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@CDCgov recommendations for healthcare workers returning to work #COVID19. Plz share

Two options

1/ test based- resolution of fever w/o meds + improvement in respiratory sx + 2 neg NP rtPCR swabs 24 hours apart
OR
2/ non test based- see next tweet

cdc.gov/coronavirus/20…
2/ non-test based- at least 3 days since recovery of symptoms (no fever w/o using meds) + improvement in respiratory symptoms + at least 7 days since symptoms first appeared

Also guidance on what to do once you go back to work (see screenshots)

#COVID19
cc @choo_ek @ashishkjha @EricTopol @IngridKatzMD @RanuDhillon @FutureDocs @thehowie @jeremyfaust @JeremyKonyndyk @T_Inglesby @LizSpecht

FYI new @CDCgov recs on healthcare workers returning to work to help guide hospitals who do not yet have their own policies.
Cc @Bob_Wachter @CarlosdelRio7 @rwyeh @DoctorNappyJ @atheendar @Atul_Gawande @Asaf_Bitton @neel_shah @DhruvKhullar @BhadeliaMD @PeterHotez @colleenmfarrell

FYI new @CDCgov recs for HC workers returning to work after #COVID19 exposure/confirmation
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Abraar Karan MD, MPH, DTM&H
@AbraarKaran
THREAD

Let's take a closer look at current @CDCgov guidelines for clearing those w/ #COVID19.

The most widely asked about:

1/ Hospitalized patients

2/ Healthcare workers @ home

3/ Non-healthcare workers @ home

I end w/ some thoughts on taking risks.

Read on.
1/ Hospitalized patients w/ #COVID19

May be removed from transmission-based precautions on a case by case basis (neg pressure rooms, PPE etc).

Screenshot below of guiding factors to consider.

Decision to discharge to home is a clinical one.

cdc.gov/coronavirus/20…
1.5/ This is important.

As hospital beds reach short supply, we will need to improve our turn around times on how long patients w/ #COVID19 need to actually be inpatient.

Some will get better and still require an isolation period at home after to minimize transmission.
Read 12 tweets
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Abraar Karan MD, MPH, DTM&H
@AbraarKaran
THREAD

1/ I read this @AdamJKucharski #COVID19 modeling piece in @TheLancet w/ great interest.

This paper examines a trend in the reproduction number Rt across a time point when travel restrictions were imposed in Wuhan.

Rt went from 2.35 to 1.05.

thelancet.com/action/showPdf…
2/
The reproduction number is the average number of new cases a single case creates (If Rt 2.35-->1 case leads to 2.35 new cases, for example).

The team used multiple data sources, including international travelers leaving Wuhan.
3/
Red line is when travel restrictions were introduced.

Remember, these results do NOT = causation.

Rt was already declining prior to travel restrictions, so likely other interventions mattered too.

The 95% CI for Rt before/after travel restrictions also overlap.
Read 5 tweets
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Abraar Karan MD, MPH, DTM&H
@AbraarKaran
1/ Decided to test the @nytimes #COVID19 model on what happens if we take social distancing seriously, today.

1st video shows the decrease of peak infections/total deaths.

With aggressive social distancing, peak from 9m to 513k; deaths from 982k to 51k

nytimes.com/interactive/20…
2/ Second video shows what happens the longer we delay #socialdistancing measures, even if we were doing an aggressive social distancing approach.

Deaths increase from 51k to 706k if we delayed implementing social distancing for a few months. Peak goes back up to over 9m cases.
3/ Third video shows how spreading the case load relates to ICU bed capacity, which here is estimated at 95k for the country.

With social distancing, your peak ICU caseload decreases from 366k to 261k.

That is by spreading out 100m total infections from 18 weeks to 18 months.
Read 5 tweets

Related threads

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Harlan Krumholz
@hmkyale
Participating in an intern'l webinar with the Chinese Cardiology Association to discuss lessons learned with #COVID-19. Learning from our colleagues. Helping us to prepare. Teamwork. @ACCinTouch #ACCIntl All welcome. From 8-10 EDT. Today March 18.heartm.docbook.com.cn/#/meeting_noti… #COVID19
@ACCinTouch Chinese colleagues making strong point about the asymptomatic transmission. Bin Cao emphasizing the importance of using the N95 masks. For healthcare workers. [Implication: importance for us to solve the shortage problem - he is giving a warning; talking about risk to HCWs.]
@ACCinTouch Chinese colleagues sharing clinical features of #COVID19; one distinctive thing is that dry cough common; but little difference in presentation with flu. In Wuhan experience… 12% had acute cardiac injury. 7% acute kidney injury.
Read 21 tweets
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T Lloyd
@T_Lloyd
Putting my sociologist hat on. For those who are tired of the science, the numbers, and the really big words; I wanna explain this in layman's term.

The problem is not so much the virus, the problem is US (double entendre)
The U.S. has a completely different cultural system than China. We are not as community-focused, family oriented, or obedient. We're not discussing if that's good or bad, only talking about WHAT IS.

What we lack in those 3 areas directly contributes to the spread of #COVIDー19
Americans don't know HOW to self-quarantine because those 3 factors are not top of mind. We don't inherently think about our neighbors. A lot of us don't even know their names.

We're not thinking about elders b/c we weren't taught that taking care of them was OUR responsibility.
Read 13 tweets
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Jarod Reyes
@jreyesdev
🤦🏻‍♂️What it’s like to get tested for COVID-19 2 months into US response: TLDR; medical staff arguing in front of my child, unclear protocol and alarming statistics shared by local pediatricians This thread is the whole story. Friday night my son comes home from school with Cough...
and Fever. Saturday morning started by calling Pediatric COVID-19 hotline, this is the instructions on our primary care homepage. After multiple attempts it was clear the hotline was not operational. ...
Our primary care pediatrician, the best, tells us to ask for a test and call the nurse line. We call @ScrippsHealth nurse hotline, three times and get rerouted to the hotline that immediately hangs up on us. We call the Saturday clinic and get rerouted to the hotline...
Read 12 tweets
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Rishi Bansal
@rishibansal_
For all my friends wondering about #COVIDー19 and #coronavirus and especially those returning from travel or exchange, I wrote a short thread of some ideas to keep in mind... 1/n

#COVID19Ontario #COVIDCanada #SocialDistance #selfisolate #WorkFromHome
First: if you are returning from ANY TRAVEL, please self-isolate for 14 days. Stay home, use a separate room/washroom, don't touch your face, wash hands, etc. More info below 👇. 2/n

#selfisolate: bit.ly/2TQ5ela
#WashYourHands : bit.ly/2x33FqT
When buying supplies, please avoid hoarding. We must ensure that there is enough supply for healthcare workers and vulnerable populations (e.g. those w/chronic diseases or the elderly) who may have trouble getting what they need. 3/n
Read 11 tweets
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Venture Capital
@kelly2277
🦠Trump’s tariffs on medical supplies was just lifted because of the #Corinavirus - but it’s no surprise that his tariffs caused shortages of masks, gowns and other essential protective wear for healthcare workers and first responders. #COVIDー19 supplychaindive.com/news/us-china-…
🔥Because of the high tariffs on medical products, orders were reduced in hopes that Trump’s idiotic trade war might end and they could purchase without the increased cost😷 wsj.com/articles/u-s-t…
🦠On February 29th the @Surgeon_General put out a frantic tweet for the public to “Seriously people- STOP BUYING MASKS!” INSTEAD of blaming Trump’s tariffs for causing shortages, they switched the blame to the public for buying masks at @HomeDepot🤨
Read 5 tweets
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Courtney Carlson
@courtneycyarkin
A #COVIDー19 testing story.: a close friend who has been in Asia with a layover in Seoul came home and self-quarantined last Saturday. As of Tuesday she has respiratory symptoms, achy, chills but no fever. Called the #DC DOH who told her to stay home. Call if it gets worse. 1/
2. She stays home. Binges Netflix etc. Wednesday she feels worse. Crap. Tightness in her chest. “I have asthma and I need to see a doctor” she says. “I was in Thailand + on a plane full of people who embarked in Seoul. “Stay home” says DOH #COVIDー19 2/
3. Feels awful. She’s asthmatic.Uses inhaler which doesn’t help. Chills. Wakes up in the middle of the night w/stomach cramping. Calls DOH-We won’t test you, but go to urgent care-just wear a mask,wash hands. She calls 3 urgent cares, All say please don’t come here. #COVID 3/
Read 12 tweets

Trending hashtags

#COVID19 #Florida #Hongshan #library #Hypocrite #COVID #KAG #Naloxone #冠状病毒 #ZeroHedge #COVIDー19 #DogsOfTwitter #HumanRights #Medicine #Revolution #Coronarivus #Racism #OANN #Diamond_Princess #COVID19southkorea #CRISIS #GrandPrincess #TerritorialWatersMuch #COVID2019mx #WorkFromHome

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