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ap
id
t
r
an
s
itio
n
to
o
n
lin
e
lear
n
i
n
g
p
r
esen
ts
ch
allen
g
es,
esp
ec
ially
f
o
r
h
ea
lth
ca
r
e
p
r
o
f
ess
io
n
als
wo
r
k
in
g
i
n
in
te
n
s
iv
e
ca
r
e
u
n
its
(
I
C
Us),
wh
e
r
e
h
e
av
y
wo
r
k
lo
ad
s
an
d
s
h
if
t
-
b
ased
s
ch
ed
u
les
lim
it
p
ar
ticip
atio
n
in
f
o
r
m
al
ed
u
ca
tio
n
s
ess
io
n
s
[
4
]
.
At
th
e
s
am
e
ti
m
e,
th
e
in
cr
ea
s
in
g
d
em
an
d
f
o
r
c
r
itical
ca
r
e
s
er
v
ic
es r
eq
u
ir
es h
ea
lth
ca
r
e
wo
r
k
er
s
to
r
ap
id
ly
ac
q
u
ir
e
n
ew
co
m
p
e
ten
cies.
Desp
ite
th
ese
ch
allen
g
es
,
I
C
Us
p
r
o
v
id
e
v
alu
a
b
le
o
p
p
o
r
tu
n
ities
f
o
r
e
x
p
er
ien
tial
lea
r
n
in
g
,
allo
win
g
h
ea
lth
ca
r
e
p
r
o
f
ess
io
n
als
to
d
ev
elo
p
s
k
ills
in
m
an
ag
in
g
cr
itically
ill
p
atien
ts
an
d
p
er
f
o
r
m
in
g
ad
v
an
ce
d
clin
ical
p
r
o
ce
d
u
r
es.
Pro
f
ess
io
n
al
o
r
g
a
n
izatio
n
s
in
I
n
d
o
n
esia
h
av
e
em
p
h
asized
th
e
n
ee
d
f
o
r
p
h
y
s
ician
s
to
ex
ten
d
th
eir
co
m
p
eten
cies
b
ey
o
n
d
th
eir
u
s
u
al
s
co
p
e
o
f
p
r
ac
tice
d
u
r
in
g
th
e
p
an
d
em
ic
[
2
]
,
[
3
]
.
Fu
r
th
er
m
o
r
e,
p
h
y
s
ician
s
p
o
s
s
ess
tr
an
s
f
er
ab
le
clin
ical
s
k
ills
,
s
u
ch
as d
ata
in
ter
p
r
etatio
n
an
d
r
o
u
tin
e
p
r
o
ce
d
u
r
es,
wh
ich
ca
n
b
e
ap
p
lied
in
cr
itical
ca
r
e
s
ettin
g
s
[
5
]
.
Ho
wev
er
,
f
r
eq
u
en
t
u
p
d
ates
to
clin
ical
g
u
id
elin
es
d
u
r
in
g
C
OVI
D
-
1
9
h
a
v
e
cr
ea
ted
ad
d
itio
n
al
ch
allen
g
es f
o
r
m
ai
n
tain
in
g
co
n
s
is
ten
t tr
ain
in
g
,
au
d
it p
r
o
ce
s
s
es,
an
d
q
u
ality
im
p
r
o
v
em
en
t.
Alth
o
u
g
h
th
e
im
p
ac
t
o
f
C
OVI
D
-
1
9
o
n
h
ea
lth
ca
r
e
s
y
s
tem
s
h
as
b
ee
n
wi
d
ely
r
ep
o
r
ted
,
th
er
e
is
lim
ited
ev
id
en
ce
r
eg
a
r
d
in
g
h
o
w
th
e
p
an
d
em
ic
h
as
in
f
lu
e
n
ce
d
m
ed
ical
ed
u
ca
tio
n
an
d
tr
ain
in
g
in
cr
itical
ca
r
e
s
ettin
g
s
,
p
ar
ticu
lar
ly
f
r
o
m
th
e
p
er
s
p
ec
tiv
e
o
f
f
r
o
n
tlin
e
h
ea
lth
ca
r
e
p
r
o
v
id
er
s
.
I
n
I
n
d
o
n
esia,
wh
er
e
h
ea
lth
ca
r
e
r
eso
u
r
ce
s
an
d
tr
ain
in
g
o
p
p
o
r
tu
n
ities
v
ar
y
,
u
n
d
er
s
tan
d
in
g
th
ese
ex
p
e
r
ien
ce
s
is
ess
en
t
ial
to
id
en
tify
in
g
ex
is
tin
g
g
a
p
s
an
d
ch
allen
g
es.
T
h
is
s
tu
d
y
aim
s
to
ex
p
lo
r
e
th
e
d
em
an
d
an
d
b
u
r
d
e
n
o
f
C
OVI
D
-
1
9
o
n
m
ed
ical
ed
u
ca
tio
n
an
d
tr
ain
in
g
f
r
o
m
th
e
p
er
s
p
ec
tiv
e
o
f
h
ea
lt
h
ca
r
e
p
r
o
f
ess
io
n
als
wo
r
k
in
g
i
n
I
C
Us
in
I
n
d
o
n
esia
d
u
r
in
g
th
e
f
ir
s
t
wav
e
o
f
th
e
p
an
d
em
ic.
Usi
n
g
a
q
u
alitativ
e
ap
p
r
o
ac
h
,
th
e
s
tu
d
y
ex
am
i
n
es
ex
p
er
ien
ce
s
,
ch
allen
g
es,
a
n
d
p
er
ce
iv
e
d
n
ee
d
s
r
elate
d
to
tr
ain
in
g
an
d
p
r
o
f
es
s
io
n
al
d
ev
elo
p
m
en
t
[
6
]
,
[
7
]
.
T
h
e
f
in
d
in
g
s
o
f
th
is
s
tu
d
y
ar
e
ex
p
ec
ted
to
in
f
o
r
m
th
e
d
ev
elo
p
m
e
n
t
o
f
ad
a
p
tiv
e,
r
esp
o
n
s
iv
e,
an
d
c
o
n
tex
t
-
s
p
ec
i
f
ic
m
ed
ical
ed
u
ca
tio
n
s
tr
ateg
i
es
f
o
r
cr
itical
ca
r
e.
Stre
n
g
th
en
in
g
tr
ain
in
g
s
y
s
tem
s
is
es
s
en
tial to
en
h
an
ce
wo
r
k
f
o
r
ce
p
r
e
p
ar
ed
n
ess
,
en
s
u
r
e
th
e
q
u
ality
o
f
ca
r
e,
an
d
im
p
r
o
v
e
h
ea
lth
s
y
s
tem
r
esil
ien
ce
d
u
r
in
g
cu
r
r
en
t a
n
d
f
u
t
u
r
e
p
u
b
lic
h
ea
lth
em
e
r
g
en
cies.
2.
M
E
T
H
O
DS
2
.
1
.
Study
des
ig
n
T
h
is
s
tu
d
y
u
s
ed
a
q
u
alitativ
e
ap
p
r
o
ac
h
with
a
s
em
i
-
s
tr
u
ctu
r
ed
in
ter
v
iew
o
f
th
e
m
e
d
ical
t
ea
m
wh
o
p
r
o
v
id
e
d
ir
ec
t
ca
r
e
to
th
e
C
OVI
D
-
1
9
team
in
n
atio
n
al
r
e
f
er
r
al
h
o
s
p
itals
in
I
n
d
o
n
esia.
T
h
e
o
n
lin
e
f
o
cu
s
g
r
o
u
p
q
u
alitativ
e
d
esig
n
th
at
we
em
p
lo
y
ed
h
as
n
u
m
er
o
u
s
ad
v
a
n
tag
es.
T
h
is
d
esig
n
f
ac
ilit
ate
s
an
in
ter
ac
tiv
e
an
d
th
o
r
o
u
g
h
ex
p
l
o
r
atio
n
o
f
in
f
o
r
m
an
ts
'
p
er
ce
p
tio
n
s
an
d
ex
p
er
ien
ce
s
.
I
n
ad
d
itio
n
,
g
r
o
u
p
in
te
r
v
iews
h
elp
clar
if
y
an
y
th
o
u
g
h
ts
o
r
id
ea
s
th
at
a
f
ac
e
-
to
-
f
ac
e
in
ter
v
iew
m
ig
h
t
n
o
t
u
n
co
v
e
r
.
Als
o
,
it
ca
n
f
in
d
wid
esp
r
ea
d
p
er
s
p
ec
tiv
es
o
n
a
n
is
s
u
e
an
d
in
s
ig
h
tf
u
l
d
if
f
er
en
ce
s
b
etwe
en
p
eo
p
le
an
d
g
r
o
u
p
s
[
8
]
,
[
9
]
.
T
h
u
s
,
o
u
r
s
tu
d
y
-
f
o
cu
s
ed
g
r
o
u
p
s
wer
e
m
o
s
t
ap
p
r
o
p
r
iate
to
ac
h
iev
e
th
e
s
tu
d
y
o
b
jectiv
es.
T
h
e
co
n
v
er
s
atio
n
s
wer
e
h
eld
o
n
lin
e
b
ec
au
s
e
o
f
th
e
co
n
tin
u
in
g
C
OVI
D
-
1
9
p
an
d
em
ic
,
s
o
cial
d
is
tan
cin
g
in
I
n
d
o
n
esia
,
an
d
th
e
f
a
ct
th
at
it wa
s
a
co
s
t
-
ef
f
ec
tiv
e
m
eth
o
d
[
1
0
]
.
I
t
also
en
s
u
r
ed
a
th
o
r
o
u
g
h
in
v
esti
g
atio
n
o
f
th
e
p
ar
ticip
an
ts
'
p
er
s
p
ec
tiv
es,
ex
p
ec
tatio
n
s
,
an
d
c
h
allen
g
es,
a
n
d
it
was
tim
ed
to
cr
ea
te
r
ec
o
m
m
en
d
atio
n
s
f
o
r
ch
a
n
g
es
a
n
d
id
ea
s
th
at
co
u
ld
b
e
ev
alu
ated
in
f
u
tu
r
e
s
tu
d
ies
.
2
.
2
.
P
a
rt
icipa
nts
Pu
r
p
o
s
iv
e
s
am
p
lin
g
was
u
s
ed
in
th
is
s
tu
d
y
to
co
llect
th
e
d
at
a.
T
h
e
in
clu
s
io
n
cr
iter
ia
wer
e:
i
)
G
en
er
al
p
r
ac
titi
o
n
er
s
,
in
ter
n
s
,
r
esid
en
t
s
,
s
p
ec
ialis
ts
in
an
es
th
esia,
a
n
d
in
ten
s
iv
e
ca
r
e
u
n
it
co
n
s
u
l
tan
ts
;
ii
)
P
r
o
v
id
in
g
d
ir
ec
t c
ar
e
to
C
OVI
D
-
1
9
p
atien
ts
; a
n
d
ii
i
)
B
ein
g
willin
g
to
p
ar
ticip
ate
in
th
is
s
tu
d
y
.
I
n
to
tal,
6
6
m
e
d
ical
team
s
to
o
k
p
ar
t
in
ei
g
h
t
f
o
cu
s
g
r
o
u
p
d
is
cu
s
s
io
n
s
,
with
ea
ch
g
r
o
u
p
h
av
i
n
g
eig
h
t
to
n
in
e
p
ar
ticip
an
ts
.
T
h
e
m
ale
-
to
-
f
em
ale
p
ar
ticip
a
n
t
r
atio
i
n
d
i
s
cu
s
s
io
n
s
was
k
ep
t
at
a
s
u
ita
b
le
lev
el
(
3
5
/6
0
)
.
Fo
c
u
s
g
r
o
u
p
d
is
cu
s
s
io
n
s
wer
e
ca
r
r
ied
o
u
t
u
n
til th
e
s
atu
r
atio
n
o
f
n
ew
e
v
id
en
ce
was r
ea
ch
e
d
.
2
.
3
.
P
r
o
ce
du
re
Par
ticip
an
ts
wh
o
ch
o
o
s
e
to
p
a
r
ticip
ate
in
o
u
r
s
tu
d
y
r
ec
eiv
ed
an
em
ail
with
in
s
tr
u
ctio
n
s
o
n
h
o
w
to
u
s
e
th
e
v
ir
tu
al
f
o
cu
s
g
r
o
u
p
d
is
cu
s
s
io
n
an
d
an
i
n
ter
v
iew
g
u
id
e.
A
u
n
iq
u
e
u
s
er
n
am
e
an
d
p
ass
wo
r
d
wer
e
ass
ig
n
ed
to
ac
ce
s
s
th
e
o
n
lin
e
f
o
r
u
m
u
s
in
g
th
eir
lo
g
-
i
n
n
am
es
an
d
p
ass
wo
r
d
s
.
On
ly
m
o
d
er
at
o
r
s
h
ad
d
ir
ec
t
co
n
n
ec
tio
n
s
to
th
e
d
is
cu
s
s
io
n
b
o
ar
d
f
o
r
d
ata
co
llectio
n
.
T
h
e
an
o
n
y
m
ity
an
d
co
n
f
id
e
n
tiality
o
f
th
e
in
f
o
r
m
atio
n
co
n
tain
e
d
in
th
e
tr
an
s
cr
ip
ts
an
d
th
e
f
in
al
r
ep
o
r
t
wer
e
g
u
ar
a
n
teed
.
T
h
e
p
ar
ticip
an
ts
ag
r
ee
d
to
p
ar
ticip
a
te
b
y
co
m
p
letin
g
a
d
ata
co
llectio
n
p
r
o
ce
d
u
r
e
o
n
th
e
I
n
ter
n
et
th
at
o
b
tain
ed
th
eir
in
f
o
r
m
e
d
co
n
s
en
t
b
y
p
r
esen
tin
g
th
em
with
all
th
e
r
elev
an
t in
f
o
r
m
atio
n
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
S
tr
en
g
th
en
in
g
in
ten
s
ive
ca
r
e
tr
a
in
in
g
in
r
esp
o
n
s
e
to
C
OV
I
D
-
1
9
:
less
o
n
s
fo
r
… (
Mo
ch
a
m
a
t H
elmi
)
25
2
.
4
.
Study
s
et
t
ing
a
nd
da
t
a
c
o
llect
io
n
R
esear
ch
er
s
,
in
co
n
s
u
ltatio
n
with
ex
p
er
ts
,
d
ev
elo
p
ed
a
d
i
s
cu
s
s
io
n
g
u
id
e
f
o
r
u
s
e
in
th
is
s
tu
d
y
's
elec
tr
o
n
ic
f
o
c
u
s
g
r
o
u
p
s
y
n
ch
r
o
n
o
u
s
d
is
cu
s
s
io
n
s
.
All
au
th
o
r
s
r
ev
is
ed
an
d
a
p
p
r
o
v
ed
th
e
m
an
u
al,
wh
ich
was
th
en
p
il
o
te
d
with
f
o
u
r
p
eo
p
l
e.
E
ac
h
p
ar
ticip
a
n
t
was
ask
e
d
to
an
s
wer
s
ev
en
o
p
en
-
e
n
d
e
d
q
u
esti
o
n
s
,
wh
ich
allo
wed
th
em
to
talk
ab
o
u
t
as
m
an
y
to
p
ics
as
p
o
s
s
ib
le.
T
h
e
m
o
d
er
ato
r
led
th
e
f
o
c
u
s
g
r
o
u
p
d
is
cu
s
s
io
n
s
d
u
r
in
g
th
e
m
o
n
th
s
o
f
J
u
ly
a
n
d
Au
g
u
s
t
2
0
2
0
.
Fo
r
ea
c
h
g
r
o
u
p
,
a
f
o
r
u
m
was
estab
lis
h
ed
at
th
e
b
eg
in
n
in
g
o
f
th
e
co
n
f
er
e
n
ce
to
p
r
o
v
id
e
an
i
n
tr
o
d
u
ctio
n
,
wh
ich
co
n
tain
e
d
q
u
esti
o
n
s
th
at
ask
ed
p
ar
ti
cip
an
ts
ab
o
u
t
th
eir
p
er
ce
p
tio
n
s
o
f
ed
u
ca
tio
n
n
ee
d
s
an
d
b
ar
r
ier
s
,
th
eir
ex
p
er
ie
n
c
es
with
o
n
lin
e
lear
n
in
g
an
d
o
f
f
lin
e
lear
n
in
g
,
an
d
d
if
f
icu
lties
en
co
u
n
ter
ed
a
n
d
ch
allen
g
es.
T
h
e
web
s
ite
was
u
s
ed
as
a
p
latf
o
r
m
f
o
r
liv
e
p
ar
allel
d
is
cu
s
s
io
n
am
o
n
g
p
a
r
ticip
an
ts
.
Usi
n
g
an
o
n
lin
e
co
n
f
er
en
cin
g
s
er
v
ice,
t
h
e
p
ar
ticip
an
ts
h
ad
a
co
n
v
er
s
a
tio
n
,
an
d
th
e
n
th
eir
co
n
v
er
s
atio
n
was
r
ec
o
r
d
e
d
.
I
n
g
en
er
al,
g
r
o
u
p
d
is
cu
s
s
io
n
s
to
o
k
9
0
-
1
2
0
m
i
n
u
tes.
T
h
e
f
in
al
two
f
o
c
u
s
g
r
o
u
p
s
d
is
cu
s
s
ed
s
atu
r
atio
n
an
d
r
ea
ch
ed
th
e
co
n
s
en
s
u
s
th
at
ad
d
itio
n
al
p
ar
ticip
an
ts
wer
e
u
n
n
ec
ess
ar
y
,
an
d
as
a
r
esu
lt,
it wa
s
ag
r
ee
d
to
s
to
p
th
e
s
tu
d
y
th
er
e.
2
.
5
.
Da
t
a
a
na
ly
s
is
T
h
e
co
n
ten
t
an
aly
s
is
d
ev
elo
p
e
d
b
y
B
r
au
n
an
d
C
lar
k
e
[
1
1
]
was
ap
p
lied
to
th
e
tr
an
s
cr
ip
tio
n
s
to
b
u
ild
th
e
th
em
e.
T
h
ese
m
eth
o
d
s
h
elp
ed
s
u
m
m
ar
ize
th
e
d
ata
in
to
r
elev
an
t
in
f
o
r
m
atio
n
th
at
was
laid
o
u
t
s
y
s
tem
atica
lly
u
s
in
g
a
s
eq
u
en
ce
o
f
s
tep
s
.
An
in
d
u
ctiv
e
p
r
o
ce
s
s
was
em
p
lo
y
ed
f
o
r
an
al
y
s
is
,
an
d
th
en
c
o
d
es
wer
e
ass
ig
n
ed
to
ev
er
y
m
ea
n
in
g
f
u
l
s
en
ten
ce
b
ased
o
n
th
ei
r
u
n
d
er
ly
i
n
g
co
n
ce
p
ts
[
1
2
]
.
Af
ter
war
d
s
,
s
im
ilar
co
d
es
wer
e
d
is
co
v
er
ed
in
en
c
o
m
p
ass
in
g
s
u
b
-
th
em
es.
Fin
ally
,
s
im
ilar
s
u
b
-
th
em
es
wer
e
co
m
b
in
ed
in
to
a
s
in
g
le
ce
n
tr
al
th
em
e
th
at
r
ef
l
ec
ted
its
s
u
b
-
th
em
es.
Data
was
h
an
d
le
d
b
y
all
au
th
o
r
s
,
wh
o
a
n
aly
ze
d
an
d
c
o
d
ed
it.
T
h
e
f
ir
s
t
two
au
th
o
r
s
an
aly
ze
d
th
e
d
ata
to
g
eth
er
,
with
th
e
r
est
o
f
th
e
au
th
o
r
s
s
er
v
in
g
as
s
ec
o
n
d
co
d
er
s
.
Fo
llo
win
g
th
at,
th
e
in
itial
co
d
in
g
was
e
x
am
in
ed
an
d
c
o
m
p
ar
e
d
.
On
c
e
al
l
au
th
o
r
s
h
ad
r
ea
ch
ed
an
ag
r
ee
m
en
t,
a
n
ew
co
d
in
g
s
ch
em
e
,
s
u
b
-
th
e
m
es,
a
n
d
th
em
es we
r
e
d
ev
elo
p
e
d
[
1
3
]
,
[
1
4
]
.
3.
RE
SU
L
T
S
I
n
to
tal,
eig
h
t
o
n
lin
e
s
y
n
ch
r
o
n
o
u
s
f
o
cu
s
g
r
o
u
p
d
is
cu
s
s
io
n
s
wer
e
co
n
d
u
cted
.
E
ac
h
g
r
o
u
p
in
clu
d
ed
eig
h
t
to
n
in
e
p
a
r
ticip
an
ts
.
T
h
er
e
wer
e
6
6
r
esp
o
n
d
en
ts
,
a
n
d
m
o
r
e
t
h
an
h
alf
(
6
0
%;
n
=3
6
)
o
f
th
e
p
ar
ticip
a
n
ts
wer
e
f
em
ale.
T
h
e
p
ar
ticip
a
n
t
s
wer
e
co
m
i
n
g
f
r
o
m
all
p
r
o
v
in
ce
s
(
n
=
3
4
)
in
I
n
d
o
n
esia.
Half
o
f
th
e
s
am
p
le
p
ar
ticip
an
ts
(
5
0
%; n
=
3
3
)
wer
e
b
etwe
en
3
4
an
d
4
0
.
Du
r
in
g
th
e
an
aly
s
is
,
s
u
b
-
th
em
es we
r
e
id
en
tifie
d
an
d
class
if
ied
u
n
d
e
r
f
o
u
r
m
ajo
r
t
h
em
es,
s
u
m
m
ar
ized
b
elo
w
with
r
elev
an
t
q
u
o
tes
f
r
o
m
th
e
p
ar
ticip
a
n
ts
.
Fo
u
r
co
r
e
t
h
em
es
in
clu
d
ed
th
e
f
o
llo
wi
n
g
:
i
)
th
e
n
ee
d
f
o
r
u
p
g
r
a
d
ed
e
d
u
ca
tio
n
an
d
c
o
m
p
eten
cy
,
ii
)
th
e
n
ee
d
f
o
r
i
n
n
o
v
atio
n
in
ed
u
ca
tio
n
an
d
tr
ain
i
n
g
m
et
h
o
d
s
,
iii
)
th
e
r
o
le
o
f
a
p
r
o
f
ess
io
n
al
o
r
g
a
n
izatio
n
,
iv
)
c
h
allen
g
es e
n
co
u
n
ter
e
d
,
an
d
v
)
tim
e
c
o
n
s
tr
ain
ts
.
3
.
1
.
T
hem
e
1
:
T
he
need
f
o
r
up
g
ra
ded
educa
t
io
n a
nd
co
m
pet
ency
T
h
e
f
ir
s
t
t
h
em
e
th
at
em
er
g
ed
was
th
e
lack
o
f
u
n
d
er
s
tan
d
in
g
o
f
th
e
m
ed
ical
team
s
a
b
o
u
t
p
atien
t
ca
r
e
an
d
m
a
n
ag
em
e
n
t
o
f
C
OVI
D
-
1
9
in
th
e
I
C
U.
Alth
o
u
g
h
t
h
e
lev
el
o
f
ed
u
ca
tio
n
r
eq
u
ir
ed
to
m
ee
t
a
s
p
ec
if
ic
m
ed
ical
co
m
p
eten
c
y
s
tan
d
ar
d
is
in
d
iv
id
u
al
f
o
r
ea
c
h
tea
m
m
em
b
er
,
th
e
m
e
d
ical
s
taf
f
h
as
ag
r
ee
d
o
n
th
e
m
in
im
u
m
co
m
p
eten
cy
s
tan
d
ar
d
s
n
ec
ess
ar
y
to
s
er
v
e
p
atien
ts
with
cr
itical
co
n
d
itio
n
s
.
W
ith
co
n
s
tan
tly
s
h
if
tin
g
v
o
lu
n
teer
s
,
th
e
n
ee
d
f
o
r
e
d
u
ca
tio
n
an
d
tr
ai
n
in
g
o
n
th
e
s
am
e
t
o
p
ic
will b
e
r
ep
ea
ted
.
"I
n
d
ee
d
,
th
ere
is
a
med
ica
l te
a
m
th
a
t is st
ill la
ck
in
g
in
kn
o
w
led
g
e
o
r
p
r
o
p
er I
C
U
ma
n
a
g
em
en
t."
“Du
e
to
th
e
d
yn
a
mic
n
a
tu
r
e
o
f
in
fo
r
ma
tio
n
r
eg
a
r
d
in
g
C
OV
I
D
-
1
9
,
w
e
n
ee
d
t
o
s
ta
y
u
p
t
o
d
a
te,
b
u
t
th
ere
a
r
e
b
a
r
r
iers
a
n
d
h
ec
ticn
ess
in
vo
lved
in
d
ea
li
n
g
w
ith
th
e
u
n
ex
p
ec
ted
in
crea
s
e
i
n
d
is
a
b
led
p
a
tien
ts
.
"Of
co
u
r
s
e.
.
.
w
e
n
ee
d
mu
ch
in
fo
r
ma
tio
n
,
esp
ec
ia
lly
in
th
ese
s
i
tu
a
tio
n
s
,
w
e
la
ck
ex
ten
s
ive
ma
n
a
g
eme
n
t k
n
o
w
led
g
e
a
t t
h
e
I
C
U.
"
Ad
d
itio
n
ally
,
th
e
r
e
was
a
r
e
d
u
ctio
n
in
th
e
lev
el
o
f
c
o
n
f
id
e
n
ce
o
f
th
e
m
e
d
ical
team
s
in
p
r
o
v
id
i
n
g
d
ir
ec
t
ca
r
e
to
th
e
C
OVI
D
-
1
9
p
atien
ts
,
s
u
ch
as
ad
m
in
is
ter
in
g
in
jectio
n
s
o
r
p
er
f
o
r
m
i
n
g
in
t
u
b
atio
n
o
n
ch
ild
r
en
an
d
ad
u
lts
in
cr
itically
ill
C
OVI
D
-
1
9
,
wh
en
co
m
p
ar
e
d
to
ca
r
r
y
in
g
o
u
t
s
im
ilar
ac
tio
n
s
o
n
n
o
n
-
C
OVI
D
-
1
9
p
atien
ts
.
“In
my
o
p
i
n
io
n
,
I
b
eliev
e
th
a
t
d
o
cto
r
s
d
o
n
't
n
ee
d
to
lea
r
n
o
n
ly
a
b
o
u
t
clin
ica
l
ma
tter
s
.
B
ec
a
u
s
e
w
e
h
a
ve
to
h
a
ve
g
o
o
d
ma
n
a
g
eme
n
t a
b
ilit
y,
w
e
mu
s
t a
ls
o
h
a
ve
g
o
o
d
ca
p
a
b
ilit
y
in
m
a
n
a
g
in
g
th
e
r
o
o
m.
”
"Co
r
r
ec
tly.
I
f
yo
u
w
a
n
t
t
o
b
e
a
ma
n
a
g
er,
yo
u
'll
n
ee
d
to
lea
r
n
h
o
w
to
ma
n
a
g
e
p
eo
p
le.
We
m
u
s
t
n
o
t b
e
a
b
le
to
a
cc
o
mmo
d
a
te
p
eo
p
le'
s
s
ervices
w
h
en
r
eso
u
r
ce
s
a
r
e
min
ima
l."
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
1
,
M
ar
ch
20
26
:
23
-
31
26
Ad
d
itio
n
ally
,
m
o
s
t
r
esp
o
n
d
en
ts
ex
p
ec
t
a
p
r
o
ce
s
s
o
f
in
cr
ea
s
in
g
k
n
o
wled
g
e
to
p
r
o
v
id
e
s
er
v
ices
to
C
OVI
D
-
1
9
p
atien
ts
in
cr
itic
al
co
n
d
itio
n
s
to
b
e
b
etter
an
d
s
af
er
.
I
t
is
wid
ely
r
ec
o
g
n
ized
th
at
th
e
in
itial
m
an
ag
em
en
t
o
f
em
er
g
en
cies
in
th
e
em
er
g
en
cy
r
o
o
m
,
in
ten
s
i
v
e
ca
r
e
u
n
it,
an
d
o
th
er
em
e
r
g
e
n
cy
ar
ea
s
is
h
ig
h
ly
d
ep
en
d
e
n
t
o
n
th
e
p
r
im
ar
y
s
u
r
v
ey
'
s
ev
alu
atio
n
.
A
s
ta
tem
en
t
s
tates
th
at
th
e
m
ed
ical
team
n
ee
d
s
to
m
ain
tain
em
er
g
en
cy
p
r
o
f
icien
cy
co
n
ce
r
n
in
g
t
r
ea
tin
g
C
OVI
D
-
1
9
p
atien
ts
,
esp
ec
ially
g
e
n
er
al
p
r
ac
titi
o
n
er
s
,
an
est
h
esio
lo
g
is
ts
,
an
d
in
ten
s
iv
e
ca
r
e
co
n
s
u
ltan
ts
.
“T
h
e
term
fo
r
a
n
in
itia
l
eme
r
g
en
cy
is
ca
lled
th
e
a
ir
w
a
y;
th
e
circu
la
tio
n
o
f
co
n
s
cio
u
s
n
ess
is
ca
lled
th
e
p
r
ima
r
y,
co
r
r
ec
t?
We
co
n
ce
n
tr
a
ted
o
n
th
is
g
e
n
era
l p
r
a
cti
tio
n
er fir
s
t..
.
"
“T
h
is
p
h
ysicia
n
r
ec
o
g
n
iz
es
t
h
a
t
th
e
p
a
tien
t
is
in
s
h
o
ck
a
n
d
r
esp
o
n
d
s
b
y
ma
n
a
g
in
g
fir
s
t,
th
en
in
clu
d
in
g
t
h
e
a
ir
w
a
y.
”
".
.
.
a
n
in
te
n
s
ive
ca
r
e
p
r
a
ctitio
n
er mu
s
t k
n
o
w
w
h
ich
p
a
tien
t m
u
s
t b
e
in
tu
b
a
te
d
a
n
d
n
o
t in
tu
b
a
ted
.
"
"Th
is
is
C
OV
I
D
-
1
9
,
a
s
th
e
p
r
o
ce
d
u
r
e
ma
y
b
ec
o
me
m
o
r
e
co
mp
lica
ted
w
ith
C
O
VID
-
1
9
.
"
Fu
r
th
er
m
o
r
e
,
th
e
E
x
p
er
t T
ea
m
s
tated
th
at:
"Th
ere
a
r
e
ce
r
ta
in
a
d
ju
s
tmen
ts
w
h
ich
mu
s
t
b
e
ma
d
e
fo
r
s
p
ec
ia
liz
ed
ci
r
cu
mst
a
n
ce
s
,
s
u
ch
a
s
mec
h
a
n
ica
l
ve
n
tila
tio
n
,
p
r
o
n
e
p
o
s
itio
n
in
g
,
a
n
d
s
o
o
n
,
a
s
n
o
t
a
ll
h
o
s
p
ita
ls
ca
n
p
erfo
r
m
a
ll
o
f
th
ese
p
r
o
ce
d
u
r
es."
A
d
d
itio
n
al
k
n
o
wled
g
e
ab
o
u
t
C
OVI
D
-
1
9
f
o
r
th
e
m
ed
ical
team
was
also
r
ec
o
m
m
en
d
ed
,
esp
ec
ially
r
eg
ar
d
in
g
th
e
s
cr
ee
n
in
g
o
f
C
OVI
D
-
1
9
p
atien
ts
.
T
o
s
tr
e
n
g
th
en
an
d
r
ein
f
o
r
ce
th
eir
c
u
r
r
en
t
ex
p
e
r
tis
e,
th
e
p
ar
ticip
an
ts
ad
v
is
e
th
at
a
d
d
itio
n
al
tr
ain
in
g
o
n
in
f
ec
tio
n
p
r
e
v
en
tio
n
a
n
d
c
o
n
tr
o
l
b
e
p
r
o
v
i
d
ed
,
wh
ich
i
n
clu
d
es
m
an
ag
em
en
t
o
f
s
er
v
ices
ass
o
ciate
d
with
C
OVI
D
-
1
9
in
f
ec
tio
n
,
is
o
latio
n
r
o
o
m
s
,
zo
n
in
g
s
y
s
tem
s
,
an
d
p
r
o
p
er
m
an
ag
em
en
t
o
f
p
e
r
s
o
n
al
p
r
o
te
ctiv
e
eq
u
ip
m
e
n
t (
s
to
r
ag
e,
u
s
e,
an
d
d
is
p
o
s
al)
.
“Pa
tien
ts
w
ith
C
OV
I
D
-
1
9
h
a
ve
s
ig
n
ifica
n
tly
d
iffer
en
t
t
r
ea
tmen
t
o
u
tco
mes
co
mp
a
r
ed
to
o
th
er
p
a
tien
ts
b
ec
a
u
s
e
th
ey
u
s
e
s
ig
n
ifica
n
tly
mo
r
e
P
P
E
.
”
"P
P
E
a
n
d
in
fectio
n
co
n
tr
o
l
a
r
e
lin
ke
d
.
I
t
is
p
r
o
b
a
b
ly
s
o
me
th
in
g
th
a
t
n
ee
d
s
to
b
e
le
a
r
n
ed
to
g
eth
er.
A
n
d
,
b
ec
a
u
s
e
it's
a
s
kill,
mer
ely
s
ee
in
g
th
e
s
i
mu
la
tio
n
w
o
n
't
b
e
th
e
s
a
me
a
s
h
a
vin
g
h
im
p
erfo
r
m
it
p
ers
o
n
a
lly.
"
T
h
er
e
wer
e
m
a
n
y
u
n
iq
u
e
d
esire
s
to
lear
n
m
o
r
e
ab
o
u
t
th
e
tr
e
atm
en
t
an
d
m
an
ag
em
e
n
t
o
f
C
OVI
D
-
1
9
,
esp
ec
ially
f
o
r
c
r
itical
co
n
d
itio
n
s
.
T
o
ass
is
t
th
e
m
ed
ical
team
in
th
e
m
an
ag
e
m
en
t
a
n
d
tr
ea
t
m
en
t
o
f
C
OVI
D
-
1
9
,
th
e
p
ar
ticip
a
n
ts
r
ec
o
m
m
en
d
e
d
th
at
a
C
OVI
D
-
1
9
ed
u
ca
tio
n
al
an
d
t
r
ain
in
g
p
ac
k
ag
e
b
e
co
m
p
ile
d
f
o
r
th
e
m
ed
ical
team
to
av
o
id
co
n
f
u
s
i
o
n
an
d
to
h
el
p
av
o
i
d
o
v
e
r
lap
o
f
k
n
o
wled
g
e.
"Ma
yb
e
o
n
e
p
a
ck
a
g
e
fo
r
C
OV
I
D
-
1
9
tr
a
in
in
g
a
n
d
ed
u
ca
tio
n
ca
n
b
e
ma
d
e
b
ec
a
u
s
e
mo
s
t
o
f th
em
h
a
ve
g
r
a
d
u
a
ted
o
r
b
ec
o
me
co
n
s
u
lt
a
n
ts
,
a
ctu
a
lly
fo
r
p
s
yc
h
o
mo
to
r
a
n
d
o
th
ers
,
th
a
t's
a
ll,
b
u
t
w
h
a
t
n
ee
d
s
a
d
d
itio
n
a
l
kn
o
w
led
g
e,
s
o
it c
a
n
b
e
ma
d
e
in
p
a
ck
a
g
es."
3
.
2
.
T
hem
e
2
:
T
he
need
f
o
r
inn
o
v
a
t
io
n in e
du
ca
t
io
n a
nd
t
ra
ini
ng
m
et
ho
ds
T
h
e
s
ec
o
n
d
is
s
u
e
is
th
e
n
ee
d
f
o
r
k
n
o
wled
g
e
-
en
h
an
cin
g
m
et
h
o
d
s
.
I
t
is
ch
allen
g
i
n
g
t
o
a
p
p
l
y
th
e
way
o
f
in
c
r
ea
s
in
g
k
n
o
wled
g
e
in
p
an
d
em
ic
c
o
n
d
itio
n
s
,
p
ar
ticu
la
r
ly
wh
en
it
co
m
es
to
m
o
to
r
s
k
ills
k
n
o
wled
g
e.
T
o
o
v
er
co
m
e
th
is
in
ef
f
icie
n
cy
,
th
e
ed
u
ca
tio
n
an
d
tr
ain
i
n
g
u
n
it
u
s
es
in
f
o
r
m
atio
n
tech
n
o
lo
g
y
ass
is
tan
ce
b
y
r
ec
o
r
d
in
g
ev
er
y
ac
tiv
ity
th
at
e
x
is
ts
an
d
cr
ea
tin
g
ed
u
ca
tio
n
al
v
id
eo
s
.
T
h
e
r
ef
o
r
e
,
th
e
tr
ain
in
g
p
r
o
ce
s
s
d
o
es
n
o
t
n
ee
d
t
o
b
e
p
er
f
o
r
m
ed
r
ep
ea
te
d
ly
;
n
ew
v
o
lu
n
teer
s
ca
n
p
la
y
b
a
ck
th
e
ex
is
tin
g
v
id
eo
r
ec
o
r
d
in
g
,
an
d
t
h
en
th
ey
ar
e
g
iv
en
a
p
r
etest a
n
d
p
o
s
ttes
t to
en
s
u
r
e
k
n
o
wled
g
e
im
p
r
o
v
e
m
e
n
t.
".
.
.
A
n
d
,
ye
s
,
w
e
a
r
e
h
ere
to
ed
u
ca
te
th
em.
Th
ere
is
a
la
b
fo
cu
s
ed
o
n
d
e
ve
lo
p
in
g
s
p
ec
ia
l
s
kills
a
n
d
a
test
w
h
e
r
e
th
ey
ca
n
in
tu
b
a
te.
Ho
w
ev
er,
it
i
s
a
ll
b
a
s
ed
o
n
th
e
ma
n
n
eq
u
in
.
I
t
w
ill
b
e
d
iffer
en
t
fo
r
ea
ch
in
d
ivid
u
a
l,
esp
ec
ia
lly
w
ith
th
e
co
n
d
itio
n
o
f
C
OV
I
D
;
if
h
e
is
in
d
ee
d
p
o
s
itive,
th
ere
s
h
o
u
ld
b
e
n
o
a
ero
s
o
l o
r
s
o
meth
in
g
.
"
At
th
e
s
am
e
tim
e,
o
f
f
lin
e
lear
n
in
g
ab
o
u
t
p
er
s
o
n
al
p
r
o
tectiv
e
eq
u
ip
m
en
t (
s
to
r
ag
e,
u
s
e,
d
is
p
o
s
al)
,
h
an
d
wash
in
g
,
an
d
o
t
h
er
m
o
to
r
ic
s
k
ills
is
ess
en
tial.
T
h
e
m
o
s
t
c
o
m
m
o
n
ap
p
r
o
ac
h
is
to
p
r
o
v
i
d
e
in
s
tr
u
ctio
n
u
s
in
g
v
id
eo
s
th
at
m
ay
b
e
p
u
b
lis
h
ed
o
n
th
e
i
n
ter
n
et
an
d
s
tu
d
ied
b
y
th
e
m
ed
ical
team
r
ep
ea
ted
ly
.
I
t w
as a
l
s
o
s
tated
b
y
o
n
e
o
f
th
e
ex
p
er
ts
:
“Pro
b
a
b
ly,
w
e
ca
n
ma
ke
e
d
u
ca
tio
n
a
l
ma
teri
a
l
u
s
in
g
a
n
in
tera
ctive
vid
eo
th
a
t
c
a
n
b
e
u
p
lo
a
d
e
d
in
s
o
cia
l m
e
d
ia
s
o
th
a
t e
ve
r
yo
n
e
ca
n
s
ee
a
n
d
lea
r
n
.
”
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
S
tr
en
g
th
en
in
g
in
ten
s
ive
ca
r
e
tr
a
in
in
g
in
r
esp
o
n
s
e
to
C
OV
I
D
-
1
9
:
less
o
n
s
fo
r
… (
Mo
ch
a
m
a
t H
elmi
)
27
Ho
s
p
ital
ad
m
in
is
tr
atio
n
m
u
s
t
en
s
u
r
e
th
at
all
s
taf
f
,
in
clu
d
in
g
h
ea
lth
ca
r
e
p
r
o
v
id
e
r
s
,
ca
n
m
a
n
ag
e
PP
E
co
r
r
ec
tl
y
an
d
ad
e
q
u
ately
.
Vid
eo
-
f
ac
ilit
ated
ca
lls
/co
n
v
er
s
atio
n
s
ca
n
b
e
u
s
ed
t
o
co
n
d
u
ct
ev
alu
atio
n
s
u
s
in
g
th
e
o
n
lin
e
m
eth
o
d
(
v
id
eo
ca
lls
)
.
“M
a
yb
e
w
e
ca
n
't
g
o
o
u
t,
s
o
to
mee
t th
em,
w
e'
ll b
e
co
n
d
u
ctin
g
a
w
o
r
ksh
o
p
via
Zo
o
m.
”
T
o
o
p
tim
ize
t
h
e
ef
f
ec
tiv
e
n
ess
o
f
lear
n
in
g
o
b
jectiv
es,
it
is
n
e
ce
s
s
ar
y
to
co
llab
o
r
ate
with
v
a
r
io
u
s
p
latf
o
r
m
s
th
at
s
u
p
p
o
r
t
d
is
tan
ce
lear
n
in
g
,
p
a
r
tic
u
lar
ly
th
o
s
e
th
at
p
r
o
v
id
e
en
h
an
ce
d
ass
ess
m
en
t
an
d
ce
r
tific
atio
n
.
Fu
r
th
er
co
o
p
er
atio
n
is
r
eq
u
ir
ed
to
en
s
u
r
e
th
at
th
e
tim
in
g
o
f
o
n
lin
e
ed
u
ca
tio
n
d
o
es
n
o
t
o
v
e
r
lap
with
o
th
er
f
o
r
m
s
o
f
ed
u
ca
tio
n
.
".
.
.
.
p
r
o
fess
io
n
a
l o
r
g
a
n
iz
a
tio
n
s
th
a
t h
o
s
t su
ch
w
eb
in
a
r
s
ca
n
ta
ke
p
a
r
t
in
o
th
er w
eb
in
a
r
s
.
"
"A
ll
o
f
th
is
kn
o
w
led
g
e
mu
s
t
b
e
d
is
s
emin
a
ted
to
th
e
e
n
tir
e
med
ica
l
tea
m
in
a
timely,
effec
tive,
a
n
d
co
r
r
ec
t m
a
n
n
er."
3
.
3
.
T
hem
e
3
:
T
he
ro
le
o
f
a
pro
f
ess
io
na
l o
rg
a
niza
t
io
n
Ad
d
in
g
k
n
o
wled
g
e
ab
o
u
t
th
e
h
an
d
lin
g
o
f
C
OVI
D
-
1
9
p
atien
ts
with
cr
itical
co
n
d
itio
n
s
to
th
is
m
ed
ical
team
ca
n
b
e
am
o
n
g
th
e
r
esp
o
n
s
ib
ilit
ies
o
f
ass
o
ciatio
n
s
an
d
co
lleg
ia
,
as
claim
ed
b
y
th
e
p
r
ac
titi
o
n
er
s
lis
ted
b
elo
w:
"Yes,
a
s
s
o
cia
tio
n
s
,
b
ec
a
u
s
e
th
is
r
ela
te
s
to
a
lu
mn
i
w
h
o
w
o
r
k
in
th
e
r
eg
io
n
s
;
p
erh
a
p
s
a
s
s
o
c
ia
tio
n
s
o
r
co
lleg
iu
ms a
s
s
is
t b
y
p
r
o
vid
in
g
ma
teri
a
ls
a
n
d
r
eso
u
r
ce
p
ers
o
n
s
.
"
T
h
e
p
ar
ticip
an
ts
claim
th
at
p
r
o
f
ess
io
n
al
ass
o
ciatio
n
s
o
r
o
r
g
an
izatio
n
s
h
av
e
a
s
ig
n
if
ican
t
o
b
lig
atio
n
to
in
cr
ea
s
e
th
e
m
ed
ical
team
'
s
k
n
o
wled
g
e
to
s
er
v
e
b
etter
p
atien
ts
w
h
o
ar
e
d
ea
lin
g
wit
h
cr
itical
co
n
d
itio
n
s
s
u
c
h
as
C
OVI
D
-
1
9
d
is
ea
s
e,
as e
x
p
lain
ed
b
y
t
h
e
f
o
llo
win
g
m
em
b
e
r
’
s
s
tatem
en
t:
"S
o
,
if
yo
u
're
s
till
in
s
ch
o
o
l,
th
e
fa
cu
lty
c
a
n
p
u
r
s
u
e
it,
b
u
t
if
yo
u
'v
e
g
r
a
d
u
a
ted
,
I
b
eli
ev
e
it's
th
e
r
esp
o
n
s
ib
ilit
y
o
f p
r
o
fess
io
n
a
l g
r
o
u
p
s
to
p
r
o
vid
e
co
u
n
s
elin
g
to
mem
b
ers
to
imp
r
o
ve
th
eir ex
p
erti
s
e.
"
3
.
4
.
T
hem
e
4
:
C
ha
lleng
es
enco
un
t
er
ed
T
h
er
e
wer
e
m
a
n
y
b
ar
r
ier
s
an
d
ch
allen
g
es
to
k
n
o
wled
g
e
ac
q
u
is
itio
n
,
s
o
m
e
o
f
wh
ich
wer
e
u
n
iq
u
e
t
o
o
n
lin
e
co
u
r
s
es,
s
u
ch
as
p
e
d
a
g
o
g
ical
m
eth
o
d
s
an
d
th
e
p
r
e
s
en
ce
o
f
tech
n
ical
ch
allen
g
es
.
Mo
d
if
icatio
n
an
d
in
ter
ac
tio
n
in
t
h
e
n
ew
s
y
s
tem
wer
e
v
iewe
d
as
im
p
e
d
im
en
ts
t
o
d
ev
elo
p
in
g
an
d
im
p
lem
en
ti
n
g
o
n
lin
e
lear
n
i
n
g
,
an
d
th
e
r
e
wer
e
n
u
m
e
r
o
u
s
is
s
u
es
with
lectu
r
e
m
ater
ial
d
eliv
er
y
,
d
u
r
atio
n
,
a
n
d
a
r
r
an
g
em
en
t
o
f
lear
n
i
n
g
s
ess
io
n
s
.
T
h
e
f
o
llo
win
g
ar
e
s
o
m
e
o
f
th
e
p
ar
ticip
an
ts
'
p
er
s
p
ec
tiv
es o
n
th
ese
is
s
u
es:
“I
th
o
u
g
h
t
s
o
me
o
f
th
e
o
n
li
n
e
lectu
r
es
w
e
r
e
a
s
s
ig
n
ed
u
n
n
e
ce
s
s
a
r
ily
fo
r
a
lo
n
g
time
.
Th
e
lectu
r
es
w
ere
a
ls
o
n
o
t seq
u
en
ce
d
w
ell,
a
n
d
lectu
r
e
timin
g
ch
a
n
g
e
d
fr
eq
u
en
tly.
"
“T
h
a
t
s
es
s
io
n
w
a
s
fu
ll
o
f
lect
u
r
es
s
ch
ed
u
led
o
ve
r
a
lo
n
g
p
e
r
io
d
!
I
d
id
n
't
h
a
ve
e
n
o
u
g
h
time
to
s
tu
d
y
th
em
th
o
r
o
u
g
h
ly.
”
I
n
ter
n
et
co
n
n
ec
tiv
ity
an
d
th
e
u
s
e
o
f
o
n
lin
e
to
o
ls
ar
e
th
e
tech
n
ical
ch
allen
g
es
f
ac
e
d
b
y
p
ar
ticip
an
ts
.
Par
ticip
an
ts
id
en
tifie
d
n
u
m
er
o
u
s
tech
n
ical
d
if
f
icu
lties
en
co
u
n
ter
ed
d
u
r
in
g
o
n
lin
e
s
ess
io
n
s
,
as
in
d
icate
d
b
y
th
e
f
o
llo
win
g
s
tatem
en
ts
:
“I
w
a
s
p
l
a
g
u
ed
b
y
tech
n
ica
l
p
r
o
b
lems
like
s
lo
w
I
n
tern
et
a
n
d
b
r
o
ke
n
co
mmu
n
ic
a
tio
n
s
o
f
tw
a
r
e
d
a
ily
w
h
ile
I
w
a
s
ta
kin
g
th
e
co
u
r
s
e.
We
a
ls
o
e
n
co
u
n
tered
a
b
i
g
is
s
u
e
in
th
a
t
th
e
ma
jo
r
ity
o
f
o
u
r
tea
ch
ers
h
a
d
n
o
p
r
io
r
ex
p
erien
ce
u
s
in
g
o
n
lin
e
lectu
r
es
.
”
Wit
h
o
n
lin
e
tr
a
in
in
g
b
ein
g
q
u
ite
co
mmo
n
th
ese
d
a
ys,
I
fr
eq
u
en
tly
fa
ce
in
tern
et
d
is
co
n
n
ec
tio
n
w
h
ile
p
a
r
ticip
a
tin
g
in
o
n
lin
e
lectu
r
e
s
,
a
n
d
it is
ch
a
llen
g
in
g
fo
r
me
to
fo
llo
w
.
.
.
"
3
.
5
.
T
hem
e
5
:
T
im
e
co
ns
t
ra
i
nt
T
h
e
s
u
b
ject
o
f
tim
e
co
n
s
tr
ain
t
s
em
er
g
ed
as
a
s
tan
d
ar
d
-
is
s
u
e
ac
r
o
s
s
p
ar
ticip
an
ts
,
an
d
th
e
y
a
ll
s
aid
th
at
th
eir
b
u
s
in
ess
o
f
p
r
o
v
id
in
g
d
ir
ec
t
ca
r
e
to
p
atien
ts
h
ad
b
ec
o
m
e
th
e
m
o
s
t
s
ig
n
if
ican
t
im
p
e
d
im
en
t
to
im
p
r
o
v
in
g
th
eir
k
n
o
wled
g
e
an
d
s
k
ills
.
T
h
e
f
o
llo
win
g
s
tatem
en
ts
d
em
o
n
s
tr
ate
th
is
:
“W
e
n
ee
d
to
u
p
g
r
a
d
e,
b
u
t
w
e
a
ls
o
n
ee
d
t
o
w
o
r
k
ve
r
y
h
a
r
d
,
esp
ec
ia
lly
d
u
r
in
g
th
is
time,
th
e
n
ew
ca
s
e
a
lw
a
ys in
crea
s
in
g
d
r
a
ma
tica
lly.
"
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
1
,
M
ar
ch
20
26
:
23
-
31
28
T
h
ey
also
ex
p
e
r
ien
ce
d
if
f
icu
lt
y
in
u
p
g
r
ad
in
g
th
ei
r
k
n
o
wled
g
e
an
d
s
k
ills
,
wh
ich
c
o
u
ld
b
e
a
f
f
ec
ted
b
y
th
e
in
cr
ea
s
ed
tr
an
s
m
is
s
io
n
r
is
k
o
f
C
OVI
D
-
1
9
.
T
h
u
s
,
th
ey
s
u
g
g
e
s
ted
th
at
th
e
ed
u
ca
tio
n
a
n
d
tr
ain
in
g
d
iv
is
io
n
b
e
v
er
y
co
n
ten
t
to
p
r
o
v
id
e
th
e
in
f
o
r
m
atio
n
with
s
tr
ict
r
eg
u
la
tio
n
.
Fo
r
ex
am
p
le,
all
m
ed
ical
s
taf
f
s
h
o
u
ld
atten
d
th
e
b
asic
tr
ain
in
g
r
elate
d
to
C
OVI
D
-
1
9
;
if
n
o
t,
th
ey
w
o
u
ld
b
e
f
in
ed
.
T
h
en
,
th
e
h
o
s
p
ital
also
n
ee
d
s
to
m
an
ag
e
all
th
e
h
u
m
an
r
eso
u
r
ce
s
s
o
th
a
t
ev
en
wh
en
th
e
w
o
r
k
lo
a
d
is
h
ig
h
,
th
ey
s
till
h
av
e
a
s
ch
ed
u
le
d
tim
e
f
o
r
tr
ain
i
n
g
.
T
h
ey
ex
p
r
ess
ed
th
eir
v
iews in
th
e
f
o
llo
win
g
s
tatem
en
ts
:
“Of
co
u
r
s
e,
th
e
imp
o
r
ta
n
t
th
i
n
g
is
th
e
ed
u
ca
tio
n
a
n
d
tr
a
in
i
n
g
d
ivis
io
n
;
th
ey
h
a
ve
to
p
r
o
vid
e
b
etter
ma
n
a
g
eme
n
t
a
n
d
s
ch
e
d
u
le
to
a
r
r
a
n
g
e
tr
a
in
in
g
fo
r
ea
c
h
s
ta
ff
mem
b
er
in
th
e
I
C
U.
”
"I
th
in
k
w
e
n
ee
d
s
tr
ict
r
eg
u
la
tio
n
r
eg
a
r
d
in
g
th
e
tr
a
in
in
g
n
ee
d
ed
fo
r
med
ica
l
s
ta
ff
in
th
e
I
C
U
a
n
d
a
ls
o
n
ee
d
co
n
s
en
s
u
s
o
r
g
u
id
eli
n
e
to
a
r
r
a
n
g
e
it."
4.
DIS
CU
SS
I
O
N
C
u
r
r
en
tly
,
co
m
p
eten
cy
-
b
ased
m
ed
ical
ed
u
ca
tio
n
h
as b
ee
n
ac
ce
p
ted
as a
n
ec
ess
ar
y
tr
en
d
th
at
n
ee
d
s
to
b
e
f
o
llo
we
d
in
m
ed
ical
e
d
u
ca
tio
n
an
d
tr
ain
in
g
to
d
ea
l
with
th
e
C
OVI
D
-
1
9
p
an
d
e
m
ic.
T
h
e
tr
a
d
itio
n
al
ap
p
r
o
ac
h
b
eg
in
s
with
th
e
q
u
es
tio
n
"wh
at
s
h
o
u
ld
h
ea
lth
wo
r
k
er
s
k
n
o
w
ab
o
u
t
C
OVI
D
-
1
9
?"
an
d
th
en
"m
u
s
t
b
e
m
o
d
if
ied
to
d
eter
m
in
e
wh
at
s
k
ills
h
ea
lth
wo
r
k
er
s
r
eq
u
ir
e
t
o
d
ea
l
with
C
OVI
D
-
1
9
.
"
T
h
is
s
itu
atio
n
p
r
esen
ts
a
ch
allen
g
e
f
o
r
wh
ich
an
o
r
g
an
izatio
n
ally
d
esig
n
ed
p
atter
n
o
f
co
m
p
eten
ce
th
at
in
clu
d
es
co
m
p
o
n
e
n
ts
o
f
k
n
o
wled
g
e,
s
k
ills
,
v
alu
es,
an
d
b
eh
av
io
r
is
r
eq
u
ir
ed
.
I
n
t
o
tal,
s
h
o
wed
5
2
ess
en
tial c
o
m
p
eten
c
ies r
eq
u
ir
ed
o
f
th
e
m
ed
ical
team
i
n
s
er
v
icin
g
C
OVI
D
-
1
9
p
atien
ts
,
in
clu
d
i
n
g
s
ev
en
etio
lo
g
y
-
r
elate
d
c
o
m
p
eten
cies,
s
ev
en
ass
es
s
m
en
t,
an
d
d
iag
n
o
s
is
-
r
el
ated
co
m
p
ete
n
cies,
3
4
m
an
ag
em
en
t
-
r
elate
d
c
o
m
p
eten
cies,
an
d
f
o
u
r
p
r
o
g
n
o
s
is
-
r
elate
d
co
m
p
eten
cies.
I
n
ad
d
i
tio
n
,
wh
er
e
v
er
p
o
s
s
ib
le,
th
e
e
d
u
ca
tio
n
a
n
d
t
r
ain
in
g
d
iv
is
io
n
ca
n
a
n
d
m
u
s
t
b
e
r
ef
o
cu
s
ed
o
n
C
OVI
D
-
19
-
r
ela
ted
to
p
ics
-
f
o
r
ex
am
p
le,
tr
ain
in
g
o
n
m
o
d
if
ied
in
tu
b
atio
n
p
r
o
to
co
l,
ess
en
tial
m
ec
h
an
ical
v
en
tilatio
n
,
an
d
v
e
n
tilato
r
tr
o
u
b
lesh
o
o
tin
g
.
T
h
e
s
tu
d
y
s
h
o
ws
th
at
th
e
m
e
d
ical
team
r
e
q
u
ir
ed
k
n
o
wled
g
e,
co
m
p
eten
ce
,
an
d
eth
ical
b
eh
av
io
r
t
o
p
r
o
v
id
e
s
er
v
ices
d
u
r
in
g
th
e
C
OVI
D
-
1
9
p
a
n
d
em
ic
[
1
5
]
.
Acc
o
r
d
in
g
to
a
s
tu
d
y
,
th
e
m
ed
ical
team
'
s
k
n
o
wled
g
e,
co
m
p
eten
ce
,
an
d
eth
ical
b
eh
a
v
io
r
m
u
s
t
p
r
o
v
id
e
s
er
v
ices
d
u
r
in
g
t
h
e
C
OVI
D
-
1
9
p
a
n
d
em
ic
[
1
5
]
.
Acc
o
r
d
i
n
g
to
Miller
[
1
6
]
,
th
e
r
e
ar
e
th
r
ee
d
o
m
ain
s
o
f
c
o
m
p
ete
n
ce
:
k
n
o
wled
g
e
(
co
g
n
itiv
e)
,
s
k
ills
(
p
s
y
ch
o
m
o
t
o
r
)
,
a
n
d
b
eh
av
io
r
(
af
f
ec
tiv
e)
.
Fo
r
in
s
tan
ce
,
if
a
m
ed
ical
team
is
task
ed
with
p
r
o
v
i
d
in
g
s
er
v
ices in
a
p
an
d
em
ic
s
itu
atio
n
,
th
e
m
ed
ical
team
m
u
s
t
u
n
d
e
r
s
tan
d
th
e
d
is
ea
s
e
'
s
etio
lo
g
y
(
co
g
n
itiv
e
ar
ea
)
,
b
e
ab
le
to
co
n
d
u
ct
a
p
h
y
s
ical
ex
am
in
atio
n
(
p
s
y
ch
o
m
o
to
r
ar
ea
)
,
an
d
b
e
ab
le
to
co
m
m
u
n
ic
ate
ef
f
ec
tiv
ely
wh
ile
d
e
m
o
n
s
tr
atin
g
th
e
ab
ilit
y
t
o
co
o
p
er
ate
u
n
d
er
d
u
r
ess
(
af
f
ec
tiv
e
ar
ea
)
.
T
h
e
m
ed
ical
team
ca
n
m
ain
tain
a
h
ig
h
lev
el
o
f
co
n
f
id
en
ce
in
th
ei
r
ab
ilit
y
to
p
r
o
v
id
e
e
x
ce
llen
t
s
er
v
ice
to
p
atien
ts
b
y
d
e
v
elo
p
in
g
th
e
s
k
ills
o
f
"
u
n
d
er
s
t
an
d
in
g
h
o
w"
an
d
"u
n
d
er
s
tan
d
in
g
wh
y
.
"
A
s
im
ilar
s
tu
d
y
was
co
n
d
u
cted
i
n
He
n
an
,
wh
ic
h
co
n
clu
d
e
d
th
at
it
is
cr
itical
to
ca
r
ef
u
lly
co
n
s
id
er
th
e
k
n
o
wled
g
e
,
b
e
h
a
v
io
r
,
an
d
s
k
ills
o
f
m
ed
ical
p
er
s
o
n
n
el
wh
en
d
ea
lin
g
with
C
OVI
D
-
1
9
,
n
o
t
o
n
ly
to
en
s
u
r
e
th
at
ca
r
e
is
p
r
o
v
id
ed
ac
co
r
d
in
g
to
r
ec
o
m
m
en
d
ed
p
r
o
c
ed
u
r
es b
u
t a
ls
o
to
p
r
ev
en
t o
r
m
in
im
ize
th
e
r
is
k
o
f
ex
p
o
s
u
r
e
to
h
ea
lth
wo
r
k
er
s
.
T
h
e
r
esu
lts
o
f
th
is
s
tu
d
y
also
u
n
d
er
lin
e
th
e
lack
o
f
k
n
o
wled
g
e
o
f
m
ed
ical
team
s
in
I
C
U
o
n
p
r
o
v
i
d
in
g
d
ir
ec
t
ca
r
e
to
th
e
C
OVI
D
-
1
9
p
atien
ts
,
wh
ich
r
ed
u
ce
s
th
eir
co
n
f
id
en
ce
le
v
el
in
m
e
d
i
ca
l
s
er
v
ices.
Prio
r
r
esear
ch
h
as
s
h
o
wn
th
at
clin
ician
s
s
till
lack
an
u
n
d
er
s
tan
d
in
g
o
f
th
e
clin
ical
ch
ar
a
cter
is
tics
o
f
cr
itical
C
OVI
D
-
1
9
p
atien
ts
[
1
5
]
.
T
h
e
r
e
ar
e
m
an
y
is
s
u
es
to
co
n
s
id
e
r
,
s
u
ch
as
d
i
f
f
er
en
t
lev
els
o
f
d
is
ea
s
e
s
ev
er
ity
an
d
u
n
ce
r
tain
ty
ab
o
u
t
d
e
v
elo
p
in
g
ess
en
tial
co
n
d
itio
n
s
,
wh
en
d
ea
lin
g
with
C
OVI
D
-
1
9
p
atien
ts
in
I
C
U.
I
n
th
e
p
an
d
em
ic
er
a,
t
h
e
m
o
s
t
im
p
o
r
t
an
t
asp
ec
t
o
f
p
a
y
in
g
atten
tio
n
is
to
k
ee
p
th
e
lear
n
in
g
p
r
o
ce
s
s
s
af
e
f
r
o
m
th
e
r
is
k
o
f
C
OVI
D
-
1
9
tr
an
s
m
is
s
io
n
[
1
7
]
,
[
1
8
]
.
I
t
is
also
n
ec
ess
ar
y
to
s
cr
ee
n
wh
at
lear
n
in
g
to
p
ics
ar
e
th
e
m
o
s
t
cr
u
cial
to
b
e
d
eliv
er
ed
t
o
th
e
s
tu
d
en
ts
to
b
e
ef
f
ec
tiv
e
[
1
9
]
.
I
f
r
eq
u
ir
ed
,
a
s
taf
f
s
u
p
er
v
is
io
n
p
r
o
ce
s
s
ca
n
b
e
ca
r
r
ied
o
u
t
s
o
th
at
th
e
p
r
o
ce
s
s
o
f
k
n
o
wled
g
e
en
h
an
ce
m
en
t
ca
n
b
e
tailo
r
ed
to
th
e
n
ee
d
s
o
f
ea
ch
in
d
i
v
id
u
al
[
1
9
]
.
C
o
m
p
r
eh
en
s
iv
e
t
r
ain
in
g
with
s
p
ec
if
ic
r
e
g
u
latio
n
s
is
n
e
ed
ed
to
u
p
g
r
ad
e
an
d
im
p
r
o
v
e
m
ed
ical
team
s
'
co
n
f
id
en
ce
in
p
r
o
v
id
i
n
g
d
ir
ec
t
ca
r
e.
T
h
e
m
eth
o
d
o
f
s
tr
en
g
th
e
n
in
g
k
n
o
wled
g
e
in
t
h
e
p
a
n
d
em
ic
er
a
h
as
to
s
h
if
t
f
r
o
m
t
h
e
tr
ad
itio
n
al
class
r
o
o
m
with
a
lar
g
e
n
u
m
b
er
o
f
o
n
lin
e
lea
r
n
in
g
[
2
0
]
,
[
2
1
]
,
a
n
d
in
ca
s
e
p
r
ac
tical
m
et
h
o
d
s
ar
e
r
e
q
u
ir
ed
,
ac
tiv
ities
m
u
s
t
b
e
ca
r
r
ied
o
u
t
with
a
lim
ited
n
u
m
b
e
r
o
f
p
e
o
p
le
in
v
o
lv
ed
an
d
b
y
im
p
lem
en
tin
g
s
tr
ict
h
ea
lth
p
r
o
to
co
ls
.
T
h
e
co
n
ce
p
t
o
f
v
o
l
u
n
teer
in
g
r
e
q
u
ir
es
p
r
o
p
e
r
e
d
u
ca
tio
n
an
d
t
r
ai
n
in
g
d
u
e
to
f
r
e
q
u
en
t
s
taf
f
ch
a
n
g
es
[
8
]
,
[
2
2
]
,
[2
3
]
.
Ho
wev
er
,
o
n
e
o
f
th
e
is
s
u
es
r
aised
in
th
is
s
tu
d
y
is
h
o
w
to
ch
o
o
s
e
th
e
m
o
s
t
ef
f
ec
tiv
e
m
eth
o
d
f
o
r
in
cr
ea
s
in
g
k
n
o
wled
g
e
.
L
ea
r
n
i
n
g
m
et
h
o
d
s
a
r
e
also
b
ein
g
f
o
r
ce
d
to
ev
o
lv
e
to
aid
in
ac
q
u
ir
in
g
k
n
o
wled
g
e
an
d
c
o
m
p
eten
ce
at
a
d
is
tan
ce
.
T
h
is
ap
p
r
o
ac
h
m
o
d
if
icatio
n
al
s
o
n
ec
ess
itates
ac
ad
em
ics
an
d
s
tu
d
en
ts
s
tu
d
y
in
g
a
s
y
s
tem
th
at
ca
n
allo
w
d
i
s
tan
ce
lear
n
in
g
m
et
h
o
d
s
wh
ile
r
etain
in
g
a
h
ig
h
le
v
el
o
f
lear
n
in
g
q
u
ality
.
An
o
th
er
s
tu
d
y
e
x
p
lain
s
th
at
e
-
lear
n
in
g
h
as
m
o
r
e
a
d
v
a
n
ta
g
es
th
an
d
ir
ec
t
tr
ain
in
g
b
ec
au
s
e
it
ca
n
ad
ap
t
to
d
aily
ac
tiv
ities
[2
4
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
S
tr
en
g
th
en
in
g
in
ten
s
ive
ca
r
e
tr
a
in
in
g
in
r
esp
o
n
s
e
to
C
OV
I
D
-
1
9
:
less
o
n
s
fo
r
… (
Mo
ch
a
m
a
t H
elmi
)
29
I
n
f
o
r
m
ati
o
n
te
c
h
n
o
l
o
g
y
h
as b
e
co
m
e
th
e
b
es
t h
o
p
e
i
n
t
h
e
p
r
o
c
ess
o
f
k
n
o
wle
d
g
e
a
n
d
s
k
ill
e
n
h
an
ce
m
e
n
t
f
o
r
s
ta
f
f
i
n
C
O
VI
D
-
1
9
g
o
v
e
r
n
an
ce
.
F
o
r
t
h
is
r
ea
s
o
n
,
t
h
e
s
u
p
er
v
is
o
r
s
an
d
s
t
u
d
e
n
ts
m
u
s
t
q
u
ick
ly
b
e
a
b
l
e
t
o
g
e
t
th
e
m
o
s
t
o
f
i
n
f
o
r
m
at
io
n
te
c
h
n
o
l
o
g
y
t
h
at
s
u
p
p
o
r
ts
th
e
e
d
u
ca
t
io
n
an
d
t
r
ai
n
i
n
g
p
r
o
ce
s
s
,
in
cl
u
d
i
n
g
i
m
p
r
o
v
i
n
g
t
h
e
q
u
ali
ty
o
f
t
h
e
d
e
v
i
ce
s
u
s
e
d
s
o
t
h
a
t
t
h
e
k
n
o
wle
d
g
e
t
r
an
s
f
e
r
p
r
o
ce
s
s
ca
n
r
u
n
s
e
am
less
l
y
[2
5
]
,
[
2
6
]
.
K
n
o
wle
d
g
e
en
h
a
n
ce
m
e
n
t u
s
i
n
g
s
u
c
h
m
et
h
o
d
r
em
ai
n
s
a
c
h
all
e
n
g
e
f
o
r
ed
u
ca
t
o
r
s
t
o
b
e
a
b
l
e
t
o
f
i
n
d
p
r
o
p
e
r
lea
r
n
i
n
g
t
y
p
es
a
n
d
way
s
to
m
ax
im
i
ze
th
e
le
a
r
n
i
n
g
p
r
o
c
ess
,
m
ai
n
t
ai
n
t
h
e
e
f
f
e
cti
v
e
n
ess
o
f
t
h
e
d
e
li
v
e
r
y
o
f
c
ar
e
t
o
p
ati
e
n
ts
,
a
n
d
en
s
u
r
e
s
t
u
d
en
ts
ac
h
i
ev
e
th
e
ex
p
e
cte
d
c
o
m
p
ete
n
c
y
ta
r
g
ets
[2
7
]
.
T
h
e
r
ef
o
r
e
,
ed
u
ca
t
o
r
s
s
h
o
u
ld
f
o
c
u
s
o
n
t
h
e
q
u
al
it
y
o
f
t
h
e
d
eli
v
e
r
y
co
m
m
u
n
i
ca
t
io
n
,
i
n
n
o
v
ati
o
n
o
f
t
h
e
s
h
ar
in
g
p
r
o
ce
s
s
,
c
o
ll
a
b
o
r
a
ti
o
n
wi
th
v
a
r
i
o
u
s
p
ar
t
ies
to
h
el
p
th
e
lea
r
n
i
n
g
p
r
o
ce
s
s
,
in
c
r
ea
s
e
f
l
e
x
ib
i
lit
y
,
an
d
p
r
o
p
e
r
p
r
e
p
ar
e
d
n
e
s
s
o
f
p
la
n
s
f
o
r
k
n
o
wl
e
d
g
e
e
n
h
an
ce
m
e
n
t
a
cti
v
it
ies
th
a
t
wil
l
b
e
ca
r
r
ie
d
o
u
t
[2
8
]
.
I
n
a
d
d
it
io
n
,
it
is
a
ls
o
v
i
tal
t
o
h
a
v
e
a
g
o
o
d
in
te
r
n
et
co
n
n
e
cti
o
n
t
o
c
o
m
m
u
n
ic
ate
an
d
ev
en
s
i
m
u
lat
e
e
f
f
ec
t
iv
el
y
o
r
s
o
u
n
d
q
u
ali
ty
o
f
t
h
e
a
u
d
i
o
a
n
d
v
i
d
e
o
[
29
]
,
[
3
0
]
.
T
h
e
r
e
a
r
e
s
o
m
e
l
i
m
i
ta
t
i
o
n
s
t
o
t
h
i
s
s
t
u
d
y
.
T
h
e
f
i
n
d
i
n
g
s
o
f
t
h
i
s
s
t
u
d
y
c
a
n
n
o
t
b
e
g
e
n
e
r
a
l
i
z
e
d
d
u
e
t
o
t
h
e
l
i
m
i
t
e
d
s
a
m
p
l
e
s
i
z
e;
e
v
e
n
a
l
l
p
a
r
t
i
c
i
p
a
n
ts
w
e
r
e
c
o
m
i
n
g
f
r
o
m
a
l
l
n
a
t
i
o
n
a
l
r
e
f
e
r
r
a
l
h
o
s
p
it
a
ls
f
o
r
C
O
V
I
D
-
1
9
i
n
3
4
p
r
o
v
i
n
c
e
s
i
n
I
n
d
o
n
e
s
i
a
.
A
l
t
h
o
u
g
h
f
o
u
r
c
o
r
e
t
h
e
m
e
s
a
n
d
s
e
v
e
r
a
l
s
u
b
t
h
e
m
e
s
e
m
e
r
g
e
d
f
r
o
m
o
u
r
s
t
u
d
y
,
t
h
e
a
u
t
h
o
r
s
a
r
e
a
w
a
r
e
t
h
at
t
h
is
m
o
d
a
l
i
t
y
m
u
s
t
b
e
o
t
h
e
r
p
o
t
e
n
t
ia
l
s
t
r
e
n
g
t
h
s
a
n
d
w
e
a
k
n
e
s
s
e
s
f
o
r
m
e
d
i
ca
l
t
ea
m
s
i
n
I
C
U
.
5.
CO
NCLU
SI
O
N
E
d
u
ca
tio
n
an
d
tr
ain
in
g
ar
e
ess
en
tial
to
s
tr
en
g
th
e
n
th
e
ca
p
ac
i
ty
o
f
h
ea
lth
ca
r
e
team
s
in
r
esp
o
n
d
in
g
to
th
e
C
OVI
D
-
1
9
p
a
n
d
em
ic,
p
ar
ticu
lar
ly
in
em
er
g
e
n
cy
h
o
s
p
itals
th
at
r
ely
o
n
v
o
lu
n
teer
s
taf
f
with
d
i
v
er
s
e
b
ac
k
g
r
o
u
n
d
s
an
d
le
v
els
o
f
e
x
p
er
ien
ce
.
I
m
m
ed
iate
a
n
d
c
o
n
t
in
u
o
u
s
tr
ain
i
n
g
is
cr
itical
f
o
r
m
an
ag
in
g
cr
itically
ill
C
OVI
D
-
1
9
p
atien
ts
,
in
cl
u
d
in
g
r
ap
id
k
n
o
wled
g
e
u
p
d
ates,
r
eg
u
lar
r
ef
r
esh
er
co
u
r
s
es,
an
d
s
y
s
tem
atic
ev
alu
atio
n
o
f
o
n
lin
e
e
d
u
ca
tio
n
p
latf
o
r
m
s
.
I
n
f
o
r
m
atio
n
tec
h
n
o
lo
g
y
r
em
ai
n
s
a
p
r
im
ar
y
m
e
th
o
d
f
o
r
d
eliv
er
in
g
tr
ain
in
g
wh
ile
m
in
im
izin
g
in
f
ec
tio
n
r
is
k
s
.
Giv
en
th
e
f
r
eq
u
e
n
t
r
o
tatio
n
o
f
v
o
lu
n
teer
s
taf
f
,
tr
ain
in
g
in
itiativ
es
m
u
s
t
b
e
r
ep
ea
ted
an
d
co
n
tin
u
o
u
s
ly
u
p
d
ate
d
to
en
s
u
r
e
c
o
m
p
eten
cy
ac
r
o
s
s
all
team
m
em
b
e
r
s
.
Fu
tu
r
e
r
esear
ch
s
h
o
u
ld
ex
p
lo
r
e
b
o
th
o
n
lin
e
an
d
o
f
f
lin
e
teac
h
in
g
m
o
d
alities
to
id
en
tify
th
e
m
o
s
t
ef
f
ec
tiv
e
ap
p
r
o
ac
h
es.
Dev
elo
p
in
g
a
s
tr
u
ctu
r
ed
tr
ain
i
n
g
m
o
d
el
t
h
at
in
teg
r
ates
an
o
p
tim
al
b
alan
ce
o
f
o
n
lin
e
lear
n
in
g
with
p
r
ac
tical,
h
an
d
s
-
o
n
e
x
p
er
ien
ce
will
b
e
ess
en
tial
to
en
h
an
ce
th
e
k
n
o
wled
g
e,
clin
ical
s
k
ills
,
an
d
p
r
ep
ar
ed
n
ess
o
f
I
C
U
m
ed
ical
team
s
.
Stre
n
g
th
en
in
g
th
ese
ed
u
ca
tio
n
an
d
tr
ain
i
n
g
s
tr
ateg
ies
is
n
o
t
o
n
ly
cr
it
ical
f
o
r
th
e
cu
r
r
en
t
p
an
d
em
ic
r
esp
o
n
s
e
b
u
t w
ill al
s
o
im
p
r
o
v
e
r
esil
ien
ce
an
d
r
ea
d
in
ess
f
o
r
f
u
tu
r
e
p
u
b
lic
h
ea
lth
e
m
er
g
en
cies.
RE
F
E
R
E
NC
E
S
[
1
]
Jo
h
n
s Ho
p
k
i
n
s C
o
r
o
n
a
v
i
r
u
s
R
e
s
o
u
r
c
e
C
e
n
t
e
r
,
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C
O
V
I
D
-
1
9
D
a
s
h
b
o
a
r
d
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y
t
h
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C
e
n
t
e
r
f
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y
s
t
e
ms Sc
i
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c
e
a
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d
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n
g
i
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r
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g
(
C
S
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E)
a
t
J
o
h
n
s
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o
p
k
i
n
s
U
n
i
v
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si
t
y
,
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o
h
n
s
H
o
p
k
i
n
s
U
n
i
v
e
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si
t
y
.
[
O
n
l
i
n
e
]
.
A
v
a
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l
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t
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p
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:
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p
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c
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d
:
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c
1
9
,
2
0
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2
)
.
[
2
]
U
N
ESCO
,
“
C
O
V
I
D
-
19
e
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u
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t
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[
O
n
l
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e
]
.
A
v
a
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:
h
t
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p
s:
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o
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9
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c
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.
(
a
c
c
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d
:
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e
c
1
9
,
2
0
2
2
)
.
[
3
]
M
.
N
i
c
o
l
a
e
t
a
l
.
,
“
T
h
e
s
o
c
i
o
-
e
c
o
n
o
m
i
c
i
m
p
l
i
c
a
t
i
o
n
s
o
f
t
h
e
c
o
r
o
n
a
v
i
r
u
s
p
a
n
d
e
m
i
c
(
C
O
V
I
D
-
1
9
)
:
a
r
e
v
i
e
w
,
”
I
n
t
e
rn
a
t
i
o
n
a
l
J
o
u
r
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a
l
o
f
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u
r
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ry
,
v
o
l
.
7
8
,
p
p
.
1
8
5
–
1
9
3
,
J
u
n
.
2
0
2
0
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
i
j
s
u
.
2
0
2
0
.
0
4
.
0
1
8
.
[
4
]
M
.
H
.
R
a
j
a
b
,
A
.
M
.
G
a
z
a
l
,
a
n
d
K
.
A
l
k
a
t
t
a
n
,
“
C
h
a
l
l
e
n
g
e
s
t
o
o
n
l
i
n
e
m
e
d
i
c
a
l
e
d
u
c
a
t
i
o
n
d
u
r
i
n
g
t
h
e
C
O
V
I
D
-
19
p
a
n
d
e
m
i
c
,
”
C
u
re
u
s
,
Ju
l
.
2
0
2
0
,
d
o
i
:
1
0
.
7
7
5
9
/
c
u
r
e
u
s.
8
9
6
6
.
[
5
]
C
.
C
o
u
g
h
l
a
n
e
t
a
l
.
,
“
C
O
V
I
D
-
1
9
:
l
e
ss
o
n
s
f
o
r
j
u
n
i
o
r
d
o
c
t
o
r
s
r
e
d
e
p
l
o
y
e
d
t
o
c
r
i
t
i
c
a
l
c
a
r
e
,
”
P
o
st
g
r
a
d
u
a
t
e
Me
d
i
c
a
l
J
o
u
rn
a
l
,
v
o
l
.
9
7
,
n
o
.
1
1
4
5
,
p
p
.
1
8
8
–
1
9
1
,
M
a
r
.
2
0
2
1
,
d
o
i
:
1
0
.
1
1
3
6
/
p
o
s
t
g
r
a
d
me
d
j
-
2
0
2
0
-
1
3
8
1
0
0
.
[
6
]
A
.
T.
C
o
g
h
l
a
n
,
H
.
P
r
e
s
k
i
l
l
,
a
n
d
T.
Tz
a
v
a
r
a
s
C
a
t
sam
b
a
s,
“
A
n
o
v
e
r
v
i
e
w
o
f
a
p
p
r
e
c
i
a
t
i
v
e
i
n
q
u
i
r
y
i
n
e
v
a
l
u
a
t
i
o
n
,
”
N
e
w
D
i
rec
t
i
o
n
s
f
o
r
Ev
a
l
u
a
t
i
o
n
,
v
o
l
.
2
0
0
3
,
n
o
.
1
0
0
,
p
p
.
5
–
2
2
,
2
0
0
3
,
d
o
i
:
1
0
.
1
0
0
2
/
e
v
.
9
6
.
[
7
]
K
.
C
a
l
k
i
n
s
e
t
a
l
.
,
“
Th
e
e
a
r
l
y
i
m
p
a
c
t
o
f
C
O
V
I
D
-
1
9
o
n
i
n
t
e
n
si
v
e
c
a
r
e
n
u
r
s
e
s’
p
e
r
so
n
a
l
a
n
d
p
r
o
f
e
ssi
o
n
a
l
w
e
l
l
-
b
e
i
n
g
:
a
q
u
a
l
i
t
a
t
i
v
e
st
u
d
y
,
”
I
n
t
e
n
si
v
e
a
n
d
C
r
i
t
i
c
a
l
C
a
re
N
u
rsi
n
g
,
v
o
l
.
7
6
,
p
.
1
0
3
3
8
8
,
2
0
2
3
,
d
o
i
:
1
0
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1
0
1
6
/
j
.
i
c
c
n
.
2
0
2
3
.
1
0
3
3
8
8
.
[
8
]
R
.
T
o
se
p
u
e
t
a
l
.
,
“
Ex
p
e
r
i
e
n
c
e
o
f
h
e
a
l
t
h
c
a
r
e
w
o
r
k
e
r
s
i
n
c
o
m
b
a
t
t
i
n
g
C
O
V
I
D
-
1
9
i
n
I
n
d
o
n
e
s
i
a
:
a
d
e
s
c
r
i
p
t
i
v
e
q
u
a
l
i
t
a
t
i
v
e
st
u
d
y
,
”
Be
l
i
t
u
n
g
N
u
rsi
n
g
J
o
u
rn
a
l
,
v
o
l
.
7
,
n
o
.
1
,
p
p
.
3
7
–
4
2
,
2
0
2
1
,
d
o
i
:
1
0
.
3
3
5
4
6
/
b
n
j
.
1
2
5
1
.
[
9
]
H
.
W
.
S
e
t
i
a
w
a
n
e
t
a
l
.
,
“
C
h
a
l
l
e
n
g
e
s
f
o
r
h
e
a
l
t
h
c
a
r
e
w
o
r
k
e
r
s
c
a
r
i
n
g
f
o
r
C
O
V
I
D
-
1
9
p
a
t
i
e
n
t
s
i
n
I
n
d
o
n
e
s
i
a
:
a
q
u
a
l
i
t
a
t
i
v
e
s
t
u
d
y
,
”
I
N
Q
U
I
RY:
T
h
e
J
o
u
r
n
a
l
o
f
H
e
a
l
t
h
C
a
r
e
O
r
g
a
n
i
za
t
i
o
n
,
Pr
o
v
i
si
o
n
,
a
n
d
F
i
n
a
n
c
i
n
g
,
v
o
l
.
5
8
,
J
a
n
.
2
0
2
1
,
d
o
i
:
1
0
.
1
1
7
7
/
0
0
4
6
9
5
8
0
2
1
1
0
6
0
2
9
1
.
[
1
0
]
K
.
T
a
t
e
s
e
t
a
l
.
,
“
O
n
l
i
n
e
f
o
c
u
s g
r
o
u
p
s
a
s
a
t
o
o
l
t
o
c
o
l
l
e
c
t
d
a
t
a
i
n
h
a
r
d
-
to
-
i
n
c
l
u
d
e
p
o
p
u
l
a
t
i
o
n
s
:
e
x
a
m
p
l
e
s
f
r
o
m p
a
e
d
i
a
t
r
i
c
o
n
c
o
l
o
g
y
,
”
BM
C
Me
d
i
c
a
l
Re
s
e
a
r
c
h
M
e
t
h
o
d
o
l
o
g
y
,
v
o
l
.
9
,
n
o
.
1
,
p
.
1
5
,
D
e
c
.
2
0
0
9
,
d
o
i
:
1
0
.
1
1
8
6
/
1
4
7
1
-
2
2
8
8
-
9
-
1
5
.
[
1
1
]
V
.
B
r
a
u
n
a
n
d
V
.
C
l
a
r
k
e
,
“
U
si
n
g
t
h
e
m
a
t
i
c
a
n
a
l
y
si
s
i
n
p
s
y
c
h
o
l
o
g
y
,
”
Q
u
a
l
i
t
a
t
i
v
e
Re
s
e
a
rc
h
i
n
Psy
c
h
o
l
o
g
y
,
v
o
l
.
3
,
n
o
.
2
,
p
p
.
7
7
–
1
0
1
,
Jan
.
2
0
0
6
,
d
o
i
:
1
0
.
1
1
9
1
/
1
4
7
8
0
8
8
7
0
6
q
p
0
6
3
o
a
.
[
1
2
]
M
.
V
a
i
smo
r
a
d
i
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