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September 14 | Daily COVID-19 LST Report

Climate

· Analysis of a cross-sectional, self-reported survey of 10,624 Internet users revealed that 17% of survey participants used telehealth due to the pandemic with Blacks, Latinos, and those identified with other races having statistically significant higher odds than White participants. The authors urge the need for social change to combat systemic racism, especially in the setting of the COVID-19 pandemic, and call for better access and adaptation to telehealth for all races, ethnicities, and socioeconomic groups.


· Anthropologists from Austria and Pakistan offer multiple reasons why COVID-19 may overwhelm low-income countries, using Pakistan as an example. The authors discuss risk factors such as economic disparities, lack of sanitation facilities, and distrust towards governmental actions, and outline how such factors will hinder the recovery process of struggling countries.

Epidemiology

· A retrospective study in New Jersey compared patients admitted from March 1-14, 2020 (control group) to patients admitted March 18-31, 2020 (COVID-era group) and found that the number of trauma admissions decreased by 44.9% in the COVID-era group, with length of stay and injury severity scores being significantly reduced in the COVID-era group. The COVID-era group had fewer falls and motor vehicle collision patients, but more self-inflicted injuries suggesting that stay at home orders implemented to reduce the transmission of COVID-19 resulted in less severe and fewer numbers of trauma injuries, but may have increased psychological stress in the population.

· A retrospective cohort study of 496 COVID-19 patients in Singapore found clinical features including anosmia and dysgeusia were more predictive of COVID-19 cases among patients with acute respiratory illness compared to abnormalities in laboratory results and radiographic images.

Transmission & Prevention

· A news article by The Journal of the American Medical Association (JAMA) discusses COVID-19 vaccine development, highlighting advances in mRNA vaccines from SARS-CoV-2 RNA sequencing with benefits including ease of laboratory production without growth in eggs or cell lines, making large scale development and manufacturing more feasible. Authors suggest that a functional COVID-19 mRNA vaccine may be a viable option for commercial production and could aid in advancement of vaccines for other diseases such as human immunodeficiency virus (HIV), herpes simplex virus (HSV), and influenza.

· Infectious Disease doctors at the University of California, San Francisco hypothesize that universal facial masking may reduce the severity of COVID-19 disease in addition to preventing transmission. Specifically, the authors hypothesize that mask-wearing may increase the proportion of infected people remaining asymptomatic by reducing the viral inoculum to which mask-wearers are exposed. The authors suggest that increasing the proportion of mild or asymptomatic SARS-CoV-2 can result in strong cell-mediated immunity, highlighting the role of universal masking in controlling the COVID-19 pandemic.

Adjusting Practice During COVID-19

· Retrospective review from the Journal of Knee Surgery evaluated the enhanced recovery after surgery (ERAS) protocol which sought to reduce length of hospital stay and complications for post-operative patients. When comparing cases of knee arthroplasties from the last quarter of 2019 (199 cases) to that of the first quarter in 2020 (76 cases), patients during the COVID-19 outbreak had shorter lengths of inpatient stay without significant changes to the complication or readmission rates.


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