The American Society of Anesthesiologists has heard at its annual Anesthesiology 2020 meeting that telehealth technology has been affording positive experiences for patients. Even before the coronavirus outbreak, patients who saw a pain medicine specialist via telehealth saved time and money and were highly satisfied with their experience, according to a study presented at the virtual event. Conducted from August 1, 2019 to June 30, 2020, the study highlights how many chronic pain patients are confident they will receive good care via telehealth, while at the same time benefiting from avoiding lengthy commutes and less time spent in traffic. The results bolster the case for provider adoption of telehealth technology, which has already seen a significant rise in usage as a result of the Covid-19 pandemic and patients being cautious about traveling to healthcare facilities for appointments for fear of contracting the virus. [Related reading: Older patients use telehealth almost as much as younger ones, report finds] While patients who are being evaluated for new conditions will likely be better served by an initial face-to-face consultation, follow-ups can occur efficiently once the relationship with the provider has been established. Indeed, the anesthesiologists at the conference predict up to 50% of visits could be conducted remotely.
We’ve written before about how telehealth has come into its own during the COVID-19 pandemic. Indeed, the coronavirus pandemic has driven the adoption of telehealth services, and it’s not just younger patients that have been taking advantage, according to a new report. Contrary to popular belief, older patients have also been embracing telehealth services, as shown in a recent report by Strata Decision Technology. Based on data collected from 43 health systems, as well as telehealth visit data from the American Medical Association and the Centers for Medicare & Medicaid Services, the report shows that while telehealth visit utilization was highest for the 30–39 age cohort (27.95%), individuals in their 70s (22.52%), 80s (20.29%), and even 90s (19.04%) have been utilizing telehealth offerings. Jeffrey Gelblum, MD, a practicing neurologist at First Choice Neurology in Aventura, Florida, says telehealth is enabling older patients to access healthcare services they may otherwise have missed out on. “Historically, we had to deal with older folks who may not be able to drive and older folks who would have difficulty finding a parking space. If the weather was bad, some older folks did not want to go to a doctor appointment. Driving for older folks is problematic in terms of compliance. But now with telehealth, that situation has been resolved,” he says. Telehealth also allows older patients to see their physicians more often than if they were having to attend face-to-face appointments.
The switch to telehealth that many doctors and patients have had to make as a result of the COVID-19 pandemic has been largely positive, new research shows. Furthermore, the majority say some of the changes will be permanent going forward. According to the survey of 500 executives in the healthcare industry, conducted by marketing agency Boston Digital, 57% of respondents said telehealth had increased the quality of patient care. In fact, more than half of those surveyed said their organisation had created new portals or micro-sites in response to the pandemic. Only 8% of respondents said telehealth initiatives were not important to their organisation. Most survey respondents said more than 40% of the changes they had made in the face of the coronavirus pandemic would likely remain permanent. However, the findings of the survey, while positive on the whole, do highlight some challenges that the telehealth industry must overcome. The most prominent challenge, the survey found, was patients’ ability to use new technologies. Speaking to Healthcare IT News, Peter Prodromou, president at Boston Digital, said: “To overcome barriers, including a patient’s ability to understand new programs and associated technology, healthcare providers must implement a seamless user experience and a robust digital marketing strategy that effectively communicates to their diverse patient community.”
Telehealth has gone from being a supplementary means of accessing healthcare services to one of the primary ways patients seek treatment, a new report has revealed. According to Doximity's 2020 State of Telemedicine Report, the impact of the coronavirus pandemic has had a profound effect on telehealth, driving its adoption. In fact, the report says that telehealth is expected to account for more than 20% of all medical visits in the United States this year and drive $29 billion worth of healthcare services revenue. The Doximity report also found that as much as $106 billion of current US healthcare spend could be virtualized by 2023. This projection highlights the increasing acceptance and adoption of telehealth among both patients and physicians. The report says there is a likelihood that care providers will find themselves competing to offer the best telemedicine experience. Prior to the pandemic, just 14% of American patients had taken advantage of telehealth services. Since the COVID-19 outbreak, this figure has risen by 57%. For those with a chronic illness the increase was 77%. Nearly a quarter (23%) of respondents said they plan to use telehealth once the pandemic ends, while 27% said they feel more comfortable using telemedicine since the pandemic. You can read the full Doximity report here. [Related reading: Use of telehealth technology among US specialists increased during pandemic]
British-Swedish pharmaceutical company AstraZeneca’s large-scale human COVID-19 vaccine trial has been paused after one of the participants developed an unexplained illness. A spokesperson for AstraZeneca said the pause is “routine” and occurred when the firm’s standard review process was triggered. An independent committee will now review safety data pertaining to the trial. AstraZeneca stressed that an adverse reaction was only witnessed in one study participant, and that pausing trials was a common part of the vaccine development process. No details have been released about the nature of the participant’s illness, but it has been reported that the individual is expected to recover. Right now, all trials of the joint AstraZeneca-University of Oxford developed vaccine, AZD1222, have been halted worldwide, including in the United States, UK, Brazil, South Africa, and India. AZD1222 is one of three COVID-19 vaccines in late-stage Phase 3 trials in the United States. AstraZeneca and eight other drug makers have said they will not seek approval from US government regulators for any vaccine until all data showed it was safe and effective. All of the companies, which include Johnson & Johnson, Merck & Co, GlaxoSmithKline, Novavax Inc, Sanofi and BioNTech, said “the safety and well-being of vaccinated individuals” was their top priority.
Officials at the Ohio Department of Medicaid are seeking to make expanded telehealth coverage — which was put in place in March to address the coronavirus pandemic — permanent. When the coronavirus pandemic struck, telehealth options for more than three million people living in Ohio were expanded to help cover their healthcare needs. Prior to the expansion, Ohio’s telehealth services saw less than 1,000 claims from providers per month for physical health services, and 4,000 for mental health services. Since the pandemic hit in March, almost 630,000 members have used telehealth, resulting in around 2.6 million claims. Furthermore, more than 200,000 people have sought help via virtual care channels from the Ohio Department of Mental Health and Addiction Services (MHAS), resulting in around 1.28 million claims. A further 1.3 million claims were filed by more than 480,000 Medicaid members using telehealth to access care from providers outside the MHAS network. Following this significant increase in telehealth usage in Ohio, the state’s Department of Medicaid has filed documents petitioning the state to add more healthcare providers to the list of those eligible to bill for telehealth services, expanding the program permanently. “This permanent expansion of clinically appropriate telehealth services allows us to increase access to quality care while maintaining the fiscal sustainability and integrity of Ohio’s Medicaid program,” said Ohio Medicaid Director Maureen Corcoran in a statement.
With the number of confirmed COVID-19 cases worldwide now at more than 25 million, any news involving potential vaccines is important, which is why a recent announcement from AstraZeneca Plc is exciting. The British multinational pharmaceutical and biopharmaceutical company, which has its headquarters in Cambridge, England, says it has begun to enroll 30,000 participants aged above 18 in the United States for a large-scale human trial of its COVID-19 vaccine candidate, AZD1222. The US trial will evaluate whether the vaccine can prevent COVID-19 infection or keep the illness from becoming severe, the National Institutes of Health said in a statement. It also will assess if the vaccine can reduce incidence of emergency department visits due to COVID-19. AstraZeneca says the study is being funded by the US Government and that participants will either receive two doses of either AZD1222 or a saline control (a placebo), four weeks apart. The AstraZeneca shot, which has been developed by researchers from the University of Oxford, is one of the farthest along of numerous COVID-19 vaccines in development. As well as the US trial, a final-stage test of the vaccine is underway in the United Kingdom. Preliminary results from this test could be yielded as soon as next month. Other companies that have COVID-19 vaccines in phase 3 trials include Moderna Inc. and Pfizer Inc.
Medical specialists, including cardiologists, gastroenterologists, pulmonologists, and respiratory physicians, significantly increased their use of telehealth technology during the COVID-19 pandemic, new research shows. According to the survey by data and analytics company GlobalData, 79% of US medical specialists said their use of telemedicine technology had increased since the start of the coronavirus outbreak. One in five (20%) said their usage had stayed the same. Of the medical professionals who said their use of telehealth services had increased, almost 30% reported an increase of 81% to 100%. Prior to the outbreak, less than half of the medical professionals surveyed were using telehealth services. But their experiences must have been positive, as more than three-quarters said they will continue to take advantage of telehealth once the pandemic is over. Interestingly, while 24% of medical professionals reported that they would not continue to use telehealth technology going forward, most said it was because they needed to see their patients in person to conduct examinations. Speaking about the findings of the survey, Kathryn Whitney, director of thematic analysis at GlobalData, said: “Telemedicine has been critical during the COVID-19 pandemic to limit the risk of person-to-person transmission of the virus and to reduce the burden on overwhelmed healthcare systems.”
The total cost in lost working time of UK employees travelling to appointments with their doctors last year was a staggering £1.5bn, new research reveals. According to a report published by health insurance firm AXA PPP Healthcare, online General Practitioner (GP) appointments could play a significant role in boosting efficiencies across both business and healthcare. The report, produced by the Centre for Economics and Business Research (CEBR), suggests that if virtual appointments were used in the first instance, the number of face-to-face GP appointments conducted last year could have been reduced by 50m. In addition, virtual appointments eliminate the need for patients to travel, thus reducing their chances of being exposed to the novel coronavirus. Furthermore, they allow GPs to reduce their risk of exposure too. The CEBR report also highlights how online consultations, which can be more easily booked, amended, and cancelled, would help reduce the number of missed appointments. NHS Digital figures show that this is an issue, with one in 20 GP appointments recorded as ‘did not attend’ in 2019. By enabling patients to more easily manage appointments, online GP services could free up the equivalent of 60 years of GP consultation time per year. Whether the prevalence of virtual GP services continues to grow once the COVID-10 pandemic is over remains to be seen. What is certain is that they are playing a vital role as the crisis continues.
A new 90-minute test that can distinguish if someone has COVID-19 or another seasonal illness will be highly beneficial come the flu season (December to March) in the UK, the government there has said. The “on-the-spot” swab and DNA tests can detect coronavirus and flu. They will be rolled out in hospitals and care homes across the UK starting next week. At present, a third of COVID-19 tests in the UK take at least 24 hours to process. The UK Government has said that almost half a million of the new rapid tests, called LamPORE, will be available from next week in hospitals and care homes. The investment will help the UK Government work towards hitting its target of testing all care home staff and residents — a move that’s designed to identify so-called ‘silent spreaders’ individuals who are infected but asymptomatic. In addition, thousands of DNA test machines that can analyse nose swabs will be deployed to UK NHS hospitals from September, following successful rollouts across eight London hospitals. The c. 5,000 machines will provide around 5.8m test over the coming months. While the accuracy of the new swab and DNA tests has not yet been determined, Sir John Bell, Regius Professor of Medicine at Oxford University, said they are on a par with current lab-based tests.
We recently wrote about how being overweight or obese increases COVID-19 risks. Now, a new study has revealed how Latinx individuals are significantly more likely to test positive for SARS-CoV-2 —, the novel coronavirus that causes COVID-19 — than any other ethnic or racial group. The researchers who conducted the study believe crowded living conditions, plus an economic necessity to continue working outdoors throughout the pandemic have contributed to the higher infection rates among Latinx communities. Furthermore, the researchers say that members of these communities are disproportionately less likely to have health insurance than their peers from other ethnic and racial groups. This reality, the researchers say, has contributed to the disparities we see today. For the study, the researchers analyzed over 35,000 COVID-19 test results from hospitals and outpatient clinics in the Baltimore-Washington area. They found that 16.3% of the tests were positive. Of those positive results, Latinx individuals accounted for 42.6% of the total, followed by black people (17.6%), “others” (17.2%), and white people (8.8%). Another uncovered discrepancy was that Latinx patients who tested positive and were subsequently hospitalized were significantly less likely to have been previously diagnosed with a health condition, something, the researchers suggest, could be due to them having poorer access to healthcare. The research, which is published in JAMA, involved a collaboration between the Johns Hopkins University School of Medicine and the university’s Center for Data Science in Emergency Medicine.
Being obese or overweight increases the chances of someone with COVID-19 experiencing serious illness, complications, and death, new research suggests. Having examined existing studies, Public Health England (PHE) found that carrying excess weight put people at greater risk of requiring hospital admission or intensive care. Furthermore, that risk grew as weight increased. The findings of the PHE evidence review come ahead of an expected UK Government announcement relating to new measures to curb obesity in the country. At present, the UK has some of the highest obesity levels in Europe, with almost two-thirds of adults now either overweight or obese. Many believe that the coronavirus pandemic and subsequent lockdown have served to exacerbate many people’s weight issues, with individuals stuck at home for prolonged periods and unable to carry out their usual exercise regimes. The findings of the evidence review will be of particular concern to groups that are already at higher risk of COVID-related complications, such as older people, black and ethnic minorities, and those living in more deprived areas. Dr Alison Tedstone, chief nutritionist at Public Health England, said the current evidence was clear: “Losing weight can bring huge benefits for health - and may also help protect against the health risks of Covid-19," she said. "The case for action on obesity has never been stronger.”
If people washed their hands regularly, social distanced, and wore face masks most COVID-19 outbreaks could be prevented, even without a vaccine or additional treatments, a new study has found. According to the research published in the journal PLoS Medicine, which created a COVID-19 prevention and spread model, the steps should work in most western countries. The research found that government-imposed social distancing measures, such as closing business establishments, cancelling in-person events, and advising people to stay at home whenever possible, can delay the peak of a COVID-19 epidemic by up to seven months on their own. However, when coupled with regular handwashing and wearing masks, the peak of the epidemic can be delayed by a further few months. Furthermore, the earlier people adopt such measures, the greater the positive impact. The researchers from the University Medical Center Utrecht in the Netherlands said in a country where 90% of the population uses multiple actions, such as hand washing and social distancing, a large outbreak of COVID-19 or a second wave could be averted. Speaking about the findings of the research, Ganna Rozhnova, an infectious disease modeler at the University Medical Center Utrecht, said: “If nearly all [the] population adopted self-imposed measures we would not have to confront the possibility of secondary lockdowns as well as the possibility that we may find our medical systems overwhelmed during the peaks of epidemics.”
A coronavirus vaccine developed by the Universality of Oxford and AstraZeneca appears safe and triggers an immune response that should protect people against infection. According to a trial of the vaccine involving 1,077 participants, the findings of which are published in The Lancet, the vaccine led to individuals making antibodies and T-cells that fight SARS-CoV-2, the new coronavirus. Within just 14 days of receiving the vaccine, participants’ T-cell levels peaked. After 28 days participants’ antibody levels peaked. Both T-cells and antibodies are crucial in the body’s immune defence of viruses, which is why any effective vaccine needs to induce both in the people who receive it. But while the findings are immensely promising, more research is needed to determine exactly how safe the vaccine is, whether it can indeed provide protection against SARS-CoV-2 and how long any protection would last. Nevertheless, the UK has already ordered 100m doses of the vaccine. Prof Andrew Pollard, from the Oxford research group, told the BBC: “We're really pleased with the results published today as we're seeing both neutralising antibodies and T-cells. “They're extremely promising and we believe the type of response that may be associated with protection. “But the key question everyone wants to know is does the vaccine work, does it offer protection... and we're in a waiting game.” The next step is for more than 10,000 people to take part in the next stage of the trial to further determine how safe the vaccine is. [Related reading: World leaders pledge billions to help develop coronavirus vaccine]
People who have recovered from COVID-19 and gained immunity to the disease could lose it again within months, a new study from the UK suggests. According to the research by a team from King’s College London, the novel coronavirus (SARS-CoV-2) could reinfect people year after year, much like common colds. Having studied the immune responses of more than 90 patients and healthcare workers at Guy’s and St Thomas’ NHS foundation trust, the researchers found that COVID-19 antibody levels peaked about three weeks after the onset of symptoms. [Related reading: Coronavirus: Immunity levels likely to be higher than antibody tests suggest] Blood tests revealed that while 60% of COVID-19 patients displayed a “potent” antibody response at the height of their battle with the disease, this figure fell to just 17% three months later. In some cases, antibody levels became undetectable. The findings of the study have implications when it comes to developing a COVID-19 vaccine, as well as achieving greater herd immunity. The bottom line is that if antibody levels drop over time and people are able to be reinfected seasonally, a vaccine would not actually provide any long-term benefits. Speaking about the findings of the study, Dr Katie Doores, lead author from King’s College London, said: “People are producing a reasonable antibody response to the virus, but it’s waning over a short period of time and depending on how high your peak is, that determines how long the antibodies are staying around.”
Following an open letter from more than 200 scientists to the World Health Organization (WHO), the international body is rethinking its stance on how COVID-19 spreads through the air. “We wanted them to acknowledge the evidence,” Jose Jimenez, a chemist at the University of Colorado who signed the paper, told the Reuters news agency. “This is definitely not an attack on the WHO. It's a scientific debate, but we felt we needed to go public because they were refusing to hear the evidence after many conversations with them,” he said. The WHO has acknowledged that emerging evidence shows how the coronavirus can be spread by tiny particles suspended in the air. It’s a reality that makes transmission of the virus in crowded, closed or poorly ventilated spaces much more likely. Outdoors, the aerosols evaporate and disperse much more quickly, reducing the risk of infection. Until now, WHO guidance does not address the fact that COVID-19 can be transmitted through minuscule droplets that hang in the air for potentially hours. All the evidence will now be thoroughly evaluated to determine its reliability, which could lead to new advice and guidelines from the WHO. As a result, compulsory face mask rules and even stricter social distancing measures could be implemented in places like bars, restaurants and public transport.
Authorities in China have stepped up precautions after a person in the country’s Inner Mongolian region was diagnosed with bubonic plague. According to state reports, the Bayannur patient is in quarantine and in a stable condition. A second suspected case involving a 15-year-old girl is currently being investigated. While it remains unclear how either patient contracted the disease, the young girl is said to have been in contact with a marmot (pictured), a species of giant squirrel. Once the world’s most feared disease, bubonic plague is easily treated nowadays using antibiotics. Nevertheless, the herdsman’s diagnosis will cause concern given the impact of the ongoing COVID-19 pandemic globally. Bubonic plague is caused by Yersinia pestis bacteria that live in some animals (mainly rodents) and their fleas. As a result of the bubonic plague discovery, a level 3 alert, which bans the hunting and eating of animals that could carry the disease, has been implemented until the end of the year. It is worth noting that these new cases are nothing out of the ordinary. From 2010 to 2015, 3,248 cases of bubonic plague were reported worldwide, including 584 deaths. Speaking about the recent bubonic plague outbreak in China, Dr Matthew Dryden, consultant microbiologist at the University of Southampton in the UK, told BBS News: “It is good that this has been picked up and reported at an early stage because it can be isolated, treated and spread prevented. “Bubonic plague is caused by a bacterium and so, unlike Covid-19, is readily treated with antibiotics. So although this might appear alarming, being another major infectious disease emerging from the East, it appears to be a single suspected case which can be readily treated.”
More people have immunity to coronavirus than antibody tests suggest, new research shows. The study from Sweden found that for every person who tested positive for antibodies — which are usually a strong indicator of whether someone has previously had an infection — two were found to have specific T-cells which identify and destroy infected cells. According to the research from the Karolinksa Institute in Sweden, even individuals who had mild or asymptomatic cases of COVID-19 had T-cells, despite testing negative for antibodies. The research is important because it could mean that more people than first thought have immunity to COVID-19. However, it is not yet clear whether this just protects the individual, or if it also stops them from passing on the infection to others. Prof Danny Altmann at Imperial College London described the study as “robust, impressive and thorough" and said it added to a growing body of evidence that "antibody testing alone underestimates immunity”. The results of the study are so new that they have not undergone peer review, nor been published in a scientific journal. Nevertheless, they can be seen as good news from a public health perspective as they indicate that public immunity to COVID-19 is likely a lot higher than first thought.
A strict COVD-19 lockdown has been reinstated near Beijing in China after a small surge in cases. The restrictions in Anxin county in Hebei province affect around 400,000 people, with only those classed as ‘essential workers’ allowed to leave their homes. One member of each household is also allowed to go out once a day to shop for necessities. In the last two weeks, there have been 18 new COVID-19 cases in Anxin. While this may sound like only a small number, China is taking the threat of a potential second coronavirus wave seriously, hence the swift lockdown. Luckily, Anxin county, which is approximately 90 miles south of Beijing, is not as densely populated as many of China’s other large urban centers and local officials believe this small spike can be contained. Up until two weeks ago when Beijing experienced a spate of new COVID-19 cases, the Chinese capital had gone 57 days without a locally-transmitted case. Despite the pockets of new cases appearing, China has, in general, successfully “flattened the curve” in recent months. While places like the United States and South America witness thousands of new cases on a daily basis, China has added only 4,700 since the start of March.
The United States Centers for Disease Control and Prevention (CDC) has previously recommended people wear cloth face coverings in public settings to reduce the spread of SARS-CoV-2. However, some people have been concerned about whether face coverings, such as masks, cause carbon dioxide (CO2) poisoning. Experts have now come out saying that’s impossible. Speaking about the use of cloth face masks, Prof Keith Neal, an infectious disease expert, said wearing one will not cause hypercapnia (too much carbon dioxide in the blood). Echoing these comments, Darrell Spurlock Jr., PhD, RN, the director of the Leadership Center for Nursing Education Research at Widener University, said: “Rebreathing tiny amounts of CO2 from wearing either properly fitted N95 respirators or more loosely fitted cloth or surgical masks is of no concern for the vast, vast majority of people.” Carbon dioxide molecules are tiny and do not get trapped by the breathable material used to make cloth ace masks. When you breathe out, the carbon dioxide goes through and round the mask. Surgeons and other medical professionals regularly wear much more heavy duty face coverings all day without coming to harm. Face masks can play a potentially important role in reducing the spread of SARS-CoV-2 because they can help limit it being transmitted by an infected individual. This is particularly true for people who are asymptomatic and do not actually know they have the virus. The only stipulation when it comes to the wearing of cloth face masks is that people with existing lung conditions should consult their physician before doing so. This is because masks do affect normal air entry and could make breathing difficult for people with severe lung diseases. [Related reading: COVID-19: Could a second wave already be here?]
With many countries now seemingly in control of the COVID-19 pandemic, attention is turning to a potential ‘second wave’ of the virus. But what does this actually mean? The Spanish Flu pandemic that began in early March 1918 lasted for around two years. But it was the second wave of the virus during three especially cruel months in the fall of 1918 that proved to be the deadliest. It raises questions about whether there will be a second wave of COVID-19. Now the easiest way to picture a second wave is to think of waves on the sea. The total number of infections goes up and then down, until the next wave comes along and the process begins all over again. To say that one wave has ended, the total number of infections needs to fall substantially. If we were then to see a significant rise once more, it would be safe to say that we are experiencing a so-called second wave. Health officials in South Korea believe the country is now experiencing a second wave of COVID-19 infections. Despite being one of the success stories of the pandemic, officials are now bracing for potential restrictions for several more months. While global lockdowns have had a profound impact on economies and people’s lives, lifting them too much and too early could lead to a second wave of COVID-19. That’s why any easing will come in stages and contact tracing and wearing face masks could be the new norm for a while. Hopefully, with effective social distancing measures and frequent handwashing, a second COVID-19 wave can be averted. However, what actually happens remains to be seen. [Related reading: This cost effective, low-dose steroid could be a breakthrough treatment for COVID-19]
Experts in the UK say a cost effective and widely available drug can help save the lives of seriously ill COVID-19 patients. The drug, dexamethasone, a steroid, has been around since the early 1960s, and is usually given in low doses to patients with severe asthma, allergies and painful/swollen joints. It is also used to treat autoimmune conditions, such as systemic lupus erythematosus and rheumatoid arthritis. Dexamethasone’s effect on inflammation and our immune systems is what is believed to make it useful in treating patients with severe COVID-19 infections. The drug is part of the RECOVERY Trial, the largest clinical trial to date aiming to identify treatments that may be beneficial for COVID-19 patients. As part of the trial, researchers studied the effect of dexamethasone in 2,000 patients and compared that to the outcomes in 4,000 patients who did not receive it. Dexamethasone was found to cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth. This equates to one life saved for every eight on ventilators and every 20-25 treated with oxygen. One of the biggest benefits of dexamethasone is that it is not cost prohibitive, meaning it could be pivotal for treating COVID-19 in poorer countries. [Related reading: What does it mean for a vaccine if the new coronavirus mutates?]
As the number of SARS-CoV-2 infections around the world passes eight million, hopes still remain on a vaccine being developed. But what does it mean for a potential vaccine if the new coronavirus mutates? Well, the bottom line is that all viruses mutate, it is part of their life cycle, so there’s a very good chance that SARS-CoV-2 will too. The good news though is that mutations can actually lead to weaker viruses, although the reality is that there’s usually no noticeable difference in the disease’s transmission and fatality rates. This seems to be the case with SARS-CoV-2. Mutations that are currently spreading around places like New York do not seem to be any more infectious or fatal than the original strain that came out of Wuhan, China, in late December. According to the Scripps Research Institute in Florida, any SARS-CoV-2 vaccine that is developed will also likely be effective against mutated forms of the virus. It’s the reason why our very effective vaccine for measles, mumps, and rubella (which are RNA viruses like SARS-CoV-2) still protects us, despite these viruses mutating over the years. So even if SARS-CoV-2 mutates further down the road, while we might see some breakthrough infections, it wouldn’t necessarily lead to a new pandemic. [Related reading: How long before there’s a coronavirus vaccine?]
The World Health Organization’s Maria Van Kerkhove, MD and technical lead for the WHO’s pandemic response, caused a stir recently when she implied that transmission of the coronavirus from asymptomatic individuals appears to be “very rare.” Now, the WHO has sought to clarify her comments, saying they were based on a relatively small set of studies. Kerkhove’s comments caused confusion because they appeared to directly contradict advice from several public health organizations. While evidence suggests that individuals with symptoms are most infectious, others do not develop any symptoms at all, despite testing positive for SARS-CoV-2. What remains unknown is how many other people these asymptomatic individuals go on to infect. It’s one of the reasons why Europe-wide lockdowns have been so effective in halting the spread of the virus, saving millions of lives. Then there are people who infect others while they are pre-symptomatic, meaning before they have actually developed any symptoms but later do. According to the United States Centers for Disease Control and Prevention (CDC), pre-symptomatic individuals account for around 40% of coronavirus transmission. Director of the WHO's health emergencies programme, Dr Michael Ryan, said he was "absolutely convinced" that asymptomatic transmission was occurring; "the question is how much". So the bottom line seems to be that we simply don’t know how big a role asymptomatic individuals play in the spread of the virus. More research is needed.
While the COVID-19 lockdowns across Europe have not been easy for most people, new research shows that they have been effective in saving countless lives. According to the study by a team at Imperial College, London, Europe-wide lockdowns to reduce the impact of SARS-CoV-2 have saved more than three million lives. The team said that if lockdown had not been implemented across the continent, the “death toll would have been huge”. However, the team also warned that Europe is still only at the beginning of the pandemic and that scores more people could be infected. Assessing the impact of lockdowns up to the beginning of May in 11 European countries: Austria, Belgium, Denmark, France, Germany, Italy, Norway, Spain, Sweden, Switzerland and the UK. By that time, approximately 130,000 people had died from COVID-19 in those countries. Using disease modelling, the researchers predicted how many deaths there would have been if no lockdowns and restrictions had been enforced. They estimated 3.2 million people would have died by 4 May, the report in the journal Nature shows. In other words, lockdown measures prevented around 3.1 million lives, including 470,000 in the UK, 630,000 in Italy and 690,000 in France. "Lockdown averted millions of deaths, those deaths would have been a tragedy," said Dr. Seth Flaxman, from Imperial College. [Related reading: Which demographic worries least about COVID-19?]
With all the media attention it’s received, and the very real threat it poses to our health, many people are, quite rightly, worried about COVID-19. Interestingly, though, some demographics are a lot less worried about COVID-19 than others, new research has found. According to the study by a small team from Georgia State University — the findings of which are published in The Journals of Gerontology — older men are less likely to worry and make fewer behavioral changes in response to the SARS-CoV-2 pandemic. The research concludes that these older men — typically aged between 65 and 81 — need more education and intervention to ensure they perceive the risks of COVID-19 accurately. This is especially important when you consider that Centers for Disease Control and Prevention (CDC) figures show that 8 out of 10 COVID deaths in the United States have been people aged 65 and over. Furthermore, men are at greater risk of requiring intensive care interventions and have a higher likelihood of worse outcomes, including death. Speaking about the findings of the study, author Dr. Sarah Barber, a gerontology and psychology researcher at Georgia State University, said not worrying too much is actually a good thing under normal circumstances. But right now, things are anything but normal, and worrying less could ultimately lead to fewer protective COVID-19 behavior changes — a reality that could have a knock-on effect on others. [Related reading: Research shows warmer temperatures do slow COVID-19 transmission (but not by much)]
Research shows warmer temperatures do slow COVID-19 transmission (but not by much) Warmer temperatures have long been associated with reduced transmission rates of some respiratory viruses. It’s one of the reasons why flu tends to have a much larger impact during winter months. Therefore, it stands to reason that the spread of SARS-CoV-2 could also be slowed or even halted as countries start to experience warmer temperatures. Now, research seems to have confirmed what many people have thought. For the study, researchers from the Mount Auburn Hospital in Cambridge, Massachusetts looked at the effect of temperature, precipitation, and UV index on COVID-19 case rates in the United States from January 22, 2020 through April 3, 2020. They found the rate of COVID-19 incidence does decrease as temperatures get warmer, up until 52 degrees F. After that, virus transmission does not decrease significantly. Furthermore, while the overall impact remains modest, a higher UV index also assists in slowing the growth rate of new cases. Precipitation was not found to have any impact on the spread of the virus. The findings will comes as welcome news as many states in America see warmer weather easing in. However, the Centers for Disease Control and Prevention has warned that the COVID-19 pandemic could worsen again in the fall and winter as temperatures drop. [Related reading: What is COVID-19 antibody testing (and why is it useful?)]
There have been numerous reports recently about how both the European Union and the United States Food and Drug Administration (FDA) have now approved certain COVID-19 antibody tests. But what are these tests for and are they useful in the overall fight against the pandemic? An antibody test basically checks your blood for antibodies. These are made when your body fights an infection, like if you had COVID-19. The test isn’t actually looking for the infection itself, rather signs that your body has built a defense against it i.e. you had the infection and your body responded accordingly. One of the valuable outcomes of antibody tests is that they help us ascertain just how many people have potentially had the new coronavirus (SARS-CoV-2). This helps build a fuller picture of the virus’ spread, as well as calculate how many people there are out there who could still potentially get it. Such information could help in the development of strategies to safeguard communities and possibly allow for more freedom of movement. Antibody tests could also help identify individuals who have had COVID-19 and whose blood could be used to help those fighting the disease. [Related reading: Losing sleep over the COVID-19 outbreak? These 5 tips will help]
The widespread panic and uncertainty being caused by the ongoing COVID-19 pandemic means sleep isn’t coming easy for many people right now. But good quality sleep is the bedrock of our lives, consuming about a third of our total time on this planet and dramatically influencing the other two-thirds. That’s why it’s so important that we all get enough good quality sleep on a regular basis. With that in mind, here are five tangible tips to promote better sleep at this difficult time: 1. Get into a routine By getting in sync with your body’s natural sleep-wake cycle, or circadian rhythm, you can significantly boost your chances of getting a good night’s sleep. If you get into a routine of sleeping and waking at the same times each day, you’ll feel more refreshed and energized than if you follow random patterns. 2. Exercise more In addition to the physical and mental health benefits, regular exercise also helps you sleep better. And while cardiovascular exercise, strength training and yoga are all great for helping you sleep – especially if you do them during the day and not just before bed. 3. Watch your diet For the best sleep, try and eat a balanced diet that contains vegetables, fresh fruits, whole grains, and low-fat proteins that are rich in B vitamins - like fish, poultry, meat, eggs, and dairy. 4. Consume less alcohol While some people rely on alcohol to help them fall asleep, studies show that alcohol does not improve sleep. In fact, it reduces rapid eye movement (REM) sleep, which is thought to be the most restorative kind. 5. Limit gadget use at night Blue light from TVs, smartphones, tablets and other gadgets plays havoc with your circadian rhythm and, as a result, the release of the sleep-inducing hormone melatonin is suppressed. For the best night’s sleep, limit your use of gadgets and other visual devices to around one to two hours before bed.
In our Coronavirus disease (COVID-19) advice for the public post we talked about the importance of frequent hand washing in significantly reducing the spread of the virus. Now, a new study by UK researchers shows that washing your hands between six and 10 times a day provides the greatest protection. For the study, the researchers looked at data from 2006-2009 relating to viruses similar to the one responsible for the current pandemic. They found that washing hands with soap and water was effective at killing such viruses. In fact, of the 1,663 study participants, those who washed their hands at least six times a day were significantly less likely to be infected by a virus. Interestingly, hand-washing more than 10 times a day resulted in no additional benefits. Speaking about the findings of the study, its author, Dr Sarah Beale, from University College London, said: “Good hand hygiene should be practised at all times regardless of whether you show symptoms or not. “This will help protect yourself and prevent unwittingly spreading the virus to others around you.” The study is published in Wellcome Open Research and is awaiting peer review.
As we continue to tackle the virus outbreak and take steps to reduce its momentum, widespread sharing of health advice has become commonplace. But if there is one thing the current coronavirus pandemic has highlighted, it is that there is so much misinformation out there. Let’s look at a few examples and see why they aren’t just false, but also potentially dangerous: Bogus health claim 1: Drinking alcohol kills coronavirus While alcohol-based hand gels and sprays can remove the new coronavirus from hands, drinking alcohol (any kind) will have no positive impact, and could actually cause serious damage to your health. Whenever you hear any advice about alcohol and coronavirus, it is referring to the kind that helps clean your hands. Bogus health claim 2: There are licensed drugs for treating COVID-19 Just because President Trump has spoken on several occasions about hydroxychloroquine as a potential treatment for COVID-19, it doesn’t make it a licensed or even recommended treatment. In fact, there is still no proof that hydroxychloroquine helps prevent or cure COVID-19, and misusing it could cause serious side effects. Bogus health claim 3: You can check if you have COVID-19 by holding your breath The only way to determine if you have COVID-19 is to undergo a laboratory test. Being able to hold your breath for 10 seconds or more without coughing or feeling discomfort will not prove anything. You can read about more coronavirus myths on the World Health Organization website.
You can’t switch on the news right now without hearing the word ‘coronavirus’. But coronaviruses are actually nothing new and most people will be infected with one at some point in their life. But don’t worry, most coronaviruses cause only moderate symptoms. In fact, of the seven known coronaviruses that affect humans, four are endemic (found regularly) and rarely cause severe disease on their own. These four are called 229E, OC43, NL63, and HKU1. Coronaviruses 229E and OC43 usually result in the common cold most of us experience from time to time, particularly during the winter. However, there are also three known coronaviruses that cause more severe symptoms: SARS-CoV, MERS-CoV and the one we are dealing with now, SARS-CoV-2. What SARS, MERS and the new coronavirus have in common is that they are more dangerous for people with underlying medical conditions. And while SARS and MERS have significantly higher case fatality rates than COVID-19, the latter is more infectious. Finally, it is worth noting that there have been no new SARS cases for over a decade. However, MERS remains a public health concern, with a handful of cases cropping up every year. Two of the biggest challenges with the current SARS-CoV-2 outbreak are that many people are asymptomatic and our lust for international travel and the ease with which we can do it have allowed the virus to spread rapidly around the globe. [Related reading: Why COVID-19 hits some people harder than others]
With the number of confirmed coronavirus cases now topping 4 million globally, the urgency to develop a vaccine has never been greater. Now something that’s been witnessed throughout this pandemic is the way COVID-19 seems to hit some people harder than others. Whether a COVID-19 patient is hospitalized and requires more serious medical interventions, like ventilation, often depends on several risk factors. Age In the United States, 8 out of 10 COVID-19 deaths have occurred in patients aged 65 and older. The reason for this is thought to be because elderly individuals have more chronic medical conditions, such as heart disease and diabetes. Diabetes A recent meta-analysis of 13 separate studies found that people with diabetes were nearly 3.7 times more likely to have a critical case of COVID-19 or to die from the disease than patients without any underlying health conditions. Heart disease and hypertension The American Heart Association says people with cardiovascular issues, including heart disease and hypertension, generally tend to suffer worse COVID-19 complications than those with no pre-existing conditions. Smoking A study from China found that 12.3% of current smokers were admitted to an ICU, were placed on a ventilator or died. This compares to 4.7% of non-smokers. Obesity Being obese has been linked to an increased severity of COVID-19 in younger patients. Furthermore, a separate study from China – which has not yet been peer-reviewed – found that obese individuals were more than twice as likely to develop severe pneumonia as compared with patients who were normal weight.
With more evidence emerging that COVID-19 can cause dangerous blood clots in some patients, new research shows that blood thinners could help improve survival rates. According to the study by a team from Mount Sinai Hospital in New York City, which looked at nearly 2,800 COVID-19 patients admitted to five hospitals across the Mount Sinai Health System, blood thinners were seen to have a positive impact on patient outcomes. The blood thinners were found to be especially helpful for patients who were put on ventilators to help them breathe. The study found that 63% of patients on ventilators who were not given blood thinners died, compared to 23% of patients on ventilators who were given blood thinners. Furthermore, of the patients who died, those who were given anticoagulants did so after spending an average of 21 days in the hospital. In contrasts, those who didn't receive anticoagulants died after an average of just 14 days in the hospital. Finally, the study also revealed that patients who were given blood thinners were not significantly more likely to develop bleeding problems -- one of the risks of taking such drugs. Speaking about the findings of the research, study senior author Dr. Valentin Fuster, director of Mount Sinai Heart and physician-in-chief at the Mount Sinai Hospital, said: “Using anticoagulants should be considered when patients get admitted to the ER and have tested positive for COVID-19, to possibly improve outcomes.” [Related reading: World leaders pledge billions to help develop coronavirus vaccine]
As the number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases globally passes 3.5 million, world leaders have pledged more than $8bn (€7.3bn) to help with the development of a coronavirus vaccine and fund research into diagnosing and treating the disease. The donations came from more than 30 countries, as well as numerous UN and philanthropic bodies and research institutes. Pop singer Madonna was one of the donors, pledging $1.1m (€1m), while Norway matched the European Commission’s contribution of $1bn (€920m) and France, Saudi Arabia and Germany all pledged $500m (€458m). Japan promised to give more than $800m (€733). Russia and the United States, which has suspended funding to the World Health Organization, were notably absent from the online summit hosted by the European Union (EU). Meanwhile, China, where SARS-CoV-2 originated in December, was represented by its ambassador to the EU. The EU said that $4.4bn of the money raised will go towards developing a vaccine, $2bn on the search for a treatment and $1.6bn for producing tests. In an open letter published in newspapers over the weekend, French President Emmanuel Macron and German Chancellor Angela Merkel said the pledged funds would “kickstart an unprecedented global co-operation between scientists and regulators, industry and governments, international organizations, foundations and healthcare professionals”. “If we can develop a vaccine that is produced by the world, for the whole world, this will be a unique global public good of the 21st Century,” they added. [Related reading: How long before there’s a coronavirus vaccine?]
Young people with COVID-19 who are obese are at greater risk of being hospitalised and experiencing more severe symptoms, new research has found. According to the study of 3,615 patients who had tested positive for COVID-19, while being overweight didn’t appear to have any negative impact on individuals aged 60+, it did in younger patients. Compared to those with a healthy Body Mass Index (BMI), which is less than 30, patients with BMIs of 30-34 were twice as likely to need hospitalisation and twice as likely to need acute care. Meanwhile, while younger COVID-19 patients with BMIs of 35 or higher were also found to be twice as likely to require hospitalisation, they were three times more likely to end up in the intensive care unit. One of the study co-authors, Jennifer Lighter, MD, a hospital epidemiologist in New York City, said the findings are significant, especially in the US where 42% of the population has a BMI over 30 and is considered obese. “Our hospital was one of the first to find the association between obesity and coronavirus, but I think it will soon become very common,” Lighter said. It is important for frontline health workers to understand how being obese potentially changes a patient’s clinical outlook and consider such patients as high-risk.
We’ve written previously about a lesser known COVID-19 symptom to look out for. But as experts learn more about COVID-19, new symptoms of the infection are coming to light. In addition to fever, coughing and difficulty breathing, plus a sudden loss of smell or taste (as per our above-referenced post), some people with COVID-19 have also presented with less typical symptoms, including nausea, diarrhea, delirium, chickenpox-like lesions, and more. Indeed, according to a study by Stanford Medicine, which analyzed the medical records of 116 patients who had tested positive for COVID-19, almost a third displayed digestion related symptoms, including loss of appetite, nausea, vomiting, and diarrhea. Meanwhile, a study in Italy that looked at 88 patients who has tested positive for COVID-19 found that approximately 20% displayed skin symptoms, including a red rash, widespread hives, or chickenpox-like lesions. While people with atypical COVID-19 symptoms may also develop more classic symptoms too, not all will. And then there are the individuals who contract the virus and don’t have any symptoms at all i.e. are asymptomatic. This is why it is useful to spread awareness about some of the less common COVID-19 symptoms, so that people can potentially spot if they or someone they know develops the disease.
While there is a lot of focus on how infectious disease outbreaks, like the ongoing COVID-19 pandemic, can impact our physical health, their effect on our psychological wellbeing is often overlooked. But the current coronavirus outbreak is scary. Add this to the fact that many of us are spending more time than ever before stuck in our homes and it’s easy to understand how our mental health could be affected by what’s going on. With that in mind, we have compiled this short list of things you can do to protect your mental health during this testing time. 1. Stay informed (but avoid speculation) It’s important to stay informed about the COVID-19 outbreak and access information from high quality, reputable sources. Rumour and speculation only serve to fuel anxiety, which is why you should avoid less than trustworthy news. Also, don’t feel as though you have to constantly watch, read or listen to updates. Limit you consumption to once or twice a day to reduce overwhelm. 2. Stay connected It can be easy to feel isolated right now, especially if you are used to going out and interacting socially with other people. Overcome this feeling by staying as connected as possible with your friends and family. We’ve never had so many methods of communication available to us, so take advantage of technology and keep social conversations going. 3. Stay busy When we’re not keeping ourselves occupied, there’s a tendency for our minds to run wild – especially while there is an ongoing global pandemic. This can lead to negative thoughts, including lots of ‘what if’ scenarios. Use the extra time you’ve got right now to complete all those tasks around your house you’ve been meaning to do for ages. It’ll keep your mind occupied and give you a sense of achievement. [Related reading: 5 simple ways to stay physically active while you’re stuck at home]
The ongoing COVID-19 outbreak means many of us are spending a lot more time at home than we usually do. If you’re someone who enjoys regular trips to the gym, or jogs around your local park, you might be feeling decidedly antsy right now. But while social distancing measures and self-isolation means fewer opportunities to stay fit and active outdoors, there are ways you can maintain your physical and mental health while at home. Fortunately, there are a number of activities you can do at home that will satisfy the global recommendations for adults to accumulate at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week. Here are 5 ways to stay physically active in your own home: 1. Online yoga Yoga is great for both physical health and general wellness. It can also help relieve lower back and neck pain. The best part of all is you can practice it very easily and affordably at home. Just put some comfy clothes on and find a yoga channel you like on YouTube. 2. Simple resistance exercises If you haven’t got proper weights at home, no problem. Just be a little creative instead. Use a can of soup in each hand in place of dumbbells and do repetitions while sat comfortably on a chair. Find heavier objects if you want more resistance. 3. Basic calisthenics Calisthenics are exercises that require nothing more than your own body weight. So things like sit-ups, push-ups and pull-ups are all classed as calisthenics. If you want some additional encouragement, pull up a YouTube video and workout while watching it. 4. Home cardio Cardiovascular exercises work by increasing your heart rate for a short period of time. Examples of cardio exercises include running on the spot, jumping jacks, lunge jumps, and skipping in place. 5. Household chores Believe it or not, your household chores are a great way to get some exercise. Vacuuming and mopping floors is a great way to burn some calories, while removing laundry from the washing machine and hanging it out to dry gives your muscles a workout.
Several studies have revealed that COVID-19 is disproportionately impacting men and the potential reasons include everything from biology to bad habits. According to the World Health Organization, men have accounted for 69% of COVID-19 related deaths in Europe. Meanwhile, reports suggest that in New York City men have been dying from COVID-19 at almost twice the rate of women. It is thought that both genetics and lifestyle choices play a part when it comes to COVID-19 outcomes in men. First and foremost, because of their extra X chromosome, women have stronger immune systems and respond better to infections than men. Then there is the fact that more elderly men suffer from heart disease than elderly women and that high blood pressure and liver disease are more prevalent in men too. All of these conditions are factors that are associated with more negative COVID-19 outcomes. In addition, men are statistically more likely to smoke than women. In fact, according to Our World in Data figures, more than one-third (35%) of men in the world smoke, compared to just over 6% of women. With smoking one of the biggest risk factors for chronic lung disease, men are at a much greater disadvantage should they get COVID-19. [Related reading: Can you catch the new coronavirus twice?]