fangcang shelter hospitals in covid 19 pandemic the practice and its significance CORD-Papers-2021-10-25 (Version 1)

Title: Fangcang shelter hospitals in COVID-19 pandemic: the practice and its significance
Published: 5/1/2020
Journal: Clin Microbiol Infect
DOI: 10.1016/j.cmi.2020.04.038
Author Name: Shang, L
Author link:
Author Name: Xu, J
Author link:
Author Name: Cao, B
Author link:
sha: 97a7a427583b976f0f18642ffff4110cce33fee4
license: no-cc
license_url: [no creative commons license associated]
source_x: Elsevier; Medline; PMC
pubmed_id: 32360781
pmcid: PMC7252175
has_full_text: TRUE
Keywords Extracted from Text Content: Dongxihu Fangcang human gastrointestinal centre Fangcang SARS-CoV-2 BC people left Fangcang shelter hospitals D-dimer COVID-19 patients COVID-19 Wuhan, China [7 Fangcang shelter faecaleoral Wuhan [9 blood oxygen Wuhan, Coronavirus disease 2019 cardiovascular [4, 5] healthpolicy Wang [3] blood cell patient patients COVID-19 [6
Extracted Text Content in Record: First 5000 Characters:Coronavirus disease 2019 (COVID-19), an emerging respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been spreading across the world rapidly and claiming tens of thousands of lives. On 11 March 2020, the WHO announced it to be a global pandemic. As of 6 April 2020, more than a million COVID-19 cases have been confirmed globally with over 60 000 deaths [1] . The rapidly increasing number of COVID-19 cases is posing a huge challenge to medical systems worldwide. In pandemicaffected areas, hospital beds are limited and overwhelmed by the large numbers of patients. Given the shortage of medical resources in some countries, only severely ill patients can be admitted to hospitals, leaving many more patients, often with mild-to-moderate symptoms, left unattended at home. Home isolation can lead to two problems. First, individuals with SARS-CoV-2 infection who stay at home contribute to the household and community transmission of SARS-CoV-2. It is inevitable that those staying at home will have close contact with their family members and easily transmit the virus. Also, it may be hard for some countries to strictly manage the large number of patients under home isolation because of the lack of extensive human resources, so the patients might move around and have contact with other people in the community. This could result in community transmission and further increase the number of COVID-19 cases [2] . Second, leaving patients at home might delay the optimised timing of supportive medical care. Individuals with COVID-19 can deteriorate quickly from mild/moderate to severe illness [3] . Individuals in home isolation often did not receive appropriate symptom monitoring and prompt referral to hospitals when necessary. Without appropriate medical care, individuals with rapid disease progression would further increase the burden of medical systems. The abovementioned factors will consistently contribute to the shortage of medical resources and ultimately collapse the medical system, as is happening currently in many disease-stricken areas around the world. During past infectious disease epidemics or natural disasters, mobile field hospitals have been put in place to cope with the shortage of medical resources [4, 5] . However, the capacity of mobile field hospitals is comparatively small, especially in the face of the exponentially increasing number of COVID-19 cases. The Fangcang shelter hospital, also referred to as 'Fangcang hospital' for short, was built in Wuhan, China to curb the spread of COVID-19 and provide timely basic medical care to patients. Fangcang shelter hospitals were transformed from large public facilities such as sports stadia and exhibition centres in a very short time, providing a large number of beds to admit and treat individuals with mild-tomoderate COVID-19. As discussed at length in a recent healthpolicy article, the major functions of Fangcang shelter hospitals are isolation, triage, basic medical care, frequent monitoring and rapid referral [6] . Apart from being a hospital, the Fangcang shelter hospital also provided food and shelter, as well as social engagement, for individuals with COVID-19 [6] . By obviating the risk of within-household and community transmission, Fangcang shelter hospitals were one of the key measures to control the epidemic in Wuhan, China [7] , and could be a game changer for other countries as well [8] . In this issue of Clinical Microbiology and Infection, Wang et al. described the work flow of Fangcang shelter hospitals and reported the clinical characteristics of COVID-19 patients in Dongxihu Fangcang shelter hospital, one of the largest Fangcang shelter hospitals in Wuhan [9] . Dongxihu Fangcang shelter hospital was transformed from an exhibition centre to a temporary hospital with more than 1000 beds and began to admit patients on 7 February 2020. The authors retrospectively analysed the clinical data of 1012 individuals admitted to the Dongxihu Fangcang shelter hospital from 7 to 12 February 2020. All patients had laboratory-confirmed COVID-19 with moderate symptoms (respiratory rate <30 breaths/ minute and blood oxygen saturation >93% at resting state), and were tested negative for influenza virus before admission. They were also required to have self-care ability without serious underlying diseases or co-morbidities. This paper was the first to report the clinical characteristics of individuals with mild-to-moderate COVID-19 in a Fangcang shelter hospital. The most common symptoms (fever and cough), underlying diseases (hypertension and diabetes) and radiological manifestations (patchy opacity and ground-glass opacity) in this cohort were similar to the observations in previous reports [10, 11] . However, the authors reported a relatively high rate of diarrhoea (15%) in the Fangcang cohort [12] . It is still not clear whether this is a characteristic of mild disease or related to certain treatments bef
Extracted PMC Text Content in Record: First 5000 Characters:BC is the corresponding author and conceived the article. LS and JX wrote the original draft and BC, JX and LS were responsible for reviewing and editing the article. All authors have no conflicts of interest to declare. No financial support was received for the present work.
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