27th in the series of weekly WACEM-ACAIM Joint Group Meetings
COVID Care, by Dr. Sagar Galwankar
Dr. Galwankar started off this meeting with some insight into the institutional responses from his hospital in Florida. Some notable features included daily internal communications, engaging in innovation, and public education. A key to good functioning of plans was the team work employed. They were proactive with enforcing safety procedures and protocols, including strict visitation policies (which were reviewed daily), reiterating PPE donning/doffing procedures and mask usage, handling waste disposal, patient transportation. Every admission received a COVID swab, and suspected cases received rapid testing. A public education portal allowed for quality and science based information sharing with the public.
Case Presentations, by Dr. Sagar Sinha
Dr. Sinha presented two cases which generated valuable discussion about its key messages. Sharing a few links below:
Resuscitation of Adult Cardiac Arrest Patients during a Pandemic: https://onlinelibrary.wiley.com/doi/full/10.1002/emp2.12096
Ventilator allocation guidelines, NYS DOH Draft Statement:
Cardiac Arrest Algorithm during COVID-19 (ACLS):
COVID-19 in Paediatrics, by Dr. Lorraine Mendez and Dr. Nicholas Bencomo
This important presentation began with a summary of the pathophysiology, transmission and clinical features of COVID-19. It then focused on PIMS (Paediatric Inflammatory Multisystem syndrome) / MIS-C (Multisystem Inflammatory Syndrome in Children) which is a Kawasaki-like disease first reported in Europe and USA. With the theory that Type 1 cytokine (Interferon alpha and beta) release is associated with milder disease, whereas Type 2 cytokine (interferon gamma and TNF) release is associated with moderate to severe disease, which might explain the different severity of presentations. We discussed the disease as defined by the CDC, and the outpatient treatment algorithms. Links below:
Case definition of MIS-C by CDC: https://emergency.cdc.gov/han/2020/han00432.asp
Clinical Guidance from American College of Rheumatology: https://www.rheumatology.org/Portals/0/Files/ACR-COVID-19-Clinical-Guidance-Summary-MIS-C-Hyperinflammation.pdf
Global Distribution of COVID-19 papers, by Dr. Sunil Raina
Dr. Raina dove into the publication world during the pandemic. His review of publications as listed on PubMed showed a 70% increase in references from 30000+ to 55000+ within the span of 7 months. Clinical trials revealed 112 resources, of which 33% came from one contributing country (China). It revealed a differential distribution of research references by geography, and highlighted the COVID-ization of research in 2020.