Viewpoints: Lack Of Protection, Equipment Makes Dangerous Work For Medical Teams Fighting COVID-19; Lessons On Treating Patients With Pre-Existing Conditions

Boston Globe: Code Blue: We’re Doctors And We Need Personal Protective Equipment To Shield Us From The Coronavirus — Now
A critical lack of personal protective equipment — masks, N95 respirator masks, and powered air purifying respirators — makes our jobs not just difficult, but dangerous. The consequences of this failure to protect health care workers will be substantial. While it may take years to train a physician or nurse, it may take only a single exposure to kill one. (Regan Bergmark and Thomas Tsai, 3/25)

Bloomberg: Coronavirus: Why Surgeons Don't Want To Operate Right Now
Last week, the Italian government began publishing a new dataset related to the coronavirus pandemic. It features a list of names, starting with 68-year-old Roberto Stella, president of the Medical Association of Varese, in Lombardy. Stella’s name tops a roll call of doctors who’ve died from Covid-19 since March 11 alone. It had grown to 24 when I checked while writing this column — more than double the reported rate of medical deaths in China. The numbers confirmed what many doctors in the U.K. have suspected for some weeks: Those on the front lines are most at risk, not simply of catching the virus, but of getting its most severe form. So far, however, the very countries that have been slow to enact measures to suppress transmission in the community also lag behind in understanding and responding to the threat Covid-19 poses to doctors. (Therese Raphael, 3/24)

New England Journal of Medicine: Critical Supply Shortages — The Need For Ventilators And Personal Protective Equipment During The Covid-19 Pandemic
On March 11, 2020, the World Health Organization designated “coronavirus disease 2019” (Covid-19) a global pandemic. As the number of cases in the United States continues to grow, political leaders are encouraging physical (or “social”) distancing to slow the rate of transmission. The goal of this practice is to flatten the curve of new infection, thereby avoiding a surge of demand on the health care system, but the effects of physical distancing may take weeks to appear. U.S. hospitals are already reporting shortages of key equipment needed to care for critically ill patients, including ventilators and personal protective equipment (PPE) for medical staff. Adequate production and distribution of both types of equipment are crucial to caring for patients during the pandemic. (Megan L. Ranney, Valerie Griffeth, and Ashish K. Jha, 3/25)

Fox News: Coronavirus And Cardiovascular Disease – Stopping A Deadly Duo
As the COVID-19 pandemic continues to spread, one thing we have learned is that people with pre-existing chronic diseases are at substantially higher risk of severe complications and death. As we race to respond to this pandemic, we need to protect and provide care for the most vulnerable among us, including people living with cardiovascular disease and other chronic diseases. People with coronavirus infection and cardiovascular disease, hypertension and diabetes are at least twice as likely to die. Smoking is especially deadly – one study found that smokers have 14 times greater odds of developing COVID-associated pneumonia than non-smokers. (Former CDC chief Tom Frieden, 3/25)

New England Journal of Medicine: Practical Measures To Help Prevent Covid-19 
The rapid spread of SARS-CoV-2, a novel coronavirus that emerged in late 2019, and the resulting Covid-19 disease has been labeled a Public Health Emergency of International Concern by the World Health Organization. What physicians need to know about transmission, diagnosis, and treatment is the subject of ongoing updates from infectious disease experts at the Journal. In this audio interview conducted on March 25, 2020, the editors discuss transmission of SARS-CoV-2 and how to prevent it, particularly in at-risk health care workers. (Eric J. Rubin, Lindsey R. Baden, and Stephen Morrissey, 3/26)

Stat: Covid-19 Is Scary. A CRISPR-Made Pandemic Could Be Scarier 
Uncertainty breeds panic. As Covid-19 spreads across the planet, stock markets have crashed in response to the economic impact this virus will wreak on the global economy and cities around the world are shutting down. We shouldn’t really be surprised by SARS-CoV-2, the new coronavirus. We’ve seen this scenario play out before with Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). (Neal Baer, 3/26)

The Washington Post: It’s A Scary Time To Be Pregnant, But I’m Still So Grateful
This is my worst fear. I’m in labor, with a high fever, straining to breathe through contractions while wearing a mask. The moment my baby is born, she is taken away from me. I can’t hold her. I can’t touch her. The only way I can get breast milk to her is to express it and give it to someone else to feed her. If I survive the infection, it will be weeks before I can be sure that I’m no longer contagious and can be with my newborn. In the meantime, she will be tested to see whether she has acquired the infection. If she has, she could become critically ill and die. (Leana S. Wen, 3/25)

Stat: Covid-19 Might Delay The July 1 Start Date For New Medical Residents 
Some projections place the peak of Covid-19 infections in the U.S. between May and June. If it is still going strong at the end of June, it will collide with the start of a new year in teaching hospitals across the country: July 1 is traditionally the day that new doctors who had been medical students just a month or two earlier start work as doctors. (Martin Kaminski and Frances Ue, 3/26)

The New York Times: No Single Player Can Win This Board Game. It’s Called Pandemic.
Our new reality became very immediate for my wife Donna and me in late February, when she came down with nasty, flulike symptoms and couldn’t get tested for the coronavirus for four long weeks. When she finally did, we were relieved the test came back negative. But this felt personal in more ways than one: Donna was the inspiration for Pandemic, a board game that was originally released in 2008. I designed it to play with her. (Matt Leacock, 3/25)

Modern Healthcare: There'll Be No 'Back To Normal' For Healthcare After COVID-19 Crisis
As a result of this coronavirus crisis and our collective response to it, we just might be seeing what healthcare can look like once this crisis has passed. And it will pass, leaving all of us, and those we exist to serve, with a very different idea of what is possible from a transformed and consumer-centric healthcare industry. Simply, and at great risk of sensationalizing the milestone, the end of the COVID-19 coronavirus crisis will mark the beginning of a new day in healthcare. (Jonathan Manis, 3/25)

The Hill: We're In 'Emergency Mode' For Coronavirus — We Can Do The Same Thing For Climate 
A meme has been going around social media reading, “climate change needs coronavirus’s publicist.” The truth is, everyone who is treating coronavirus as an emergency is its publicist. Humans are social creatures. We look to one another to assess the seriousness of situations and decide whether or not to enter “emergency mode.” (Margaret Klein Salamon, 3/25)

The Wall Street Journal: New York’s Ailing Hospitals
Desperate for more hospital beds to treat a surge of coronavirus patients, New York Gov. Andrew Cuomo has understandably asked President Trump to task the U.S. Army Corps of Engineers to convert convention centers and empty college dorm rooms into makeshift wards. The virus wasn’t predictable. But it’s worth pointing out that the state’s hospital bed shortage is in part due to years of Medicaid mismanagement. (3/25)

Miami Herald: Haslem Angry At Spring Breakers Cavalier Attitude
The Miami Heat’s Udonis Haslem saw videos of insensitive Spring Breakers in his back yard saying things like, “If I get corona, I get corona,” and saw red. The party must go on? No, Haslem determined, the party must go, period. And it can’t be said often enough that everyone has a role to play in stopping the deadly coronavirus pandemic.Haslem, a 17-year NBA veteran, who is usually an enforcer for his teammates on the court, did the same for Miami. (3/25)

Boston Globe: Mass. Needs A Comprehensive Care Response To The Coronavirus
Heroic physicians, nurses, and other health care professionals and workers, led by brilliant managers, are working night and day to provide the best possible care while planning for a potentially overwhelming surge of demand. However, given the speed of contagion and the severity of symptoms, especially in older, frail, and unprotected populations, we now face the possibility that the COVID-19 pandemic could overwhelm our hospital and ambulatory care infrastructure sometime in April. (Robert Master, Gary L. Gottlieb, David Margulies, Chris Kryder, John Loughnane and David Martin, 3/25)

The Times-Picayune and The Advocate: Among The Pandemic's Centers, Metropolitan New Orleans Deserves Support
Doing the numbers, the crisis of coronavirus is serious in metropolitan New Orleans — higher than many other places.Among the top ten counties for cases, Orleans Parish is the only one not in the New York metropolitan area, according to an analysis by The Times-Picayune and The Advocate. Are we being neglected by national policymakers? A feeling of abandonment is not new to the metropolitan area in New Orleans, given the disastrous federal response — or lack thereof — after Hurricane Katrina in 2005. (3/25)

Boston Globe: How A Remote Island Hospital Prepares For The Coronavirus Pandemic
Nantucket Cottage Hospital has 14 licensed beds. We have no intensive care unit and only five ventilators, and these resources are most needed to handle acute cases of COVID-19. Other areas of the hospital have been identified as places to care for patients and increase our capacity if necessary, including outpatient departments. But if we face a significant surge of COVID-19 patients, our providers and facility could quickly be overwhelmed. (Gary Shaw and Diane Pearl, 3/26)