoy, Istanbul, Turkey.
                Article
                S0010-4825(22)00354-7 105562
                10.1016/j.compbiomed.2022.105562
                9072769
                7c37f680-4bb2-44d5-904e-65b79662696f
                © 2022 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 23 November 2021
                : 6 March 2022
                : 23 April 2022
                Categories
                Article

                multi-objective,resource optimization,patient allocation,uncertainty,covid-19,epidemic logistics

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