mHealth and eHealth Applications for a Medicalized Quarantine Hotel during the COVID-19 Pandemic

Abstract

Background In Taiwan, the number of confirmed cases of coronavirus disease 2019 (COVID-19) has risen significantly in May 2021. The second wave of the epidemic occurred in May 2022. mHealth (mobile health, social media communities) and eHealth (electronic health, Hospital Information System) can play an important role in this pandemic by minimizing the spread of the virus, leveraging health care providers' time, and alleviating the challenges of medical education.

Objectives This study aimed to describe the process of using mHealth and eHealth to build a medicalized quarantine hotel (MQH) and understand the physical and mental impact of COVID-19 on patients admitted to the MQH.

Methods In this retrospective observational study, data from 357 patients who stayed at the MQH were collected and their psychological symptoms were assessed using an online Brief Symptom Rating Scale (BSRS). Descriptive statistics, independent sample t-test, univariate analysis of variance, and multiple linear regression analysis were performed.

Results The patients' mean age was 35.5  ±   17.6 years, and 52.1% (n  =  186) of them were males. Altogether, 25.2% (n  =  90) of the patients had virtual visits. The average duration of the hotel stay was 6.8  ±   1.4 days, and five patients (0.01%) were transferred to the hospital. The three most common symptoms reported were cough (39%), followed by the sore throat (22.8%), and stuffy/runny nose (18.9%). Most patients achieved a total BSRS score of 0 to 5 points (3,569/91.0%), with trouble falling asleep (0.65  ±   0.65), feeling tense or high-strung (0.31  ±   0.66), and feeling down or depressed (0.27  ±   0.62) scoring highest. The BSRS score was the highest on the first day. The sex of the patients was significantly related to the BSRS score (p  <  0.001).

Conclusion mHealth and eHealth can be used to further monitor an individual's physiological and psychological states. Early intervention measures are needed to improve health care quality.

Keywords

Quarantine Hotel - electronic health systems - mobile application - psychological distress - COVID-19

Background and Significance

The global evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a highly contagious virus causing the coronavirus disease 2019 (COVID-19), has been a potential threat to human health worldwide. COVID-19 has spread widely since its first appearance in Wuhan, China, in December 2019.[1] [2] On January 30, 2020, it was declared a global public health emergency of international concern.[3] The COVID-19 pandemic had a major impact on the well-being of people and countries worldwide, with major implications for public health, society, safety, and the economy.[4] For almost 2 years, various control strategies have been utilized globally.[5]

The hospitality industry, particularly the lodging and accommodation sector, was severely affected by the global pandemic. Traditionally, hotels depend highly on business and leisure travel for their revenue, but with the travel restrictions brought about by the COVID-19 pandemic, low-to-zero occupancy rates were recorded.[6] A quarantine hotel is a possible solution to address the demand for temporary quarantine accommodation. Prior studies have also discussed the role of quarantine hotels associated with the use of preventive protocols in hospitals to reduce the occurrence of hospital outbreaks.[7] Quarantine hotels are a viable solution not only for the containment of COVID-19 but also for patient care.[8] Quarantine hotels are a community-based public health intervention designed to mitigate the spread of COVID-19 within the community.[9] The hotel isolation program aimed to provide a safe and supportive environment for individuals who are homeless, live in crowded or congregate housing, or whose families and/or landlords do not want them to return out of fear of potential COVID-19 exposure.[10]

In Taiwan, despite early success in controlling the spread of the disease in 2020, the number of confirmed cases had risen significantly since May 2021.[11] The second surge of the epidemic was more serious. The number of confirmed cases on May 10, 2022, exceeded 50,000 for the first time in a single day.[12] As the number of COVID-19 cases escalated, hospitals faced problems with overcrowding and insufficient isolation space.[13] Taipei City government launched a new program that recruited hotels and turned them into medicalized quarantine hotels (MQHs), equipped with medical staff and resources, to provide care for patients with COVID-19. The MacKay Memorial Hospital (MMH), a medical center located in Taipei City, managed the MQHs.

SARS-CoV-2 attacks the virus carrier's immune system, jeopardizing their health and mortality. The most common symptoms are fever, cough, fatigue, dyspnea, and an increased presence of sputum.[14] Diarrhea, myalgia, hemoptysis, sore throat, sneezing, and runny nose are less common symptoms.[15] Some patients may also report a headache.[16] COVID-19 has been reported to cause a series of psychological health threats in the general public.[17]

Quarantine is often an unpleasant experience, and activity restriction and isolation might affect patients' psychological health. Separation from loved ones, loss of freedom, uncertainty over disease status, and boredom can, on occasion, create dramatic effects. Suicides were also reported.[18] The hotel program operates on the premise that all suspected or confirmed COVID-19-positive individuals or individuals vulnerable to COVID-19 require physical, emotional, social, and family support to aid their recovery.[19]

Objectives

According to the American Telemedicine Association, telehealth is defined as “technology-enabled health and care management and delivery systems that extend capacity and access”[20] and includes modalities such as “remote patient monitoring, telehealth, teleconsultation, and the use of mobile application-based technology.”[21] Telehealth has developed rapidly in recent years, and the pandemic has accelerated its implementation and usage.[22]

The use of telehealth or telemedicine in the COVID-19 pandemic is aiding in improving the epidemiological control, and therefore management, of clinical cases. It protects both infected and noninfected individuals as well as physicians.[23] A hotel-based, telemedicine-enabled management represents a feasible and safe approach for patients with COVID-19 requiring long-term isolation. The widespread adoption of telemonitoring tools as alternatives to unnecessary hospitalization gets particular relevance in the context of the ongoing second or third wave of COVID-19 in many countries.[24] mHealth (mobile health, social media communities) is a medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices.[25] mHealth can be used for both information exchange and remote monitoring and diagnosis[26] and involves the use of mobile communication systems to manage health care activities, share medical data, analyze health information, and improve overall patient outcomes and experience.[27] eHealth (electronic health, Hospital Information System [HIS]) is an emerging field at the intersection of medical informatics, public health, and business, referring to the health services and information delivered or enhanced through the internet and related technologies.[20] eHealth solutions can support care and treatment by facilitating the exchange of treatment-relevant data among health care providers. The utilization of advanced technologies might also be required by health care systems to enhance patient-centered health care. Essential components of such a virtual hospital consist of both telehealth and electronic health records.[21] The eHealth program can be executed if all hospitals at the provincial and regional levels have implemented the HIS.[22] eHealth and mHealth are two major approaches that have been used extensively during the COVID-19 pandemic to deliver remote health care services.[24] This study aimed to describe the adaptation of an MQH to provide hospital-level care to patients with COVID-19 during the pandemic in Taiwan and explore the physical and psychological impact of COVID-19 on patients staying at the MQH.

Methods

This retrospective study described the implementation of the MQH during the second surge of COVID-19 cases in May 2022 in Taiwan. Taiwanese health authorities began to stretch the existing test–trace–isolation capacity for COVID-19 control. MMH was asked to lead the establishment of the MQH.

Architecture of the Medicalized Quarantine Hotel

The MQH system consists of the Taiwan Centers for Disease Control (CDC), Taipei City Health Bureau, hospitals, and health care services ([Fig. 1]). The MQH received and treated asymptomatic or mildly symptomatic patients with COVID-19 based on the same admission criteria, relocation criteria, infection control protocol, patient care guidelines, and discharge criteria set up in advance by infectious disease specialists at the MMH. The Green World Jian Pei Hotel, a 126-bed, three-star hotel that is 1.6 km away from MMH, was transformed into a medicalized hotel and opened for patient care from May 12, 2022, to June 30, 2022. The medical quarantine hotel staff consisted of physicians, pharmacists, nurses, the official transportation staff, hotel staff, National Army Chemical Corps, and police officers. Physicians were able to understand the patient's discomfort through virtual visits and order interventions and medicines. The pharmacists dispensed the medicines according to the doctor's orders; the nursing staff then administered the medicines. The physicians mandated polymerase chain reaction (PCR) testing twice a week for release from isolation. The official transportation staff assisted in transporting medicines and specimens between the hospital and the hotel. The hotel staff provided food and environmental services, and a police officer was present 24 hours to monitor and maintain hotel security. The National Army Chemical Corps were utilized to disinfect the surroundings three times a day. Every health care worker was trained in COVID-19 management and personal protective measures, including personal protective equipment, before deployment. To prevent contamination, “dirty” and “clean” circuits were established. The clean circuit included the staff entrance and exit, medical supplies, catering, and cleaning. The dirty circuit focused on the entrance and exit of patients, clothing and catering for patients, and disposal of medical waste. According to the MMH protocol, every health care worker caring for patients with COVID-19 was screened weekly for SARS-CoV-2 infection by PCR testing. This study was conducted in accordance with the Declaration of Helsinki.

Fig. 1 The architecture of medicalized quarantine hotel. HIS, Hospital Information System; NIDRS, New Infectious Disease Reporting System (this is an original figure).

Medicalized Quarantine Hotel Process

The functions of the MQH ([Fig. 2]) comprised eight phases. In phase 1, the Taipei City Health Bureau and hotel staff contacted and dispatched patients who were homeless or could not be isolated at home according to the criteria through a Line group. In phase 2, the Taipei City Health Bureau contacted quarantine taxis to take patients from their homes to hotels through a Line group. In phase 3, the nurse allocated rooms to patients based on the stage of their infection. When the patient arrived at the hotel, the nurse greeted the patient at the front desk and asked them to use their mobile devices, such as mobile phones, PDAs, and other wireless devices, to scan the QR code to join official social media communities, such as Line (official account), WeChat, WhatsApp, and Facebook. The nurse then informed the patients about the hotel policies regarding COVID-19 isolation. In phase 4, patients were asked to report their body temperature and discomfort symptoms and complete the Brief Symptom Rating Scale (BSRS) twice a day (9 a.m./3 p.m.) using Google Forms. If the total BSRS score was >6 points or the suicidal thoughts item was >2 points, the nursing staff provided individualized care by telephone or via Line. In phase 5, each health care provider had individual job responsibilities and performed daily care activities. In phase 6, virtual hospitals were set up on-site during weekdays. Information staff were responsible for preparing the computer and printer and assisted in connecting the hospital's system to the HIS of MMH. The physicians could immediately issue doctor's orders, medicines, and tests according to the patients' needs after the hotel virtual visit. In phase 7, the Taiwan CDC recommended that confirmed patients must accept a mandatory supervised quarantine period of 7 days in the hotel. When the patient's PCR test result was negative, the nursing staff connected to the New Infectious Disease Reporting System (NIDRS) of the Taiwan CDC system to obtain a notice of isolation relief from the hotel. Finally, in phase 8, when the patient received the notice, they could choose to leave the MQH at 12 or 6 a.m. the next day and go home. Only the staff had permission to enter or edit the data in Line and Google Forms. When the patient left the MQH, staff let the case leave the Line group to ensure the security and confidentiality of the data.

Fig. 2 Process of medicalized quarantine hotel (this is an original figure).

Survey Instrument

The BSRS (five items) containing five items was used to assess patients' psychological symptoms.[28] The BSRS is commonly used for screening psychological disorders and is available in Taiwan with excellent validity and reliability.[29] Internal consistency (Cronbach α) coefficients of the BSRS-5 ranged from 0.77 to 0.90. The test–retest reliability coefficient was 0.82.[30] The use of the BSRS in patients with COVID-19 was reported to have good reliability and validity.[31] A Google Form with the questionnaire was created and the patients were asked to fill it out twice a day (9 a.m./3 p.m.). The BSRS scale is a self-administered questionnaire that includes the following five items of psychological symptoms: trouble falling asleep, feeling tense or high-strung, feeling down or depressed, feeling irritable or angry, and feeling inferior to others.

For suicide prevention, the Taiwan BSRS-5 added a sixth item that directly asked the patient about suicide attempts.[30] The score for each item ranged from 0 to 4 (0, not at all; 1, a little bit; 2, moderately; 3, quite a bit; and 4, extremely). The score for the suicide ideation item ranged from 0 to 4; in which a score ≥2 is considered moderate, requiring professional psychiatric consultation. A total score of >14 on the BSRS or a score of >1 on the additional suicide survey item indicates a severe mood disorder. Scores between 10 and 14 indicate moderate mood disorders, and those between 6 and 9 indicate mild mood disorders. According to the study, the optimal cutoff point for normal/psychological symptoms was ⅚. Thus, patients with BSRS scores <5 were considered to be normal.[29]

Statistical Analyses

Data were analyzed using SPSS version 26 (IBM Corp., Armonk, New York, United States). The qualitative variables were presented as absolute and relative frequencies, whereas the numeric variables were reported as means with standard deviation. Descriptive statistics, an independent sample t-test, a univariate analysis of variance, and a multiple linear regression analysis were performed. Statistical significance was defined as p  <  0.05 for all statistical tests.

Results

Patient Characteristics

The study enrolled a total of 357 (186 males) patients with COVID-19 with a mean age of 35.5  ±   17.6 (range: 1–87) years. Chronic diseases were present in 79.6% (n  =  284) of patients. The majority of the patients had received three doses of vaccine (267/74.8%), followed by those who received two doses (47/13.2%). Among the patients, 90 (25.2%) received virtual visits. Only five patients were transferred back to the hospital. The average duration of the hotel stay was 6.8  ±   1.4 days ([Table 1]).

Table 1 Characteristics of patients admitted to the medicalized quarantine hotel (n  =  357)

Characteristics	Number (%)
Age (y), mean (SD)	35.5 (17.6)
<  1	2 (0.6)
1–20	38 (10.6)
21–40	197 (55.2)
41–59	79 (22.1)
≥60	41 (11.5)
Gender
Male	186 (52.1)
Female	171 (47.9)
Chronic disease
No	284 (79.6)
Yes	73 (20.4)
Vaccine
0	22 (6.2)
1st	17 (4.8)
2nd	47 (13.2)
3rd	267 (74.8)
4th	4 (1.1)
Out of hospital clinic
Yes	90 (25.2)
No	267 (74.8)
Symptoms category
Cough	56 (15.7)
Stuffy/runny nose	44 (12.3)
Sore throat	38 (10.6)
Transfer to hospital rate	5 (1.4)
Length of day, mean (SD)	6.8 (1.4)

Abbreviation: SD, standard deviation.

Brief Symptom Rating Scale and Symptoms

Nine patients could not use their mobile phones to fill in the BSRS score in Google Forms owing to their old age or the severity of the illness. Only 348 of the 357 enrolled patients completed the BSRS questionnaire.

A total of 3,922 responses for BSRS and symptoms were obtained from Google Forms ([Table 2]). The total BSRS score was the highest on the first day of the stay at the MQH (i.e., the first two measurements; [Fig. 3]). Most patients scored 0 to 5 points (3,569/91.0%), followed by those with scores of 6 to 9 (229/5.8%), 10 to 14 (111/2.8%), and ≥15 (13/0.3%). For suicidal thinking, most patients scored 0 points (3,790, 96.6%), followed by scores of 1 (101/2.6%), 2 (30/0.8%), and 3 (1/0.1%). The items with the highest scores were trouble falling asleep (0.65  ±   0.65), feeling tense or high-strung (0.31  ±   0.66), and feeling down or depressed (0.27  ±   0.62). Among the patients with subjective symptom data, the most common symptoms were cough, sore throat, and stuffy/runny nose.

Fig. 3 The trend in Brief Symptom Rating Scale (BSRS) scores.

Table 2 Patients' Brief Symptom Rating Scale score and symptoms obtained using Google Forms (N  =  3,922)

Characteristics	Number (%)	Mean	Standard deviation
BSRS total score
0–5	3,569 (91.0)
6–9	229 (5.8)
10–14	111 (2.8)
≥15	13 (0.3)
Suicidal thinking 0/1/2/3	3,790 (96.6)/101 (2.6)/30 (0.8)/1 (0.1)
BSRS item
Trouble falling asleep		0.65	0.65
Feeling tense or high strung		0.31	0.66
Feeling down, depressed		0.27	0.62
Distressed feeling irritable  or angry		0.26	0.62
Feeling inferior to others		0.14	0.44
Symptoms
Cough	2,118 (39.0)
Sore throat	1,237 (22.8)
Stuffy/runny nose	1,026 (18.9)
Tired	519 (9.5)
Diarrhea	102 (1.9)
Abnormal sense of taste or smell	95 (1.7)
Tachypnea	50 (0.9)
Fever	28 (0.5)
Cough	2,118 (39.0)

Abbreviation: BSRS, Brief Symptom Rating Scale.

Factors Related to the Brief Symptom Rating Scale

Univariate analysis revealed that sex (t  =  3.89, p  <  0.001), age (F  =  3.36, p  <  0.05), and vaccination (F  =  2.60, p  <  0.05) were significantly associated with the BSRS score ([Table 3]). Multiple linear regression analysis showed that women had higher BSRS scores than men ([Table 4]).

Table 3 Association between the demographic characteristics and Brief Symptom Rating Scale score (n  =  348)

Characteristics	n	Mean (SD)	t/F
Age (y)
<  1	0	–	3.36[a]
1–20	38	1.10 (1.95)
21–40	193	1.54 (2.31)
41–59	77	2.08 (2.47)
≥60	40	0.82 (1.64)
Gender
Male	181	1.07 (1.89)	3.89[b]
Female	167	2.01 (2.53)
Chronic disease
No	278	1.53 (2.31)	0.08
Yes	70	1.50 (2.10)
Vaccine
0	20	1.10 (1.59)	2.60[a]
1st	17	0.57 (1.04)
2nd	45	0.97 (1.89)
3rd	261	1.74 (2.41)
4th	5	0.30 (0.57)

Abbreviation: SD, standard deviation.

^a p-Value  <  0.05

^b p-Value  <  0.001

Table 4 Multiple regression analysis to determine the association between the demographic characteristics and Brief Symptom Rating Scale score (n  =  348)

Variables	Unstandardized coefficients	SE	Standardized coefficients	t-Value	p-Value
Age	−0.087	0.170	−0.032	−0.514	0.607
Gender	−0.909	0.241	−0.200	−3.763	0.000[a]
Chronic disease	0.192	0.340	0.034	0.564	0.573
Vaccine	0.277	0.149	0.101	1.862	0.063

Abbreviation: SE, standard error.

^a p-Value  <  0.001

Discussion

This study investigated the process of using mHealth and eHealth to establish a MQH and to gain an understanding of the physical and mental impact of COVID-19 on patients admitted to MQH. The present study findings contribute to improvements in the continuously evolving quarantine system. As the number of COVID-19 cases in Taiwan declined, the number of people in need of isolation also decreased. Hence, the facility was closed by the end of June 2022. During its 2 months of operation, 357 people were admitted for isolation, staying for an average of 6.8 days; only five people required transfer to a hospital.

The COVID-19 pandemic continues to have significant direct and indirect health care consequences, including physical and mental health.[28] [32] In our study, the most common symptom reported was cough (39%), followed by sore throat (22.8%) and stuffy/runny nose (18.9%). The psychological impacts of COVID-19 are more pervasive than the physiological impacts.[33] The BSRS typed into Google Forms was used to assess the patient's psychological symptoms. The three items with the highest average scores in the BSRS were trouble falling asleep, feeling tense or high-strung, and feeling down or depressed. Consistent with the extant literature, infectious disease pandemics affect people's mental health, leading to negative emotions, such as anxiety and depression, and increased stress levels.[29] In this study, patients who had BSRS scores of >6 points or suicidal thoughts scores of >2 points received individual care from nurses via the Line or telephone. In the MQH, nurses responded to the patients' psychological problems on the phone or the Line. It is recommended that nurses can carry out relevant psychological counseling training and establish relevant procedures to identify whether these patients should be referred to a psychologist or whether the psychologist or psychological counselors should be asked to join the team to provide the necessary care.

The study findings revealed that most patients had a BSRS score of 0 to 5, which is within the normal range, and the highest scores were recorded on the first day of the stay. Therefore, during the stay at MQH, the medical staff should pay attention to the identified psychological problems, especially when patients first check into the hotel, and take initiative to provide the necessary care. Furthermore, our study identified key factors associated with the BSRS score, such as age, sex, chronic disease, and vaccination. The study reported positive associations between sex and vaccination with the BSRS score. Multiple linear regression analysis indicated that only sex was significantly associated, consistent with a similar study.[34] Thus, attention should be paid to the psychological symptoms of female patients staying at MQHs.

Telehealth refers to any health care activity performed through telecommunication. Telehealth practice includes consumer and professional education, and encompasses distinct domains of application, including live videoconferencing, the asynchronous transmission of recorded data, remote patient monitoring, and mobile health (i.e., any activity supported by mobile devices such as cell phones, tablet computers, or wearable devices).[22] Telehealth has great potential in providing collaborative and patient-centered care, thus improving the satisfaction of patients and health care providers.[35] The study findings highlight the opportunities with the actionable potential to sustain the use of telehealth and advance provider well-being.[36]

eHealth is connected to medical informatics, public health, and business, referring to the health services and information delivered or enhanced through the internet and related technologies.[24] MQHs have an efficient relationship with each other through eHealth, for example, MMH uses the HIS database and Taiwan CDC uses the NIDRS database. The simplicity of design and the possibility of connection to the HIS database allows administrators and users to access the reports they need with higher confidence and speed and avoid the repeated collection of information.[22]

mHealth provides medical support remotely and addresses patients' health problems without direct contact, provides health care advice, and facilitates long-distance patient and clinician contact, care, advice, reminders, education, and monitoring.[37] Therefore, it was widely used during the epidemic.[38] Line, one of the most popular smartphone-based social media applications in Taiwan that is similar to WeChat, WhatsApp, and Facebook, has also emerged as an effective medium for delivering health education to patients.[39] Line integrates functions, such as graphics, text, audio, and video, which collectively provide a popular and convenient method of interactive information exchange.[34] Patients or their families can use appropriate communication methods through Line according to their own needs. Concurrently, Google Forms were also used by the patients to log their body temperature, discomfort symptoms, and BSRS responses twice a day using their mobile phones. In this study, several patients consulted us regarding their physical and psychological symptoms and informed us that they did not understand the education module on the Line. This facilitated the patients to obtain medical support from doctors through virtual visits.

Our experience, to date, indicates that MQH is safe, acceptable to patients, and addresses a large unmet need. Hospitals with nearby suitable hotels might therefore consider adopting them to meet the surging demand for beds during the COVID-19 pandemic or similar events, in the future. Moreover, rapid increase in the use of mHealth and eHealth coordinated by a key tool enables the long-term care of patients with COVID-19. The deployment of hotels for quarantine purposes offers several advantages. From a security perspective, it is easier to ensure that people do not break the quarantine protocols compared with isolation at home. Additionally, it provides income for facilities that would otherwise be largely vacant owing to border restrictions and lockdowns. However, there were a few limitations concerning the operations of the MQH. First, because of the surge in cases, the number of patients in each cubicle was two or three, which is not ideal. Second, the patients were at varying stages of infection, raising concerns of reinfection, although no data, presently, affirms this occurrence. Finally, hotels are designed predominantly as short-term sleeping quarters, not as self-contained infection-secure living spaces. Dedicated access routes for patients and staff need to be delineated, ensuring the best possible infection prevention. Moreover, cleaning staff needs to be properly trained to sanitize rooms. This study also had some limitations. First, this was a single-center retrospective study with a small sample size. Second, the lack of a control group. Third, the short follow-up period. Fourth, since it was not mandatory for all patients to fill out the BSRS questionnaire, older or more severely ill patients did not fill out the questionnaire, which might have resulted in nonresponse bias.

Conclusion

Our findings provide preliminary guidance to support clinical and logistical decision-making about the adaptation of MQHs and revealed the advantages of a medicalized quarantine center over a nonmedicalized center, including real-time monitoring, timely symptom treatment, and early detection of patients' need for transfer. Successful use of quarantine as a public health measure requires a reduction of the negative effects associated with it. Using mHealth and eHealth to quickly address the patients' needs was critical in managing the COVID-19 pandemic surge, which makes them worthy of clinical application.

Clinical Relevance Statement

The establishment of MQHs as alternate care sites address the need to divert asymptomatic or mildly symptomatic patients during a COVID-19 pandemic surge. The use of mHealth and eHealth as educational and monitoring tools for patients during quarantine ensures timely treatment and psychological support. This information, regarding the use of MQHs in Taiwan, can be useful for future similar containment measures.

Multiple-Choice Questions

1. Which of the following sources of information is used to create the MQHs?

   • Emergency room information system

   • NIDRS and HIS system

   • Community health information system

   • Reports in the CDC system

   Correct Answer: The correct answer is option b. The sources of information for creating MQHs were the NIDRS and HIS systems.

2. Which of the following is the main function of the MQHs?

   • Determine people's travel history in high-risk areas

   • Solving the problem of overcrowding in hospitals during the epidemic

   • Performing virus monitoring and tracking with COVID-19

   • Determining the number of visits and chaperoning

   Correct Answer: The correct answer is option b. The main function of the MQHs is to solve the problem of overcrowding in hospitals during the epidemic.

Conflict of Interest

None declared.

Acknowledgments

The authors wish to thank all experts and patients who participated in this study for sharing their valuable experiences.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed and approved by the Ethics Committee of The MacKay Memorial Hospital (protocol code: 22MMHIS313e, date of approval October 14, 2022).

Authors' Contributions

Conceptualization, S.C.L., H.T.Y., Y.H.L., and S.M.H.; writing—original draft preparation, S.M.H.; writing—review and editing, S.C.L., H.T.Y., Y.H.L., and S.M.H. All authors have critically reviewed, provided intellectual input to the manuscript, and approved the final version of the manuscript.

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Publication History

Received: 17 January 2023

Accepted: 01 May 2023

Article published online:
26 July 2023