P128 The implications of SARS-CoV-2 on a Cardiothoracic unit

Introduction The effort to prevent healthcare systems becoming overrun during the 2020 COVID-19 pandemic has come at the cost of delaying operations and with that bringing difficult risk analysis to help decide which operations should go ahead. With COVID-19 being a novel disease there is limited evidence for guidance on this issue. We have previously presented work highlighting the high risk of mortality associated with a perioperative cardiothoracic patient becoming COVID-19 positive and thus decided to implement a series of changes to departmental perioperative practice. This work presents these interventions and compares the infection and the mortality rate with those before the intervention was put in place. Method Two retrospective loops were performed. Pre intervention, 5/3/20 – 20/4/20, and post intervention, 21/4/20- 23/6/20. Inclusion criteria: patients who had received cardiothoracic surgery at University Hospital of Wales within 4 weeks of the positive COVID-19 PCR (1st loop n = 53, 2nd loop n = 40). Exclusion criteria included re-admissions from greater than 4 weeks (n = 2). Interventions included 14 day pre op isolation, a strict multifaceted screening regime, reverse barrier nursing and delaying operations if diagnostic uncertainty. Results 9/51 patients from the pre intervention loop and 2/40 from post intervention loop tested +ve for COVID-19. The pre intervention mortality was 5/9 and post intervention mortality was 0/2. Conclusion Our data suggest that simple changes to perioperative practice can decrease the transmission of COVID-19 during this period. Thus, allowing surgical services to run at a reduced risk

Bioterrorism

Bioterrorism is the deliberate use of biological agents to cause illness, death, and fear for ideological or personal purposes. The agents might be disseminated through aerosolization, food, human carriers, infected insects, or water. The incubation periods of these agents can vary from hours to weeks, with early symptoms mimicking many other infectious diseases. The diagnosis might not be suspected unless cases occur in clusters. Early identification of outbreaks will depend largely on the ability of primary care and emergency room physicians to identify and promptly report cases to the public health authorities. Specific treatment (if available) of affected individuals will depend on the pathogen, and for contagious diseases such as smallpox and plague, isolation of patients and their contacts, barrier nursing, quarantine, and restriction of the movements and social interactions of people are important control measures.

An Analysis of the International and Domestic Health Hazards Posed by the 2014 West African Ebola Virus Disease Outbreak

An epidemic of "ebolavirus" in West Africa, which was first identified in March 2014, is now the largest Ebola Virus Disease (EVD) outbreak on record. The West African epidemic will only be quelled through widespread adherence of public health initiatives promoting barrier-nursing techniques, health education, and the rapid identification of cases. The ongoing EVD outbreak in West Africa is unlikely to affect public health in the U.S. significantly.