Introduction As of September 2021, the COVID-19 pandemic has led to 42,500,000 cases and 680,000 deaths in the United States. In Rhode Island, there have been 170,000 cases and 2,820 deaths. Investigating resource utilization and waste production during disease outbreaks can inform efforts at disaster preparedness. The purpose of this study was to examine trends in waste production during the COVID-19 pandemic. Methods This is a descriptive study examining trends in waste production during the COVID-19 pandemic. The study was conducted at a suburban community hospital in Rhode Island. Data was collected on regulated medical waste (RMW) and linen use from October 2019-July 2021. Adjusted patient days (APD) values were calculated using hospital census and revenue data. Total weight and weight/APD were calculated for each month of the study period. Data was then compared with overall COVID-19 cases and hospitalizations in Rhode Island. This data was gathered from the Rhode Island Department of Health (RIDOH) COVID Response Data Hub. Results Regulated Medical Waste (RMW) by total weight was lowest in April 2020, when the hospital census and adjusted patient days (APD) were at their lowest. In contrast, linen use remained largely consistent with pre-pandemic levels during the initial months of the pandemic despite a decrease in hospital census. The highest linen weight/APD value (23.32 lbs/APD) was in April 2020. Both RMW and linen use (weight/APD) decreased during the study period. Linen use was highest during months with increased COVID-19 cases and hospitalizations. Conclusions This study examined trends in waste production at a community hospital during the COVID-19 pandemic. Linen use was highest during months of increased COVID-19 cases and hospitalizations, while RMW production decreased. There was a particular increase in linen use in April 2020, when the pandemic was in its initial phases.
BACKGROUND: Children with COVID-19 usually present with mild symptoms. We characterize visits with respect to symptoms and testing in the outpatient setting. METHODS: A retrospective chart review of sick visits in a pediatric academic primary care clinic April-August 2020. We included possible COVID-19 cases, or persons under investigation (PUIs), recording symptoms, positive contacts, and COVID-19 testing. Descriptive statistics and Chi-square or Fisher's exact tests for comparisons were used. RESULTS: 32% (476/1,474) of sick visits were PUIs;20% were telehealth. Symptoms most commonly reported were fever, congestion/rhinorrhea and cough. 76% of PUIs were tested for COVID-19. Only presence of COVID-19 contacts and loss of taste/smell were significantly associated with positive tests (p<0.001). CONCLUSION: Nearly a third of sick visits in an academic pediatric practice were seen for possible COVID-19 symptoms and most were tested. The majority with and without COVID-19 had fever, congestion and/or cough. Our findings suggest low thresholds for testing in children.
A retrospective review of 384 patients who had undergone rubber band ligation for hemorrhoidal disease by one surgeon from 1988 to 1993 is presented. The primary indications for treatment were rectal bleeding and prolapse. Eighty-nine percent of the patients were improved following treatment. In selected patients, rubber band ligation is an acceptable alternative to surgical hemorrhoidectomy.
Lead poisoning has been referred to as the most important environmental health hazard for children in New England. Medical professionals are in a unique position to perform a number of interventions that could make a lasting impact. First, physicians and nurses, particularly in the areas of pediatrics and family medicine, can provide anticipatory guidance to all families with young children. Lead poisoning, in contrast to long held beliefs, is an affliction that affects all socioeconomic groups. Parents should thus be informed regarding sources of lead, including occupational and hobby sources, and basic nutritional and abatement information should be provided. Second, health care workers should encourage lead screening in appropriately aged children at recommended intervals based on known risk factors. Once a blood lead concentration greater than 20[symbol: see text]g/dl has been obtained in a child, treatment or referral to an established lead clinic should be undertaken in a timely fashion. For children with low or moderate lead levels, many pediatricians or family physicians prefer to supervise their patients' treatment, including chelation therapy. For children with higher levels or in instances when the health care professional elects to refer, there are several lead clinics throughout New England whose clinicians are experienced in the treatment of childhood lead poisoning. Finally the medical profession needs to publicly recognize, as child advocates, that lead poisoning is one of the most common pediatric health problems in the United States and that it is entirely preventable. Fortunately, after many years and much hard work, Rhode Island finally has laws that start to deal with the lead problem in an appropriately aggressive fashion.(ABSTRACT TRUNCATED AT 250 WORDS)
