August 14, 2020
40% of people who contract COVID-19 don't show symptoms
Researcher Monica Gandhi, infectious disease specialist at the University of California in San Francisco, looked more closely at recorded infections and the individuals infected who claimed asymptomatic. When looking at a homeless shelter in Boston, 147 residents were infected, but 129 of those infected reported experiencing no symptoms; a food processing plant in Arkansas reported 481 infections, and again, nearly 95% of those infected were asymptomatic; and, in prisons across multiple states, 3,277 individuals were infected, while only 132 (4%) reported experiencing symptoms. Overall, this is a good thing. But why is it the case? The most popular theory is that more of us than we know are already walking around with partial immunity (largely thanks to "memory" T-cells). The verdict is still out, but the findings could have far-reaching implications on the way we respond to the virus. Read more
The health of Americans in the Northeastern states seems to be on the rise, while residents of some Southern states are facing a sharp decline during the pandemic. As of the release of these findings, New York, Maine, Connecticut, New Hampshire, New Jersey, Rhode Island, and Vermont are leading the recovery efforts so far, based on their COVID-19 death and hospitalization rates (the lowest in the country) for the latest week recorded. On the other hand, Mississippi, Florida, Alabama, South Carolina, Arkansas, Georgia, and Louisiana are struggling with the highest rates of hospitalization and death due to COVID-19 over the same week. Idaho and Nevada are also seeing similarly grave conditions, as rates of COVID-19 continue to increase. Results for these findings are based on key metrics of state health pertaining to COVID-19, namely: recent death rate, positive COVID-19 testing rate, transmission number, hospitalization rate, and influenza activity level. If the aforementioned states can do it, there's hope that the rest will also be able to turn things around. Read more
Researches at the CDC found that the hospitalization of children due to COVID-19 increased between March and July, and that one in three hospitalized children needed admittance to the ICU due to infection severity (a rate similar to that of adults). Children in minority groups have been hospitalized more frequently than white children, a trend also seen in adults. Overall, these findings have urged public health officials to better track pediatric cases of the virus and enforce more consistent mitigation efforts in environments where the gathering of children is essential or hard to avoid. Read more
Research from the American Heart Association is finding a connection between individuals' level of education and their risk of heart disease. Multiple studies have already shown that education can be a strong predictor of heart disease, and now Dr. Arshed A. Quyyumi, director of the Emory Clinical Cardiovascular Research Institute in Atlanta, is adding further insight to this finding. He shared that a college-educated person who has already had a heart attack faces the same risk of mortality during a specific period of time as a non college educated person who has not had a heart attack. Moreover, the risk of individuals with only a grade school education of eventually facing heart disease, failure, or stoke is about 55%, while the same risk factor for those with graduate degrees is about 35%. While knowledge about the exact levers that are being pulled here is still unclear, Quyyumi notes that people with higher levels of education are likely to get better jobs, have more consistent health insurance, and are less likely to experience chronic financial stress—all contributing factors when it comes to heart disease and other illnesses. Read more
School nurses were already splitting time between different schools prior to COVID-19, but now, both staffing and access to PPE are major questions—and potential challenges—for the public school system. As the academic year nears and many school districts are set to welcome students back, the National Association of School Nurses says, "on-campus medics are wholly unprepared because of a lack of funding and nurses." In addition to existing responsibilities, schools nurses will now have to become adept at identifying students who might be at school despite possibly having COVID-19 symptoms. Many nurses are ready to do their best this fall, even with limited resources, but ensuring hand washing, the donning of face coverings, and the cleaning of surfaces will now be more important than ever. Read more
Leigh Bowie is a travel nurse with nearly 30 years of experience. During a recent travel assignment to New York, Bowie stated that she hadn't seen anything quite like COVID-19—from converting virtually every unit to a COVID-19 unit to even going so far as to open a closed hospital wing to add eight extra beds. She said she saw patient after patient who, no matter how much oxygen she gave them, couldn't grasp a full breath of air. After her February-March assignment in New York ended, she said the suffering and death she saw there was so inescapable that she didn't want to stay in the city a day longer than necessary. She said that while in New York, the virus felt inescapable. Conversely, when she was back in Arizona, it felt like people didn't even think the threat was real; whether people believed in conspiracy theories or were in denial, they all behaved as if they were untouchable. She wondered, "If people understand that the disease is dangerous, why aren’t they acting like it?" She still doesn't quite have her answer, but a near future of following outbreak from city to city, largely due to this lack of attention or even outright denial, seems to be the reality for her. Read more
One positive that the pandemic has brought with it is the relaxation of practice restrictions for Advanced Practice Registered Nurses (APRNs). This summer, a study is being carried out with the sole purpose of measuring the "impact of decisions by state leaders to waive physician oversight of APRNs during the pandemic." Researchers are hopeful that positive findings may provide strong evidence to policymakers that relaxing these same regulations in the long term can provide an overall benefit to the health system and access to care. Read more
Clockin' Out ✌
Last week, we asked you what is the best brand of stethoscope?
The poll revealed that 65% of nurses reported "Littman" as the best brand of stethoscope.
In other news, "An epidemiologist, an ICU doctor, and a scientist walk into a bar... just kidding." - Amanda Weinstein, @ProfWeinstein