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While most workers are staying at home, essential workers are continuing their job on site. Meanwhile, ”health care workers account for at least 11% of reported SARS-CoV-2 infections”. Indeed, few measures have been taken to stratify the risks of essential workers and protect the most vulnerable ones until now. The Centers for Disease Control and Prevention (CDC) have recently elaborated a framework for counseling the patients who are working during the pandemic, and classified them based on their risk factors and precautions needed for each group.

1. The following people should be advised about their high risk and consider to stop working:

  • High risk of death from SARS-CoV-2 AND contact with people known to have coronavirus
    • High risk = 65 years and older, living in a nursing home or long-term care facility, lung and heart diseases, immunocompromised, severe obesity, diabetes, dialysis, liver disease.

2. The following people should discuss with their primary care physician about their individual risks and opportunities to mitigate exposure or even consider to stop working. Precautions should be taken if they work.

  • Middle age OR younger age with high-risk of death from SARS-CoV and contact with people known to have coronavirus
  • High risk of death from SARS-CoV-2 and contact with people with uncertain coronavirus status

3. The following people should be instructed to wear a mask outside the home, practice hand hygiene and use personal protective equipment as recommended.

  • Younger age without high-risk condition regardless of the occupational risk of contracting SARS-CoV-2
  • People working from home or with strict physical distancing regardless of the risk of death from SARS-CoV-2
  • Middle age OR younger age with high-risk of death from SARS-CoV and contact with people with uncertain coronavirus status

The same framework could be applied to the soon-returning back to work people. Moreover, financial safety should be ensured by the government until we can provide these workers health safety measures at their workplace.

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Pneumonia is a common complication of COVID-19 and has a characteristic pattern on chest CT scans. Dr. Adam Bernheim, a radiologist at Mount Sinai Health System, New York, and other doctors analyzed 121 CT scans from China and concluded that COVID-19 pneumonia presents itself as hazy patches, or “ground glass opacities”, that “tend to cluster on the outside edge of both lungs, by the ribs”.

Associated Press. COVID-19 lung patterns show few clues for treating pneumonia. La Times. March 20, 2020.

Original article: https://www.latimes.com/science/story/2020-03-23/covid-19-lung-patterns-pneumonia

Blood clots are life-threatening complications of COVID-19, and many doctors prescribe prophylactic anticoagulation drugs to prevent them. For some of his patients, Dr. Hooman Poor, pulmonologist at Mount Sinai Hospital, New York, uses tissue plasminogen activator (tPA).

Dr. Poor prescribed an injection of tPA to a 55 year old patient in shock and observed a good response. However, her condition deteriorated soon after, probably because of new clots forming. That said, Dr. Poor tried a low dose drip of tPA for 24 hours in addition to an anticoagulant. Unfortunately, the woman died from other complications days later.

This experimental treatment shows that research must be done to prevent and treat patients with blood clots.

Lauran Neergaard. Doctor treating COVID-19 patients gambles on clot-busting drug. April 11, 2020.

Original article: https://www.latimes.com/science/story/2020-04-11/doctor-treating-coronavirus-patients-gambles-on-clot-busting-drug

Contact tracing is an efficient strategy to prevent spread of a virus. In fact, Apple and Google are in the process of making an application that could potentially alert users when they have been in contact with a COVID-19 positive individual.

To do so, smartphone owners must download the app, which will be available around mid-may, and voluntarily update their medical status. The phone will use Bluetooth to detect nearby devices equipped with the same application up to 30 feet away. When two people are in the same area for more than 5 minutes, their data will anonymously exchange on their phone and be stored for 14 days, the incubation period of the virus. If someone has been exposed to the virus, they will receive an alert with information on how to proceed.

George Petras and Jennifer Borresen. Apple and Google join forces on tech for app that could warn you of coronavirus exposure. USA Today. April 28, 2020.

Original article: https://www.usatoday.com/in-depth/news/2020/04/28/contract-tracing-app-could-warn-you-of-coronavirus-exposure/5163841002/

Since the beginning of the COVID-19 pandemic, children have been the least affected group, but doctors around the world are warning healthcare professionals that they can suffer from a multi-system inflammatory state requiring intensive care. In fact, the clinical presentation can share similarities with toxic shock syndrome or Kawasaki disease. Not all of the children in this state were confirmed to have COVID-19. Also, children can present with abdominal pain and gastrointestinal symptoms that can lead to shock or heart problems according to Spain’s Association of Pediatrics.

Maria Cheng. European doctors warn rare kids’ syndrome may have coronavirus tie. USA Today. April 28, 2020.

Original article: https://www.usatoday.com/story/news/world/2020/04/28/coronavirus-doctors-warn-kawasaki-disease-may-have-covid-19-tie/3038537001/

Alarming cases of large vessel occlusions have been reported among adults in their 30s and 40s. At Mount Sinai Hospital, Manhattan, a 44 year old man, without any pre-existing conditions, was admitted with a severe stroke and no evidence of respiratory symptoms, even though he tested positive for COVID-19.

Dr. Thomas Oxley, vascular and interventional neurologist, noted that the brain imaging of the patient looked “like a can of spaghetti”, something he had never seen before. New clots were forming around the area of the stroke as he was removing the clot.

Ariana Eunjung Cha. Young And Middle-Aged People, Barely Sick With Covid-19, Are Dying Of Strokes. Washington Post. April 25, 2020.

Original article: https://www.washingtonpost.com/health/2020/04/24/strokes-coronavirus-young-patients/

Major racial disparities appear to be present in many states. In fact, data from Illinois shows that only 13.2% of individuals tested for SARS-CoV-2 were African-Americans, yet they made up 38.1% of deaths and 24.2% of confirmed cases, which is disproportionate to their population size. In Kansas, Latinos are infected at over twice the rate of non-Latinos and are also tested at a lower rate.

COVID-19 can worsen outcomes within racial minorities because they have poorer access to healthcare, a high incidence of chronic illness and are sometimes wary of the healthcare system.

Ronald J. Daniels and Marc H. Morial. The Covid-19 Racial Disparities Could Be Even Worse Than We Think. Washington Post. April 23, 2020.

Original article: https://www.washingtonpost.com/opinions/2020/04/23/covid-19-racial-disparities-could-be-even-worse-than-we-think/

Many research groups around the globe are in a race to develop a vaccine against COVID-19, but a laboratory at The Jenner Institute at Oxford University is ahead of others. In fact, they had already proven last year that a similar vaccine against another coronavirus was safe for humans. They can now move on to the next phase to prove its effectiveness. The team estimates that the first batch of vaccines could be available around September.

David D. Kirkpatrick. In Race for a Coronavirus Vaccine, an Oxford Group Leaps Ahead. New York Times. April 27, 2020.

Original article: https://www.nytimes.com/2020/04/27/world/europe/coronavirus-vaccine-update-oxford.html

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