COVID-19 Daily: ER Docs Procure PPE, Earlier Pandemic Start


Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today: 

Doctors Take PPE Procurement Into Their Own Hands

Frustrated with shortages of personal protective equipment (PPE), physicians joined forces to create a new distribution channel and get supplies to those most in need. Now the most centralized such platform in the United States, has already delivered hundreds of thousands of units of PPE to cities nationwide.

The initiative began with a tweet from Esther Choo, MD, from the Oregon Health and Science University in Portland, which drew attention to PPE shortages. Choo then worked with Megan Ranney, MD, an emergency physician at Rhode Island Hospital in Providence, to cofound the new enterprise.

The doctors are now collaborating with other organizations, procuring bulk orders when possible and soliciting donations of PPE. Taking action to address the PPE shortages head-on is empowering, Ranney said, and helps address her concerns as she witnesses an increasing number of young people and healthcare colleagues with COVID-19.

Early Case in France Sheds Light on Pandemic Start

It turns out that a fishmonger in France who tested negative for the flu in late December 2019 actually had COVID-19 almost 1 month earlier than the first confirmed cases in that country, according to a Reuters report. Researchers identified the 42-year-old man when they reevaluated 24 people who tested negative for flu in December and January. 

The case could be important to determine when and where the virus initially emerged. A spokesman for the World Health Organization said she was not surprised, and there could be other earlier cases that come to light. How the man acquired the infection remains unclear. He reportedly had no history of recent travel or any known connection to China but did work near a Paris airport where he was exposed to international travelers. 

Alcohol Abuse Associated With COVID-19 Linked to Liver Problems 

Physicians in Los Angeles report an increase in hospitalizations related to alcohol problems that they attribute to the challenges of COVID-19 isolation. Increased anxiety, stress, and boredom could be driving more alcohol consumption and more people to UCLA Medical Center with liver dysfunction.  

Social isolation also could be amplifying chronic underlying drinking problems for some individuals. Furthermore, the pandemic could be worsening binge drinking, particularly among people in their 30s and 40s, and doctors are seeing symptoms including yellow eyes, convulsions, and confusion. 

The World Health Organization has warned about alcohol use during the COVID-19 pandemic. However, North America and Europe have designated places that sell alcohol an essential service, even making alcohol available for delivery.

“Why We Cannot Test Our Way Out of This”

Expanding COVID-19 testing throughout the United States may not be the “cure all” proposed by some to contain the pandemic, Anish Koka, MD, notes in a commentary for Medscape. 

Even with approximately six million Americans tested as of May 1, and public health and other experts calling for more testing, the performance of available assays could impede the ultimate goal of containing COVID-19, Koka, a cardiologist in private practice in Philadelphia, points out. 

Limited sensitivity, cross-reactivity with other viruses, and false-positives are among the challenges that remain before universal testing makes sense, Koka argues. Furthermore, many tests initially made available on the market did not undergo FDA validation because of an Emergency Use Authorization. 

Unlikely a Mutation Is Making COVID-19 More Transmissible

A preliminary report that a mutation in the novel coronavirus is making it more transmissible is getting a fair amount of attention, but experts remain unconvinced, according to a story in The New York Times. 

The preliminary report from researchers at Los Alamos Laboratory in New Mexico pointed to a new mutation emerging in Europe in February, gaining dominance as the virus spread to other countries. However, unlike the flu, no new strain of the novel coronavirus has emerged, virologists contend. And although mutations arise in all viruses over time, no strong evidence yet points to more robust transmission or a deadlier form of the virus behind the COVID-19 pandemic, they add.

“Anything but Normal”: Doc Gives Birth During Pandemic

Leana Wen, MD, emergency physician, public health professor, and former health commissioner of Baltimore, relayed her first-hand experience with delivering her second child during the pandemic. She noticed PPE that was fraying from repeated use, learned that relinquishing control over the situation was required but uncomfortable, and felt the lack of usual support after being discharged home with a newborn. She shared these and other insights to help other women navigate the challenges of childbirth during the COVID-19 pandemic. 

Fast Five Quiz: SARS 

Test your knowledge on severe acute respiratory syndrome (SARS), a serious, potentially life-threatening viral infection caused by a virus from the Coronaviridae family: SARS-associated coronavirus (SARS-CoV). This Fast Five Quiz includes a comparison of the characteristics, workup, and management of SARS and COVID-19.

In Memoriam

As front-line healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. Hundreds throughout the world have died. 

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form

Damian McNamara is a journalist at Medscape Medical News, focusing on neurology, psychiatry, and cardiology. 

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