Take 20 Seconds for Good Information Hygiene

 

[Image from The News Literacy Project.]

In the face of rampant misinformation on social media, the interdisciplinary team of PhDs and Clinicians at Dear Pandemic recommend the following steps for good Information Hygiene:

• Assess the source
• Go beyond the headlines
• Identify the author
• Check the date
• Examine supporting evidence
• Check your biases [Separate fact from emotion]
• Turn to Fact Checkers

These skills will help you root out good info from bad on the interwebs.

Advice for good information hygiene:

Take 20 seconds guidance serves as an apt metaphor for practicing good information hygiene. Peter Adams, the News Literacy Project’s senior vice president of education, made the connection during a March 14 segment of NPR’s All Things Considered.  Here is how Peter described it: “The equivalent of taking 20 seconds and washing your hands is very much the same in the information space. If everyone can take 20 seconds, investigate the source, do a quick Google search, stay skeptical, we can eliminate a great deal of the confusion and misinformation out there.”

Brought to you by Ascension Wisconsin Library Services. 

How Sars-Cov-2 Evades Our Immune System

A discovery by researchers at the Texas A&M College of Medicine could lead to new therapies to prevent the virus from proliferating in the human body.

The immune system is a complex network of cells and proteins that is designed to fight off infection and disease, especially those like the coronavirus, or SARS-CoV-2, that can cause numerous issues in the human body. But many individuals are still at risk of being infected with the coronavirus, letting it replicate in the body and further transmitting to other individuals.

The underlying mechanism of how SARS-CoV-2 escapes from the immune system has been poorly understood. However, researchers from the Texas A&M University College of Medicine and Hokkaido University have recently discovered a major mechanism that explains how SARS-CoV-2 can escape from the immune system and replicate in the human body. Their findings were recently published in the journal Nature Communications.

Read more ...

Brought to you byAscension Wisconsin Library Services. 

Ascension Authors Publish Covid Study in BMJ Quality & Safety

Congratulations to our very own Ascension Clinical Network Services Leaders:

Dr. Mohamad Fakih,

Dr. BalighYehia, 

Dr. Richard Fogel, 

and Dr. Joseph Cacchionone,

working with other Ascension data science professionals, 

for publishing a timely and relevant article relative to the ongoing pandemic

in BMJ Quality & Safety.

Thank you for sharing you expertise, knowledge, and commitment to with the wider world.

COVID-19 hospital prevalence as a risk factor for mortality: an observational study of a multistate cohort of 62 hospitals

Mohamad Ghazi Fakih 1, Allison Ottenbacher 2, Baligh Yehia 3, Richard Fogel 3, Collin Miller 2, Angela Winegar 2, Christine Jesser 4, Joseph Cacchione 3

BMJ Quality & Safety

2021 Oct 5;bmjqs-2021-013721.

 doi: 10.1136/bmjqs-2021-013721. Online ahead of print.

PMID: 34611041

 

PMCID: PMC8494532

 

DOI: 10.1136/bmjqs-2021-013721 

Link to Article

Abstract:

Background: The associated mortality with COVID-19 has improved compared with the early pandemic period. The effect of hospital COVID-19 patient prevalence on COVID-19 mortality has not been well studied.

Methods: We analysed data for adults with confirmed SARS-CoV-2 infection admitted to 62 hospitals within a multistate health system over 12 months. Mortality was evaluated based on patient demographic and clinical risk factors, COVID-19 hospital prevalence and calendar time period of the admission, using a generalised linear mixed model with site of care as the random effect.

Results: 38 104 patients with COVID-19 were hospitalised, and during their encounters, the prevalence of COVID-19 averaged 16% of the total hospitalised population. Between March-April 2020 and January-February 2021, COVID-19 mortality declined from 19% to 12% (p<0.001). In the adjusted multivariable analysis, mid and high COVID-19 inpatient prevalence were associated with a 25% and 41% increase in the odds (absolute contribution to probability of death of 2%-3%) of COVID-19 mortality compared with patients with COVID-19 in facilities with low prevalence (<10%), respectively (high prevalence >25%: adjusted OR (AOR) 1.41, 95% CI 1.23 to 1.61; mid-prevalence (10%-25%): AOR 1.25, 95% CI 1.13 to 1.38). Mid and high COVID-19 prevalence accounted for 76% of patient encounters.

Conclusions: Although inpatient mortality for patients with COVID-19 has sharply declined compared with earlier in the pandemic, higher COVID-19 hospital prevalence remained a common risk factor for COVID-19 mortality. Hospital leaders need to reconsider how we provide support to care for patients in times of increased volume and complexity, such as those experienced during COVID-19 surges.

Keywords: COVID-19; hospital medicine; mortality (standardised mortality ratios).

A Pill for Covid? Molnupiravir Explained

Promising early results for an oral therapeutic for SARS-CoV2. Here's what we know and what it may mean. Transcript, podcast, links.

Dr. Zubin Damania / ZDogg MD's 12-minute podcast helps to interpret Merck's new research data and what we know so far.    Together with the vaccines that prevent disease, this treatment in a pill could spell the end this pandemic. 

Want to know more? Read the press release on Becker's Hospital Review from October 1, 2021.

Dr Fogel's Latest Video Addresses Key Covid-19 Topics

In a new video, Richard Fogel, MD, FACC, FHRS, Senior Vice President and Chief Clinical Officer, Clinical & Network Services, Ascension, provides the latest information on four topics related to COVID-19:

• The state of the pandemic.

• Breakthrough infections.

• Vaccine effectiveness and booster doses.

• Alternative treatments.

All Ascension associates will need to be vaccinated against COVID-19 by Nov. 12 for the safety of patients and visitors, associates, families and loved ones, and the community.

Recognizing that there may be instances when an associate may seek a medical or religious accommodation to a vaccination requirement, an exemption process is in place. Exemption applications are due by October 1 to allow time for review. Learn more in our Frequently Asked Questions.

Mental Health Resources for Health Care Staff and Patients

Many people are experiencing increased stress and anxiety as we continue to battle COVID-19.  A blog post from the director of the National Institute of Mental Health states “The mental health impacts of COVID-19 continue. From all that we know, it is clear these impacts will outlive the pandemic itself.”[1] The American Psychological Association reports that many people are coping with their stress in unhealthy ways including increased alcohol consumption.[2] 

Mental Health Resources

Mental Health from MedlinePlus Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act as we cope with life.

How to Improve Mental Health from MedlinePlus: provides health information and tips for improving your mental health.

Depression from MedlinePlus  Depression is more than just a feeling of being sad or “blue” for a few days. If you are one of the more than 19 million teens and adults in the United States who have depression, the feelings do not go away.

Anxiety from MedlinePlus  Anxiety is a feeling of fear, dread, and uneasiness. It might cause you to sweat, feel restless and tense, and have a rapid heartbeat. It can be a normal reaction to stress. For example, you might feel anxious when faced with a difficult problem at work, before taking a test, or before making an important decision.

SAMHSA (The Substance Abuse and Mental Health Services Administration) leads public health efforts to advance the behavioral health of the nation and to improve the lives of individuals living with mental and substance use disorders, and their families.

Caring for your Mental Health – National Institute on Mental Health Mental health includes emotional, psychological, and social well-being. It affects how we think, feel, act, make choices, and relate to others. Mental health is more than the absence of a mental illness—it’s essential to your overall health and quality of life. Self-care can play a role in maintaining your mental health and help support your treatment and recovery if you have a mental illness.

NIH Emotional Wellness Toolkit: This NIH toolkit provides six strategies for improving your emotional health. 

NIH Social Wellness Toolkit: This NIH toolkit provides six strategies for improving your social health.

CDC COVID-19: Care for Yourself: The Centers for Disease Control and Prevention (CDC) provides information on caring for yourself, particularly during the COVID-19 pandemic.

CDC COVID-19: Coping With Stress: CDC provides information on how to cope with stress, particularly during the COVID-19 pandemic.

Shareable Resources on Coping with COVID-19 from NIMH: Help raise awareness about coping with COVID-19 by sharing these resources, includes graphics and social media.

Utilize your workplace EAP

What is an Employee Assistance Program (EAP)? An Employee Assistance Program (EAP) is a voluntary, work-based program that offers free and confidential assessments, short-term counseling, referrals, and follow-up services to employees who have personal and/or work-related problems.  EAPs address a broad and complex body of issues affecting mental and emotional well-being, such as alcohol and other substance abuse, stress, grief, family problems, and psychological disorders.  EAP counselors also work in a consultative role with managers and supervisors to address employee and organizational challenges and needs.  Many EAPs are active in helping organizations prevent and cope with workplace violence, trauma, and other emergency response situations.

Get immediate help in a crisis

Call 911

Disaster Distress Helpline

• 1-800-985-5990 (press 2 for Spanish)
• text TalkWithUs for English or Hablanos for Spanish to 66746.
• Spanish speakers from Puerto Rico can text Hablanos to 1-787-339-2663.

National Suicide Prevention Lifeline

• 1-800-273-TALK (8255) for English,
• 1-888-628-9454 for Spanish
• Lifeline Crisis Chat 

National Domestic Violence Hotline

• 1-800-799-7233
• text LOVEIS to 22522

National Child Abuse Hotline 

• 1-800-4AChild (1-800-422-4453)
• text 1-800-422-4453

National Sexual Assault Hotline from RAINN (Rape, Abuse & Incest National Network,) the nation's largest anti-sexual violence organization. 

• 1-800-656-HOPE (4673)
• Online Chat 

The Eldercare Locator 

• 1-800-677-1116  TTY Instructions

Veteran’s Crisis Line

• 1-800-273-TALK (8255)
• Crisis Chat 
• text: 8388255

Find a health care provider or treatment for substance use disorder and mental health

SAMHSA’s National Helpline

• 1-800-662-HELP (4357)
• TTY 1-800-487-4889
• Treatment Services Locator Website
• Interactive Map of Selected Federally Qualified Health Centers 

[1] Joshua Gordon, “NIMH Director’s Messages.”

[2] American Psychological Association, “One Year Later, a New Wave of Pandemic Health Concerns.”

Originally posted here by Bobbi Newman, the Community Engagement and Outreach Specialist at the Network of the National Library of Medicine Region 6 at the University of Iowa on August 3, 2021. Reprinted with permission from the author.

Nature on How the Coronavirus Infects Cells — and Why Delta is so Dangerous

 

A computer simulation of the structure of the coronavirus SARS-CoV-2.Credit: Janet Iwasa, University of Utah

Nature recently posted a fascinating Daily Briefing article about how the coronavirus infects cells-- and why Delta is so dangerous.

The article features an animated SARS-Cov-2 cell, the stalks of the spike proteins waving as if they were in a parade ...  There are several other illustrations to help explain this thing that has the world in it's thrall at the present moment.  

It's a 15-minute read.

Scudellari, M. (2021, July 28). How the Coronavirus INFECTS cells - and why delta is so dangerous: Scientists are unpicking the life cycle of SARS-CoV-2 and how the virus uses tricks to evade detection. Nature News. https://doi.org/10.1038/d41586-021-02039-y

Swiss Cheese Respiratory Virus Defense Infographic

An infographic created by Virologist Ian Mackay to help clarify that in order to best limit personal risk and community risk from being infected by, or passing on, SARS-CoV-2, we need to think of using a range of risk reduction measures. Each have their own failings and these can be affected by circumstances so layering them up helps avoid any single measure's (layer) problems (holes).

Or you could just physically distance by living on island, by yourself, forever! (I reckon we'll run out of islands).

So instead, think about this layered approach originally outlined in 1990 by Prof James Reason.    Based on Prof James Reason's analyses (e.g. https://royalsocietypublishing.org/doi/10.1098/rstb.1990.0090). Layout inspired by a graphic from @sketchplanator (https://sketchplanations.com/the-swiss-cheese-model)

Mackay, Ian M. (2020): The Swiss Cheese Respiratory Virus Defence. figshare. Figure. https://doi.org/10.6084/m9.figshare.13082618.v21.  The image appears here under a CC4 license.  

• Read more about why Mackay created the Swiss Cheese infographic in this article at Forbes.    
• It includes more on the interpretation, and a bit about the "misinformation mouse" nibbling away in the center slice.  

Pandemic Era Burnout in the Age of Covid-19: Healthcare IT News Series

 

This Healthcare IT News is running a series on Pandemic Era Burnout in the Age of Covid-19

These feature stories dig deep into the causes of burnout for employees across healthcare during the COVID-19 crisis. CIOs, clinicians, IT developers, patients and others offer advice on how to combat the stressors that lead to burnout – and describe how technology can both hurt and help during this stressful time.

See the full series as new stories are added.

• Pandemic-era burnout: One consumer’s tiring, tech-enabled journey) to find memory care for a parent (September 21, 2020)

• Pandemic-era burnout: Healthcare CIOs talk stress, and offer tips for a cure (Sept. 28, 2020)
• Pandemic-era burnout: How physicians manage crushing workloads and IT demands (October 12, 2020)

• Pandemic-era burnout: EHR vendor strategies to support staff (October 26, 2020)

• Pandemic-era burnout: Nurses in the trenches say technology hurts and helps  (November 9, 2020)

Expert Searches for Covid Topics in Ovid Medline

For those of you who prefer searching Ovid Medline, they have created a number of Expert Searches on Covid-related (and many other) topics.    

This can save you oodles of time and typing!

Ovid's disclaimer:

• This page is intended to provide some hints, advice and suggestions about how search strategies might be built, not to act in place of strategies built with expert subject knowledge or the assistance of a Medical Librarian.

Click the green down arrow to see the search strategy.

Here's an example of the expert search strategy for best evidence for cloth face masks:

Click on "Launch Ovid Expert Search" to run the search in Ovid Medline.  

• Be patient.  This may take a minute or so to run, but it's worth it when you see the time it will save you in typing it all in by hand!  
• Once you run the Expert Search Strategy, you can then modify the search as needed, including using limits to get it down to a manageable size. 

Search Tips & Tutorials for Ovid Medline

Questions or comments, contact Your Ascension Wisconsin Librarians: 

 Michele Matucheski        Kellee Selden

PubMed Clinical Queries Update to Include a Covid-19 Search for Best Evidence

The PubMed Clinical Queries page will soon be updated with design and content changes. The new page design aligns with the new PubMed and includes a new category for COVID-19 searches. Links and bookmarks created for the legacy PubMed Clinical Queries page will be redirected to the new page when this change takes effect.

The PubMed Clinical Queries page will initially include COVID-19 Articles and Clinical Study Categories (see Figure 1). The new COVID-19 filter strategies are published in the PubMed User Guide and may evolve over time.

Figure 1: PubMed Clinical Queries Page.

The Systematic Review and Medical Genetics filters that were included in the legacy PubMed Clinical Queries page have moved:

• Systematic Review is available as a default Article Type filter on the filter sidebar for PubMed search result pages (see Figure 2).
• The Medical Genetics searches are available as filters that may be added to a query using the filter name with the search field tag [filter]: for example, sickle cell anemia AND genetic counseling[filter]. The complete list of filters and associated search strategies are published in the PubMed User Guide.

Figure 2: PubMed Article Type Filter.

For more information about using Clinical Queries and the filter strategies, please see the PubMed User Guide:

• Clinical Queries
• Clinical Queries Filters
• Systematic Reviews

By Jessica Chan
National Center for Biotechnology Information

Originally posted to the NLM Technical Bulletin on October 14, 2020.

Chan J. PubMed Clinical Queries Update Coming Soon. NLM Tech Bull. 2020 Sep-Oct;(436):e8.

ISSN 2161-2986 (Online) Content not copyrighted; freely reproducible.

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Masks May Do More Than We Think: ZDoggMD Talks with Dr Monica Gandhi

 

This is recent episode from ZDoggMD' podcast.    

I'd read cited the NEJM article last month and was intrigued with the idea of variolation, so I was happy to hear one of the authors talk about it in this discussion with Dr. Zubin Damania (aka ZDoggMD).   Dr. Gandhi also goes over the current state of the evidence re: face masks.  I was pleased to hear that I was familiar with all the studies she talks about concerning the efficacy of masks to prevent transmission of respiratory infections.  Dr. Gandhi comes from a background of treating patients with HIV, and has a different approach to convincing people to take care of themselves and others, whether it be wearing condoms or face masks.  No shaming here. ;-)

I hope you enjoy it as much as I did!  

Here is the PubMed citation for her article: 

Facial Masking for Covid-19 - Potential for "Variolation" as We Await a Vaccine.
Gandhi M, Rutherford GW.N Engl J Med. 2020 Sep 8. doi: 10.1056/NEJMp2026913. Online ahead of print.  PMID: 32897661

Masks May Do More Than We Think (w/Dr. Monica Gandhi)

From ZDogg's introduction to this episode:

What if masks acted to reduce severity of COVID-19 infection for the WEARER, fostering immunity like a vaccine and allowing a full societal reopening?

Dr. Monica Gandhi is a UCSF professor of Medicine in the division of HIV, infectious diseases, and global medicine. She and her colleagues recently proposed just such a theory in the New England Journal of Medicine. In this fantastic interview she outlines the emerging data in support of the idea that masks may do more than we think.

Here’s a NY Times piece about her proposal, and here’s a paper she co-authored in the Journal of General Internal Medicine.

And here’s ZDogg's piece on masks that summarizes some of Dr. Gandhi’s work.

Full Transcript is available at ZDoggMD.

References (directly from Dr. Gandhi) :

Viral inoculum theory: Higher viral inocula or “dose” linked to severity of disease

Well described in animal studies and some human studies for respiratory and GI illnesses -higher infective dose thought to lead to faster/greater pathogen replication, leading to a more aggressive and damaging innate inflammatory response, or overwhelming adaptive immune response- all leading to more severe disease.   This is a hypothesis for diseases in which immunopathology plays a role in viral pathogenesis, such as COVID-19 (Rouse BT, Sehrawat S. Immunity and immunopathology to viruses: what decides the outcome? Nat Rev Immunol. 2010;10(7):514-526)

Some evidence for the “viral inocula” theory for SARS/MERS. Evidence in SARS-CoV-2 fom degree of illness in household contacts/ health care workers at beginning of pandemic.  Papers supporting viral inoculum theory. [43 more citations available at ZDogg's site.]