COVID-19 Update: Intubation Boxes, Patients Refusing Masks


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.

Safety of Intubation Boxes Questioned

Certain aerosol boxes manufactured and used in hospitals around the world to protect healthcare workers while intubating COVID-19 patients may instead increase exposure to airborne particles that carry the virus, a new study published in Anaesthesia indicates. The researchers say these devices were produced outside the normal regulatory framework, and thus were never clinically tested or validated for effectiveness and safety.

The box essentially concentrates the virus, one of the researchers told Medscape Medical News, and because the box has holes on the sides to allow providers’ arms in, the gaps “act as nozzles, so when a patient coughs, it creates a sudden wave of air that pushes all these particles out the path of least resistance” and into the face of the intubator.

How to Handle Patients Who Refuse Masks

Even though wearing masks in public is now required in most states, some patients may still refuse to wear one when coming in for an appointment. Attorney and former nurse practitioner Carolyn Buppert, MSN, JD, advises clinicians how to respond without getting sued.

“Refusing to see a patient unless the patient wears a mask is not denying care,” she writes, “but rather establishing reasonable conditions for getting care.”

Serological Tests “Not Good Enough”

Current evidence does not support the continued use of existing point-of-care serological tests for COVID-19, researchers concluded after conducting a new systematic review and meta-analysis of studies that measured sensitivity, specificity, or both of a COVID-19 serological test compared with a reference standard.

“Future studies to evaluate serological tests for COVID-19 should be designed to overcome the major limitations of the existing evidence base,” they write in BMJ.

Children Rarely Transmit Virus

Children appear less likely than adults to be the first cases of COVID-19 within a household, suggests a contact-tracing study published in Pediatrics of the families of 39 children younger than 16 years.

“Unlike with other respiratory infections, children do not seem to be a major vector of SARS-CoV-2 transmission, with most pediatric cases described inside familial clusters and no documentation of child-to-child or child-to-adult transmission,” the researchers write.

New WHO Guidance on Aerosol Transmission

The World Health Organization (WHO) released new guidelines on the transmission of COVID-19 Thursday after a group of scientists pushed the agency to update its guidance to include airborne transmission, Reuters reported.

The new guidance acknowledges outbreak reports related to indoor crowded spaces that have suggested the possibility of aerosol transmission, such as during choir practice, in restaurants or fitness classes, and states that more research is “urgently needed to investigate such instances and assess their significance for transmission of COVID-19.”

Trending Clinical Topic: Antibodies

As the pandemic rages on, issues surrounding the antibodies developed after infection became this week’s top trending clinical topic. Medscape’s Reference team rounds up some of the most recent research.

The Week That Wasn’t

This week in COVID-19 news, researchers suggested that bandanas are the least effective nonmedical face covering, and a new study said going to the gym doesn’t increase COVID-19 risk. But you didn’t see these headlines on Medscape Medical News. Here’s why.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. More than 1700 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.

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Victoria Giardina is Medscape’s editorial intern. She has previously written for The Dr. Oz Show and is currently a national lifestyle writer for Her Campus. She can be reached at or on Twitter @ VickyRGiardina.

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