Reduced turnover times make flexible optical reusable scope with EndoSheath~ Technology significantly cost-effective

EndoSheath bronchoscopy（Vision Sciences,Inc.） uses a sterile,disposable microbial barrier that may meet the growing needs for safe,efficient,and cost effective flexible bronchoscopy.The purpose of this open-label comparative study was to compare and calculate the costs-per-airway-procedure of the reusable fiberscope when used with and without EndoSheath Technology;and to record the turnover time from the completion of the use of each scope until its readiness again for the next use.Seventy-five new patients’ airways requiring airway maneuvers and manipulations with Vision Sciences,Inc.,reusable fiberscope with EndoSheath Technology were evaluated for the costs comparisons with reassessed historical costs data for Olympus scope assisted tracheal intubations.As compared to costs of an intubation（$158.50） with Olympus scope at our institute,the intubation costs with Vision Sciences,Inc.,reusable fiberscope with EndoSheath technology was $81.50（P 〈 0.001）.The mean turnover time was 5.44 min with EndoSheath technology as compared to previously reported 30 min with Olympus fiberscope（P 〈 0.001）.Based on our institutional experience,Vision Sciences,Inc.,reusable fiberscope with EndoSheath technology is significantly cost effective as compared to the Olympus scope with significantly improved turnover times.

Modelling the test, trace and quarantine strategy to control the COVID-19 epidemic in the state of São Paulo, Brazil

Testing for detecting the infection by SARS-CoV-2 is the bridge between the lockdown and the opening of society.In this paper we modelled and simulated a test-trace-andquarantine strategy to control the COVID-19 outbreak in the State of São Paulo,Brasil.The State of São Paulo failed to adopt an effective social distancing strategy,reaching at most 59%in late March and started to relax the measures in late June,dropping to 41%in 08 August.Therefore,São Paulo relies heavily on a massive testing strategy in the attempt to control the epidemic.Two alternative strategies combined with economic evaluations were simulated.One strategy included indiscriminately testing the entire population of the State,reaching more than 40 million people at a maximum cost of 2.25 billion USD,that would reduce the total number of cases by the end of 2020 by 90%.The second strategy investigated testing only symptomatic cases and their immediate contacts e this strategy reached a maximum cost of 150 million USD but also reduced the number of cases by 90%.The conclusion is that if the State of São Paulo had decided to adopt the simulated strategy on April the 1st,it would have been possible to reduce the total number of cases by 90%at a cost of 2.25 billion US dollars for the indiscriminate strategy but at a much smaller cost of 125 million US dollars for the selective testing of symptomatic cases and their contacts.