COVID-19 Scan for Jul 22, 2020

News brief

Survey: ED doctors stressed over workplace COVID-19 exposures

Early in the COVID-19 pandemic, US emergency department (ED) physicians said they were stressed by exposures to infected patients to the point that it impinged on their home lives and female ED doctors reported higher stress levels than their male counterparts, according to survey results published today in Academic Emergency Medicine.

A total of 426 respondents to an emailed survey sent to all ED physicians at seven academic healthcare facilities in seven cities from Feb 23 to Apr 10 reported that their stress levels were a median of 5 on a scale of 1 to 7 (1 indicating not at all, 7 indicating extremely).

Levels of emotional exhaustion and burnout increased from a median of 3 before the pandemic to 4. About 91% of physicians said that they had changed their behavior toward family and friends as a result of worries about infecting them, with 77% reporting that they had been less affectionate.

Respondents cited measures that would help relieve their emotional and mental burdens at work, the most common of which were the provision of adequate personal protective equipment (PPE), rapid COVID‐19 testing at physician discretion, clearer hospital communication about COVID‐19 protocol changes, and assurance that physicians can take a leave of absence to care for themselves and their families.

More respondents were men (55% vs 45%), but women reported that the pandemic hit them harder at work and home (median score, 6) than men (median score, 5). Of the 419 respondents (98%) who reported patient contact from Feb 15 to their survey time, 410 (98%) reported seeing patients whom they suspected of having coronavirus infections.

In addition to the anxiety generated by inadequate PPE, the authors noted that physicians have experienced additional stressors as the pandemic has progressed, including "childcare and homeschooling demands, the economic impact of declining ED volumes, and changes in health care delivery (lack of personal connections with patients because of limited time in rooms)."
Jul 22 Acad Emerg Med study

1 in 5 US homes lack resources to self-isolate over COVID-19, study finds

Home isolation or quarantine after a diagnosis of or exposure to COVID-19 is impossible in 25.3 million US homes (21% of all US dwellings and 30% of units with more than one occupant) because of an insufficient number of bedrooms, bathrooms, or both, according to a research letter published yesterday in the Annals of Internal Medicine.

The finding means that about 81 million Americans, if infected by or exposed to the novel coronavirus, can't follow recommendations from the World Health Organization and the US Centers for Disease Control and Prevention to stay in a separate bedroom with its own bathroom, if possible.

The researchers used data from the most recent (2017) American Housing Survey from the US Census Bureau to identify 57,984 homes with roughly 303 million residents. On average, the homes had 2.8 bedrooms, 1.8 bathrooms, and 2.5 residents.

Native American and Hispanic residents were two or three times more likely than others to live in homes unsuitable for isolation or quarantine, while blacks and Asians were 1.7 times more likely. More low-income residents than those with higher incomes lived in homes that lack sufficient space and plumbing for isolation. Apartments, older buildings, and residences in the Northeast were most likely to be unsuitable.

The authors said that the racial and socioeconomic pattern found in the survey mirrors that of both the high incidence of COVID-19 infections in those groups and persistent racial discrimination in housing access.

"Policymakers should consider offering (but not requiring) persons needing isolation or quarantine the option of staying at no cost in underutilized hotels, under medical supervision, with free meal delivery and internet and telephone access," they wrote. "This might reduce medical costs and economic damage from work absenteeism and job loss, as well as the risks to and burdens on many families."
Jul 21 Ann Intern Med research letter

News Scan for Jul 22, 2020

News brief

Ebola sickens 2 more in DRC Equateur outbreak, 62 total, with 27 deaths

Two more Ebola infections were confirmed in the Democratic Republic of the Congo (DRC) Equateur province outbreak, both of them in Mbandaka, the provincial capital, the World Health Organization (WHO) African regional office and its DRC office said on Twitter.

The new cases push the outbreak total to 62 cases, which include 58 confirmed and 4 probable cases. Three more people died from their infections, raising the fatality count to 27.

Yesterday the WHO's DRC office said six suspected patients from one family have agreed to go to the treatment center following intense community advocacy in Ipeko, the hot spot in Mbandaka. Three confirmed cases have already been reported in the group.

The DRC's latest outbreak, its 11th, is occurring in the same area where an outbreak occurred in 2018. The illness total in the current outbreak recently passed the earlier total. The WHO has said the virus spread is occurring across a broad area of the province, and cases in Mbandaka are a concern, given its travel connections to Kinshasa and neighboring countries. Also, several infected patients were still in the community, raising the risk of further virus spread.
Jul 22 WHO African regional office tweet
Jul 21 WHO DRC office tweet
Jul 21 WHO DRC office tweet about suspected cases

Salmonella Newport outbreak sickens 125 people in 15 states

The Centers for Disease Control and Prevention (CDC) yesterday reported an outbreak of Salmonella Newport infections that has sickened 125 people, 24 of them hospitalized, in 15 states as of Jul 20.

The outbreak was first identified on Jul 10, when 13 people became ill from Salmonella Newport in three states. Infected people reported starting to feel sick from Jun 19 to Jul 7.

No deaths have been reported in the outbreak, which has not been linked to a specific food, grocery store, or restaurant chain. But after analyzing specimens from those infected, investigators determined the bacteria causing the illnesses are closely related genetically, meaning that there is likely a common source of infection.

Cases have been reported in Oregon (42 infections), Utah (28), Michigan (12), Montana (11), Wyoming (9), Ohio (5), California (3), Iowa (3), Minnesota (3), North Carolina (3), and Missouri (2). In addition, Illinois, Tennessee, Wisconsin, and Washington state all reported 1 case.

The CDC does not recommend avoiding any particular food or food source but advises washing hands and surfaces often, washing fruits and vegetables, keeping raw and cooked separate, cooking foods to a high enough temperature to kill pathogens, and refrigerating perishable foods within 2 hours, or 1 hour if serving outside and the temperature is 90°F or hotter.
Jul 21 CDC investigation notice