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COVID-19 Update

Neda Frayha, MD and Devang Patel, MD

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In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel and our own Dr. Neda Frayha discuss the latest, clinician-focused updates on the COVID-19 coronavirus outbreak. 

  1. Wuhan Coronavirus - 2019-n-CoV. Infectious Diseases Society of America. Accessed 2 Mar 2020
  2. 2019 Novel Coronavirus (2019-n-CoV), Wuhan, China. Centers for Disease Control and Prevention. Accessed 2 Mar 2020.
  3. Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. Accessed 2 Mar 2020.
  4. del Rio C, Malani PN. COVID-19—New Insights on a Rapidly Changing Epidemic. JAMA. Published online February 28, 2020. doi:10.1001/jama.2020.3072
  5. Fauci AS, Lane HC, Redfield RR. Covid-19 - Navigating the Uncharted. N Engl J Med. Feb 28, 2020; DOI: 10.1056/NEJMe2002387
  6. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. Published online February 24, 2020. doi:10.1001/jama.2020.2648
  7. Bai  Y, Yao  L, Wei T,  et al. Presumed asymptomatic carrier transmission of COVID-19.  JAMA. Published online February 21, 2020. doi:10.1001/jama.2020.2565
  8. Zhang W, Du RH, Li B,  et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes.  Emerg Microbes Infect. 2020; 9(1):386-389.
  9. Wang D, Hu B, Hu C,  et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.1585
  10. Yee J, Unger L, Zadravecz F, et al.  Novel coronavirus 2019 (COVID‐19): Emergence and implications for emergency care. Ann. Emerg. Med 2020; 1– 7.
  11. Li Q, Guan X, et al. Early transmission dynamics in Wuhan, China of novel coronavirus-infected pneumonia. N Engl J Med January 29, 2020. DOI: 10.1056/NEJMoa2001316
  12. MacIntyre CR, Chughtai AA. Facemasks for the prevention of infection in healthcare and community settings  BMJ 2015; 350 :h694.
  13. 13. Rezaie S. “COVID-19: The Novel Coronavirus 2019.” REBEL EM Blog, March 1, 2020. Available at:

Ian L., Dr -

With regard to the supply of PPE -masks gowns googles gloves there is a huge supply in “ Elective Care “ from cosmetic surgery to joint replacements to screening colonoscopy that in a crises will have to be deployed to primary care and long term aged care facilities .
With respect to testing say patients with a runny nose and slight sore throat the flocculated nasal swab has good sensitivity and is easy to obtain in fact patients and also health care workers can take their own swabs store as per instructions ie at 4-10C and have them sent to test centre with the viral panel turn around which can be 6-8 hours per run 24/7 this will cover a lot .

Ian L., Dr -

Another option is industrial raincoats which can be washed with diluted bleach as part of the gown protection -industrial goggles and- maxi guard half face respirators with replaceable P2 per filters R7N11 as an example with iterations .

Fredrik H. -

What do you think about this article?

Should we in primary care temporarily recommend pausing ACE inhibitors or ARBs for a while?

Neda F., MD -

Hi Fredrik. This is a hot topic right now and so far major organizations like the ACC are recommending we continue ACEs and ARBs in the patients who are already on them. We will definitely be watching this space and will keep you all posted. Thanks for sharing the article! -- Neda

Eve C. -

I just listened to free bonus that you pushed out to EM Rap about NSAIDS/ACE/ARBs and would love to see info like this pushed out to primary care rap as well. We may be tasked to function in more emergent setting and would benefit from any critical care/ER information as well at this point.

Neda F., MD -

Hi Eve. We are on it! We are working on a whole curriculum to address these exact questions. Thanks so much for writing in. -- Neda

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