A Family Medicine response to the COVID-19 lockdown: University of Pretoria perspective

Edith N. Madela-Mntla, Sanele Ngcobo
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Abstract

Background The COVID-19 pandemic caused great social, political and economic disruption, and imposed unprecedented changes in work, lifestyle, service delivery and social interactions in South Africa and worldwide. Healthcare providers, working in often already overstretched healthcare systems, found themselves at the forefront of global and national efforts to contain the havoc of morbidity and mortality wreaked by SARS-CoV2. This chapter describes efforts by the University of Pretoria’s Department of Family Medicine (UPDFM) to deliver on its mandate of teaching, learning, and research in the face of the disruptions of the COVID-19 pandemic during the March-September 2020 nationwide hard lockdown. Methods A perspective review was undertaken, drawing on reports, meeting minutes, email correspondences and electronic personal communications analysed to describe the activities undertaken by the UPDFM during the study period. Results Nationally, some of the adaptive responses triggered by the COVID-19 lockdown drew from the pre-existing UPDFM repertoire of community-oriented, learner- and patient-centred practices of service delivery. Key among these practices were data collection and management using validated tools; virtual communication and meetings; health promotion and disease prevention through training nurses, community health workers and patients on newly developed Covid-19 prevention strategies; clinical intervention, including screening and diagnosis, treatment and care coordination using telemedicine and full service delivery in homeless shelters; patient referral/mobility by staff using sponsored rental cars and using an application to call an ambulance, and treatment continuation through home delivery of medication. Conclusions COVID-19 restrictions presented the UPDFM with a unique opportunity to draw from its experience and create rapid, impactful interventions. Most lessons learnt by the UPDFM during the crisis proved invaluable for use beyond the acute phase of the pandemic, thereby transforming the health system for better pandemic preparedness.
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家庭医学应对COVID-19封锁:比勒陀利亚大学的观点
2019冠状病毒病大流行造成了巨大的社会、政治和经济混乱,并给南非和全世界的工作、生活方式、服务提供和社会互动带来了前所未有的变化。卫生保健提供者往往在已经不堪重负的卫生保健系统中工作,他们发现自己处于全球和国家努力的最前沿,以遏制SARS-CoV2造成的发病率和死亡率的严重破坏。本章描述了比勒陀利亚大学家庭医学系(UPDFM)在2020年3月至9月全国硬封锁期间,面对COVID-19大流行的中断,为履行其教学、学习和研究任务所做的努力。方法进行透视回顾,利用报告、会议纪要、电子邮件通信和电子个人通信进行分析,以描述UPDFM在研究期间所开展的活动。在全国范围内,COVID-19封锁引发的一些适应性反应借鉴了UPDFM现有的面向社区、以学习者和患者为中心的服务提供实践。这些实践的关键是使用经过验证的工具进行数据收集和管理;虚拟沟通和会议;通过培训护士、社区卫生工作者和患者了解新制定的Covid-19预防战略,促进健康和预防疾病;临床干预,包括利用远程医疗进行筛查和诊断、治疗和护理协调,并在无家可归者收容所提供全面服务;工作人员使用赞助的租车转介/移动病人,并使用申请呼叫救护车,以及通过家庭递送药物来继续治疗。COVID-19限制为UPDFM提供了一个独特的机会,可以从其经验中吸取教训,制定快速、有效的干预措施。普遍可持续发展机制在危机期间吸取的大多数经验教训证明是非常宝贵的,可以在大流行急性阶段之后加以利用,从而改变卫生系统,更好地防范大流行。
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