Biggest carbon dioxide drop: Real-time data show COVID-19's massive impact on global emissions

Potsdam Institute for Climate Impact Research (PIK)

While the ongoing coronavirus pandemic continues to threaten millions of lives around the world, the first half of 2020 saw an unprecedented decline in carbon dioxide emissions -- larger than during the financial crisis of 2008, the oil crisis of the 1979, or even World War II.

While the ongoing coronavirus pandemic continues to threaten millions of lives around the world, the first half of 2020 saw an unprecedented decline in CO2 emissions -- larger than during the financial crisis of 2008, the oil crisis of the 1979, or even World War II. An international team of researchers has found that in the first six months of this year, 8.8 percent less carbon dioxide was emitted than in the same period in 2019 -- a total decrease of 1551 million tonnes. The groundbreaking study not only offers a much more precise look at COVID-19's impact on global energy consumption than previous analyses. It also suggests what fundamental steps could be taken to stabilize the global climate in the aftermath of the pandemic.

"What makes our study unique is the analysis of meticulously collected near-real-time data," explains lead author Zhu Liu from the Department of Earth System Science at Tsinghua University in Beijing. "By looking at the daily figures compiled by the Carbon Monitor research initiative we were able to get a much faster and more accurate overview, including timelines that show how emissions decreases have corresponded to lockdown measures in each country. In April, at the height of the first wave of Corona infections, when most major countries shut down their public life and parts of their economy, emissions even declined by 16.9 %. Overall, the various outbreaks resulted in emission drops that we normally see only on a short-term basis on holidays such as Christmas or the Chinese Spring Festival."

The study, published in the latest issue of Nature Communications, shows which parts of the global economy were most impacted. "The greatest reduction of emissions was observed in the ground transportation sector," explains Daniel Kammen, professor and Chair of the Energy and Resources Group and also professor in the Goldman School of Public Policy, University of California, Berkeley. "Largely because of working from home restrictions, transport CO2 emissions decreased by 40 % worldwide. In contrast, the power and industry sectors contributed less to the decline, with -22 % and -17 %, respectively, as did the aviation and shipping sectors. Surprisingly, even the residential sector saw a small emissions drop of 3 %: largely because of an abnormally warm winter in the northern hemisphere, heating energy consumption decreased with most people staying at home all day during lockdown periods."

To paint this comprehensive and multidimensional picture, the researchers based their estimates on a wide array of data: precise, hourly datasets of electricity power production in 31 countries, daily vehicle traffic in more than 400 cities worldwide, daily global passenger flights, monthly production data for industry in 62 countries as well as fuel consumption data for building emissions in more than 200 countries.

The researchers also found strong rebound effects. With the exception of a continuing decrease of emissions stemming from the transportation sector, by July 2020, as soon as lockdown measures were lifted, most economies resumed their usual levels of emitting CO2. But even if they remained at their historically low levels, this would have a rather minuscule effect on the long-term CO2 concentration in the atmosphere.

Thus, the authors stress that the only valid strategy to stabilize the climate is a complete overhaul of the industry and commerce sector. "While the CO2 drop is unprecedented, decreases of human activities cannot be the answer," says Co-Author Hans Joachim Schellnhuber, founding director of the Potsdam Institute for Climate Impact Research. "Instead we need structural and transformational changes in our energy production and consumption systems. Individual behavior is certainly important, but what we really need to focus on is reducing the carbon intensity of our global economy."

'Hunker down': The fall Covid-19 surge is here

Christina Maxouris and Holly Yan

As predicted, the US is now grappling with a new Covid-19 surge -- one that could overwhelm hospitals, kill thousands of Americans a day by January and leave even young survivors with long-term complications.

"We went down to the lowest point lately in early September, around 30,000-35,000 new cases a day. Now we're back up to (about) 50,000 new cases a day. And it's going to continue to rise," Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, said Tuesday.

"This is the fall/winter surge that everyone was worried about. And now it's happening. And it's happening especially in the northern Midwest, and the Northern states are getting hit very hard -- Wisconsin, Montana, the Dakotas. But it's going to be nationally soon enough."

Across the country, more than 30 states have reported more Covid-19 cases this past week than they reported the previous week, according to data from Johns Hopkins University.

And Dr. Anthony Fauci, the nation's top infectious disease expert, sounded an alarm about certain states' test-positivity rates, saying they may be a good indicator that steeper climbs in case rates are ahead.

For the whole country, test positivity averaged 5.1% over the past week as of Tuesday. But in at least 13 states, the figure was above 10%: in Alabama, Florida, Iowa, Idaho, Indiana, Kansas, Montana, Nebraska, Nevada, South Dakota, Utah, Wisconsin and Wyoming, according to the COVID Tracking Project.

"You'd like to see (the rates) less than 3%, optimally 1% or less," Fauci, director of the National Institute of Allergy and Infectious Diseases, said at an event hosted by the College of American Pathologists.

"We're starting to see a number of states well above that, which is often -- in fact, invariably -- highly predictive of a resurgence of cases, which historically we know leads to an increase in hospitalizations and then ultimately an increase in deaths," he said.

In Denver, recent case counts are as "high right now as they were at the height of the pandemic back in May," Mayor Michael Hancock said Monday.

He said hospitalizations have also soared, and residents could face tighter Covid-19 restrictions if the numbers keep going up.

Kansas has broken its record for the highest average number of daily cases with more than 700 cases per day this past week, Gov. Laura Kelly said.

More than 1,000 new cases were reported Tuesday in Colorado. "It's very worrisome. It's very alarming. This is our highest single-day caseload since March," Gov. Jared Polis said.

In Wisconsin, a field hospital is opening this week to handle a rapid rise in coronavirus patients. The state recently reported record-high numbers of Covid-19 cases, hospitalizations and daily deaths.

If Americans don't turn the tide, the US could be in for a devastating winter. The University of Washington's Institute for Health Metrics and Evaluation projects more than 135,000 people in the US could die within the next three months.

"This winter -- this November, December, January, February -- could be the worst time in our epidemic," Hotez said. "Get ready to hunker down."

How overwhelmed hospitals can affect all patients

As we've seen throughout this pandemic, surges in new Covid-19 cases may lead to increased hospitalizations and deaths in the following weeks.

At least 10 states have reported record-high Covid-19 hospitalizations since Friday, according to data from the COVID Tracking Project. Five of them -- Arkansas, Montana, North Dakota, Oklahoma and Wisconsin -- reported records on Monday.

"Hospitals could again become overwhelmed," emergency medicine physician Dr. Leana Wen said. "And then we're not just talking about patients with coronavirus who might be in trouble. It's also about other patients who might be coming in for heart attacks and strokes and car accidents who may find a situation that's really untenable."

Kentucky Gov. Andy Beshear expressed concern about a rising number of hospitalizations. The commonwealth reported 741 Kentuckians are currently hospitalized for coronavirus, with 170 in the intensive care unit and 90 on a ventilator, he said.

Utah Gov. Gary Herbert said the state has seen infection rates and case counts skyrocket over the past month to the highest they've been, with new cases hovering around 1,000 per day since October 4.

"We are utilizing 15.8% of our ICU beds to treat COVID-19 patients, more than double what we were before, and our total ICU utilization is at 69.6%," Herbert tweeted. "This leaves our hospitals precariously close to being unable to treat COVID and non-COVID patients in need of critical care."

Some health care workers in the US still don't have adequate personal protective equipment and testing supplies, emergency medicine physician Dr. Megan Ranney said.

"We're quite fearful for what we are heading into," she said.

Nationwide, hospitalizations have been ticking up -- 35,072 were reported Monday, and the daily count has climbed relatively steadily since a recent low of about 28,600 on September 20.

A vaccine trial is paused, but that's 'completely expected'

As Americans wait for a safe and effective vaccine, Johnson & Johnson has paused the advanced clinical trial of its experimental vaccine because of an unexplained illness in one of the volunteers, the company announced.

The drugmaker said Tuesday that it didn't know immediately know whether the ill volunteer had received the vaccine candidate or a placebo, and that it had little information about the illness itself.

Johnson & Johnson said that it learned of the illness Sunday and immediately informed the study's independent Data Safety Monitoring Board (DSMB), which is reviewing the illness.

"It's not at all unusual for unexpected illnesses to occur in large studies over their duration," and sometimes they have nothing to do with the drug candidate, Mathai Mammen, global head of research at Johnson & Johnson's pharmaceutical division, Janssen, said Tuesday in the company's third-quarter earnings call.

As of Tuesday morning, the study was still blinded, meaning neither those directly administering the drugs or placebos nor the volunteers know which volunteers are receiving which elements of the study, Mammen said. The DSMB can "unblind" the study to investigate the illness if necessary, he said.

This kind of pause isn't immediately concerning, said Dr. Ashish Jha, dean of the Brown University School of Public Health.

"This is completely expected, and it's just a reminder how ridiculous it is to try and meet a political timeline of having a vaccine before November 3," Jha said, referring to President Donald Trump's wishes to have a vaccine ready for the public by Election Day.

"The Johnson & Johnson trial is the biggest trial of the vaccine that I know of -- 60,000 people," Jha said. "Within that trial, you'd expect a few pauses."

This is the second Phase 3 Covid-19 vaccine trial to hit the pause button in the US. AstraZeneca's vaccine trial was paused last month because of a neurological complication in a volunteer. While that trial has resumed in other parts of the world, it remains paused in the US while health officials investigate.

Fauci said Tuesday that current efforts toward vaccine development are "on a really good track" despite the Johnson & Johnson news.

"A couple of the vaccines are very close to getting some sort of information," Fauci said during a call with the nation's governors, according to audio of the call obtained by CNN.

Fauci mentioned vaccines being tested by Moderna and Pfizer. "We're getting to the point where we're almost being able to look at the first look at the data, which is a predetermined thing done by the data and safety monitoring board," he said.

The vaccine effort, more broadly, "is on really a good track," he said. "We should know by November or December whether or not we have a safe and effective vaccine. ... It is conceivable that we might even know before then."

When a vaccine does become available, health experts have said it's crucial that enough people become immunized for the preventative to be effective -- and many are worried that won't be the case.

"I'm extremely worried about how politicized this situation is around the vaccine and how people are reacting to it," Moncef Slaoui, the scientific head of the US government's initiative to develop a vaccine as soon as possible, said Tuesday.

"We will be fully transparent: People will understand exactly the performance of the vaccines, their safety and their benefit," Slaoui said in an interview on Fox News.

"And I hope people will realize that the only way really to allow us to move away and control this pandemic will be through mass vaccination," he said.

Coronavirus Reinfections Are Real but Very, Very Rare

 Apoorva Mandavilli

A case in Nevada has spurred new concerns that people who have recovered from the infection may still be vulnerable. That’s unlikely, experts say.

Reports of reinfection with the coronavirus evoke a nightmarish future: Repeat bouts of illness, impotent vaccines, unrelenting lockdowns — a pandemic without an end.

A case study published on Monday, about a 25-year-old man in Nevada, has stoked those fears anew. The man, who was not named, became sicker the second time that he was infected with the virus, a pattern the immune system is supposed to prevent.

People waited to be tested for coronavirus at Elmhurst Hospital Center in New York in March.Credit...John Minchillo/Associated Press

But these cases make the news precisely because they are rare, experts said: More than 38 million people worldwide have been infected with the coronavirus, and as of Monday, fewer than five of those cases have been confirmed by scientists to be reinfections.

“That’s tiny — it’s like a microliter-sized drop in the bucket, compared to the number of cases that have happened all over the world,” said Angela Rasmussen, a virologist at Columbia University in New York.

In most cases, a second bout with the virus produced milder symptoms or none at all. But for at least three people, including one patient in Ecuador, the illness was more severe the second time around than during the first infection. An 89-year-old woman in the Netherlands died during her second illness.

Rare as these cases may be, they do indicate that reinfection is possible, said Akiko Iwasaki, an immunologist at Yale University, who wrote a commentary accompanying the Nevada case study, published in The Lancet Infectious Diseases.

“It’s important to note that there are people who do get reinfected, and in some of those cases you get worse disease,” Dr. Iwasaki said. “You still need to keep wearing masks and practice social distancing even if you have recovered once from this infection.”

We asked experts what is known about reinfections with the coronavirus, and what the phenomenon means for vaccinations and the course of the pandemic.

Reinfection with the coronavirus is an unusual event.

First, the good news: Reinfection seems to be vanishingly rare.

Since the first confirmed case of reinfection, reported in Hong Kong on Aug. 24, there have been three published cases; reports of another 20 await scientific review.

But it’s impossible to know exactly how widespread the phenomenon is. To confirm a case of reinfection, scientists must look for significant differences in the genes of the two coronaviruses causing both illnesses.

In the United States, where testing was a rare resource much of this year, many people were not tested unless they were sick enough to be hospitalized. Even then, their samples were usually not preserved for genetic analysis, making it impossible to confirm suspected reinfections.

A vast majority of people who do get reinfected may go undetected. For example, the man in Hong Kong had no symptoms the second time, and his infection was discovered only because of routine screening at the airport.

“There are a lot of people that are going to also have been exposed that aren’t having symptoms, that we’re never going to hear about,” said Marion Pepper, an immunologist at the University of Washington in Seattle.

People whose second infections are more severe are more likely to be identified, because they return to the hospital. But those are likely to be even rarer, experts said.

“If this was a very common event, we would have seen thousands of cases,” Dr. Iwasaki said.

In most people, the immune system works as expected.

Reinfections can occur for any number of reasons: because the initial infection was too mild to produce an immune response, for example, or because the immune system was compromised by other health conditions. On occasion, a patient may be exposed to a large amount of virus that seeded an infection before the immune response could respond.

This variability is entirely expected, experts said, and has been observed in patients with diseases like measles and malaria.

A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19

Journal of Critical Care

Andrea Cortegiani, Giulia Ingoglia, Mariachiara Ippolito, Antonino Giarratano, Sharon Eina

Abstract

PurposeCOVID-19 (coronavirus disease 2019) is a public health emergency of international concern. As of this time, there is no known effective pharmaceutical treatment, although it is much needed for patient contracting the severe form of the disease. The aim of this systematic review was to summarize the evidence regarding chloroquine for the treatment of COVID-19.

Methods

PubMed, EMBASE, and three trial Registries were searched for studies on the use of chloroquine in patients with COVID-19.

Results

We included six articles (one narrative letter, one in-vitro study, one editorial, expert consensus paper, two national guideline documents) and 23 ongoing clinical trials in China. Chloroquine seems to be effective in limiting the replication of SARS-CoV-2 (virus causing COVID-19) in vitro.

Conclusions

There is rationale, pre-clinical evidence of effectiveness and evidence of safety from long-time clinical use for other indications to justify clinical research on chloroquine in patients with COVID-19. However, clinical use should either adhere to the Monitored Emergency Use of Unregistered Interventions (MEURI) framework or be ethically approved as a trial as stated by the World Health Organization. Safety data and data from high-quality clinical trials are urgently needed.

Keywords: SARS-CoV-2COVID-19ChloroquinePneumoniaCoronavirus

Breaking News ‘Don't You Think This Whole COVID-19 Thing is Overblown?’

Emergency Medicine
Volume 42, Issue 4A

Mosley, Mark

Introduction

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?”.

Keywords

Clinical aspects, diagnosis, treatment

Breaking News: 16 Common-Sense Tips and Facts for Dealing with COVID-19

Emergency Medicine News
Volume 42 - Issue 4A 

Mosley, Mark

Introduction

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.

Keywords

Epidemiology

Artificial Intelligence and Machine Learning to Fight COVID-19

Physiological Genomics
Volume 52, Issue 4, April 2020, Pages 200-202

Alimadadi, Ahmad; Aryal, Sachin; Manandhar, Ishan; Munroe, Patricia B.; Joe, Bina; Cheng, Xi

Introduction

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (13), has become an unprecedented public health crisis. Coronavirus Resource Center at Johns Hopkins University of Medicine has reported a total of 23,638 deaths as worldwide COVID-19 infections surpass 500,000 (as of 5 PM EST on March 26, 2020). On March 16, 2020, the White House, collaborating with research institutes and tech companies, issued a call to action for global artificial intelligence (AI) researchers for developing novel text and data-mining techniques to assist COVID-19-related research.

Keywords

Artificial Intelligence, COVID-19, Machine Learning, SARS-CoV-2

Elevated Plasmin (Ogen) As A Common Risk Factor For COVID-19 Susceptibility

Physiological reviews
Volume 100, Issue 3, July 2020, Pages 1065-1075

Ji, Hong-Long; Zhao, Runzhen; Matalon, Sadis; Matthay, Michael A.

Introduction

Patients with hypertension, diabetes, coronary heart disease, cerebrovascular illness, COPD, and kidney dysfunction have worse clinical outcomes when infected with SARS-CoV-2, for unknown reasons. The purpose of this review is to summarize the evidence for the existence of elevated plasmin(ogen) in COVID-19 patients with these comorbid conditions. Plasmin, and other proteases, may cleave a newly inserted furin site in the S protein of SARS-CoV-2, extracellularly, which increases its infectivity and virulence. Hyper-fibrinolysis associated with plasmin leads to elevated D-dimer in severe patients. The plasmin(ogen) system may prove a promising therapeutic target for combating COVID-19.

Keywords

Comorbidity, COVID-19, fibrinolysis, plasmin(ogen), SARS-CoV-2

Protecting high-risk cardiac patients during the Covid-19 outbreak

Journal of Cardiothoracic and Vascular Anesthesia

Pisano, Antonio; Landoni, Giovanni; Zangrillo, Alberto

Abstract

In the effort to face the ongoing Coronavirus Disease 2019 (COVID-19) epidemic, which caused severe pneumonia requiring intensive care unit (ICU) admission in up to 15% of confirmed cases so far, many hospitals in Italy are setting up new ICUs, stopping nonurgent admissions, limiting the access to emergency rooms and wards, and providing separate pathways for suspected COVID-19 and other diseases. In parallel, it is mandatory to continue ensuring the provision of non-postponable treatments (eg, primary percutaneous coronary interventions or urgent/emergency cardiac surgical procedures).

Keywords

Clinical aspects, diagnosis, treatment

Assessment of health information about the prevention of COVID-19 on the Internet

JMIR Public Health and Surveillance

Hernández-García, Ignacio; Giménez-Júlvez, Teresa

Abstract

Background: The internet is a large source of health information and has the capacity to influence its users. However, the information found on the internet often lacks scientific rigor, as anyone may upload content. This factor is a cause of great concern to scientific societies, governments, and users.

Objective: The objective of our study was to investigate the information about the prevention of coronavirus disease 2019 (COVID-19) on the internet.

Methods: On February 29, 2020, we performed a Google search with the terms "Prevention coronavirus," "Prevention COVID-19," "Prevención coronavirus," and "Prevención COVID-19". A univariate analysis was performed to study the association between the type of authorship, country of publication, and recommendations to avoid COVID-19 according to the World Health Organization (WHO).

Results: In total, 80 weblinks were reviewed. Most of them were produced in the United States and Spain (n=58, 73%) by digital media sources and official public health organizations (n=60, 75%). The most mentioned WHO preventive measure was "wash your hands frequently" (n=65, 81%). A less frequent recommendation was to "stay home if you feel unwell" (n=26, 33%). The analysis by type of author (official public health organizations versus digital media) revealed significant differences regarding the recommendation to wear a mask when you are healthy only if caring for a person with suspected COVID-19 (odds ratio [OR] 4.39). According to the country of publication (Spain versus the United States), significant differences were detected regarding some recommendations such as "wash your hands frequently" (OR 9.82), "cover your mouth and nose with your bent elbow or tissue when you cough or sneeze" (OR 4.59), or "stay home if you feel unwell" (OR 0.31).

Conclusions: It is necessary to urge and promote the use of the websites of official public health organizations when seeking information on COVID-19 preventive measures on the internet. In this way, users will be able to obtain high-quality information more frequently, and such websites may improve their accessibility and positioning, given that search engines justify the positioning of links obtained in a search based on the frequency of access to them.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

Initial Experience of an Emergency Department in Shenzhen in Responding to the Emerging Wuhan Coronavirus Pneumonia

Annals of Emergency Medicine
Volume 75, Issue 4, April 2020, Page 556.

Lu, K. L.; Chen, S.; Leung, L. P.

Since the emergence of a cluster of patients with pneumonia caused by a novel coronavirus (COVID-19) in Wuhan, Hubei, China, in December 2019, emergency departments (EDs) in China have instituted special measures to manage patients with potential exposure to the virus. We describe our initial experience in managing the current outbreak caused by COVID-19…

Keywords

Epidemiology

The Cardiovascular Burden Of Coronavirus Disease 2019 (COVID-19) With A Focus On Congenital Heart Disease

International Journal of Cardiology

Tan, Weiyi; Aboulhosn, Jamil

Introduction

Coronavirus disease 2019 (COVID-19), caused by a novel betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first described in a cluster of patients presenting with pneumonia symptoms in Wuhan, China, in December of 2019. Over the past few months, COVID-19 has developed into a worldwide pandemic, with over 400,000 documented cases globally as of March 24, 2020. The SARS-CoV-2 virus is most likely of zoonotic origin, but has been shown to have effective human-to-human transmission. COVID-19 results in mild symptoms in the majority of infected patients, but can cause severe lung injury, cardiac injury, and death. Given the novel nature of COVID-19, no established treatment beyond supportive care exists currently, but extensive public-health measures to reduce person-to-person transmission of COVID-19 have been implemented globally to curb the spread of disease, reduce the burden on healthcare systems, and protect vulnerable populations, including the elderly and those with underlying medical comorbidities. Since this is an emerging infectious disease, there is, as of yet, limited data on the effects of this infection on patients with cardiovascular disease, particularly so for those with congenital heart disease. We summarize herewith the early experience with COVID-19 and consider the potential applicability to and implications for patients with cardiovascular disease in general and congenital heart disease in particular.

Keywords

Clinical aspects, diagnosis, treatment

Breaking News: Brace for Chloroquine Poisonings Because of the Coronavirus Pandemic

Emergency Medicine
Volume 42, Issue 4A

Gussow, Leon

Introduction

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.”

Keywords

Clinical aspects, diagnosis, treatment

Response to the COVID-19 Epidemic: The Chinese Experience and Implications for Other Countries

International Journal of Environmental Research and Public Health 2020,
Volume 17, Issue 7, Page 2304

Liu, Wei; Yue, Xiao-Guang; Tchounwou, Paul B.

Abstract

The ongoing outbreak of the novel coronavirus disease (COVID-19) that occurred in China is rapidly spreading globally. China’s bond and strict containment measures have been proved (in practice) to significantly reduce the spread of the epidemic. This was obtained through the use of emergency control measures in the epidemic areas and the integration of resources from multiple systems, including business, community, technology, education, and transportation, across the country. In order to better understand how China has managed to reduce the public health and economic impacts of the COVID-19 epidemic, this editorial systematically reviews the specific measures for infection prevention and control of the disease. The best practices for COVID-19 eradication in China provide evidence-based strategies that could be replicated in other countries.

Keywords

COVID-19; epidemic, China, emergency control measures, public health

Science Education in the Era of a Pandemic

Science & Education

Erduran, Sibel.

In late February 2019, when the Covid-19 crisis began to spread across South Korea, my doctoral student Wonyong Park was there for his data collection in secondary schools. Unphased by the growing national epidemic at the time, he remarked: “As a Cambridge student, Newton once had to return home due to the plague outbreak in England, during which he made his greatest discoveries! However, as the situation develops, I promise I’ll keep healthy and make this time most useful for me.” Now, about a month later, the entire planet finds itself in the midst of a pandemic

Keywords

Epidemiology

Unprecedented Solutions for Extraordinary Times: Helping Long-Term Care Settings Deal with the COVID-19 Pandemic

Infection Control & Hospital Epidemiology

Gaur, Swati; Dumyati, Ghinwa; Nace, David A.; Jump, Robin L. P.

Our healthcare system faces an unprecedented strain as it struggles with the coronavirus disease 2019 (COVID-19) pandemic. With cases now reported in 53 states and territories, community spread is either already occurring or imminent in most localities. Most healthcare systems are experiencing limited access to diagnostic tests accompanied by delays in test results of more than 24 hours.1 Trials to assess potential treatments are underway, with mounting difficulty in acquiring agents as the demand for them increases.

Keywords

Clinical aspects, diagnosis, treatment

Roadblocks to Infection Prevention Efforts in Healthcare SARS-CoV-2/COVID-19 Response

Disaster Medicine and Public Health Preparedness

Popescu, Saskia

Abstract

The outbreak of a novel coronavirus, COVID-19, is challenging international public health and healthcare efforts. As hospitals work to acquire enough personal protective equipment and brace for potential cases, the role of infection prevention efforts and programs has become increasingly important. Lessons from the 2003 SARS-CoV outbreak in Toronto and 2015 MERS-CoV outbreak in South Korea have unveiled the critical role that hospitals play in outbreaks, especially of novel coronaviruses. Their ability to amplify the spread of disease can rapidly fuel transmission of the disease and often those failures in infection prevention and general hospital practices contribute to such events. While efforts to enhance infection prevention measures and hospital readiness are underway in the United States, it is important to understand why these programs were not able to maintain continued, sustainable levels of readiness. History has shown that infection prevention programs are primarily responsible for preparing hospitals and responding to biological events but face under-staffing and focused efforts defined by administrators. The current U.S. healthcare system though, is built upon a series of priorities that often view biopreparedness as a costly endeavor. Awareness of these competing priorities and the challenges infection prevention programs face when working to maintain biopreparedness is critical in adequately addressing this critical infrastructure in the face of an international outbreak.

Keywords

Epidemiology

Gains From The Novel Corona Virus

J Korean Med Sci
Volume 35, Issue 12, e136

Chung, Min Suk

Introduction

Novel corona virus (SARS -CoV-2) has provided us with not only losses but also gains in Korea.

Cartoon Editorial

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

A Randomized Trial Of Instructor-Led Training Versus Video Lesson In Training Health Care Providers In Proper Donning And Doffing Of Personal Protective Equipment

Disaster Medicine and Public Health Preparedness

Christensen, Liva; Rasmussen, Charlotte Schang; Benfield, Thomas; Franc, Jeffrey Michael

Abstract

Objective: This study compared live instructor-led training with video-based instruction in personal protective equipment (PPE) donning and doffing. It assessed the difference in performance between (1) attending 1 instructor-led training session in donning and doffing PPE at 1 month prior to assessment, and (2) watching training videos for 1 month.

Methods: This randomized controlled trial pilot study divided 21 medical students and junior doctors into 2 groups. Control group participants attended 1 instructor-led training session. Video group participants watched training videos demonstrating the same procedures, which they could freely watch again at home. After 1 month, a doctor performed a blind evaluation of performance using checklists.

Results: Nineteen participants were assessed after 1 month. The mean donning score was 84.8/100 for the instructor-led group and 88/100 for the video group; mean effect size was 3.2 (95% CI: -7.5 to 9.5). The mean doffing score was 79.1/100 for the instructor-led group and 73.9/100 for the video group; mean effect size was 5.2 (95% CI: -7.6 to 18).

Conclusion: Our study found no significant difference in donning and doffing scores between instructor-led and video lessons. Video training could be a fast and resource-efficient method of training in PPE donning and doffing in responding to the COVID-19 pandemic.

Keywords

personal protective equipment, coronavirus, video training, randomized trial

COVID-19 in Endoscopy: Time to do more?

Gastrointestinal Endoscopy

Thompson, Christopher C.; Shen, Lin; Lee, Linda S.

Introduction

We have read with great interest the paired articles on SARS-CoV-2/Novel Coronavirus19 (COVID-19) in this issue of Gastrointestinal Endoscopy. The first is entitled “Coronavirus (COVID-19) outbreak: what the department of endoscopy should know” by Repici et al, 1 which describes the Italian experience, and the second is “Considerations in performing endoscopy during the COVID-19 pandemic” by Soetikno et al, 2 which is drawn largely from the Hong Kong experience. We would like to congratulate the authors for their development and rigorous account of the endoscopic practices they have successfully used to minimize infection of endoscopy staff while providing essential services in this high-risk environment. We would also like to share a U.S. hospital perspective gained from our experience contending with numerous COVID-19 cases following the Biogen conference in Boston, Massachusetts.

Keywords

Clinical aspects, diagnosis, treatment