Emergency Medicine
Volume 42, Issue 4A
I work in an emergency department in Wichita, KS. That may not matter, but it's important to have context. We have one confirmed case of COVID-19 (from a cruise ship) as I'm writing this on March 19. But we are testing hardly anyone—yet. Patients and friends ask several times a day, “Don't you think this whole thing is overblown?”.
Clinical aspects, diagnosis, treatment
Emergency Medicine News
Volume 42 - Issue 4A
Many of these suggestions are not new, but we need new vigilance in the wake of COVID-19.
1. Wash your hands with every entry into and exit from a room.
Wash your hands for 20 seconds. Think of something to say, sing, or pray that takes 20 seconds, or do three rounds of slow, deep meditative breathing. Water with soap may be better, especially if there is a sanitizer shortage. The virus has a lipid layer, so soap or alcohol that is 60% or higher breaks it down.
Epidemiology
Emergency Medicine
Volume 42, Issue 4A
President Trump voiced enthusiasm in a March 19 press conference for using the drug chloroquine against the coronavirus, saying, “It's been around a long time, so if things don't go well, we know it won't kill anyone.”
Clinical aspects, diagnosis, treatment
International Journal of Antimicrobial Agents
Coronavirus disease 2019 (COVID-19) originated in the city of Wuhan, Hubei Province, Central China, and has spread quickly to 72 countries to date. COVID-19 is caused by a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [previously provisionally known as 2019 novel coronavirus (2019-nCoV)]. At present, the newly identified SARS-CoV-2 has caused a large number of deaths with tens of thousands of confirmed cases worldwide, posing a serious threat to public health. However, there are no clinically approved vaccines or specific therapeutic drugs available for COVID-19. Intensive research on the newly emerged SARS-CoV-2 is urgently needed to elucidate the pathogenic mechanisms and epidemiological characteristics and to identify potential drug targets, which will contribute to the development of effective prevention and treatment strategies. Hence, this review will focus on recent progress regarding the structure of SARS-CoV-2 and the characteristics of COVID-19, such as the aetiology, pathogenesis and epidemiological characteristics.
COVID-19, SARS-CoV-2, 2019-nCoV, Coronavirus, Pneumonia
BMJ
Volume 368, 2020, m1282-m1282
Healthcare staff in the West Midlands have been told not to start chest compressions or ventilation in patients who are in cardiac arrest if they have suspected or diagnosed covid-19 unless they are in the emergency department and staff are wearing full personal protective equipment (PPE).
The guidance from the University Hospitals Birmingham NHS Foundation Trust says that patients in cardiac arrest outside the emergency department can be given defibrillator treatment if they have a “shockable” rhythm. But if this fails to restart the heart “further resuscitation is futile,” it says.
COVID-19, SARS-CoV-2, Treatment
New Scientist
Volume 245, Issue 3275, March 2020, Page 56
Victorian corpse displays sparked John Troyer's interest in how humans use technology around dead bodies. He explores our fascination with death and its impact on life.
Epidemiology
New Scientist
Volume 245, Issue 3275, March 2020, Page 7
Around a fifth of the global population is in lockdown as COVID-19 cases continue to rise, reports Jessica Hamzelou.
HE covid-19 pandemic is speeding up, the World Health Organization's director general has warned. As New Scientist went to press, 382,000 cases of the disease had been confirmed, although the actual number is likely to be much higher. More than 16,500 people have died.
Epidemiology
New Scientist
Volume 245, Issue 3275, 28 March 2020, Pages 10-11
It is easy to spread the virus without realising you are ill, reports Graham Lawton
WITH more than 380,000 confirmed cases worldwide, one thing is clear about the new coronavirus: it is very good at infecting people. Now studies are starting to reveal just how infectious it is – and when a person with covid-19 is most likely to spread the virus.
Epidemiology
New Scientist
Volume 245, Issue 3275, March 2020, Pages 44-48
There has never been a more important time to keep your immune system fit and healthy. And as Graham Lawton discovers, there are now ways to keep it younger than you are.
WASH your hands religiously for 20 seconds, sneeze into your elbow, avoid touching your face, stay 1 meter away from all other people and, as a last resort, self-quarantine for a week with only your emergency rations for company. If you want to avoid getting the new coronavirus, all of these are a good idea. But ultimately, one of the most important things standing between you and a deadly bout of COVID-19 is your immune system.
Epidemiology
New Scientist
Volume 245, Issue 3275, March 2020, Page 9
The UK government has released the scientific advice it has received on covid-19, and independent experts aren't impressed, reports Jessica Hamzelou
Epidemiology
New Scientist
Volume 245, Issue 3275, 28 March 2020, Pages 10-11
SAY you have caught COVID-19 and recovered – are you now immune for life, or could you catch it again? We just don't know yet.
In February, reports emerged of a woman in Japan who had been given the all-clear after having COVID-19 but then tested positive for the SARS-CoV-2 virus a second time. There have also been reports of a man in Japan testing positive after being given the all-clear, and anecdotal cases of second positives have emerged from China, too.
Epidemiology
International Journal of Antimicrobial Agents
In December 2019, the outbreak of the 2019 novel coronavirus disease (COVID-19) in China spread worldwide, becoming an emergency of major international concern. SARS-CoV-2 infection causes clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus. Human-to-human transmission has been described with incubation times between 2-14 days, facilitating its spread via droplets, contaminated hands or surfaces. Early diagnosis, quarantine, and supportive treatments are essential to cure patients. We therefore reviewed the literature on all available information about the epidemiology, diagnosis, isolation and treatments of COVID-19. Treatments, including antiviral agents, chloroquine and hydroxychloroquine, corticosteroids, antibodies, convalescent plasma transfusion and vaccines, will be discussed in this article. Additionally, registered trials about treatment were listed to develop approaches for the current urgent demand for therapy.
COVID-19, Pandemic, Diagnosis, Isolation, Remdesivir, Clinical trials
The Veterinary Record
Volume 186, Issue 12, Pages 370-370
Vet practices are putting aside human-compatible ventilators, oxygen supplies and personal protective equipment such as surgical masks, as well as anaesthetic machines and monitors, for use in saving human lives. The scheme has been promoted by the RCVS, the BVA and several other veterinary associations and businesses.
Epidemiology
New Scientist
Volume 245, Issue 3275, 28 March 2020, Pages 20-21
The way society functions in the US has made it more vulnerable to pandemics. Could things be different, asks Chelsea Whyte.
The coronavirus outbreak is a once-in-a-century event – and it seems the US has spent the past 100 years unwittingly weakening its defences.
In fact, the US is probably the developed economy with the worst type of healthcare system to tackle COVID-19. Many economic and healthcare policies it has enacted don't prioritise public health, and it is finding out first-hand how dangerous that can be.
The impact of this has been seen in the past month or so in the lack of testing – as of 23 March, the US has done 238,632 tests compared with 338,036 in South Korea, a far smaller country.
Epidemiology
BMJ (Clinical research ed.)
Volume 368, March 2020, m1263-m1263
Nearly 700 000 people signed up in the first 24 hours of the launch of an app to help track the spread of coronavirus across the UK in real time and collect information on the range of self-reported symptoms and the characteristics of those most at risk.
The Covid Symptom Tracker app (covid.joinzoe.com) enables users to make a daily report of any symptoms. It is available free of charge to members of the public in the UK. The app has also been given to 5000 twins and their families recruited from the ongoing TwinsUK cohort study.
Clinical aspects, diagnosis, treatment; Epidemiology
The Veterinary record
Volume 186, Issue 12, Pages 365-365
Not all veterinary businesses are suffering a downturn in demand – or their fortunes – during the Covid-19 pandemic.
Quite the reverse for those offering the public access to telemedicine or remote first-line advice services – they appear to be positively thriving and competing for customers.
Last week, FirstVet, which provides on-demand video consultations with local, qualified vets throughout the UK, reported it has seen a 20 per cent week-on-week increase in pet owners using its video vet service between February and March due to self isolation and mandatory quarantine.
Meanwhile, Joii, a pet care app that offers video consultations with vets, said it had experienced ‘a substantial increase’ in users, with almost 30,000 people downloading or using the app in the past two months. The app has been trending at number 1 within the medical category in both Google Play and the Apple store…
Clinical aspects, diagnosis, treatment; Epidemiology
BMJ (Clinical research ed.)
Volume 368, March 2020, m1268-m1268
Final year medical students are to be offered early provisional registration and foundation year 1 (FY1) doctors early full registration with the General Medical Council to help staffing levels during the covid-19 pandemic, a joint statement from regulatory and training bodies released on 25 March says.
The statement from the UK health departments, the GMC, Health Education England, NHS Education for Scotland, Health Education and Improvement Wales, the Northern Ireland Medical and Dental Training Agency, and the Medical Schools Council states that final year medical students who have been deemed by their medical school to have met the GMC’s outcomes for graduates can graduate early.
COVID-19, SARS-CoV-2, Treatment
BMJ (Clinical Research ed.)
Volume 368, 2020, m1278-m1278
The US has become the country with the most confirmed cases of covid-19 with 86 762 diagnoses on the morning of 27 March—more than China or Italy—and 1306 deaths. The rise in cases is steeper in the US than in any other large country. Almost half of US cases are in the state of New York while neighbouring New Jersey has the second-most cases. Texas and some other states now require people coming from New York to self-quarantine. But there are multiple cases in every US state and every sizeable city, with prominent clusters in New Orleans, Detroit, Chicago, Miami, Atlanta, and the Denver region.
Epidemiology
BMJ
Volume 368, 2020, m1261-m1261
Singlehanded GPs are worried about what will happen to their practice patients if they themselves become ill with the covid-19 virus and have to self-isolate, it has emerged.
The situation has been highlighted by a case of a husband and wife GP, both older than 70, who each have their own singlehanded practices in Nottingham.
Doctors Noble Vinayakumar Phillips and Naomi Phillips have sought, unsuccessfully so far, to secure assurances over what will happen to their patients if they both have to self-isolate.
Officials say practices should have been informed about how they can support each other, make better use of technology, and have access to “buddying” arrangements for practices with major staff absences.
COVID-19, SARS-CoV-2, Treatment
BMJ
Volume 368, 2020, m1185-m1185
Extra risk is plausible on current balance of evidence Emerging evidence suggests that the most serious complications of covid-19 are sepsis and cardiovascular or respiratory complications. They occur predominantly in elderly people and those with underlying health conditions. Does use of non-steroidal anti-inflammatory drugs (NSAIDs) increase these risks? We don’t know for certain, but additional risks are plausible on the current balance of evidence.
Clinical aspects, diagnosis, treatment