On Friday 19 March 2021, approximately one hundred and ninety (190) persons tuned in to the webinar on the clinical management of COVID-19 in health facilities and the community.
Hosted by the PAHO/WHO Office for Barbados and the Eastern Caribbean Countries, it was conducted on the backdrop of an increasing number of severe COVID-19 cases in several countries, requiring hospitalization and critical care management. The objective was to share best practice guidance for optimal care of COVID-19 patients during hospitalization, to reduce morbidity and death, and in the process protect health care workers during the delivery of care.
This second webinar on the clinical management of COVID-19 was again moderated by Dr. Rufus Ewing, Health Systems and Service Advisor at the PAHO/WHO Office for Barbados and the Eastern Caribbean Countries.
Dr. Yitades Gebre, PAHO/WHO Representative to Barbados and the Eastern Caribbean Countries, opened the webinar by welcoming participants and providing a brief presentation on the status of countries in the Eastern Caribbean as it relates to the outbreak.
The main objectives of the webinar were achieved as subject matter experts presented and answered questions on evidence-based use of current therapeutics in the management of COVID-19 patients, this was done by Dr. Ariel Izcovich, PAHO Consultant, Clinical Medical Service, Hospital Alemán, Buenos Aires, Argentina; and the optimal use of oxygen and ventilatory mechanisms in the management of hospitalized COVID-19 patients with varying levels of severity, by Dr. Thiago Lisboa, Institute de Pesquisa HCOR - Hospital do Coração São Paulo, Brazil.
The subject matter expert presentations and dialogue were supplemented by country presentations and expert panelist sharing experiences with technology-based approach for the monitoring of COVID-19 patients in the community setting and protocol for early intervention to reduce morbidity. This first presentation was made by Dr. Glen Philipcien, District Medical Officer, Saint Lucia. Dr. Sneha Shanbhag, Consultant Internist, Mount St. John’s Medical Center, Antigua & Barbuda, followed by presenting on the management of critical COVID-19 patients in the Intensive Care Unit /hospital setting and the use of various protocol-based therapeutic options and modalities of ventilatory support, protocols for the triaging, discharging, admitting and referral of COVID-19 patients in the community, emergency room and critical care setting.
The intervention of the final expert panelists focused on the importance of creating a safe work environment for health care workers to reduce the risk of infection with the SARS-CoV-2 virus, which was highlighted as an issue of increasing concern.
The expert panelists represented were Dr. Simone French, Director of Emergency Medicine, University Hospital of the West Indies (UHWI), Jamaica, Dr. Corey Forde, Infectious Disease Physician, Queen Elizabeth Hospital, Barbados, and Dr. Valeska Stempliuk, PAHO Advisor, Health Surveillance, Disease Prevention and Control, Jamaica Office.
Some of the salient messages from the webinar were:
- Creating a safe work environment with adequate ventilation systems, work-flow organization, and intervention protocols for aerosol generating procedures are critical in reducing infection among health care workers.
- Using technology to enhance monitoring of COVID-19 patients in community settings to improve early detection and intervention of decompensating patients may reduce the reduce morbidity and mortality.
- Establishing a context-based evaluation and triaging system to enhance early detection and intervention of decompensating or at-risk COVID-19 patients may reduce morbidity and mortality.
- Optimizing oxygenation by non-invasive methods using high flow devices, as a first step instead of intubation and positive pressure ventilation is the better approach.
- Despite the protocol-based use of ivermectin by some countries in the management of COVID-19 patients, the current evidence from clinical trials is that there are no benefits with its use in patients with any level of disease severity.
- The medications showing some benefit in COVID-19 patients include:
- Dexamethasone in COVID-19 patients with severe disease
- Colchicine in patients with mild disease
- Tocilizumab in patients with severe disease
Web recording:
Passcode: *4.T8NET
Presentations:
- Ongoing living update on COVID-19 therapeutic options: Summary of Evidence - Dr. Ariel Izcovich
- Experiences in the management of COVID-19 patients in the non-acute care community setting - Dr. Glen Philipcien
- Experiences in the management of COVID-19 patients in the acute/critical care setting - Dr. Sneha Shanbhag
