EVENT MEDICAL MEDIA SCAN – JUNE 2020 EDITION

The links below represent a wide range of topics in news articles, resources, and journal articles. The views and opinions expressed are those of the author(s) identified in the respective articles, and do not necessarily reflect the views of Odyssey Medical, or the author of this blog post.

FOREWORD:

We ended the month of April with 53,236 confirmed and presumptive cases of COVID-19 in Canada. As of May 31, we had 90,947 confirmed and presumptive cases across the country. Nunavut remains the only Canadian jurisdiction to be COVID-free (after a false positive case identified at the beginning of May)

Canada, and countries around the world are slowly beginning the re-opening. Having said that, mass gatherings of all kinds (i.e. music festivals, sports, fairs, etc.) are on hold for fear of rapid spreading of SARS-COV-2. When can we expect the return of music festivals? Read the predictions below.

COVID CLINICAL RESOURCES

You’ll find two clinical resources below – UptoDate requires no introduction for many of you – there is no paywall on the COVID-19 guide below.

The Seattle guide is a document complied by various physicians in the Seattle area on all things COVID-19 related.  You will find links to research articles embedded within the guide. It may not be the best formatted document, but it definitely packs a ton of information.

[UptoDate] Coronavirus disease 2019 (COVID-19): Epidemiology, virology, clinical features, diagnosis, and prevention
[Seattle Collaborative Guide] Frontline COVID-19 Guide
Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers

COVID – RE-OPENING

This re-opening guide was written with contribution from professionals across North America, specifically for events, entertainment venues and event professionals.

ESA Reopening Guide — Event Safety Alliance
https://www.eventsafetyalliance.org/esa-reopening-guide

COVID – Legal

Two aspects emerged as the re-opening plans kicks into high gear – what are the legal liabilities for those operating and whether the use of legal waivers is the answer. Secondly, as events around the world are cancelled or postponed, some events are facing potential class action lawsuits over decisions of not refunding patrons.

COVID-19, sports and waivers: How to limit the risk of legal liability in the “new normal”
https://www.lexology.com/library/detail.aspx?g=a00652c0-b896-4321-b0b7-9eddc2a314e1

Ultra Music Festival Faces Class Action Lawsuit Over Refund Policy
https://www.rollingstone.com/pro/news/ultra-music-festival-faces-lawsuit-1005485/

COVID – Insurance

In typical times, insurance is the safety net for many events organizers. Whether it’s personal injuries, issues with venues/vendors and/or involuntary cancellation of events. However, COVID-19 has led many to wonder if insurance would really protect them. Should COVID-19 be classed as an “Act of God”? How would that affect coverage available to policyholders?

Why COVID-19 cost this reinsurer $1.2 billion in three months
https://www.canadianunderwriter.ca/insurance/why-covid-19-cost-this-reinsurer-1-2-billion-in-three-months-1004178153/

COVID – Mass Gathering

By now most of us have resigned to the fact there will likely not be any mass gatherings for the remainder of the year. However, some have predicted the trend will continue well into 2021 or even 2022. Why is that? You can read more from the links below.

The other aspect of mass gathering is the potential for rapid spread of the disease. You will find some interesting articles below about “silent spreaders” and “super-spreaders”.

No festivals in 2021 either? Organizers fear future insurance terms
https://nltimes.nl/2020/04/27/festivals-2021-either-organizers-fear-future-insurance-terms

UK live music and festival sector at risk of collapse due to coronavirus
https://www.theguardian.com/music/2020/may/13/uk-live-music-festivals-sector-at-risk-coronavirus

Superspreader Events Offer a Clue on Curbing Coronavirus
http://apkmetro.com/superspreader-events-offer-a-clue-on-curbing-coronavirus/

Coronavirus: The mystery of ‘silent spreaders’
https://www.bbc.com/news/uk-52840763

COVID – Research

Four journal articles that may be of interest to you. First, the Lancet article looked into the history of how masks became a standard tool in medical setting.  

Next, the The New England Journal of Medicine article reviews cases from the Seattle region. The breakdown in data may be of interest to you.

Finally, two articles from the Canadian Medical Association Journal – one on the prediction of demands for CCU beds in Canada based on whether self-isolation protocol was followed, and the other looking at lessons that can be learnt from Hong Kong’s response to the COVID-19 pandemic.

[The Lancet] A history of the medical mask and the rise of throwaway culture
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31207-1/fulltext?rss=yes

[NEJM] Covid-19 in Critically Ill Patients in the Seattle Region — Case Series
https://www.nejm.org/doi/full/10.1056/NEJMoa2004500?query=featured_home

[CMAJ] Projecting demand for critical care beds during COVID-19 outbreaks in Canada
https://www.cmaj.ca/content/192/19/E489

[CMAJ] What can countries learn from Hong Kong’s response to the COVID-19 pandemic?
https://www.cmaj.ca/content/192/19/E511

PHOTO CREDITS:

“Pulling Through Together” – Photo taken by Stephen Chui of a mural in Vancouver by artist Benjamin T. Stone

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Event Medical Media Scan – May 2020 Edition

The links below represent a wide range of topics in news articles, resources, and journal articles. The views and opinions expressed are those of the author(s) identified in the respective articles, and do not necessarily reflect the views of Odyssey Medical, or the author of this blog post.

Foreword:

We ended the month of March with 8,591 confirmed and presumptive cases of COVID-19 in Canada. As of April 30, we had 53,236 confirmed and presumptive cases across the country. Nunavut was the last part of Canada to be free of COVID, but has since had its first  confirmed case.

As parts of the country begin the slow re-opening, we will look at COVID-related materials, while also branching out to other topics that may be of interest to the event medicine community.

COVID Learning Tools

COVID-19 Primer: Virtual Patient Simulation
https://interactives.nejm.org/external/covid_simulation/index.html

This is an interactive learning tool from The New England Journal of Medicine. It provides a primer for the basic (i.e. not ICU) clinical considerations in managing patients with possible COVID infection.

Quick ICU Training for COVID-19
https://www.quickicutraining.com

This training tool is a project between multiple Ontario-based hospitals and the University of Toronto to ensure clinicians who don’t normally operate in a critical care environment to become prepare for such operation. You will find videos, instruction text and pocket cards/cheat sheets available on the website.

COVID Clinical Resources

Two clinical resource below that you will find lots of good summary on research articles, best practices, etc. – one from John Hopkins University (a point of care guide) and one from EMRAP (a guide directed towards emergency physicians and staff)

Johns Hopkins POC Guide: Coronavirus COVID-19 (SARS-CoV-2)
https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540747/all/Coronavirus_COVID_19__SARS_CoV_2_

COVID Journals/Research

The NEJM presents a case study, and the various treatment options available. It is give you some good food-for-thoughts.

[NEJM] Clinical Practice:  Mild or Moderate Covid-19
https://www.nejm.org/doi/full/10.1056/NEJMcp2009249

Given the close proximity to Mainland China, and its experience with SARS, Hong Kong was slated to be hit hard by COVID. However, case numbers remains low – the study looked into how early measures impacted the transmission of SARS-COV2 and the seasonal flu.

[The Lancet] Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30090-6/fulltext

“If clinical suspicion of infection associated with COVID-19 remains
after an initially negative nasopharyngeal swab, we urge clinicians
to continue isolation procedures to prevent nosocomial infection.”

[CMAJ] SARS-CoV-2 infection in a 76-year-old man with negative results for nasopharyngeal swabs and possible nosocomial transmission
https://www.cmaj.ca/content/cmaj/early/2020/04/29/cmaj.200641.full.pdf

This article looks at how psychological science can help reinforce COVID19 public health messaging.

[The Lancet] Pitfalls of judgment during the COVID-19 pandemic
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30096-7/fulltext

This article looks at disease progression in the post-pandemic world and what public health surveillance needs to be in place.

[Science] Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period
https://science.sciencemag.org/content/early/2020/04/24/science.abb5793

COVID News Articles

The four news articles below look into different aspects of COVID.

First, the WHO cautioned whether we can rely on the common percpetion “got it once and you are immuned to the disease”. 

The second article looks at how our own immune system may be contributing to the replication of SARS-COV2 in our bodies. 

The third article looks at how drug supplies have shifted in face of COVID – are people more likely to die from contaminated drugs as borders close and the movement of people restricted?

Finally, as the situation with COVID stabilize across the country and plans to re-open gets closer, are we really able to go back to life as we knew pre-COVID?  

“Immunity passports” in the context of COVID-19
https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19

SARS-CoV-2 may be exploiting our immune system’s ‘first responder’ cells
https://www.livescience.com/coronavirus-immune-interferon-response.html

Pre-Hospital Care

Some US paramedics have been given the authority to use ketamine in an ambulance setting. Some Canadian doctors have also argued for the use here. Is the drug effective?

[Prehospital and Disaster Medicine] Ketamine as a Prehospital Analgesic: A Systematic Review
https://doi.org/10.1017/S1049023X20000448

Mass Gatherings

It’s increasingly evident that mass gatherings will not happen around the world this summer. What are the impacts to event organizers and the event community as a whole?  Would insurance have saved them?

In demonstrating why the need to cancel mass gathering, the article “Point of Contagion” described how “superspreaders” managed to pass the SARS-COV2 to others in otherwise mundane activities.

Finally, a study in Australia looked into the data of event medical teams – if you have been part of a medical team, no doubt you will find some aspect of it resonates with you.

The Impact of Coronavirus on Meetings and Events
https://www.eventsforce.com/blog/infographic-the-impact-of-coronavirus-on-meetings-and-events/

A summer like no other: Canada’s COVID-19 crisis puts festivals, concerts, fun on ice
https://globalnews.ca/news/6862504/coronavirus-canada-summer-cancelled/

Photo Credits:

“Together for What’s to Come” – Photo taken by Stephen Chui of a mural in Vancouver by artist Mega McGrath

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Event Medical Media Scan – April 2020/COVID-19 Edition

Foreword: We ended the month of February with just 76 confirmed cases of COVID-19 in Canada. Fast forward to March 31, we had 8591 confirmed and presumptive cases across the country – a whopping 11204% increase in a span of a month.

As we look back on March,  and unlike the previous editions of the media scan – COVID-19 will be the only topic we focus on. We included a number of government directives, resources, journal articles and other clinical resource you may find useful.

Guidance

[Health Canada] Optimizing the use of masks and respirators during the COVID-19 outbreak

https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-devices/masks-respirators-covid19.html

[Health Canada] 3D printing and other unconventional manufacturing of personal protective equipment in response to COVID-19

https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-devices/covid-19-unconventional-manufacturing-personal-protective-equipment.html

Journal Articles

We have chosen articles from three well-respected peer-reviewed journals (The British Medical Journal, The Lancet and The New England Journal of Medicine) looking at different aspect of COVID-19. 

The BMJ conducted a retrospective analysis of patients who died from COVID-19 in China, and attempted to come up with clinical characteristics and laboratory findings relevant to the mortality of COVID-19 patients.

The Lancet reflects on how COVID-19 affected mass gatherings around the world, and what impact it has beyond health.

Finally, NEJM looked at the grim reality of the ethics in allocating medical resources in a public health crisis. Who gets to live? Who will sacrifice?

[The Lancet] Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma

“These cancellations have social and economic impacts on public morale, on national economies, and on individual livelihoods.”

https://www.thelancet.com/journals/lancet/article/PIIS0140673620306814/fulltext

[New England Journal of Medicine] Fair Allocation of Scarce Medical Resources in the Time of Covid-19

“Priority for limited resources should aim both at saving the most lives and at maximizing improvements in individuals’ post-treatment length of life. Saving more lives and more years of life is a consensus value across expert reports.”

https://www.nejm.org/doi/full/10.1056/NEJMsb2005114

Resources

We have included a number of resources – from drug trials underway, to symptom evaluation, mental health to preparing for the workplace and cyber-security realities of COVID-19. 

News Articles

The first article echoes the NEJM journal article on resource allocation at a time when the medical system is overburdened. 

The second and third news article details how Mexico is bucking the trend from other world countries – as they continue to allow mass gatherings to be held, and allowing cruise-ships to dock when no other countries are willing to allow port calls.  Mexico has so far only reported 1215 cases of COVID-19. Is the country heading into a dangerous territory, or do they know something we don’t?

[Inside Science] Ethical Anguish in a Time of COVID-19

“One way to ease the ethical problem for physicians is to use committees to make the decisions, taking the burden off individual doctors. In Italy, a set of rules newly formulated by the Italian College of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) gives external support for the decision. Physicians can then follow the guidelines.”

https://www.insidescience.org/news/ethical-anguish-time-covid-19

[USA Today] Mexico holds off canceling mass gatherings amid coronavirus threat

https://www.usatoday.com/story/news/world/2020/03/14/coronavirus-mexico-holds-off-canceling-mass-gatherings-amid-pandemic/5049632002/

[USA Today] Mexico will receive cruise ships amid coronavirus pandemic, but will ‘individually fumigate’ passengers

https://www.usatoday.com/story/travel/cruises/2020/03/27/covid-19-mexico-receive-cruise-ships-but-fumigate-passengers/2924077001/

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