COVID-19 Daily: US HCW Infections and Deaths, CPR Guidance

Ellie Kincaid

April 15, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Here are the coronavirus stories Medscape's editors around the globe think you need to know about today: 

CDC Quantifies Deaths, Infections of Healthcare Workers 

As of April 9, more than 9000 healthcare workers in the United States had diagnosed cases of COVID-19 and at least 27 had died, according to data the Centers for Disease Control and Prevention (CDC) published Tuesday

The CDC report notes that the number of cases among healthcare workers "is likely an underestimation," because data on whether patients were healthcare workers was available for only 16% of reported cases. 

Of the nearly 50,000 COVID-19 cases reported to the CDC that included information on whether the patient was a healthcare worker, nearly one fifth were healthcare workers. Among healthcare worker patients with data on potential exposure settings, more than half reported contact with a known COVID-19 patient only in healthcare settings.

Interim Guidance for CPR

Eight medical societies have issued interim guidance on treatment of victims of cardiac arrest with suspected or confirmed COVID-19. The guidelines call for clinicians to take into account a variety of factors, including age, comorbidities, and illness severity to determine the appropriateness of resuscitation, and "the likelihood of success" must be balanced "against the risk to rescuers and patients from whom resources are being diverted," the authors state. 

"The guidance sought to balance the provision of timely, high-quality resuscitation to patients while simultaneously protecting rescuers," one of the authors told | Medscape Cardiology

Essential vs Elective

As federal and state authorities have directed that healthcare providers discontinue nonessential care during the COVID-19 pandemic, "efforts to determine what care should qualify as essential have devolved into emotional appeals and publicity campaigns for different interest groups hoping that the squeaky wheel will get the grease," the director of the division of medical ethics at New York University Langone Medical Center, in New York City, and a coauthor write in Medscape

They propose a framework they call "a structured, ethical way to think about which sorts of services should be considered essential and which services might be offered even if not deemed essential."

Is Hydroxychloroquine Making COVID-19 Clinical Trials Harder?

With widespread off-label use of drugs such as hydroxychloroquine, some researchers trying to run clinical trials of COVID-19 interventions are facing challenges to achieve baseline conditions that would help their studies get decisive results, Undark reports. Many patients who might have been candidates have already received another experimental treatment. Anecdotally, doctors have reported patients declining trials in order to receive hydroxychloroquine. 

"Desperate clinicians all over the country are using drugs off-label because they don't have anything else," said the director of the Center for Drug Evaluation and Research at the US Food and Drug Administration. But that may make it more difficult for researchers to find out what really works. 

How Frontline Healthcare Workers Try to Protect Their Families

Healthcare workers and first responders are going to great lengths to keep their families safe from COVID-19, WebMD Health News reports, as they worry that they are carrying the virus home from work with them. 

Many, like a Boston-area firefighter, are staying away from their families. After answering a call to treat a man in his 20s with COVID-19-like symptoms who needed CPR, the firefighter decided he couldn't go home after his shift. He drove by his house to wave to his family, then checked into a hotel, and later found free housing in Harvard University dorms. 

"As long as adequate safeguards related to PPE and testing are not in place, hospitals and public health officials should be isolating health care workers from their families and communities," one expert said. "It is the only way to be sure that further community transmission is slowed."

What Do You Think of the Reaction to COVID-19?

In response to the spread of COVID-19, some medical offices have converted to telemedicine visits or closed entirely, while some hospitals have rationed personal protective equipment and told employees not to speak publicly. Public health officials have suggested that the general public wear homemade masks, and various lockdown orders have been declared.

What do you think of various stakeholders' reactions to COVID-19? Let Medscape know by participating in our poll

Medscape and Top Comedians Team Up for a COVID-19 Fundraiser

As Rob Corddry, Daily Show alum and star of The Unicorn on CBS, watched a good friend who works in a Los Angeles hospital struggle to keep up with the pace of COVID-19, he wanted to do something to help. Corddry has joined forces with Medscape and WebMD to raise money for Project C.U.R.E., an international organization that provides face masks and other protective medical equipment to millions of healthcare workers across the world.

You can watch the world premiere of the "Funny You Should Mask" fundraiser on the Medscape Facebook page tomorrow, April 16, at 8 PM ET. It stars Corddry along with Dr Ken Jeong, Eric Andre, Sasheer Zamata, Nicole Byer, and Kumail Nanjiani, plus some healthcare workers on the front lines of the COVID-19 fight. 

You can also check out the Medscape Instagram page tomorrow to listen to video messages of thanks to healthcare workers from other famous comedians, including Ed Helms and Sarah Silverman.

In Memoriam

As front-line healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. Hundreds throughout the world have died. 

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form

Ellie Kincaid is Medscape's associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine.

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