24th in the series of WACEM-ACAIM Joint Working Group Meetings
ED & COVID-19: Where are the patients gone? presented by Dr. Lateef
Talks for this week kicked off with Dr. Lateef's insightful talk about the trends of ED attendance during the pandemic. Hospitals across Singapore, and more widely, across the world, saw a significant reductions in hospital attendances at the beginning of the pandemic. A qualitative analysis showed multiple reasons as to why this phenomenon occurred, ranging from altered health-seeking behavior to cultural influences, from attempts at self-management to lack of manpower. The concept of Behavioral Immune Responses (BIR) was also introduced, which refers to the psychological processes that infer infection risk based on perceptual clues through activation of various behavioral, emotive and cognitive responses that motivate pathogen-avoidance behaviors.
Blind Spots, presented by Dr. Stawicki
The topic of discussion by Dr. Stawicki alludes to the concept so regularly repeated in medicine, 'The eyes see what the mind knows'. Rather, the corollary, what the mind doesn't know, goes unseen. There are multiple areas in and outside of health care which led to the less than efficient handling of the crisis and learning from these instances will help us, not just with the ongoing pandemic, but future outbreaks. The paper is still in production.
HCW in COVID, presented by Dr. Sahu
Dr. Sahu presented results of his meta-analysis about healthcare workers infected by COVID-19. (Link: https://www.ajemjournal.com/article/S0735-6757(20)30483-6/fulltext ). The study concludes a significant risk of contracting COVID-19 among healthcare workers, but low incidence of severe morbidity and mortality.
Other papers co-authored by Dr. Sahu:
Evolution of Medical COVItrature, presented by Dr. Tiwari
Dr. Tiwari's paper and presentation highlighted the patterns and trends of literature during this pandemic, of which there were admittedly many. The difference in publications about clinical discussions and education and training for instance, among other examples, showed the trends in publication, or indeed, readership.
Clinical Update, presented by Dr. Downing
Dr. Downing's presentation of New York data confirmed obesity as being a significant indicator common between adults and children with COVID-19. The other notable point was the discrepancy in infection incidence and severity based upon latitudinal variations which led to the idea of a link between vitamin D deficiency and COVID-19.
Goals of Care in COVID, presented by Dr. Garg
Dr. Garg talked about topic that many a clinician has struggled with. The introduction of discussions regarding advanced directives - always difficult in the acute setting, and even more in the presence of a pandemic. Particularly one where there is already some healthcare paranoia, and specifically in the case of a disease with such high numbers of morbidity and mortality. Dr. Garg shared her hospital's introduction of a protocol nudging clinicians to have appropriately timed difficult conversations, which unfortunately remain vital in our communications with patients and their relatives.
More to follow next week...