COVID-19 Update: Doc Fired for PPE Complaint, Swab Comparison

Ryan Syrek, MA

July 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:

MD Fired Over PPE Complaints

After 17 years, emergency physician Ming Lin, MD, was fired from St. Joseph Medical Center in Bellingham, Washington after making public pleas for stronger COVID-19 protections. In Facebook posts and messages sent to hospital managers, Lin asked for better respiratory protections, quicker lab turnarounds, and more restrictions for visitors. Shortly thereafter, Lin was removed from his role.

"It was quite traumatic," said Lin, who has practiced emergency medicine for 30 years. "It feels like someone just punched you in the gut." Lin is now suing the medical administration company under which he was contracted to work. His legal challenge alleges wrongful termination in violation of public policy and breach of contract, among other claims.

Anti-retaliation lawsuits filed by nurses and doctors have steadily increased since the start of the pandemic. Legal experts say that knowing your legal rights when it comes to workplace safety and retaliation is critical, especially as the pandemic worsens. 

Self-Swabs for At-Home Tests Comparable to In-Office Swabs

A new study shows that results of COVID-19 tests using midnasal swabs taken at home are similar to results of tests using nasopharyngeal swabbing performed by clinicians. The study of 185 participants found that home swab testing was 80% sensitive and 98% specific for detecting SARS-CoV-2, compared with testing administered by clinicians.

The latest results, published online in JAMA Network Open, support earlier findings reported in the same journal. In a previous study of 30 participants, Stanford University researchers found patient-collected specimens to be 100% sensitive and 95% specific.

Researchers behind the new, larger study suggest that these findings indicate self-swab collection "is safe and scalable in the pandemic setting, permitting widespread testing of symptomatic participants early in illness and the potential for prompt self-isolation and contract tracing."

However, one potential limitation to the study is the fact that most participants were healthcare providers. Whether the general public would be as adept at obtaining samples could be a concern, although further studies are planned.

Clinicians Raise Awareness of Chronic COVID-19

A group of doctors in the United Kingdom are fighting for clinical recognition of what they call "long COVID." More than 100 clinicians in a Facebook group called UK Doctors: COVID "Long Tail" argue that, because to a lack of awareness, thousands of coronavirus patients risk going without treatment and support for debilitating symptoms that can last for months.

Reported symptoms of chronic COVID-19 include ongoing cardiac, gut, and respiratory issues; skin manifestations; neurological and psychiatric problems; severe fatigue; and relapsing fevers, sometimes lasting longer than 16 weeks.

The group of clinicians warns of the need for clinical recognition of chronic COVID, along with systems to log symptoms and manage patients in the community. Three members have highlighted their concerns in the BMJ and other social media outlets. They warn that a failure to recognize chronic COVID-19 could lead to major consequences for a return to work across all professions, as well as implications for disease prevention.

Public Disregard Stuns Doc Who Survived COVID-19

After recovering from COVID-19 himself, Michael Saag, MD, an infectious disease doctor in Alabama, is frustrated by his community's response to the pandemic. Despite a dramatic increase in confirmed cases, Saag says it is still common to see fewer than half the people inside stores wearing masks.

The doctor said he became particularly upset recently after stopping by a restaurant to pick up a takeout order and seeing 60 people inside. "Myself and one other person were the only two people wearing masks. And everybody else, not only were they not wearing masks, they were congregating together," he said. "And they look at me like I'm some sort of pariah wearing a mask."

In other areas as well, doctors are speaking out about how the public’s failure to take coronavirus seriously is affecting them. Some physicians and nurses say that, although they were hailed as heroes early on, they now feel more like cannon fodder, as the response to the pandemic has become increasingly political.

"Father of ECMO" Explains Its Use in COVID-19 Patients

Robert Bartlett, MD, a leader in the development of extracorporeal membrane oxygenation (ECMO), shared his thoughts on how that technology is now being used in select patients with COVID-19. The so-called "father of ECMO" explained that the treatment is only used after all conventional approaches have been exhausted.

Bartlett spoke about outcome data, associated risks, and potential future uses. He noted that earlier use of ECMO has been discussed but clarified that "no one is seriously doing that" right now. Interest in ECMO as a treatment of last resort is likely to remain high, as the number of severe COVID-19 cases continues to rise. 

Teens, Tweens Most Likely to Spread COVID: Should Schools Reopen?

A new study has found that children and teenagers aged 10-19 are more likely to spread coronavirus among family members than adults and children younger than 10. The study out of South Korea was published online as an early release article from Emerging Infectious Diseases.

Researchers at the US Centers for Disease Control and Prevention and the Korea CDC analyzed reports from nearly 60,000 people who had contact with 5706 coronavirus patients between January and March. They found that, in households with coronavirus patients aged 10-19 years, nearly 19% of contacts tested positive for COVID-19.

This was the highest rate of transmission among the age groups, with children younger than 10 having the lowest rate (5.3%)

Given these findings, how do you feel about sending kids back to school? Submit your response in our reader poll.

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 1800 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.

Ryan Syrek, MA, is the section editor for Medical Student and Resident content at Medscape.

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