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June 18 | Daily COVID-19 LST Report

Climate

· Social psychologists in the United Kingdom argue that under-reaction by the authorities, mismanagement of communication and space, and systemic factors such as poverty are more responsible for avoidable deaths during the COVID-19 pandemic than collective over-reaction and selfishness. This suggests that failure in community leadership plays a larger role in fatalities during emergencies than does collective psychology.

· The director of the WHO Collaborating Center on Public Health Law and Human Rights recommends using the current COVID-19 pandemic to rebuild WHO as a responsive international agency by allocating more funding, ensuring member state compliance with WHO's recommendations, and increasing WHO's freedom to act without political influence.

· A systematic review of COVID-19 research authorship found that women represent 34% of all authors, 29% of first authors, and 26% of last authors in COVID-19 publications. They suggest that this is similar to the underrepresentation of women authorship seen in many research fields and may also hint at gender disparities in COVID-19 data and the global pandemic response.





Epidemiology

· A retrospective study of 936 outpatients who presented with fever to the Tongji Hospital Clinic in Wuhan, China during the peak time period of COVID-19 (January 30 to February 4, 2020) found that 67% of all fever patients tested positive for COVID-19. Additionally, they found that muscle ache and dyspnea were more specific symptoms of COVID-19 than fever and cough.

· A cross-sectional study conducted in Indianapolis found that 3.1% of 2,953 adults tested positive for SARS-CoV-2 by nasopharyngeal swab testing. Of the 81 SARS-CoV-2 positive participants who completed a follow-up interview, 71.6% remained asymptomatic at 14 days while the other 28.4% reported one or more symptoms.

· A study of 1,353 COVID-19 positive children found the three most common symptoms in this population were fever (21.7%), cough (15.4%), and abnormal breathing (8.1%) with the most severe manifestations, such as intubation or myocarditis, occurring in less than 0.7% of patients, and only 1.9% of patients requiring ICU care.

Transmission & Prevention

· An event-study model utilizing data from 15 states plus Washington, D.C. that had implemented mandatory masks in public revealed a statistically significant decrease in daily county-level growth rates of COVID-19 after implementation of mask wearing mandates, suggesting that transmission rates of COVID-19 may decrease as more states mandate face masks in public.


Management

· Guidelines and recommendations for practice during the pandemic include:

o Convalescent plasma benefits and donation

o Anticoagulation-related gastrointestinal bleeding

· Pulmonary specialists describe how utilizing nearby hotels for recovering COVID-19 patients discharged from overwhelmed hospitals may be an effective method to meet surging demands citing this approach’s success in certain Italian hospitals.

· A retrospective study of 38 COVID-19 patients found that patients who developed severe COVID-19 had a statistically significantly higher CD4/CD8 ratio than patients that did not develop severe COVID-19, which suggests that clinicians may be able to use lymphocyte ratios to predict disease severity.


Adjusting Practice During COVID-19

· Guidelines and recommendations for adjusting clinical practice include management of febrile children younger than 3 years old as well as for empiric antibiotic therapy for children younger than 36 months.

· Three adult COVID-19 patients who suffered ischemic strokes with involvement of large cerebral arteries led Iranian researchers to posit inflammatory response to cytokine release due to SARS-CoV-2 infection as a potential underlying mechanism and recommend that all patients who suffer from ischemic strokes during the pandemic be tested for SARS-CoV-2 infection, emphasizing the need for further investigation of the link between strokes and COVID-19.


R&D: Diagnosis and Treatments

· A comparative study between two SARS-CoV-2 serology detection methods⁠—chemiluminescence (n=109) and the colloidal gold method (n=60)⁠—using data from 4 clinical trials (n=169 patients with COVID-19) found that for the IgM antibody, the chemiluminescence method had an earlier (by about 1-2 days) positive conversion time, earlier positive results at different stages of COVID-19 disease, and an earlier downward trend in positive results than the colloidal gold method, with similar results for the IgG antibody.

o The authors suggest that the more sensitive chemiluminescence method may be better suited for high sample detection and early disease diagnosis, such as for suspected patients with negative nucleic acid results, and that the colloidal gold method may be optimal for sporadic cases and emergencies due to its faster return of results and use of less sophisticated equipment.


Mental Health and Resilience Needs

· A review of the mental health impact of the COVID-19 pandemic on the general population, healthcare workers, and vulnerable groups indicated that long-term psychological and social consequences (i.e. exacerbation of existing psychiatric disorders, depression, etc.) could arise in vulnerable individuals during the pandemic and increase the risk for suicidal behaviors.

o Three different approaches for suicidal preventive interventions (universal, selective, and indicated) were presented and the authors emphasize the importance of further research in mitigating the mental health effects of the pandemic to reduce COVID-19 related suicides.

· Researchers from the Department of Clinical Psychology at Albizu University-Miami discuss the psychological impact of the COVID-19 pandemic, including an increase in interpersonal violence, urging for a catalog of digital mental health resources for both survivors and perpetrators to help with emotional responses to trauma and to develop effective communication strategies.


Silver Linings

· Healthcare reform recommendations are outlined as the current pandemic could be a rare catalyst for major political shifts toward a more efficient and effective system of care, primarily addressing barriers to paying for services and provider reimbursement.


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