Category: Covid-19

U.S. hospitals, public health authorities, and digital health companies have quickly deployed online symptom checkers to screen patients for signs of Covid-19. The idea is simple: By using a chatbot powered by artificial intelligence, they can keep anxious patients from inundating emergency rooms and deliver sound health advice from afar.

Or at least that was the pitch.

Late last week, a colleague and I drilled more than a half-dozen chatbots on a common set of symptoms fever, sore throat, runny nose to assess how they worked and the consistency and clarity of their advice. What I got back was a conflicting, sometimes confusing, patchwork of information about the level of risk posed by these symptoms and what I should do about them.

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A chatbot posted on the website of the Centers for Disease Control and Prevention determined that I had one or more symptom(s) that may be related to COVID-19 and advised me to contact a health care provider within 24 hours and start home isolation immediately.

But a symptom checker from Buoy Health, which says it is based on current CDC guidelines, found that my risk of a serious Novel Coronavirus (COVID-19) infection is low right now and told me to keep monitoring my symptoms and check back if anything changes. Others concluded I was at medium risk or might have the infection.

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Most people will probably consult just one of these bots, not eight different versions as I did. But experts on epidemiology and the use of artificial intelligence in medicine said the wide variability in their responses undermines the value of automated symptom checkers to advise people at a time when above all else they are looking for reliable information and clear guidance.

These tools generally make me sort of nervous because its very hard to validate how accurate they are, said Andrew Beam, an artificial intelligence researcher in the department of epidemiology at the Harvard TH Chan School of Public Health. If you dont really know how good the tool is, its hard to understand if youre actually helping or hurting from a public health perspective.

The rush to deploy these chatbots underscores a broader tension in the coronavirus outbreak between the desire of technology companies and digital health startups to pitch new software solutions in the face of a fast-moving and unprecedented crisis, and the solemn duty of medical professionals to ensure that these interventions truly benefit patients and dont cause harm or spread misinformation. A 2015 study published by researchers at Harvard and several Boston hospitals found that symptom checkers for a range of conditions often reach errant conclusions when used for triage and diagnosis.

Told of STATs findings, Buoys chief executive, Andrew Le, said he would synchronize the companys symptom checker with the CDCs. Now that they have a tool, we are going to use it and adopt the same kind of screening protocols that they suggest and put it on ours, he said. This is probably just a discrepancy in time, because weve been attending all of their calls and trying to stay as close to their guidelines as possible.

The CDC did not respond to a request for comment.

Before I continue, I should note that neither I nor my colleague is feeling ill. We devised a simple test to assess the chatbots and limited the experiment to the web- and smartphone-based tools themselves so as not to waste the time of front-line clinicians. We chose a set of symptoms that were general enough to be any number of things, from a common cold, to the flu, to yes, coronavirus. The CDC says the early symptoms of Covid-19 are fever, cough, and shortness of breath.

The differences in the advice we received are understandable to an extent, given that these chatbots are designed for slightly different purposes some are meant to determine the risk of coronavirus infection, and others seek to triage patients or assess whether they should be tested. They also collect and analyze different pieces of information. Buoys bot asked me more than 30 questions, while Cleveland Clinics and bots created by several other providers posed fewer than 10.

But the widely varying recommendations highlighted the difficulty of distinguishing coronavirus from more common illnesses, and delivering consistent advice to patients.

The Cleveland Clinics tool determined that I was at medium risk and should either take an online questionnaire, set up a virtual visit, or call my primary care physician. Amy Merino, a physician and the clinics chief medical information officer, said the tool is designed to package the CDCs guidelines in an interactive experience. We do think that as we learn more, we can optimize these tools to enable patients to provide additional personal details to personalize the results, she said.

Meanwhile, another tool created by Verily, Alphabets life sciences arm, to help determine who in certain northern California counties should be tested for Covid-19, concluded that my San Francisco-based colleague, who typed in the same set of symptoms, was not eligible for testing.

But in the next sentence, the chatbot said: Please note that this is not a recommendation of whether you should be tested. In other words, a non-recommendation recommendation.

A spokeswoman for Verily wrote in an email that the language the company uses is meant to reinforce that the screening tool is complementary to testing happening in a clinical care situation. She wrote that more than 12,000 people have completed the online screening exam, which is based on criteria provided by the California Department of Public Health.

The challenge facing creators of chatbots is magnified when it comes to products that are built on limited data and guidelines that are changing by the minute, including which symptoms characterize infection and how patients should be treated. A non-peer-reviewed study published online Friday by researchers at Stanford University found that using symptoms alone to distinguish between respiratory infections was only marginally effective.

A week ago, if you had a chatbot that was saying, Here are the current recommendations, it would be unrecognizable from where we are today, because things have just moved so rapidly, said Karandeep Singh, a physician and professor at the University of Michigan who researches artificial intelligence and digital health tools. Everyone is rethinking things right now and theres a lot of uncertainty.

To keep up, chatbot developers will have to constantly update their products, which rely on branching logic or statistical inference to deliver information based on knowledge that is encoded into them. That means keeping up to date on new data that are being published every day on the number of Covid-19 cases in different parts of the world, who should be tested based on available resources, and the severity of illness it is causing in different types of people.

Differences I found in the information being collected by the chatbots seemed to reflect the challenges of keeping current. All asked if I had traveled to China or Iran, but thats where commonality ended. The Cleveland Clinic asked whether I had visited a single country in Europe Italy, which has the second most confirmed Covid-19 cases in the world while Buoy asked whether I had visited any European country. Providence St. Joseph Health, a hospital network based in Washington state, broke out a list of several countries in Europe, including Italy, Spain, France, and Germany.

After STAT inquired about limiting its chatbots focus to Italy, Cleveland Clinic updated its tool to include the United Kingdom, Ireland, and the 26 European countries included in the Schengen area.

The differences also included the symptoms they asked about and the granularity of information they were capable of collecting and analyzing. Buoys bot, which suggested I had a common cold, was able to collect detailed information, such as specific temperature ranges associated with my fever and whether my sore throat was moderate or severe.

But Providence St. Joseph asked only whether I had experienced any one of several symptoms, including fever, sore throat, runny nose, cough, or body aches. I checked yes to that question, and no to queries about whether I had traveled to an affected country or come in contact with someone with a lab-confirmed case of Covid-19. The bot (built, like the CDC one, with tools from Microsoft) offered the following conclusion: You might be infected with the coronavirus. Please do one of the following call your primary care physician to schedule an evaluation or call 911 for a life threatening emergency.

All of the chatbots I consulted included some form of disclaimer urging users to contact their doctors or otherwise consult with medical professionals when making decisions about their care. But the fact that most offered a menu of fairly obvious options about what I should do seemed to undercut the value of the exercise.

Beam, the professor at Harvard, said putting out inaccurate or confusing information in the middle of a public health crisis can result in severe consequences.

If youre too sensitive, and youre sending everyone to the emergency room, youre going to overwhelm the health system, he said. Likewise, if youre not sensitive enough, you could be telling people who are ill that they dont need emergency medical care. Its certainly no replacement for picking up the phone and calling your primary care physician.

If anyone would be enthusiastic about the possibilities of deploying artificial intelligence in epidemiology, Beam would be the guy. His research is focused on applying AI in ways that help improve the understanding of infectious diseases and the threat they pose. And even though he said the effort to deploy automated screening tools is well intentioned and that digital health companies can help stretch resources in the face of Covid-19 he cautioned providers to be careful not to get ahead of the technologys capabilities.

My sense is that we should err to the centralized expertise of public health experts instead of giving people 1,000 different messages they dont know what to do with, he said. I want to take this kind of technology and integrate it with traditional epidemiology and public health techniques.

In the long run Im very bullish on these two worlds becoming integrated with one another, he added. But were not there yet.

Erin Brodwin contributed reporting.

This is part of a yearlong series of articles exploring the use of artificial intelligence in health care that is partly funded by a grant from theCommonwealth Fund.

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I asked eight chatbots if I had Covid-19. The answers varied widely - STAT

Self-testing at home to find out whether somebody has had Covid-19 is an efficient way to find out if they are safe to return to work, a senior health official has said.

Prof Yvonne Doyle, the medical director of Public Health England, told the health select committee that finger-prick home tests would be available very soon. We expect that to come within a couple of weeks, but I wouldnt want to promise on that, she said.

It was critical to understand what is going on and allow people to return to work she said. Self-testing was not new and was well understood by the public, with routine tests available such as the pregnancy test. The intention is to allow people to do as much of this as they validly can. It is by far the most efficient way, if the technology will support it, she said.

On Wednesday Prof Sharon Peacock, from Public Health England, told MPs on the science and technology committee that a home test to detect antibodies indicating somebody has had Covid-19 was being evaluated this week in Oxford to make sure it worked as well as is claimed and would be available next week. Government advisers later cautioned that the test might not be ready so quickly.

But the health secretary, Matt Hancock, has said the government has bought 3.5m antibody tests and will buy more.

Governments around the world are all seeking better and faster tests to show whether people have the disease or have had had it and recovered.

Singapore developed an antibody test as early as February. The US Covid-19 co-ordinator, Dr Deborah Birx, has said the US government is interested in it, and private US companies are also developing antibody tests. They include California-based Biomerica, which is selling to Europe and the Middle East, and New York-based Chembio Diagnostics, which is selling to Brazil.

Some are developed now. We are looking at the ones in Singapore, Birx said on Monday at a White House press briefing. We are very quality-oriented. We dont want false positives.

UK firms and academics have also developed self-test kits for Covid-19 that are expected to be available to buy in the coming weeks or months.

One cheap test is made by Mologic, a diagnostic test firm based in Bedford. Another kit has been developed by researchers at three UK universities led by Brunel University.

Mologic has produced the first prototypes of an antibody test for Covid-19, building on its experience of developing a rapid test kit for Ebola. Assessment and validation of the test began this week at the Liverpool School of Tropical Medicine and St Georges, University of London.

The company said it would take three to four months before the test is available in the UK and other countries. It will cost 1 in the UK and will be as simple to use as a home pregnancy test but will use saliva or blood rather than urine, with results ready in 10 minutes.

Mologic, which received 1m from the UK government to develop the test, will be able to make 8m kits a year at facilities in the UK and Senegal. In Senegal it will be sold for less than $1.

These tests could be a game-changer for diagnosis and follow-up of patients both in hospital and in the community, allowing us to detect cases early and isolate patients and their families rapidly, said Dr Emily Adams, a senior lecturer in diagnostics for infectious disease at the Liverpool School of Tropical Medicine.

The test kit developed by researchers at Brunel University London, Lancaster University and the University of Surrey is based on science evaluated in the Philippines to check chickens for viral infections.

The battery-operated handheld device processes nasal or throat swabs that are inserted into it, and delivers the results within 30 to 45 minutes via a smartphone app. The team has approached UK, US and European regulators for approval and is in talks with 60 manufacturers. It could be available to the public within a few weeks.

The device will be priced at 100 and can test six people at once. The test can detect the virus in individuals who show no symptoms because it recognises the DNA structure of the virus in the samples.

Read more:

Covid-19 self-test could allow return to work, say health officials - The Guardian

Today the Surgeon General of the United States, Jerome Adams, MD, said on the Today Show that this week could get bad for many Americans who will face a growing rise of COVID-19 cases in their communities.

"Everyone needs to act as if they have the virus right now. So, test or no test, we need you to understand you could be spreading it to someone else. Or you could be getting it from someone else. Stay at home," Adams said, while admonishing young Americans who are still crowding on beaches from coast to coast for not taking national calls for social distancing seriously.

Confirmed US cases rose by 9,541 today, to 42,817, according to the Johns Hopkins online tracker, with 458 associated deaths.

For the second day in a row, democratic US senators blocked a nearly $2 trillion coronavirus stimulus bill, saying the bill offered too much protection to corporations and failed to protect individuals who have lost or will lose their jobs because of the pandemic.

The Washington Post reported that several million Americans have already lost their jobs because of the virus, and the Dow Jones industrial average has lost more than 10,000 points in 6 weeks, dropping below 19,000 points today.

Included in the bill is a provision to send some American households a check for $1,200 in April, and give $350 billion to small businesses who have lost workers and consumers in recent weeks.

Over the weekend Senator Rand Paul (R-Ky), became the first senator to test positive for the virus, and Senator Amy Klobuchar (D-MN) said today her husband was hospitalized in Maryland and receiving oxygen after being diagnosed as having COVID-19.

Late last week governors in New York, New Jersey, California, Connecticut, Oregon, and Illinois all told citizens to stay home, except for essential workers. Over the weekend and through today, governors in Wisconsin, Indiana, Michigan, Ohio, West Virginia, Delaware, and Louisiana also issued similar orders.

"I know this has been difficult and has disrupted the lives of people across our state. That's why issuing a #SaferAtHome order isnt something I thought we'd have to do, and it's not something I take lightly," said Wisconsin Governor Tony Evers on Twitter. "But here's the bottom line: folks need to start taking this seriously."

"You can still get out and walk the dogsit's good exercise and its good for everyones mental healthbut please don't take any other unnecessary trips, and limit your travel to essential needs like going to the doctor, grabbing groceries, or getting medication," he said.

Governors in Maryland and Massachusetts did not issue shelter-in-place measures, but did order the closing of all non-essential businesses in each state, Politico reported. Last week Pennsylvania took a similar step.

The orders mean more than 100 million Americas, or about one third of the country, are under stay-at-home restrictions. But as governors take decisive actions, there were signs on Twitter that President Donald Trump may be considering reversing his "15 days to slow the spread" social distancing campaign, which was announced over a week ago.

"WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF. AT THE END OF THE 15 DAY PERIOD, WE WILL MAKE A DECISION AS TO WHICH WAY WE WANT TO GO!" Trump tweeted late last night.

New York Governor Andrew Cuomo late last week also shuttered non-essential businesses, but he calls his plan a "pause" for New York. That order went into effect last night.

New York has emerged as the nations biggest hot spot of the coronavirus, with 6% of the cases detected in the world, the New York Times reported. Today Cuomo ordered a new directive to state hospitals: increase capacity by at least 50%. Cuomo also announced that a 1,000-bed field hospital will be constructed at the Javits Center, and be operational by the end of next week.

Today New York reported a total of 20,875 cases, including 12,305 in New York City. According to the New York Times tracker, there have ben 125 deaths in the state.

In Washington state, the first to be hit hard with the virus, case totals stood at 1,996, with 95 deaths.

Continue reading here:

Surgeon General on COVID-19: 'This week it's going to get bad' - CIDRAP

This blog is part of a series providing regional analysis on the effects of the coronavirus.

By Jihad Azour

, Franais,

The impact of COVID-19 and the oil price plunge in the Middle East and the Caucasus and Central Asia has been substantial and could intensify. With three-quarters of the countries reporting at least one confirmed case of COVID-19 and some facing a major outbreak, the coronavirus pandemic has become the largest near-term challenge to the region. Like much of the rest of the world, people in these countries were taken utterly by surprise with this development, and I would like to express my solidarity with them as they cope with this unprecedented health crisis.

This challenge will be especially daunting for the regions fragile and conflict-torn statessuch as Iraq, Sudan, and Yemenwhere the difficulty of preparing weak health systems for the outbreak could be compounded by reduced imports due to disruptions in global trade, giving rise to shortages of medical supplies and other goods and resulting in substantial price increases.

Uncertainty about the nature and duration of the shocks has complicated the policy response.

Beyond the devastating toll on human health, the pandemic is causing significant economic turmoil in the region through simultaneous shocksa drop in domestic and external demand, a reduction in trade, disruption of production, a fall in consumer confidence, and tightening of financial conditions. The regions oil exporters face the additional shock of plummeting oil prices. Travel restrictions following the public health crisis have reduced the global demand for oil, and the absence of a new production agreement among OPEC+ members has led to a glut in oil supply. As a result, oil prices have fallen by over 50 percent since the start of the public health crisis. The intertwined shocks are expected to deal a severe blow to economic activity in the region, at least in the first half of this year, with potentially lasting consequences.

Channels of economic impact

Heres what we know.

First, measures to contain the pandemics spread are hurting key job-rich sectors: tourist cancellations in Egypt have reached 80 percent, while hospitality and retail have been affected in the United Arab Emirates and elsewhere. Given the large numbers of people employed in the service sector, there will be wide reverberations if unemployment rises and wages and remittances fall.

Production and manufacturing are also being disrupted and investment plans put on hold. These adverse shocks are compounded by a plunge in business and consumer confidence, as we have observed in economies around the world.

In addition to the economic disruptions from COVID-19, the regions oil exporters are affected by lower commodity prices. Lower export receipts will weaken external positions and reduce revenue, putting pressures on government budgets and spilling over to the rest of the economy. Oil importers, on the other hand, will likely be affected by second-round effects, including lower remittance inflows and weaker demand for goods and services from the rest of the region.

Finally, sharp spikes in global risk aversion and the flight of capital to safe assets have led to a decline in portfolio flows to the region by near $2 billion since mid-February, with sizable outflows observed in recent weeksa risk I underscored in a recent blog. Equity prices have fallen, and bond spreads have risen. Such a tightening in financial conditions could prove to be a major challenge, given the regions estimated $35 billion in maturing external sovereign debt in 2020.

Against this challenging backdrop, the region is likely to see a big drop in growth this year.

Policy priorities

The immediate policy priority for the region is to protect the population from the coronavirus. Efforts should focus on mitigation and containment measures to protect public health. Governments should spare no expense to ensure that health systems and social safety nets are adequately prepared to meet the needs of their populations, even in countries where budgets are already squeezed. Governments in the Caucasus and Central Asia, for example, are increasing health spending and considering broader measures to support to the vulnerable and shore up demand. In the Islamic Republic of Iran, where the coronavirus outbreak has been particularly severe, the government is ramping up health spending, providing additional funding to its Ministry of Health.

Beyond that overarching imperative, economic policy responses should be directed at preventing the pandemica temporary health crisisfrom developing into a protracted economic recession with lasting welfare losses to the society through increased unemployment and bankruptcies. However, the uncertainty about the nature and duration of the shocks has complicated the policy response. Where policy space is available, governments can achieve this goal using a mix of timely and targeted policies on hard-hit sectors and populations, including temporary tax relief and cash transfers.

Temporary fiscal support should consist of measures that provide well-targeted support to affected households and businesses. This support should aim to help workers and firms weather the significant, but hopefully temporary, stop in economic activity that the health measures being implemented to control the spread of the coronavirus will entail. This support will have to take account of the fiscal space that is available, and where policy space is limited be accommodated by reprioritizing revenue and spending objectives within existing fiscal envelopes. Where liquidity shortages are a major concern, central banks should stand ready to provide ample liquidity to banks, particularly those lending to small and medium-sized enterprises, while regulators could support prudent restructuring of distressed loans without compromising loan classification and provisioning rules.

When the immediate crisis from the coronavirus has begun to dissipate, consideration could be given to more conventional fiscal measures to support the economy, such as restarting infrastructure spending, although fiscal space has been significantly eroded over the last decade. Given the nature of the current slowdown, trying to stimulate the economy at this time is unlikely to be successful and would risk eliminating the limited fiscal space that is still available.

Many countries are already introducing targeted measures. For example, several countriesKazakhstan, Qatar, Saudi Arabia, and the United Arab Emirates, to name a fewhave announced large financial packages to support the private sector. These packages include targeted measures to defer taxes and government fees, defer loan payments, and increase concessional financing for small and medium-sized enterprises.

Other countries, particularly the regions oil importers, have more limited policy space. Lower revenues resulting from lower importson top of additional pandemic mitigation spendingare expected to widen fiscal deficits in these economies. And while well-targeted health spending should not be sacrificed, very high debt in many of these oil-importing countries means that they will lack the resources to respond adequately to the broader economic slowdown. As such, these countries should try to strike a balance between easing credit conditions and avoiding vulnerability to capital outflows, and, where possible, allow the exchange rate to cushion some of the shocks. Sizeable financing needs are likely to arise in some countries.

Support from the IMF

Since the outbreak of COVID-19, we have been in continuous interaction with the authorities in our region to offer advice and assistance, especially those in urgent need of financing to withstand the shocks. The Fund has several tools at its disposal to help its members surmount this crisis and limit its human and economic cost, and a dozen countries from the region have already approached the Fund for financial support. Work is ongoing to expedite approval of such requestslater this week, our Executive Board will consider a request from the Kyrgyz Republic for emergency financing, likely the first such disbursement since the outbreak of the COVID-19 pandemic. A few other requests will be considered by the Executive Board in the coming days. Now, more than ever, international cooperation is vital if we hope to prevent lasting economic scars.

The IMF and COVID-19

Originally posted here:

COVID-19 Pandemic and the Middle East and Central Asia: Region Facing Dual Shock - International Monetary Fund

The U.S. Food and Drug Administration (FDA) has updated its rules around use of experimental treatments for the ongoing COVID-19 pandemic to include use of convalescent plasma, in cases where the patients life is seriously or immediately threatened. This isnt an approval of the procedure as a certified treatment, but rather an emergency clearance that applies only on a case-by-case basis, and only in extreme cases, as a means of helping further research being done into the possible efficacy of plasma collected from patients who have already contracted, and subsequently recovered from, a case of COVID-19.

Plasma is a component of human blood specifically the liquid part which contains, among other things, antibodies that contribute to a bodys immune response. Use of plasma, through direct transfusion into a patient, like every other proposed treatment for COVID-19 (and the SARS-CoV-2 virus that causes it), has not undergone the clinical studies needed to show that its actually safe and effective in combating the disease.

Despite a lack of completed clinical trials, the FDA has granted this temporary authorization under its Investigational New Drug Applicants (eINDS) exemption, in light of the extent and nature of the current public health threat that COVID-19 represents. A number of pre-clinical and clinical trials around use of plasma from patients who have recovered are underway, however, and there are some promising signs that convalescent plasma could indeed be effective against SARS-CoV-2.

This is hardly the first time that convalescent plasma has been proposed or attempted to fight off a disease. People who have had a virus and subsequently recovered from it typically build up an immunity to it either long-term, as with chicken pox, or short-term, as with the seasonal flu. Logically, it stands to reason that it should be possible, at least in theory, to take the antibodies from one individual who has already developed them, and transfuse them into a patient whose immune system is not doing a good enough job producing its own.

Convalescent plasma transfusions have been used in previous outbreaks, including against the H1N1 flu, as well as the original SARS and MERS epidemics, with varying results.

A number of research projects are underway regarding use of plasma against COVID-19, including a study by a team of Chinese medical professionals published in pre-print format (prior to any peer review) that studied 10 severe patients who received donations from recently recovered patients. That study found that in five of the 10 cases, the level of antibodies increased rapidly immediately post-transfusion (four other patients already had a high level of antibodies, and that persisted), and that within a week, the presence of the virus was undetectable in seven patients.

That still isnt a formal clinical study, but other small-scale investigations from clinical practice have shown similar results. A group of doctors and researchers have also put together a set of protocols for use by doctors working with both donors and recipients to help align efforts across investigations and ensure that everyone working on this problem in the medical science community is working from the same playbook.

New York Governor Andrew Cuomo announced that state health agencies would be beginning a convalescent plasma trial this week, and it was cited by FDA Director Dr. Stephen Hahn as an area of early promise last week during a White House coronavirus task force briefing.

All donor patients would have to be tested to confirm that they are not at risk of transmitting the virus, and they must also qualify as a blood donor under the existing rules in place by state and federal agencies. While some early studies have shown that plasma transfusions could be effective in prophylactic use (meaning treating healthy people before they encounter the virus), this FDA specifically prohibits any prophylactic use.

As with all the treatments currently under development, this will take a lot of testing and research both to validate, and then to certify for general use though there are a lot of researchers working on those challenges, because work to date shows this is likely to be more effective as a strategy in cases that havent yet progressed to the severe symptom stage. Convalescent plasma treatment isnt new, or even all that sophisticated, but it does have the advantage of being relatively safe (in line with standard blood transfusions, once a person is confirmed to no longer be carrying any active virus), so this could be something to watch for more active updates versus some of the longer-lead treatment technologies in development.

More here:

FDA now allows treatment of life-threatening COVID-19 cases using blood from patients who have recovered - TechCrunch

Downloadable COVID-19 Coronavirus Resources

Please be advised that any and all information, comments, analysis, and/or recommendations set forth above relative to the possible impact of COVID-19 on potential insurance coverage or other policy implications are intended solely for informational purposes and should not be relied upon as legal advice. As an insurance broker, we have no authority to make coverage decisions as that ability rests solely with the issuing carrier. Therefore, all claims should be submitted to the carrier for evaluation. The positions expressed herein are opinions only and are not to be construed as any form of guarantee or warranty. Finally, given the extremely dynamic and rapidly evolving COVID-19 situation, comments above do not take into account any applicable pending or future legislation introduced with the intent to override, alter or amend current policy language.

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Coronavirus - COVID-19 Resources - Brown & Brown Insurance

Sudden loss of a sense of smell could be a sign of a COVID-19 infection, doctors recently reported.

The complete loss of smell, or anosmia, is already associated with viruses; about 40% of anosmia cases occur after a viral infection, according to a statement published online on March 21 by ENT UK at The Royal College of Surgeons of England, an association of ear, nose and throat physicians in the United Kingdom.

However, a growing body of data from COVID-19 patients in several countries strongly suggests that "significant numbers" of those patients experienced anosmia as one of the disease's symptoms, according to the ENT UK statement.

Anecdotal evidence further describes the loss of smell and the loss of taste known as dysgeusia in people who had no other symptoms but who tested positive for COVID-19, representatives of the American Academy of OtolaryngologyHead and Neck Surgery (AAOHNS) in Alexandria, Virginia, said in a March 22 statement.

Related: Coronavirus outbreak: Live updates

Doctors with AAOHNS recommended in the statement that loss of taste and smell be added to the list of symptoms when screening for signs of COVID-19, particularly when these sensory losses are isolated that is, not accompanied by any signs of respiratory illness.

Such cases of isolated anosmia have been reported in Iran, the U.S., France and northern Italy, according to the ENT UK statement. Dr. Claire Hopkins, president of the British Rhinological Society, said in the statement that she had personally examined four patients during the past week, all under the age of 40, who exhibited no symptoms other than the sudden loss of smell.

"I think these patients may be some of the hitherto hidden carriers that have facilitated the rapid spread of COVID-19," Hopkins said.

When doctors at the University Hospital Bonn in Germany recently interviewed more than 100 patients infected with COVID-19, they discovered that nearly 70% "described a loss of smell and taste lasting several days," said Dr. Hendrik Streeck, head of the hospital's Institute of Virology.

"It goes so far that a mother could not smell the full diaper of her child.Others could no longer smell their shampoo, and food began to taste bland," Streeck toldthe German news site Frankfurter Allgemeine.

Though the doctors could not say for sure when the loss of smell and taste first appeared in these patients, they suspect that the symptoms manifested as a later stage of the infection, Streeck added.

If people who have anosmia but no other symptoms were to self-isolate for seven days, "we might be able to reduce the number of otherwise asymptomatic individuals who continue to act as vectors," according to the ENT UK statement.

Originally published on Live Science.

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Loss of smell could be a symptom of COVID-19 - Livescience.com

Greta Thunberg, the 17-year-old Swedish climate activist, announced on Tuesday that she and her father, Svante, had symptoms of Covid-19 and that while hers were mild, it was extremely likely that she had contracted the virus. She used the announcement to urge young people to stay at home, even if they dont feel sick, to protect those who are more vulnerable.

Many (especially young people) might not notice any symptoms at all, or very mild symptoms, she said on Instagram, where she has 10 million followers. Then they dont know they have the virus and can pass it on to people in risk groups.

We who dont belong to a risk group have an enormous responsibility, our actions can be the difference between life and death for many others, she said.

Ms. Thunberg spoke to European Union lawmakers at a meeting in Brussels in early March. In an effort to protect her mother and her sister at home in Stockholm, Ms. Thunberg said she and her father, who accompanies her on her travels, had isolated themselves in a separate apartment.

She said she had felt tired, had shivers, a sore throat and coughed. Her father, she said, felt far worse and had a fever. Sweden offers Covid-19 tests only to those who need urgent medical care, she wrote, which meant that she was not tested.

Ms. Thunbergs solo climate strikes helped fuel a global youth movement pressing world leaders to take action to slow down catastrophic climate change. For the last several weeks, the virus has compelled climate activists to take their protests off the streets and onto the internet.

In a crisis we change our behavior and adapt to the new circumstances for the greater good of society, she said on Twitter in mid-March, urging climate protesters to post pictures of themselves online. She posted a picture of herself, with her two dogs, and her famous homemade sign that read, in Swedish, School Strike for the Climate.

On Tuesday, in her Instagram post, she urged young people to follow the advice from experts and your local authorities and #StayAtHome to slow the spread of the virus.

Originally posted here:

Greta Thunberg Says Its Extremely Likely That She Had Coronavirus - The New York Times

"Given that my wife and I had traveled extensively during the weeks prior to COVID-19 social distancing practices, and that I am at a higher risk for serious complications from the virus due to having part of my lung removed seven months ago, I took a COVID-19 test when I arrived in D.C. last Monday. I felt that it was highly unlikely that I was positive since I have had no symptoms of the illness, nor have I had contact with anyone who has either tested positive for the virus or been sick.

"Since nearly every member of the U.S. Senate travels by plane across the country multiple times per week and attends lots of large gatherings, I believed my risk factor for exposure to the virus to be similar to that of my colleagues, especially since multiple congressional staffers on the Hill had already tested positive weeks ago.

"As for my attendance at the Speed Art Museum fundraiser on March 7, unlike the other Kentucky government officials there, I had zero contact or proximity with either of the two individuals who later announced they were positive for COVID-19. The event was a large affair of hundreds of people spread throughout the museum.

"There was an announcement by the Museum and Metro Louisville Communicable Disease department that "those who public health officials consider at higher risk from possible exposure are being notified." Louisville's health director put out a statement in The Courier Journal that "most of the people at the Speed Ball were at 'very minimal risk.'" I was not considered to be at risk since I never interacted with the two individuals even from a distance and was not recommended for testing by health officials.

"I believe we need more testing immediately, even among those without symptoms. The nature of COVID-19 put me -- and us all -- in a Catch-22 situation. I didn't fit the criteria for testing or quarantine. I had no symptoms and no specific encounter with a COVID-19 positive person. I had, however, traveled extensively in the U.S. and was required to continue doing so to vote in the Senate. That, together with the fact that I have a compromised lung, led me to seek testing. Despite my positive test result, I remain asymptomatic for COVID-19.

"For those who want to criticize me for lack of quarantine, realize that if the rules on testing had been followed to a tee, I would never have been tested and would still be walking around the halls of the Capitol. The current guidelines would not have called for me to get tested nor quarantined. It was my extra precaution, out of concern for my damaged lung, that led me to get tested.

"Perhaps it is too much to ask that we simply have compassion for our fellow Americans who are sick or fearful of becoming so. Thousands of people want testing. Many, like David Newman of The Walking Dead, are sick with flu symptoms and are being denied testing. This makes no sense.

"The broader the testing and the less finger-pointing we have, the better. America is strong. We are a resilient people, but we're stronger when we stand together."

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READ: Sen. Rand Paul's statement on testing positive for Covid-19 - CNN

News Release

Monday, March 23, 2020

The National Institutes of Health will launch a website with important educational resources for coronavirus workers dealing with the spread of COVID-19.The initiative got underway after Congress passed a supplemental appropriation of $10 million on March 6 for worker-based training to prevent and reduce exposure of hospital employees, emergency first responders, and other workers who are at risk of exposure to coronavirus through their work duties. The law provided a total of $8.3 billion in emergency funding for certain federal agencies to respond to the coronavirus outbreak.

The worker-based training initiative is being led by NIHs National Institute of Environmental Health Sciences (NIEHS), which has a long-established Worker Training Program (WTP). The program awards grants for training and development of educational resources for employees in high risk occupations who serve the public during emergencies and who need skills to protect their own health as they are potentially exposed to dangerous pathogens, contaminated materials, or infected people. As a part of this effort the WTP also acts as a clearinghouse among grant recipients to broadly share the training and educational resources developed with the grant money.

Joseph Chip Hughes, who has led the NIEHS WTP for 31 years, said, These men and women are so dedicated and as they work so hard to serve and protect the public during this COVID-19 pandemic, I want to make sure they know how to protect their own health too. We dont need them getting sick, or taking the virus back to their families or their communities.

With this new supplemental funding from Congress, the NIEHS WTP is creating a COVID-19 virtual safety training initiative for frontline responders including emergency medical personnel, firefighters, law enforcement officers, environmental cleanup workers, high-risk custodial service workers, food processing and delivery workers, water and sewage treatment workers, sanitation workers, and health care facility employees.

The initial focus is to build a virtual safety training delivery platform in partnership with private sector e-learning companies with the capability to deliver synchronized just-in-time web-based training across the country in targeted high-risk industrial sectors. Additionally, a cadre of COVID-19 safety trainers and virtual safety advisors is being created to leverage the delivery of advanced training technology to frontline responders.

After learning of the special appropriation, NIEHS moved quickly to convene a national workshop in partnership with Emory Health Sciences Center on March 17. The workshop titled, Protecting Infectious Disease Responders During the COVID-19 Outbreak, used virtual meeting technology to bring together hundreds of the countrys infectious disease experts, nurses and health care providers, emergency response organizations and academic training centers to map out a web-based, technology-assisted training strategy to respond to the escalating need to ensure protections for COVID-19 responders, particularly in health care and emergency response services.

During a recent Congressional hearing on COVID-19 response, NIH Director Francis Collins, M.D., testified that NIEHS has played a very critical role in training people who can deal with outbreaks. He noted the NIEHS WTP previously helped with the Ebola response.

NIEHS WTP grant recipients provided occupational safety training to workers during the anthrax attacks in 2001, the H5N1 outbreak in 2007, and the H1N1 avian influenza outbreak in 2009; mold remediation training following Hurricanes Katrina in 2005 and Hurricane Sandy in 2012; and Ebola virus disease preparedness training 2013-2015. A list of program grantees is available at https://www.niehs.nih.gov/careers/hazmat/awardees/index.cfm.

This COVID-19 virtual safety training program will be administered by NIEHS and was developed in collaboration with the Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response, the Occupational Safety and Health Administration, and the National Institute for Occupational Safety and Health.

About the National Institute of Environmental Health Sciences (NIEHS): NIEHS supports research to understand the effects of the environment on human health and is part of the National Institutes of Health. For more information on NIEHS or environmental health topics, visit https://www.niehs.nih.govor subscribe to a news list.

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

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COVID-19 workers get training to protect their own health - National Institutes of Health