What your doctor is reading on Medscape.com:
APRIL 29, 2020 -- Here are the coronavirus stories Medscape's editors around the globe think you need to know about today:
The medical community learned Wednesday about the results of three different trials testing Gilead Sciences' experimental drug remdesivir as a COVID-19 treatment. Based on the results from one of those trials from the National Institute of Allergy and Infectious Diseases (NIAID), Anthony Fauci, MD, director of the agency, called the drug the new "standard of care."
The randomized, placebo-controlled trial of remdesivir conducted by NIAID, of 1063 hospitalized patients with advanced COVID-19, indicate that patients who received the drug recovered more quickly than patients who received a placebo, the institute announced. The median time to recovery for patients who received remdesivir was 11 days compared with 15 for patients who received placebo.
Finally, Gilead announced topline results from its open-label trial of two different treatment durations of remdesivir in 397 patients with severe COVID-19: There was no significant difference in the clinical or safety outcomes for patients who received remdesivir for 5 days compared with those who received it for 10 days.
Even as residents are being lauded as heroes for their work fighting COVID-19, they are also trainees, and some of them say they are being taken advantage of by hospitals in crisis mode. Medscape spoke with nearly 20 residents working on the front lines of the COVID-19 pandemic and found that, while some academic hospitals endeavor to protect their trainees, others have fallen short.
Residents face massive workloads in normal circumstances. Now, particularly in COVID-19 hotspots, they're overwhelmed and working longer hours for the same pay — in some cases, for little more than minimum wage. They're doing jobs outside their scope of work, often with inadequate personal protective equipment (PPE), and facing burnout and fatigue, both emotional and physical.
"I had never touched a ventilator before this," says one first-year resident in New Jersey. It's terrifying and exhausting, he says, and he is not only worried about himself, but also about the compromised care for his patients. "I'm doing my best, but half the time I don't know what I'm doing."
Widely-Cited Aerosolization Study Retracted
A study that found that aerosolized novel coronavirus could be spread nearly 15 feet — twice what health officials had believed — has been retracted, but the journal isn't saying why, Retraction Watch reports. The article received a significant amount of attention in the media, including coverage in the South China Morning Post and the Daily Mail. A handful of COVID-19 studies from China have been retracted, sparking speculation that at least some of the moves came after government pressure.
Preventing PPE-Related Skin Damage
PPE is essential for protecting healthcare workers from SARS-CoV-2, but extended use can cause skin damage. Medscape spoke with a coauthor of best practice recommendations for preventing and managing PPE-related skin damage to share her advice.
CDC Adds Six COVID-19 Symptoms
The CDC has added chills, muscle pain, headache, sore throat, repeated shaking with chills, and a loss of taste or smell to its list of COVID-19 symptoms. Fever, cough, and shortness of breath or difficulty breathing were previously on the symptoms list.
Two Possible Realities
The data available about COVID-19 so far are consistent with two different potential realities, F. Perry Wilson, MD, MSCE, says in a new commentary. In one, the virus has a disturbingly high death rate per infection, on the order of 1% to 3%, and is slowly spreading through the population like a steamroller. In the other, the virus has spread through communities incredibly rapidly, but with minimal impact on most people, except for the unlucky few who have particularly bad outcomes — a windstorm.
"Which coronavirus are we dealing with?" he asks. "We don't know. But with adequate, high-quality testing, we'll find out."
Siddhartha Mukherjee's latest essay in The New Yorker examines what medical professionals and observers have learned from the COVID-19 pandemic so far. "Everyone now asks: When will things get back to normal? But, as a physician and researcher," he writes, "I fear that the resumption of normality would signal a failure to learn. We need to think not about resumption but about revision."
As front-line healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. More than 500 throughout the world have died.
Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form.