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Betrachtung der Pandemie Phase 3 – „mitigation“ – vom Endpunkt Hospitalisation her

BACKGROUND: The phase 3—“mitigation”—of the current pandemic by SARS-CoV‑2 is now imminent also in Germany. Given the high complexity many issues have to be taken into account. Simplification is urgently warranted not to loose focus of the important things to be done. METHODS: To look at phase 3 fro...

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Autor principal: Weigl, Josef
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7149024/
http://dx.doi.org/10.1007/s11553-020-00771-3
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author Weigl, Josef
author_facet Weigl, Josef
author_sort Weigl, Josef
collection PubMed
description BACKGROUND: The phase 3—“mitigation”—of the current pandemic by SARS-CoV‑2 is now imminent also in Germany. Given the high complexity many issues have to be taken into account. Simplification is urgently warranted not to loose focus of the important things to be done. METHODS: To look at phase 3 from the endpoint—in this case hospital admission—should facilitate the focus on key variables upstream. Based on a simplified model of approximated and plausible parameters for the overall attack rate (AR), the AR(hospitalization) and the AR(ICU admission), the resources needed are compared with the available resources i.e. number of beds available in general and beds in ICU in particular. The calculations are carried out population-based for Ploen County as well as regionally together with the Kiel metropolitan area. RESULTS: Since the ARs in the up do date available cohorts are overestimated, considerably lower AR(hospitalization) and AR(ICU) should be expected. An AR(hospitalization) of 10% could not be materialized in Ploen County; one with 5% could. In the regional analysis together with the University Hospital Kiel (UKSH) an AR(hospitalization) of up to 10% is feasible, as also an AR(ICU) of 3%. The kinetics of hospital admissions is, however, dependent from countermeasures in public health as well as admission habits of the family physicians. The available number of beds is determined by beds made available and by the mean duration of hospitalization. The latter depends from the age and underlying conditions of the patients. CONCLUSIONS: System failure has to be averted by clarity in regard to the key parameters and their independent variables. The regional management is crucial and should be coordinated by a so-called bed-coordinator. Close cooperation allover the health care system is needed in alliance with the local health departments.
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spelling pubmed-71490242020-04-13 Betrachtung der Pandemie Phase 3 – „mitigation“ – vom Endpunkt Hospitalisation her Weigl, Josef Präv Gesundheitsf Originalarbeit BACKGROUND: The phase 3—“mitigation”—of the current pandemic by SARS-CoV‑2 is now imminent also in Germany. Given the high complexity many issues have to be taken into account. Simplification is urgently warranted not to loose focus of the important things to be done. METHODS: To look at phase 3 from the endpoint—in this case hospital admission—should facilitate the focus on key variables upstream. Based on a simplified model of approximated and plausible parameters for the overall attack rate (AR), the AR(hospitalization) and the AR(ICU admission), the resources needed are compared with the available resources i.e. number of beds available in general and beds in ICU in particular. The calculations are carried out population-based for Ploen County as well as regionally together with the Kiel metropolitan area. RESULTS: Since the ARs in the up do date available cohorts are overestimated, considerably lower AR(hospitalization) and AR(ICU) should be expected. An AR(hospitalization) of 10% could not be materialized in Ploen County; one with 5% could. In the regional analysis together with the University Hospital Kiel (UKSH) an AR(hospitalization) of up to 10% is feasible, as also an AR(ICU) of 3%. The kinetics of hospital admissions is, however, dependent from countermeasures in public health as well as admission habits of the family physicians. The available number of beds is determined by beds made available and by the mean duration of hospitalization. The latter depends from the age and underlying conditions of the patients. CONCLUSIONS: System failure has to be averted by clarity in regard to the key parameters and their independent variables. The regional management is crucial and should be coordinated by a so-called bed-coordinator. Close cooperation allover the health care system is needed in alliance with the local health departments. Springer Berlin Heidelberg 2020-03-23 2020 /pmc/articles/PMC7149024/ http://dx.doi.org/10.1007/s11553-020-00771-3 Text en © Springer-Verlag GmbH Germany, part of Springer Nature 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Originalarbeit
Weigl, Josef
Betrachtung der Pandemie Phase 3 – „mitigation“ – vom Endpunkt Hospitalisation her
title Betrachtung der Pandemie Phase 3 – „mitigation“ – vom Endpunkt Hospitalisation her
title_full Betrachtung der Pandemie Phase 3 – „mitigation“ – vom Endpunkt Hospitalisation her
title_fullStr Betrachtung der Pandemie Phase 3 – „mitigation“ – vom Endpunkt Hospitalisation her
title_full_unstemmed Betrachtung der Pandemie Phase 3 – „mitigation“ – vom Endpunkt Hospitalisation her
title_short Betrachtung der Pandemie Phase 3 – „mitigation“ – vom Endpunkt Hospitalisation her
title_sort betrachtung der pandemie phase 3 – „mitigation“ – vom endpunkt hospitalisation her
topic Originalarbeit
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7149024/
http://dx.doi.org/10.1007/s11553-020-00771-3
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