학술논문
Establishing and operating a 'virtual ward' system to provide care for patients with COVID-19 at home: experience from The Gambia.
Document Type
Academic Journal
Author
Wariri O; Vaccines and Immunity Theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia owariri@mrc.gm.; Okomo U; Vaccines and Immunity Theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.; Cerami C; Nutrition Theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.; Okoh E; Disease Control and Elimination, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Oko F; Vaccines and Immunity Theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.; Jah H; Disease Control and Elimination, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Bojang K; Disease Control and Elimination, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Susso B; Clinical Services Department, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Olatunji Y; Disease Control and Elimination, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Nkereuwem E; Vaccines and Immunity Theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.; Akemokwe FM; Clinical Services Department, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Jobe M; Nutrition Theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.; Agboghoroma OF; Clinical Services Department, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Kebbeh B; Clinical Services Department, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Sowe G; Vaccines and Immunity Theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.; Gilleh T; Data Management and Archives, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Jobe N; Directorate, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Usuf E; Disease Control and Elimination, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Clarke E; Vaccines and Immunity Theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.; Brotherton H; Disease Control and Elimination, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.; Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.; Forrest K; Clinical Services Department, Medical Research Council Unit The Gambia, at London School of Hygiene and Tropical Medicine, Banjul, Gambia.
Source
Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101685275 Publication Model: Print Cited Medium: Print ISSN: 2059-7908 (Print) Linking ISSN: 20597908 NLM ISO Abbreviation: BMJ Glob Health Subsets: MEDLINE
Subject
Language
English
ISSN
2059-7908
Abstract
Health systems in sub-Saharan Africa have remained overstretched from dealing with endemic diseases, which limit their capacity to absorb additional stress from new and emerging infectious diseases. Against this backdrop, the rapidly evolving COVID-19 pandemic presented an additional challenge of insufficient hospital beds and human resource for health needed to deliver hospital-based COVID-19 care. Emerging evidence from high-income countries suggests that a 'virtual ward' (VW) system can provide adequate home-based care for selected patients with COVID-19, thereby reducing the need for admissions and mitigate additional stress on hospital beds. We established a VW at the Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, a biomedical research institution located in The Gambia, a low-income west African country, to care for members of staff and their families infected with COVID-19. In this practice paper, we share our experience focusing on the key components of the system, how it was set up and successfully operated to support patients with COVID-19 in non-hospital settings. We describe the composition of the multidisciplinary team operating the VW, how we developed clinical standard operating procedures, how clinical oversight is provided and the use of teleconsultation and data capture systems to successfully drive the process. We demonstrate that using a VW to provide an additional level of support for patients with COVID-19 at home is feasible in a low-income country in sub-Saharan Africa. We believe that other low-income or resource-constrained settings can adopt and contextualise the processes described in this practice paper to provide additional support for patients with COVID-19 in non-hospital settings.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)