September 16, 2020 - a podcast by COVID19LST

On today's episode we discuss:

—Climate: Emergency medicine physicians at Massachusetts General Hospital (U.S.) describe the challenges posed by increasing natural disasters due to climate change in the context of COVID-19, specifically an increased need for hospitals during heat waves and natural disasters, and the need for virus transmission mitigation efforts during evacuations due to fires and hurricanes. The authors propose short-term solutions to these issues, such as the need to modify sheltering in response to natural disasters, and long-term solutions, such as increasing state and national funding for climate mitigation and public health disaster plans.

· Members of global health departments in the US and India call attention to the accelerated timelines of vaccine development for COVID-19 and highlight the critical need for active safety surveillance, especially in low-and-middle income countries, to establish capacity for primary data collection in addition to delineating real adverse reactions to ensure proper understanding and awareness of the benefit-risk profile of an imminent COVID-19 vaccine.

—Transmission & Prevention: The systems director of Laboratory Services at Houston Methodist Healthcare System in Texas presents a description of the effectiveness of an Incident Command System (ICS) implemented in their organization at the very beginning of the COVID-19 outbreak. The author highlights the role of ICS in organizing the staff and patients, in addition to analyzing, planning, and implementing strategies to manage the pandemic and alleviate anxiety through communicating reliable information, indicating the importance of an ICS in organizations for constructive disaster management in the future.

—Management: A single-center retrospective cohort study or 205 patients with confirmed COVID-19 pneumonia with acute hypoxemic respiratory failure (AHRF) and 60 patients treated with corticosteroids at the physician's discretion found that patients treated with corticosteroids exhibited lower risk of ICU transfer, intubation, and death in addition to greater SpO2/FiO2 improvement when compared to controls. These results suggest that usage of corticosteroids for non-intubated patients with COVID-19 pneumonia complicated by AHRF may lead to decreased mortality and complications.

—Adjusting Practice During COVID-19: Physicians, ethicists, and public health experts in San Diego County, California present the systems and protocols they developed for county-wide, population-based crisis management of COVID-19. The team developed healthcare community coalitions, teams to triage scarce resources, systems to transmit information across multiple facilities, virtual tabletop exercises for disaster preparedness, and committees responsible for transparent communication with the public.

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