COVID-19 Update: WHO Steps Up, Mask Exemptions

Victoria Giardina

July 07, 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

WHO Steps Up

The World Health Organization (WHO) is preparing a scientific brief to address the continually emerging evidence on transmission of COVID-19 and will release it "in the coming days," an official said. The brief will likely address airborne transmission of the virus, and comes after 240 scientists published a commentary calling for attention to the possibility that SARS-CoV-2 can circulate in air via microdroplets, particularly in poorly ventilated indoor spaces.

"Airborne route of infection transmission is significant, but so far completely undermined, and not recognized by the decision makers and bodies responsible for infection control," lead commentary author Lidia Morawska, PhD, told Medscape Medical News.

In related news, the US government has formally notified the United Nations it will withdraw from the WHO, effective in 1 year, the Associated Press reports.

Mask Exemptions

As more states and cities mandate facial coverings in public, some people have called their doctors to request medical exemptions to public mask requirements. Albert Rizzo, MD, chief medical officer of the American Lung Association, offers his advice for physicians fielding such requests.

"I recommend a loose-fitting mask that covers the nose and mouth and isn't going to fall off but isn't so tight around the ears and neck to make them feel uncomfortable," Rizzo said. "If you can take the time to discuss options — mask styles, desensitization, etc — the patient usually understands and will try wearing a mask."

"Surge Testing" Plan

The US Department of Health & Human Services (HHS) announced plans for "surge testing" in three southern cities it dubbed "hot spots" — Jacksonville, Florida; Baton Rouge, Louisiana; and Edinburg, Texas. HHS will offer 5000 tests in each city for 5-12 days of surge, at no charge to those tested.

"Testing is going to help. We need to have testing. I'm all about testing," HHS Assistant Secretary Admiral Brett Giroir, MD, said during a press briefing. "That's what I think about 24/7, but we've got to do physical distancing and take other steps such as wearing masks and shielding older people and other vulnerable groups from the virus."

Higher Stroke Rates

Patients with COVID-19 may be at increased risk of acute ischemic stroke compared to patients with influenza, a retrospective cohort study from researchers at New York-Presbyterian Hospital and Weill Cornell Medicine in New York City suggests.

The study included more than 1900 adults who tested positive for COVID-19 and a historical cohort of nearly 1500 hospitalized patients with laboratory-confirmed influenza. The researchers identified strokes in 31 COVID-19 patients and three influenza patients. After adjustment for age, sex, and race, stroke risk was almost eight times higher in the COVID-19 cohort.

"These findings suggest that clinicians should be vigilant for symptoms and signs of acute ischemic stroke in patients with COVID-19 so that time-sensitive interventions, such as thrombolysis and thrombectomy, can be instituted if possible to reduce the burden of long-term disability," the researchers write.

It's a Wildfire, Not a Wave

There is much talk of a second COVID-19 "wave," yet Harvard epidemiologist William P. Hanage, PhD, believes we're using the wrong metaphor, he writes in Medscape. Ocean waves rise and fall independent of what people do, but the same is not true for COVID-19.

"A wildfire is a better metaphor for this pandemic," Hanage writes. "Even if we have doused the area around us with water, we should not be surprised to find the fire still burning elsewhere. If there is dry brush and oxygen, there will be more fire. In this metaphor, the virus is the fire, we are the dry brush, and opportunities to transmit are oxygen. An ember can be carried a long way before it sparks another blaze. We should get used to this and accept that complete normality is a long way off."

In Memoriam

As frontline 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 1700 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.

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Victoria Giardina is Medscape's editorial intern. She has previously written for The Dr. Oz Show and is currently a national lifestyle writer for Her Campus. She can be reached at vgiardina@webmd.net or on Twitter @VickyRGiardina.

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