Two major types of COVID-19
L Type (70%): More prevalent; More aggressive & spreads more quickly; Often seen in patients in Wuhan China
S Type (30%): Less aggressive; Strain spreading in countries outside of China
#COVID19FOAM
L Type (70%): More prevalent; More aggressive & spreads more quickly; Often seen in patients in Wuhan China
S Type (30%): Less aggressive; Strain spreading in countries outside of China
#COVID19FOAM
In one study, of 138 hospitalized pts with confirmed novel coronavirus-infected PNA (NCIP), the rate of hospital-associated transmission was:
Active Health Care Professionals: 40 (29%)
Hospitalized Patients: 17 (12.0%)
This suggests a 41% nosocomial spread
#COVID19FOAM
Active Health Care Professionals: 40 (29%)
Hospitalized Patients: 17 (12.0%)
This suggests a 41% nosocomial spread
#COVID19FOAM
Diamond Princess cruise ship gives us great insight into COVID-19 in an isolated environment
3711 people on board with 355 cases confirmed
This gives an R0 of 2.28
Deaths from COVID-19 was 7 out of 355 cases (Case Fatality Rate of 1.9%)
#COVID19FOAM
3711 people on board with 355 cases confirmed
This gives an R0 of 2.28
Deaths from COVID-19 was 7 out of 355 cases (Case Fatality Rate of 1.9%)
#COVID19FOAM
Widely available respiratory viral panels test only for earlier forms of human coronavirus, BUT not SARS-CoV, MERS-CoV, and COVID-19 strains which require more specialized assays
#COVID19FOAM
#COVID19FOAM
CDC also recommends a lower respiratory tract sample such as induced sputum or bronchoalveolar lavage. In my opinion, this should not be done as this can aerosolize virus.
#COVID19FOAM
#COVID19FOAM
Sensitivity of RT-PCR for COVID-19 has been reported as 60–70%
Excluding dx of COVID-19 will require multiple negative RT-PCR tests
Important to remember that pts with PNA due to COVID-19 may have lung abnormalities on chest CT & an initially negative RT-PCR
#COVID19FOAM
Excluding dx of COVID-19 will require multiple negative RT-PCR tests
Important to remember that pts with PNA due to COVID-19 may have lung abnormalities on chest CT & an initially negative RT-PCR
#COVID19FOAM
One effective strategy to offload EDs is tents outside the hospital to screen patients.
For those in the US, here is a link to ACEP's summary on EMTALA from CMS COVID19 guidance: rebelem.com/wp-content/upl…
#COVID19FOAM
For those in the US, here is a link to ACEP's summary on EMTALA from CMS COVID19 guidance: rebelem.com/wp-content/upl…
#COVID19FOAM
Surgical masks can prevent the person wearing the mask from spreading large sprays or droplets as well as preventing hand-to-face contact but do not prevent people from acquiring COVID19
#COVID19FOAM
#COVID19FOAM
Contact precautions (waterproof gown/gloves)
Aerosol-generating procedures (N95 mask or PAPR)
Non-aerosol-generating procedures (Surgical mask)
Goggles or eye shield
KEY: Exact gear used is probably less important than using PPE correctly
#COVID19FOAM
Aerosol-generating procedures (N95 mask or PAPR)
Non-aerosol-generating procedures (Surgical mask)
Goggles or eye shield
KEY: Exact gear used is probably less important than using PPE correctly
#COVID19FOAM
Finally...REBEL EM post on COVID-19 has been getting updated daily...hope this is useful to others & please continue to send links and suggestions: rebelem.com/covid-19-the-n…
#COVID19FOAM
#COVID19FOAM
