Key health and science updates on the pandemic from around the globe

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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.


Epidemiological studies show that smokers are underrepresented among the patients hospitalized for COVID-19. In fact, only 1 to 6% of hospitalized patients are smokers, but they represent 14 to 25% of the general population. 

Mathieu Morissette from the Laval University Medical department says that smokers are not just exposed to nicotine, but many other chemical compounds. If we suppose that nicotine is beneficial, it does not protect from the disease, but rather prevents severe symptoms. Other hypotheses are that nicotine could have an effect on the cytokine storm in COVID-19.

Jean-Benoit Legault, La nicotine contre le coronavirus? Pas si vite. La Presse. April 24, 2020.

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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.

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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.

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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.

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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.

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A team at Toronto’s University Health Network (UHN) developed a system to closely monitor patients remotely. Caregivers can communicate with and see the patient via a two-camera system with one pointing towards the individual and the other towards the vital signs monitor. If hypoxia is detected, the machine will send an alert. This system decreases workload, lowers risk of contracting COVID-19, optimizes PPE use and allows healthcare professionals to act rapidly in case of a deterioration.

Avis Favaro, Elizabeth St. Philip. Canadian-designed system a new way of keeping an eye on seriously ill COVID-19 patients. CTV News. April 29, 2020.

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Dr Sudhanshu Patwardhan, UK based licensed medical doctor, explained how smoking can affect outcomes of COVID-19 patients:

  • Smoking increases hypoxia and causes lung damage, thus leading to worse outcomes.
  • Many comorbidities frequently seen in smokers are risk factors for severe COVID-19 infection.
  • Transmission may be higher among smokers because of the frequent finger to mouth mouvements.

Royal Society for Public Health (RSPH). Guest Blog: COVID-19 related stress and social isolation: Risk of millions relapsing back to smoking worldwide. April 8 2020.

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Homemade and non-medical masks have grown in popularity with the PPE shortage around the world. There is no proof that masks effectively protect the people wearing them, can but they can be worn as an additional measure to protect others around you.

“These types of masks may not be effective in blocking virus particles that may be transmitted by coughing, sneezing or certain medical procedures. They do not provide complete protection from virus particles because of a potential loose fit and the materials used.”
ーGovernment of Canada

Canada Health. Considerations in the use of homemade masks to protect against COVID-19; Notice to General Public and Healthcare Professionals. Last update April 19, 2020.

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The Canadian Paediatric Surveillance Program (CPSP) is warning doctors and parents that skin manifestations, looking like pernio, can be a common presentation among children, even without respiratory symptoms. These are blueish-red lesions that can be painful and warm. They affect mostly the top and the underside of the foot, the toes and can be accompanied by cracked or dry skin. Unfortunately, there is no specific treatment in these cases.

Doctors should therefore suspect COVID-19 when these manifestations occur, and report all cases of COVID-19 positive children with skin lesions to the CPSP. 

Brooklyn Neustaeter. Pediatricians warned about ‘COVID toes’ in children infected with COVID-19. CTV News. April 27, 2020.

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