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What is Cochrane?

Cochrane has now developed a crowdsourcing application available to anyone to report on new evidence.

What is TaskExchange?

TaskExchange connects people working in health evidence with people who have the time and skills to help.

The Covid-19 pandemic provides an opportunity. While the impact is devastating and lethal to some people, at the same time it is a tragic battleground to be examined by clinicians and scientists.  Although in the coronavirus family, this new mutation is a novel and fresh organism, which has some very different pathophysiology from ordinary and historical seasonal corona influenza.

The current protocols for prevention, diagnosis, containment, and beyond are based upon standard CDC guidelines, which have been used previously for  SARS, MERS, EBOLA, and AIDS (HIV).  We are especially fortunate that one of the members of the task force is Deborah Birx, M.D. who has a life-long interest and experience with the aforementioned epidemics.

 Corona virus-19 Cheat Sheet

Evolution of CVID-19 Pandemic

For more specific details, I suggest these links regarding Covid-19

NEJM

JAMA

BMJ

UpToDate

Cochrane Database

Internet Book of Critical Care

https://register.gotowebinar.com/register/3740452101263557388

Tracking COVID-19 IMPORTANT UPDATE

BREAKING NEWS MAYOR WILLIAM DEBLASIO GAVE AN IMPASSIONED SPEECH TO NEW YORK CITY CITIZENS EXPRESSING HIS SEVERE DISAPPOINTMENT IN THE   FEDERAL GOVERNMENT.  HE REQUESTED ASSISTANCE FROM THE FEDERAL GOVERNMENT TO MEET THE NEEDS OF NEW YORK CITY BY APRIL 2020.  HE STATED THAT SUPPLIES WOULD BE EXHAUSTED AT THAT TIME. HE EXPRESSED HIS FRUSTRATION AT THE PRESIDENT'S DELAY IN USING HIS ALREADY ESTABLISHED POWERS TO ENGAGE THE MILITARY AND THE VETERANS ADMINISTRATION HEALTH CARE SYSTEM, AS WELL AS DOD TRANSPORTATION ASSETS TO DISTRIBUTE HEALTH-RELATED MATERIALS.  DEBLASIO ALSO SAID. THE PRESIDENT HAS THE POWER TO DIRECT MANUFACTURERS TO DO WHATEVER IS NECESSARY TO MEET THE NEEDS OF THE PEOPLE, INCLUDING DIVERTING MANUFACTURING FACE MASK, SURGICAL GOWNS, AND OTHER PROTECTIVE GEAR. Major hospital and medical groups called for Congress to provide $100 billion in direct assistance to front-line healthcare workers and hospitals so they can get ready for the influx of COVID-19 patients. The letter, sent Thursday by the American Hospital Association (AHA), the American Nurses Association and the American Medical Association, comes as some healthcare systems are beginning to be overwhelmed in hot spots of COVID-19 outbreaks. “Due to expenses to treat COVID-­19 patients, hospitals are currently losing up to $1 million per day,” the letter to congressional leaders said. “This loss may increase as the outbreak spreads.”  The letter calls for immediate funding in three areas. The first is a stabilization fund that will include covering losses due to the suspension of elective services, a key moneymaker for hospitals. The fund will also help cover training on telemedicine and telehealth as well as increased costs for more healthcare staff. Hospitals should also get money for construction and retrofitting facilities to create separate areas to screen for COVID-19. Another major priority is ensuring childcare for front-line healthcare professionals. This can be done by partnering with schools or daycare centers to provide funding for childcare. “Schools have closed in numerous states, leaving many front line health care personnel with an impossible choice—caring for their children or caring for their patients—a choice that can be alleviated if Congress takes swift and comprehensive action to assist with providing childcare during this unprecedented time,” the letter said. RELATED: Physician practices told to be extra cautious in purchasing supplies from 'grey market' Congress must also provide funding for the capacity to care for mild or moderately sick COVID-19 patients at alternative care sites. “This is a crucial step in ensuring we have as much inpatient capacity as possible to respond to the sickest COVID-­19 patients,” the letter said. “Funding also may involve creating temporary structures.” The request comes after the AHA sent a separate letter to Congress asking them to include direct assistance in a financial stimulus package the White House and Congress are hammering out. Lawmakers are debating a package of nearly $1 trillion that could include direct economic assistance to every American, payroll tax holidays and economic assistance to small businesses. Providers wanted to make sure lawmakers did not forget about them in the run-up to the stimulus but did not give a direct number until its latest letter on Thursday.The biggest worry for hospitals, healthcare workers: Protective equipment In order to bring you the most comprehensive and up-to-date information relating to the pandemic, we are publishing additional stories and all of the day’s coronavirus-related news in a PM edition. If you would prefer not to receive this newsletter, you may opt-out at any time by clicking here.

• Trump talks drug progress amid COVID-19 pandemic, but FDA chief Hahn urges caution
• The biggest worry for hospitals, healthcare workers: Protective equipment
• With new FDA approval, Abbott sets a goal of shipping 1 million coronavirus tests per week
• Eli Lilly opens labs, plans drive-thrus to help boost Indiana's COVID-19 testing capacity
• Home telehealth and testing companies pivot to mail-in coronavirus tests
• Biopharma roundup: Merck KGaA donates Rebif for study; Medtronic, GE Healthcare boost production of supplies
• Healthcare roundup: Insurer, provider and pharma groups send demands to White House
• Providers implore Congress to give $100B in assistance to handle COVID-19
• UPDATED: Bayer donates millions of tablets of chloroquine to help in COVID-19 fight
• AbbVie’s HIV drug Kaletra stumbles in COVID-19 trial, but one analyst begs to differ
• Physician practices told to be extra cautious in purchasing supplies from 'grey market'
• Pfizer's chief medical officer lays out COVID-19 facts in social media series
• Biogen's COVID-19 woes mount as virus forces Spinraza treatment delays
• Univercells' CDMO Exothera hopes to help scale COVID-19 vaccine manufacturing

Newsletter Tool - Questex

China Says This Drug Is “Clearly Effective” Against Coronavirus

 According to Japanese media, Chinese medical authorities have found that a drug called "favipiravir" has shown promise in treating COVID-19 patients.

ACCORDING TO A NEW STUDY, IT CAN TURN CORONAVIRUS TESTS NEGATIVE IN JUST FOUR DAYS.

 The Chinese government says it has officially decided to use the Japanese-developed anti-influenza drug Avigan in treating people infected with the new coronavirus.

Zhang Xinmin, director of the National Center for Biotechnology Development, said at a news conference in Beijing on Tuesday that the drug was found to be effective in clinical trials by two medical organizations in the country.

The director said the tests were conducted in the cities of Wuhan and Shenzhen and involved 240 patients and 80 patients respectively.

He said that the tests in Wuhan found that it took an average of 2.5 days for the temperature of those who were given Avigan to return to normal. It took 4.2 days for those who weren't given the drug.

He added that patients who were given the medicine were able to get rid of their cough in an average of 4.57 days, compared with 5.98 days for those who were not given it. He added that medicine had no obvious side effects.

In tests in Shenzhen, the director said those who were given the medicine after testing positive for the virus turned negative after a median of four days, while it took a median of 11 days for those without the drug.

The trial also found that X-ray photos confirmed improvements in lung conditions in about 91 percent of the patients who were given the medicine. The number stood at 62 percent for those who weren't given it.

According to Japanese media, Chinese medical authorities have found that an antiviral drug called “favipiravir” has shown promise in treating COVID-19 patients, The Guardian reports.

“It has a high degree of safety and is clearly effective in treatment,” Zhang Xinmin, an official at China’s science and technology ministry, told reporters on Tuesday.

The drug has been used in the past to fight an outbreak of the Ebola virus in Guinea. Its developer has yet to comment on the claims made by the Chinese authorities.

The drug, known also by its market name Avigan and developed by a Japanese Fujifilm subsidiary called Fujifilm Toyama Chemical, was reportedly able to turn COVID-19 tests negative for those who were infected after just four days as part of a trial involving 240 patients from Wuhan, China, and 80 patients in Shenzhen.

Without treatment, the median time was 11 days, according to The Guardian.

The drug also appeared to improve lung condition in 91 percent of patients, compared to just 62 percent whose lung conditions improved without the drug.

But it’s far from perfect at stopping the spread of the deadly virus.

“We’ve given Avigan to 70 to 80 people, but it doesn’t seem to work that well when the virus has already multiplied,” an unnamed Japanese health ministry source told the Japanese media, as quoted by The Guardian.

China Says This Drug Is “Clearly Effective” Against Coronavirus:

Coronavirus (COVID-19): Anxiety and How to Cope During a Pandemic

The World Health Organization has officially declared new coronavirus (COVID-19) a pandemic. Empower yourself to put your mental health first to help manage anxiety during this stressful outbreak.

Learn strategies for managing stress during a pandemic

It’s terrifying to learn that an illness such as coronavirus (COVID-19) is spreading across the globe. The early stages of a pandemic can be especially anxiety-provoking. During this time, you don’t know how widespread or deadly the illness is going to end up being.

Feelings of fear, anxiety, sadness, and uncertainty are normal during a pandemic. Fortunately, being proactive about your mental health can help to keep both your mind and body stronger.

Ways to take care of yourself include:

• 1. Reading the news from reliable sources (and take breaks from the news)
• 2. Recognizing the things you can control, like having good hygiene
• 3. Taking measures only if recommended by the CDC
• 4. Practicing self-care
• 5. Seeking professional help from a licensed mental health professional if necessary

A Timeline of Coronavirus (COVID-19)

The new coronavirus disease, called COVID-19, has appeared and spread extremely quickly, making its way to over 100 countries since its December 2019 discovery in China. This particular type of respiratory disease is caused by a virus called SARS-CoV-2. It’s part of a larger family of coronaviruses, the majority of which cause only the common cold. 

More dangerous types of coronavirus include the Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV). Like these more serious strains, COVID-19 can cause anything from mild respiratory problems to pneumonia or death.

Citing a mortality rate of 3.4%, the World Health Organization has declared COVID-19 a public health emergency.

How Many People Have Coronavirus? 

As of March 18, 2020, the World Health Organization has confirmed 179,111 cases of COVID-19 worldwide.3

• Cases in the United States: 3,503
• Cases in the Western Pacific Region: 91,779
• Cases in the European Region: 64,188
• Cases in South-East Asia: 508
• Cases in the Eastern Mediterranean Region: 16,786
• Cases in the Regions of the Americas: 4,910
• Cases in the African Region: 228

Pandemics by their very nature expand exponentially.  Already at the time of this writing, the number of cases exceeds 6,000 known cases (those that have been diagnosed with covid-19 tests.  In reality, the case number far exceeds 10,000.

Ways to Manage Stress

The way you cope with stress can go a long way toward ensuring that you’re taking helpful action in managing your mental health. Here are ways to help you ease anxiety surrounding coronavirus.

Read news from trustworthy sources.

Avoid media outlets that build hype or dwell on things that can’t be controlled. Instead, turn to sources that give reliable information about how to protect yourself, such as the Centers for Disease Control and Prevention (CDC).

Develop an action plan.

There are always some steps you can take to decrease risk. It may be as simple as washing your hands well and limiting travel. But recognizing these can remind you to focus on things you have control over. Just make sure the steps you’re taking are actions recommended by reputable sources.

Set limits on your media consumption.

Tuning into media stories that talk about how fast an illness is spreading, or how many people are getting sick, will increase your anxiety. Limit your media consumption to a certain time frame or a certain number of articles.

While it’s helpful to stay informed, it’s also important you don’t allow yourself to be bombarded with anxiety-provoking news all day.

Avoid the herd mentality.

Be aware that many people take action that doesn’t help. Don’t jump on a bandwagon just because other people are wearing masks or performing specific cleaning rituals (unless those things are recommended by the CDC). Otherwise, your actions could prove to be unhelpful—or perhaps even destructive.

Practice good self-care.

Eating a balanced diet, getting plenty of sleep, and engaging in leisure activities are always key to helping you stay as physically and psychologically healthy as possible during stressful times. Good self-care also keeps your immune system robust.

Seek professional help.

If your mental health is being impacted by the stress of the coronavirus, then you may want to seek professional help. A licensed mental health professional can help you manage your fears while also empowering you to make the best decisions for you and your family.

Should You Use Antiviral Medications for the Flu?

Mental Health Concerns

The 9 Best Online Therapy Programs of 2020

This link will bring you to the most highly recommended programs, with reviews

In addition to mental health concerns that may arise as a result of anxiety surrounding a pandemic, it's important to monitor existing mental health conditions to ensure they don't worsen.

Depression and Anxiety

Researchers have found that some individuals may experience mental health problems for the first time during a pandemic. Adjustment issues, depression, and anxiety may arise.

A study from the Ebola virus outbreak in Sierra Leone,1 indicated that increased numbers of people reported mental health and psychosocial problems. A study from the H1N1 influenza outbreak in 20092 indicated an increase in a variety of emotional symptoms, including somatoform disorders (symptoms such as pain and fatigue that can't be fully explained by a physical cause).

Additionally, some existing mental health conditions may get worse. Research suggests that individuals who are especially vulnerable to stress and anxiety may be at the highest risk.

Severe anxiety may also cause an increase in substance use. Individuals who have been in recovery may become more likely to relapse as their stress levels increase.

Researchers from Carleton University in Ottawa, Canada, found that people who were the least able to tolerate uncertainty experienced the most anxiety during the H1N1 pandemic.3 Those individuals were also less likely to believe they could do anything to protect themselves.

Caretakers may be at especially high risk for emotional symptoms during a pandemic as well. They may experience:

• increased depression and anxiety
• increased concerned about protecting their loved ones
• guilt about causing/not preventing a loved one's illness if they become sick

In turn, children often adopt the coping strategies they observe in their parents. Parents who grow anxious during a pandemic may end up witnessing their children develop anxiety right along with them.

High anxiety and feelings of helplessness can encourage some individuals to adopt unproven remedies or prevention methods. Some of these methods may be harmful both to individuals and to the community as a whole. So it’s important to ensure that any actions you take are actually helpful.

Coronavirus (COVID-19): Anxiety and How to Cope During a Pandemic: