COVID-19 Daily: Healthcare Worker Risk, Prone Positioning

Ellie Kincaid

May 22, 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: 

Healthcare Worker Risk

New data shed more light on the risks healthcare workers face in the COVID-19 pandemic: It may be higher early in a country or city's experience with the disease. Researchers from Wuhan, China, report that most healthcare worker infections occurred early in the disease outbreak, before clinicians may have been fully aware of the risk and thus may not have been using adequate personal protective equipment. 

In another study, symptomatic healthcare workers at two Dutch hospitals who tested positive for COVID-19 likely acquired the infection in the community during the early phase of local spread, researchers concluded. "This observation confirms the insidious nature of SARS-CoV-2 spread," the researchers write. 

Prone Position in Nonintubated Patients 

COVID-19 patients who require oxygen supplementation but who do not undergo intubation may experience some improvements in oxygenation by being put into the prone position, suggest two research letters published online in JAMA.

The studies were both small, each occurred at a single center, and neither had a control group. It's not yet clear whether prone positioning will help reduce intubation rates or the number of patients who require treatment in intensive care units. And, as one expert told Medscape Medical News, the biggest question is, "Does it save lives?" Answering that, she said, will require "huge multicenter trials."

YouTube Corrects Misdiagnosis of Doc's Video

A video interview about the COVID-19 pandemic by British oncologist and Medscape contributor Karol Sikora, MD, was removed from YouTube Tuesday for "violating guidelines." An initial appeal to have the video reinstated was initially rejected, but when Medscape Medical News inquired with Google, YouTube's parent company, a spokesperson said they had reconsidered and would now allow the video to post. 

YouTube — along with Facebook, Instagram, and Twitter — has taken steps to block or demote deceptive COVID-19 information while elevating scientifically sound sources like the World Health Organization and the Centers for Disease Control and Prevention. The social media platforms rely on algorithms to find and delete posts, but algorithms are blunt instruments and even human judgment calls can be questionable, as Sikora learned. 

"They've been told to police their stuff better so they have an army of 20-year-old kids looking at every single video on corona. It's simply bizarre! I feel a little sorry for YouTube," he told Medscape Medical News

COVID-19 and Healthcare Rationing: A Disabled Doc's View

Dinesh B. Palipana, MD, was halfway through medical school when he lost control of his car on a rain-slicked road. The car rolled nose-to-tail. When he tried to get out, he couldn't move or feel most of his body, and he was covered in blood. He was completely paralyzed from the chest down. 

Now, Palipana is senior resident in the emergency department at Gold Coast University Hospital and lecturer at Griffith University in Australia. As a doctor with disabilities, he offers his thoughts on healthcare rationing in the COVID-19 pandemic. 

Vaccine Trial Data

A vaccine in development in China appears tolerable and elicited an immune response, report researchers who conducted a safety study of 108 participants. "This is promising data, but it's early data," one expert who was not involved in the work told the New York Times of the research published in The Lancet on Friday. "Over all, I would say this is good news."

The Week That Wasn't 

This week in COVID-19 news, scientists suggested that cannabis could play a role in preventing SARS-CoV-2 infection, hamsters provided evidence that masks can curtail viral transmission, and a biotech company claimed it had discovered a "cure." But you didn't see these headlines on Medscape. We explain why in our weekly feature, "The Week That Wasn't."

Autopsy Guidance FAQ 

Medscape's reference article on COVID-19 autopsy guidance has a new section based on updated CDC recommendations for transporting the remains of people who have died of the disease. 

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. More than 1000 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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