ACP and other health entities are providing information for clinicians as the novel coronavirus disease (COVID-19) continues to spread around the world.
On March 2, the daily situation report from the World Health Organization (WHO) listed 88,948 confirmed cases worldwide (1,804 of them new). The disease was present in 65 countries, including six countries that reported their first cases the previous day (Armenia, Czechia, Dominican Republic, Luxembourg, Iceland, and Indonesia). The WHO also issued new COVID-19 guidance for businesses and employers on Feb. 26.
In the U.S., the first cases of community spread and the first deaths were reported. The CDC issued a press release regarding the first death. The agency also held a telebriefing on the virus on Feb. 26, created a preparedness checklist for health care professionals, and issued interim guidance for health care facilities on preparing for community spread. The CDC will hold a call for physicians and other clinicians on Thursday, March 5, from 2 to 3 p.m. ET, covering what to do to prepare for COVID-19 in the U.S.
More details on the characteristics of the virus were provided by a new Chinese study, published by the New England Journal of Medicine on Feb. 28. Data on 1,099 patients, from 552 hospitals, showed that 5.0% were admitted to an ICU, 2.3% were mechanically ventilated, and 1.4% died. The most common symptoms were fever (which 43.8% of patients had on admission and 88.7% developed during hospitalization) and cough (67.8%). Ground-glass opacity was the most common finding on CT (56.4%), with 17.9% of patients having no abnormality on radiography or CT. The median age of the patients was 47 years, with 0.9% of cases in children under 15 years.
Morbidity and mortality were higher among patients who were older or had comorbidities, noted the accompanying editorial by officials from the National Institutes of Health and CDC. If it is assumed that a large number of cases with no or minimal symptoms are going unreported, the data suggest that the mortality rate from the virus may be considerably less than 1%, the editorialists said. Phase 1 trials of a vaccine are expected by early spring, and potential therapies are being investigated now, they reported.
New related educational content from ACP includes “Novel Coronavirus: A Physician's Guide,” a free online learning activity that can be easily accessed on handheld devices and provides a clinical overview of infection control and patient care guidance, and a podcast, “Novel Coronavirus: What the Clinician Needs to Know.” The podcast was produced by Core IM in collaboration with ACP and includes an interview with Christina Fiske, MD, an infectious diseases subspecialist at Vanderbilt University Medical Center in Nashville, Tenn. For these coronavirus education activities, ACP members may report their learning time for CME credit without charge. ACP members are asked to share these resources with others in the health care community. Additional information on the novel coronavirus is also available on ACPOnline.org.
A new commentary published by Annals of Internal Medicine on March 3 urges clinicians to make travel history a standard part of patient encounters to help identify and contain emerging infectious diseases like the novel coronavirus. “All members of the healthcare team need training on how to integrate key epidemiologic information such as travel history in their risk assessments in the same way they are trained to ask about tobacco exposure to assess cancer and heart disease risk. They need a simple script to elicit clues for emerging infectious diseases and must be informed about current emerging pathogen threats, such as CoVID-19,” the commentary said.