# ent

id: cord-266266-ekxnn9bo
type: LAW
entity:
  CoC Homeless Populations and Subpopulations Reports United States Interagency Council on Homelessness Opening Doors Federal Strategic Plan to Prevent and End Homelessness


id: cord-339508-nf6ov39g
type: ORG
entity:
  Centers for Disease Control Return to Work Criteria National Center for Immunization and Respiratory Diseases NCIRD Division of Viral Diseases


id: cord-271599-1yu1yl12
type: ORG
entity:
  black America National Public Radio NPR United Kingdon Reuters Institute for the Study of Journalism Accessed


id: cord-332729-f1e334g0
type: WORK_OF_ART
entity:
  A Proposal for Standardized Evaluation of Epidemiological Models Developing the Theory and Practice of Epidemiological Forecasting DELPHI World Health Organization Mathematical


id: cord-337120-irpm5g7g
type: ORG
entity:
  Hygiene Task Force Society for Healthcare Epidemiology of America Association for Professionals in Infection Control Infectious Diseases Society of America Controlling


id: cord-322066-m8dphaml
type: ORG
entity:
  The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team The Epidemiological Characteristics


id: cord-339701-j0sr3ifq
type: ORG
entity:
  World Health Organization Cumulative Number of Reported Probable Cases of Severe Acute Respiratory Syndrome SARS Coronaviruses


id: cord-325181-d2cqarep
type: WORK_OF_ART
entity:
  The Fullest Look Yet at the Racial Inequity of Coronavirus Widening the Lens on Voter Suppression From Calculating Lost Votes to Fighting For Effective Voting Rights


id: cord-306352-agppehpz
type: DISEASE
entity:
  coronary heart disease congestive heart failure cardiac arrhythmia chronic obstructive pulmonary disease cancer


id: cord-352726-ep0xfen2
type: ORG
entity:
  Poverty Levels United States Detection of excess influenza severity associating respiratory hospitalization


# bib

id: cord-002095-47dbqu2r
title: When the Illness Goes Off Script—An Exercise in Clinical Reasoning
author: Al-Helou, Georges
date: 2016-03-14
txt: ./txt/cord-002095-47dbqu2r.txt
cache: ./cache/cord-002095-47dbqu2r.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4907950/
doi: 10.1007/s11606-016-3632-3
abstract: nan
summary:
  The clinician triggers the illness scripts of familiar diseases such as viral or bacterial respiratory infections and tick-borne infections to compare to his problem representation. While disseminated endemic fungal infections can cause fever, rash, lymphadenopathy, and pulmonary disease, an acute presentation with widespread skin lesions would be more likely in an immunocompromised patient. The problem representation is now fever, hypotension (resolved), diffuse pulmonary infiltrates, widespread lymphadenopathy, disseminated rash (resolved), leukopenia, thrombocytopenia, DIC, severe AKI, and mild hepatitis with no evident infection. It is the mismatch between common illness scripts (pleural) 5 and a patient''s presentation that prompts diagnosticians to consider rare diseases. Rare diseases such as HLH were considered only after the discussant found irreconcilable mismatches with the illness scripts of more common conditions. When clinicians know the illness scripts of common diseases well enough to recognize telltale deviations from the norm, they can trigger the consideration of rare conditions and request help from colleagues and other resources that will ultimately lead to a diagnosis.


id: cord-259952-58q4ma92
title: Associations between Anxiety and Depression Symptoms and Medical Care Avoidance during COVID-19
author: Ganson, Kyle T.
date: 2020-09-01
txt: ./txt/cord-259952-58q4ma92.txt
cache: ./cache/cord-259952-58q4ma92.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-06156-8
doi: 10.1007/s11606-020-06156-8
abstract: nan
summary:
  Since the outbreak of the novel coronavirus disease 2019 (COVID-19) pandemic, emergency health care utilization has acutely declined by 23% for heart attacks, 20% for strokes, and 10% for hyperglycemic crises. We fitted modified multivariable Poisson regression models to estimate the associations between four mental health symptoms (nervous, anxious, or on edge; not being able to stop or control worrying; little interest or pleasure in doing things; feeling down, depressed, or hopeless) in the past 7 days and medical care avoidance (delayed medical care; needed non-coronavirus medical care but did not get it) due to the coronavirus pandemic in the past 4 weeks. Individuals who experience all four symptoms of anxiety and depression had higher adjusted relative risk ratios of delayed medical care and not receiving needed non-coronavirus medical care, after adjustment for potential confounders (Table 2) .


id: cord-260322-b2493coe
title: Initial Experience with a COVID-19 Web-Based Patient Self-assessment Tool
author: Mehring, William M.
date: 2020-06-15
txt: ./txt/cord-260322-b2493coe.txt
cache: ./cache/cord-260322-b2493coe.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-05893-0
doi: 10.1007/s11606-020-05893-0
abstract: nan
summary:
  title: Initial Experience with a COVID-19 Web-Based Patient Self-assessment Tool As the COVID-19 pandemic spreads, patients experiencing symptoms potentially attributable to the disease require timely assessment. Automated assessment tools-such as digital self-assessment applications-offer a potential strategy for providing guidance to patients without requiring direct attention from healthcare professionals. [2] [3] [4] Our team recently developed a web-based COVID-19 selfassessment tool, available in English and Spanish, offering guidance for patients experiencing potential COVID-19 symptoms. A total of 276,560 assessments were completed, and users reported symptoms potentially attributable to COVID-19 69.6% of the time. Of those with mild symptoms, 7.1% reported direct exposure to someone with confirmed COVID-19; for these users, our tool recommends consideration of telephone consultation with a healthcare professional to determine the need for testing. In our analysis of almost 300,000 digital self-assessments from our COVID-19 self-assessment tool, 69.6% of users reported symptoms potentially attributable to COVID-19.


id: cord-261173-lnjh56ts
author: Misra-Hebert, Anita D.
date: 2020-09-01
txt: ./txt/cord-261173-lnjh56ts.txt
cache: ./cache/cord-261173-lnjh56ts.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-06171-9
doi: 10.1007/s11606-020-06171-9
summary:
  In this study, we aimed to assess whether HCW are at higher risk for COVID-19 infection, COVID-19-related hospitalization, and intensive care unit (ICU) admission compared to non-HCW using advanced statistical methodology to account for various confounders. 23 For the outcomes of hospital and intensive care unit (ICU) admission of COVID-19 testpositive patients, the propensity score covariates are those that were found associated with COVID-19 hospitalization outcome in our previous work including age, race, ethnicity, gender, smoking history, body mass index, median income, population per housing unit, presenting symptoms (including fever, fatigue, shortness of breath, diarrhea, vomiting), comorbidities (including asthma, hypertension, diabetes, immunosuppressive disease), medications (including immunosuppressive treatment, nonsteroidal anti-inflammatory drugs [NSAIDs]), and laboratory values (including pre-testing platelets, aspartate aminotransferase, blood urea nitrogen, chloride, and potassium). [7] [8] [9] [10] 12 The fact that HCW identified as patient facing had a significantly higher odds for SARS-CoV-2 test positivity suggests an increased risk of COVID-19 infection with work exposure.

title:
  Impact of the COVID-19 Pandemic on Healthcare Workers’ Risk of Infection and Outcomes in a Large, Integrated Health System

abstract:
  BACKGROUND: Understanding the impact of the COVID-19 pandemic on healthcare workers (HCW) is crucial. OBJECTIVE: Utilizing a health system COVID-19 research registry, we assessed HCW risk for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission. DESIGN: Retrospective cohort study with overlap propensity score weighting. PARTICIPANTS: Individuals tested for SARS-CoV-2 infection in a large academic healthcare system (N = 72,909) from March 8–June 9, 2020, stratified by HCW and patient-facing status. MAIN MEASURES: SARS-CoV-2 test result, hospitalization, and ICU admission for COVID-19 infection. KEY RESULTS: Of 72,909 individuals tested, 9.0% (551) of 6145 HCW tested positive for SARS-CoV-2 compared to 6.5% (4353) of 66,764 non-HCW. The HCW were younger than the non-HCW (median age 39.7 vs. 57.5, p < 0.001) with more females (proportion of males 21.5 vs. 44.9%, p < 0.001), higher reporting of COVID-19 exposure (72 vs. 17%, p < 0.001), and fewer comorbidities. However, the overlap propensity score weighted proportions were 8.9 vs. 7.7 for HCW vs. non-HCW having a positive test with weighted odds ratio (OR) 1.17, 95% confidence interval (CI) 0.99–1.38. Among those testing positive, weighted proportions for hospitalization were 7.4 vs. 15.9 for HCW vs. non-HCW with OR of 0.42 (CI 0.26–0.66) and for ICU admission: 2.2 vs. 4.5 for HCW vs. non-HCW with OR of 0.48 (CI 0.20–1.04). Those HCW identified as patient facing compared to not had increased odds of a positive SARS-CoV-2 test (OR 1.60, CI 1.08–2.39, proportions 8.6 vs. 5.5), but no statistically significant increase in hospitalization (OR 0.88, CI 0.20–3.66, proportions 10.2 vs. 11.4) and ICU admission (OR 0.34, CI 0.01–3.97, proportions 1.8 vs. 5.2). CONCLUSIONS: In a large healthcare system, HCW had similar odds for testing SARS-CoV-2 positive, but lower odds of hospitalization compared to non-HCW. Patient-facing HCW had higher odds of a positive test. These results are key to understanding HCW risk mitigation during the COVID-19 pandemic. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-020-06171-9) contains supplementary material, which is available to authorized users.


id: cord-266266-ekxnn9bo
author: Miyawaki, Atsushi
date: 2020-06-04
txt: ./txt/cord-266266-ekxnn9bo.txt
cache: ./cache/cord-266266-ekxnn9bo.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-05876-1
doi: 10.1007/s11606-020-05876-1
abstract: nan
summary:
  title: Lessons from Influenza Outbreaks for Potential Impact of COVID-19 Outbreak on Hospitalizations, Ventilator Use, and Mortality Among Homeless Persons in New York State To address this knowledge gap, using influenza outbreaks as an example, we investigated health care use among the homeless population hospitalized in New York State. 5 Next, we compared the utilization of care and patient outcomes (hospitalization through emergency department [ED], mechanical ventilation use [non-invasive or invasive], and in-hospital death) between homeless versus nonhomeless patients using multivariable modified Poisson regression models. Homeless patients experienced a higher rate of hospitalization for influenza than non-homeless persons throughout the observation period (Fig. 1) . The difference was particularly salient for the pandemic of H1N1 influenza in 2009: hospitalization rates were 2.9 per 1000 for homeless versus 0.1 per 1000 for non-homeless populations. Using the population-based data, including all hospitalizations for influenza in New York, we found that homeless persons had higher utilization of care compared with non-homeless persons.

title:
  Lessons from Influenza Outbreaks for Potential Impact of COVID-19 Outbreak on Hospitalizations, Ventilator Use, and Mortality Among Homeless Persons in New York State


id: cord-267114-tvoi6a7q
author: Abdus, Salam
date: 2020-09-18
txt: ./txt/cord-267114-tvoi6a7q.txt
cache: ./cache/cord-267114-tvoi6a7q.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32948957/
doi: 10.1007/s11606-020-06226-x
abstract: nan
summary:
  Among low-income adults with employer-sponsored insurance who had multiple chronic conditions and were enrolled in high-deductible plans, about 14.3% had family out-ofpocket prescription drug expenditures exceeding 10 percent of family disposable income. While out-of-pocket costs for prescription drugs have decreased in recent years, 1 the results of this study suggest that for low-income adults with multiple chronic conditions who are enrolled in employer-sponsored high-deductible plans, out-of-pocket prescription drug costs may still result in significant financial hardships. Adults who reported being diagnosed with high blood pressure on two or more occasions were defined as having hypertension † Base group *,**,***Statistically significantly different, based on two-sample t tests, from the no-deductible plan enrollees at the 5%, 1%, or 0.1%, respectively The sample comprised adults ages 19 to 64 who were enrolled in employer-sponsored health insurance plans and no other coverage throughout the year FPL, federal poverty level Using the self-reported priority conditions in MEPS HC, the following diagnosed conditions were identified: Diabetes, asthma, hypertension, arthritis, heart diseases, cancer, chronic bronchitis, stroke, and emphysema.

title:
  Financial Burdens of Out-of-Pocket Prescription Drug Expenditures under High-Deductible Health Plans


id: cord-270876-kul6bs3w
title: Virtual Visits and the Future of No-Shows
author: Morris, Nathaniel P.
date: 2020-06-08
txt: ./txt/cord-270876-kul6bs3w.txt
cache: ./cache/cord-270876-kul6bs3w.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-05948-2
doi: 10.1007/s11606-020-05948-2
abstract: nan
summary:
  2 By allowing patients to remotely attend appointments through audiovisual applications, virtual visits bring promise for decreasing outpatient no-shows. Patients can attend virtual visits from anywhere, including their homes, their workplaces, or even their parked cars, decreasing the burdens of making it to in-person appointments. In the study of general surgery outpatients from 2018, 123 (55%) of 223 patients reported they would prefer in-person appointments over virtual ones, even when accounting for the time and cost of coming to in-person appointments. 2 Patients and clinicians might struggle with setting up the technology needed for virtual visits, which might waste time and resources. For example, a 2019 study from Canada of home virtual visits for 75 patients at a stroke prevention clinic reported a no-show rate of 2 (3%) out of 81 appointments, but the study did not include comparisons of no-show rates for in-person clinic visits. Why do patients miss their appointments at primary care clinics?


id: cord-271599-1yu1yl12
author: Bailey, Stacy Cooper
date: 2020-09-01
txt: ./txt/cord-271599-1yu1yl12.txt
cache: ./cache/cord-271599-1yu1yl12.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-05980-2
doi: 10.1007/s11606-020-05980-2
summary:
  KEY RESULTS: From the onset to the acceleration phase, participants increasingly perceived COVID-19 to be a serious public health threat, reported more changes to their daily routine and plans, and reported greater preparedness. Individuals with low health literacy remained more likely to feel unprepared for the outbreak (RR 1.80, 95% CI 1.11–2.92, p = 0.02) and to express confidence in the federal government response (RR 2.11, 95% CI 1.49–3.00, p < 0.001) CONCLUSIONS: Adults at higher risk for COVID-19 continue to lack critical knowledge about prevention. Our first longitudinal assessment of the C3 study revealed that participants increasingly perceived COVID-19 to be a serious public health threat, reported more changes to their daily routine and plans, and had a greater sense of preparedness from the onset to the acceleration phase of the outbreak.

title:
  Changes in COVID-19 Knowledge, Beliefs, Behaviors, and Preparedness Among High-Risk Adults from the Onset to the Acceleration Phase of the US Outbreak

abstract:
  BACKGROUND: The US outbreak of coronavirus disease 2019 (COVID-19) accelerated rapidly over a short time to become a public health crisis. OBJECTIVE: To assess how high-risk adults’ COVID-19 knowledge, beliefs, behaviors, and sense of preparedness changed from the onset of the US outbreak (March 13–20, 2020) to the acceleration phase (March 27–April 7, 2020). DESIGN: Longitudinal, two-wave telephone survey. PARTICIPANTS: 588 predominately older adults with ≥ 1 chronic condition recruited from 4 active, federally funded studies in Chicago. MAIN MEASURES: Self-reported knowledge of COVID-19 symptoms and prevention, related beliefs, behaviors, and sense of preparedness. KEY RESULTS: From the onset to the acceleration phase, participants increasingly perceived COVID-19 to be a serious public health threat, reported more changes to their daily routine and plans, and reported greater preparedness. The proportion of respondents who believed they were “not at all likely” to get the virus decreased slightly (24.9 to 22.4%; p = 0.04), but there was no significant change in the proportion of those who were unable to accurately identify ways to prevent infection (29.2 to 25.7%; p 0.14). In multivariable analyses, black adults and those with lower health literacy were more likely to report less perceived susceptibility to COVID-19 (black adults: relative risk (RR) 1.62, 95% confidence interval (CI) 1.07–2.44, p = 0.02; marginal health literacy: RR 1.96, 95% CI 1.26–3.07, p < 0.01). Individuals with low health literacy remained more likely to feel unprepared for the outbreak (RR 1.80, 95% CI 1.11–2.92, p = 0.02) and to express confidence in the federal government response (RR 2.11, 95% CI 1.49–3.00, p < 0.001) CONCLUSIONS: Adults at higher risk for COVID-19 continue to lack critical knowledge about prevention. While participants reported greater changes to daily routines and plans, disparities continued to exist in perceived susceptibility to COVID-19 and in preparedness. Public health messaging to date may not be effectively reaching vulnerable communities.


id: cord-272679-dobaci5p
title: Changes in Mental Health Following the 2016 Presidential Election
author: Yan, Brandon W.
date: 2020-10-31
txt: ./txt/cord-272679-dobaci5p.txt
cache: ./cache/cord-272679-dobaci5p.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33128680/
doi: 10.1007/s11606-020-06328-6
summary:
  We used ordinary least squares linear regression to fit our model and applied BRFSS survey weights to obtain nationally representative estimates while adjusting for respondent''s age group, sex, race/ethnicity, income, educational attainment, state, and 6 months of pre-November trends. In subgroup analysis, the rise in poor mental health days in Clinton states in December 2016 reflected increases in such days by adults aged 65 and older, women, and white individuals (Table 1) . In contrast, depression rates compared to October 2016 first rose statistically in Clinton states in January 2017 (2.1percentage point increase, SE 0.8, p = 0.008), 1 month following the rise in days of reported poor mental health (Fig. 2 ). Although other factors are likely contributory, the sustained mental health worsening in Clinton states in the 6 months following the election suggests that the potential effects of Trump''s victory were not transitory, a hypothesis supported by a closely lagging rise in self-reported diagnoses of depression.

abstract:
  BACKGROUND: The 2016 presidential election and the controversial policy agenda of its victor have raised concerns about how the election may have impacted mental health. OBJECTIVE: Assess how mental health changed from before to after the November 2016 election and how trends differed in states that voted for Donald Trump versus Hillary Clinton. DESIGN: Pre- versus post-election study using monthly cross-sectional survey data. PARTICIPANTS: A total of 499,201 adults surveyed in the Behavioral Risk Factor Surveillance System from May 2016 to May 2017. EXPOSURE: Residence in a state that voted for Trump versus state that voted for Clinton and the candidate’s margin of victory in the state. MAIN MEASURES: Self-reported days of poor mental health in the last 30 days and depression rate. KEY RESULTS: Compared to October 2016, the mean days of poor mental health in the last 30 days per adult rose from 3.35 to 3.85 in December 2016 in Clinton states (0.50 days difference, p = 0.005) but remained statistically unchanged in Trump states, moving from 3.94 to 3.78 days (− 0.17 difference, p = 0.308). The rises in poor mental health days in Clinton states were driven by older adults, women, and white individuals. The depression rate in Clinton states began rising in January 2017. A 10–percentage point higher margin of victory for Clinton in a state predicted 0.41 more days of poor mental health per adult in December 2016 on average (p = 0.001). CONCLUSIONS: In states that voted for Clinton, there were 54.6 million more days of poor mental health among adults in December 2016, the month following the election, compared to October 2016. Clinicians should consider that elections could cause at least transitory increases in poor mental health and tailor patient care accordingly, especially with the 2020 election upon us. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11606-020-06328-6.


id: cord-276026-etj5vpg5
title: COVID-19 and Asian American Pacific Islanders
author: Hu, Jiun-Ruey
date: 2020-06-12
txt: ./txt/cord-276026-etj5vpg5.txt
cache: ./cache/cord-276026-etj5vpg5.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-05953-5
doi: 10.1007/s11606-020-05953-5
abstract: nan
summary:
  The American Psychiatric Association''s DSM-5 Outline for Cultural Formulation notes that "Experiences of racism and discrimination in the larger society may impede establishing trust and safety in the clinical diagnostic encounter. 6 Although no validated intervention for COVID-19-related discrimination exists yet, bystanders may be empowered by current frameworks for bystander intervention, such as from the 4 Ds of Bystander Intervention (Distract, Delegate, Direct, Delay) adapted by the American Friends Service Committee to combat racism, to the Interrupt, Question, Acknowledge, Educate, Echo framework adapted from the Southern Poverty Law Center to promote tolerance in teaching. While there has been an increase in the use of hashtags that encourage violence against Chinese people, there has also been a spike in anti-Semitic hashtags espousing racist tropes about the virus "being used to kill off large portions of the population." 8 As a medical community, we must make it clear to society that the racist rhetoric of blame threatens mental health and even lives-as we have already seen with the stabbing of the Burmese-American family.


id: cord-280410-j32tuj5s
title: COVID-Related Disruption—Finding the Silver Lining
author: Rose, Adam J.
date: 2020-08-31
txt: ./txt/cord-280410-j32tuj5s.txt
cache: ./cache/cord-280410-j32tuj5s.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-06173-7
doi: 10.1007/s11606-020-06173-7
abstract: nan
summary:
  Growing evidence shows that many non-COVID patients have stayed home with obvious heart attack symptoms rather than coming into the hospital, for fear of catching This has led to patients dying at home, increases in otherwise rare complications such as ventricular wall rupture, 2 and generally to unnecessarily severe complications from events that might have been easily managed under usual circumstances. Cancer treatment has been delayed or disrupted in many cases, despite valiant efforts by healthcare workers to continue it. COVID-19 has not been good for medical care delivery, for patients, or for healthcare workers. While some (or even many) disruptions have been bad for patients and the healthcare system, others seem to have been helpful. Certainly, readers can furnish many examples of how COVID-19 has been bad for care delivery in their area of expertise, their clinic, or their hospital.


id: cord-283862-k6b4vyut
title: From the Editor’s Desk: JGIM and COVID-19
author: Bates, Carol K.
date: 2020-04-22
txt: ./txt/cord-283862-k6b4vyut.txt
cache: ./cache/cord-283862-k6b4vyut.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-05852-9
doi: 10.1007/s11606-020-05852-9
abstract: nan
summary:
  We have expedited this "From the Editor''s Desk" even though it will not necessarily refer to articles in the same printed issue as has been our habit. Similarly, we have considered papers on materials that are behind the VA firewall and inaccessible to readers who do not work in the VA. For COVID-19 papers, we have considered the question of whether we should publish material that has also been in the lay press. Editorial guidance on the question of secondary publication comes from the International Committee of Medical Journal Editors (ICMJE). While not mentioned in ICMJE guidance, duplicate publication is also misleading in assessing promotion metrics in the overweighting of a body of work. ICMJE does have a proviso for public emergencies, stating that "…information with immediate implications for public health should be disseminated without concern that this will preclude subsequent consideration for publication in a journal." Therefore, while we recognize the risk that COVID-19-themed publications may put forward ideas that have already been disseminated in other settings, we are willing to take this risk and welcome submissions that may fall into that category.


id: cord-283917-jumgb0hs
title: The Proportion of Adult Americans at Risk of Severe COVID-19 Illness
author: Li, Hang Long
date: 2020-10-26
txt: ./txt/cord-283917-jumgb0hs.txt
cache: ./cache/cord-283917-jumgb0hs.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-06325-9
doi: 10.1007/s11606-020-06325-9
abstract: nan
summary:
  The US Centers for Disease Control and Prevention (CDC) announced on July 17, 2020, that conditions including obesity, diabetes mellitus (DM), chronic kidney disease (CKD), heart disease, and chronic obstructive pulmonary disease (COPD) are well-established risk factors predisposing individuals to severe illness from COVID-19. In this analysis, participants in the United States National Health and Nutrition Examination Survey (NHANES) 2011-2016 2 aged ≥ 20 years were included. There were minor differences in the percentage of people with ≥ 1 established and ≥ 1 any risk factor according to sex, ethnicity, education, and income level, but the percentages remained around 60% and 75%, respectively. This is the first study to estimate the proportion of the Americans in the general population at risk from severe COVID-19 illness using data from a nationally representative survey. 4 Our study shows that obesity and hypertension are the leading risk factors for severe COVID-19 illness, especially in those aged < 50 years.


id: cord-284795-0eoyxz78
author: Khetan, Aditya K.
date: 2020-06-25
txt: ./txt/cord-284795-0eoyxz78.txt
cache: ./cache/cord-284795-0eoyxz78.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32588178/
doi: 10.1007/s11606-020-05977-x
abstract: nan
summary:
  For Nipah, the fruit bats contaminated date palm sap, which was then consumed by humans who thus got infected. While public health measures, including surveillance of emerging disease hotspots, can be helpful as near-term strategies, they cannot substitute for a long-term solution that conserves biodiversity. Human activities that drive loss of biodiversity are also directly tied to climate change and increasing water scarcity. This agricultural land expansion has mostly been for farming animals (for meat and other animal products such as dairy), soybean production, and palm oil production. 5 Given the significant contribution of human meat consumption to loss of biodiversity, decreasing such consumption must be recognized as a major priority for decreasing the incidence of EID over the medium to long term. It is estimated that 25% of global GHG emissions are the result of agriculture, most of it from the farming of animals for human consumption. Evolution in action: climate change, biodiversity dynamics and emerging infectious disease

title:
  COVID-19: Why Declining Biodiversity Puts Us at Greater Risk for Emerging Infectious Diseases, and What We Can Do


id: cord-286679-g67ewzlp
author: Ordaz-Johnson, Omar H.
date: 2020-10-06
txt: ./txt/cord-286679-g67ewzlp.txt
cache: ./cache/cord-286679-g67ewzlp.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-06259-2
doi: 10.1007/s11606-020-06259-2
abstract: nan
summary:
  4 Community-based methods and partnerships with underrepresented populations can increase trust and study participation; accordingly, we sought to understand potential barriers specific to COVID-19 treatment and prevention in Black Americans using focus groups. Regarding optimized treatments for and prevention of COVID-19 among Black Americans, three major themes emerged: patient autonomy, holism, and structural racism. Emergent themes in our focus groups suggest that community involvement at the outset is critical for proper needs assessments, as well as in subsequent design and implementation of any new approaches aimed at assessing or reducing unfair burden of morbidity and mortality due to conditions disproportionately affecting Black Americans. Overall, findings highlight the importance of understanding community concerns about the orchestration of optimized treatments for COVID-19 among Black Americans, and underscore the health benefits of building community trust through early research involvement.

title:
  More Than a Statistic: a Qualitative Study of COVID-19 Treatment and Prevention Optimization for Black Americans


id: cord-297935-fk9j7q67
author: Wilson, Ellen K.
date: 2020-09-11
txt: ./txt/cord-297935-fk9j7q67.txt
cache: ./cache/cord-297935-fk9j7q67.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32918203/
doi: 10.1007/s11606-020-06177-3
summary:
  OBJECTIVE: To understand Medicaid and Medicare patient and caregiver experiences with PCMHs participating in the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration. Separate groups were held for Medicare high-risk, Medicare low-risk, Medicaid, and dually eligible beneficiaries, their caregivers, and caregivers of Medicaid children (or, in Vermont, with patients participating in the Support and Services at Home program), in two different geographical areas in each state. In recent years, Centers for Medicare & Medicaid Services (CMS) and other payers have invested significant resources in testing the patient-centered medical home (PCMH) model as a means to improve the organization and delivery of primary health care and reduce health care expenditures. Through CMS''s involvement, Medicare partnered with Medicaid and commercial payers to make payments to participating primary care practices to support PCMH transformation activities, including extending office hours, staffing care teams, coordinating care, and enhancing electronic health record (EHR) capabilities.

title:
  Patients’ and Caregivers’ Experiences with the Multi-Payer Advanced Primary Care Practice Demonstration

abstract:
  BACKGROUND: The patient-centered medical home (PCMH) model aims to improve primary health care using a patient-centered approach. Little qualitative research has investigated how the PCMH model affects patient experience with care. OBJECTIVE: To understand Medicaid and Medicare patient and caregiver experiences with PCMHs participating in the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration. DESIGN: Qualitative study. PARTICIPANTS: Medicare, Medicaid, and dually eligible patients who were patients in primary care practices participating in the MAPCP Demonstration and caregivers of such patients (N = 490). APPROACH: From July through November 2014, a trained facilitator conducted 81 focus groups in the eight states participating in the MAPCP Demonstration. Separate groups were held for Medicare high-risk, Medicare low-risk, Medicaid, and dually eligible beneficiaries, their caregivers, and caregivers of Medicaid children (or, in Vermont, with patients participating in the Support and Services at Home program), in two different geographical areas in each state. Focus group discussions were recorded, transcribed, and analyzed using NVivo qualitative data analysis software. RESULTS: Participants’ experiences with care were generally consistent with the expectations of a PCMH, although some exceptions were noted. Medicaid only and dually eligible beneficiaries generally had less-positive experiences than Medicare beneficiaries. Most participants said their practices had not solicited feedback from them about their experiences with care. Few participants knew what the term “medical home” meant or were aware that their practices were working to become PCMHs, but many had noticed changes in recent years, primarily related to the conversion to electronic health records. CONCLUSIONS: Most participants had positive experiences with their care. Opportunities exist, however, to improve care for Medicaid and dually eligible beneficiaries, and enhance patient awareness of and involvement in PCMH practice transformation.


id: cord-301399-s2i6qfjn
title: Changes in Mortality in Top 10 Causes of Death from 2011 to 2018
author: Rana, Jamal S.
date: 2020-07-23
txt: ./txt/cord-301399-s2i6qfjn.txt
cache: ./cache/cord-301399-s2i6qfjn.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32705476/
doi: 10.1007/s11606-020-06070-z
abstract: nan
summary:
  Therefore, we examined changes in the number of deaths and age-adjusted mortality rates (AAMR) attributed to the top 10 causes of death between 2011 and 2018, the last year we have data available from the Centers for Disease Control and Prevention. We chose 2011 as the start date because of earlier work showing a transition in 2011 in 2 of the top 10 causes of death (heart disease and stroke) from a long-term decline to increasing numbers of deaths since then. Important patterns of change in AAMR in the past decade have been previously noted, from stalling of the decline in mortality due to heart disease 1 to decrease in life expectancy attributed to drug overdoses and suicides among young and middle-aged adults. Further, the ≥ 65 years population is projected to increase by 39% from 52.4 million in 2018 to 73.1 million in 2030 3 so that the number of deaths from most of the 10 leading causes can be expected to increase unless more effective preventive and therapeutic interventions can be implemented.


id: cord-304839-lesa5u2n
title: Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19)
author: Jiang, Fang
date: 2020-03-04
txt: ./txt/cord-304839-lesa5u2n.txt
cache: ./cache/cord-304839-lesa5u2n.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32133578/
doi: 10.1007/s11606-020-05762-w
summary:
  In late December 2019, a cluster of cases with 2019 Novel Coronavirus pneumonia (SARS-CoV-2) in Wuhan, China, aroused worldwide concern. On January 7, 2020, researchers rapidly isolated a novel coronavirus (SARS-CoV-2, also referred to as 2019-nCoV) from confirmed infected pneumonia patients. 3 We reviewed the published clinical features, symptoms, complications, and treatments of patients with COVID-19 to help health workers around the world combat the current outbreak. Keywords used were "COVID-19," "2019 novel coronavirus," "SARS-CoV-2," "2019-nCoV," "Wuhan coronavirus," and "Wuhan seafood market pneumonia virus." After careful screening, six published articles with confirmed cases were identified and included in this review. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan

abstract:
  In late December 2019, a cluster of cases with 2019 Novel Coronavirus pneumonia (SARS-CoV-2) in Wuhan, China, aroused worldwide concern. Previous studies have reported epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19). The purpose of this brief review is to summarize those published studies as of late February 2020 on the clinical features, symptoms, complications, and treatments of COVID-19 and help provide guidance for frontline medical staff in the clinical management of this outbreak.


id: cord-305110-mujpekyu
author: Cloud, David H.
date: 2020-07-06
txt: ./txt/cord-305110-mujpekyu.txt
cache: ./cache/cord-305110-mujpekyu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32632787/
doi: 10.1007/s11606-020-05968-y
summary:
  Critical public health tools to mitigate the spread of COVID-19 are medical isolation and quarantine, but use of these tools is complicated in prisons and jails where decades of overuse of punitive solitary confinement is the norm. 10 Many advocates fear that use of isolation to curb transmission of COVID-19 in correctional facilities will complicate the emerging crisis, as incarcerated people become reluctant to report symptoms for fear of being moved to solitary confinement, those who do report symptoms will be forced to endure an experience known to cause psychological and physical harm, and system-wide unrest will be triggered in institutions where fears about being placed in medical isolation could run rampant. Yet, quarantine and medical isolation in response to COVID-19 are necessary to halt the spread of infection; without them, containment of disease transmission will be exceedingly difficult if not impossible, posing significant health risks to incarcerated people, correctional healthcare providers, security staff, and the families and communities to which workers return at the end of each shift.

title:
  Medical Isolation and Solitary Confinement: Balancing Health and Humanity in US Jails and Prisons During COVID-19

abstract:
  In the face of the continually worsening COVID-19 pandemic, jails and prisons have become the greatest vectors of community transmission and are a point of heightened crisis and fear within the global crisis. Critical public health tools to mitigate the spread of COVID-19 are medical isolation and quarantine, but use of these tools is complicated in prisons and jails where decades of overuse of punitive solitary confinement is the norm. This has resulted in advocates denouncing the use of any form of isolation and attorneys litigating to end its use. It is essential to clarify the critical differences between punitive solitary confinement and the ethical use of medical isolation and quarantine during a pandemic. By doing so, then all those invested in stopping the spread of COVID-19 in prisons can work together to integrate medically sound, humane forms of medical isolation and quarantine that follow community standards of care rather than punitive forms of solitary confinement to manage COVID-19.


id: cord-306352-agppehpz
title: Charlson Comorbidity Index Score and Risk of Severe Outcome and Death in Danish COVID-19 Patients
author: Christensen, Daniel Mølager
date: 2020-06-24
txt: ./txt/cord-306352-agppehpz.txt
cache: ./cache/cord-306352-agppehpz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32583345/
doi: 10.1007/s11606-020-05991-z
abstract: nan
summary:
  title: Charlson Comorbidity Index Score and Risk of Severe Outcome and Death in Danish COVID-19 Patients Studies assessing the impact of total comorbidity burden on outcomes of COVID-19 in age-and sex-controlled analyses are lacking. 1 In this nationwide study of Danish COVID-19 patients, we investigated if Charlson Comorbidity Index Score (CCIS) was associated with the risk of severe outcome and death. The models were used to estimate the absolute risk of both outcomes according to CCIS groups across ages 40-85 for both sexes. The estimated absolute risks of severe COVID-19 and death were increased for CCIS 1-2, 3-4, and > 4 compared with those for CCIS 0 across ages and sexes (Fig. 1) . A Charlson Comorbidity Index Score above 0 was associated with an increased risk of severe COVID-19 and death when controlled for age and sex. Figure 1 Estimated risks of severe outcome and death according to sex, age, and Charlson Comorbidity Index Score (CCIS).


id: cord-307946-1olapsmv
author: Xu, Zhijie
date: 2020-08-31
txt: ./txt/cord-307946-1olapsmv.txt
cache: ./cache/cord-307946-1olapsmv.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32869200/
doi: 10.1007/s11606-020-06107-3
summary:
  title: Primary Care Practitioners'' Barriers to and Experience of COVID-19 Epidemic Control in China: a Qualitative Study Barriers to epidemic control in primary care included inappropriate PCP scheduling and role ambiguity, difficult tasks and inadequate capacities, and inexperienced community workers and insufficient cooperation. PCPs reported potential solutions for improving countermeasures, such as improving management, optimizing workflows, providing additional support, facilitating cooperation, and strengthening the primary care system. To understand PCPs'' perceived barriers to and experience of performing their tasks in epidemic control, we recruited frontline PCPs in China and conducted in-depth interviews using a qualitative design. The government officials and medical experts irregularly visited the community/township health centers and inspected PCPs'' daily practice of epidemic control, including the material preparation and arrangement, and held meetings to discuss the existing problems and potential solutions with PCPs. One participant stated, "It really troubled me that I had to accompany those supervisors, maybe 3 to 5 times a week, and show them what we had done with countless papers and forms and photos." Some instructions distributed to PCPs by supervisors were perceived as "scratching the surface".

title:
  Primary Care Practitioners’ Barriers to and Experience of COVID-19 Epidemic Control in China: a Qualitative Study

abstract:
  BACKGROUND: The coronavirus disease 2019 (COVID-19) emerged in December 2019 and posed numerous challenges to China’s health system. Almost 4 million primary care practitioners (PCPs) participated in controlling the outbreak. However, PCPs’ barriers to and experience of the epidemic control remain unknown and are essential for improving countermeasures. OBJECTIVE: To better understand the barriers PCPs faced in COVID-19 epidemic control and their psychological and occupational impacts, and explore potential solutions. DESIGN: This qualitative study was conducted through semi-structured, in-depth interviews from February 12, to March 10, 2020. PARTICIPANTS: A purposive sample of frontline PCPs affiliated with either community health centers or township health centers in four provinces of China were recruited. APPROACH: Interviews were conducted by telephone, and then recorded, transcribed, and content analyzed. Themes surrounding PCPs’ barriers to COVID-19 epidemic control, their experience, and potential solutions were iteratively identified using the constant comparative method. KEY RESULTS: Of the 21 PCPs interviewed, 10 (48%) were women and 5 (24%) worked in rural areas. Barriers to epidemic control in primary care included inappropriate PCP scheduling and role ambiguity, difficult tasks and inadequate capacities, and inexperienced community workers and insufficient cooperation. Some PCPs perceived respect and a sense of accomplishment and were preoccupied with the outbreak, while others were frustrated by fatigue and psychological distress. PCPs reported potential solutions for improving countermeasures, such as improving management, optimizing workflows, providing additional support, facilitating cooperation, and strengthening the primary care system. CONCLUSIONS: Due to their roles in controlling the COVID-19 epidemic, PCPs in China faced a series of barriers that affected them physically and mentally. Support for PCPs should help them to overcome these barriers and work efficiently. The current findings provide insight into the challenges and potential solutions for strengthening the preparedness and response of China’s primary care system in future disease outbreaks. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-020-06107-3) contains supplementary material, which is available to authorized users.


id: cord-317440-898r34h2
title: Charges of COVID-19 Diagnostic Testing and Antibody Testing Across Facility Types and States
author: Meiselbach, Mark K.
date: 2020-09-15
txt: ./txt/cord-317440-898r34h2.txt
cache: ./cache/cord-317440-898r34h2.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32935319/
doi: 10.1007/s11606-020-06198-y
abstract: nan
summary:
  title: Charges of COVID-19 Diagnostic Testing and Antibody Testing Across Facility Types and States The CARES Act requires that private plans that do not have a negotiated rate with the provider pay the price publicly listed by the provider for COVID-19 testing, which is usually the same as or a percentage of the charge. In this study, we aim to examine the charges for the most commonly performed COVID-19 diagnostic test (CPT code: 87635) and antibody test (CPT code: 86769) across facility types and states. For COVID-19 diagnostic testing, the mean, median, and standard deviations of charges were $144.06, $100.00 (IQR $67.00-$155.00), and $162.18. A small proportion of COVID-19 diagnostic testing and antibody testing services, provided in selected states, had charges that far exceeded the Medicare rate. Anderson, PhD 1,2 a b Figure 2 Average charges for COVID-19 testing, by state. States that had ten or fewer claims were classified as "No data." The Medicare reimbursement rate is $51.31.


id: cord-322066-m8dphaml
title: Primary Care Providers: Discuss COVID-19-Related Goals of Care with Your Vulnerable Patients Now
author: Kutscher, Eric
date: 2020-05-06
txt: ./txt/cord-322066-m8dphaml.txt
cache: ./cache/cord-322066-m8dphaml.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32378009/
doi: 10.1007/s11606-020-05862-7
abstract: nan
summary:
  All of these unknowns often result in doctors uncomfortable in talking about risks and benefits of intubation with their patients until it is clear that the patient has progressed to a point of needing respiratory support. We as primary care doctors have the privilege of knowing our patients the best. We must also ask our patients about what medical interventions they would want if they were to contract COVID-19 and require respiratory support. Given the data we know about COVID-19 and the risks and benefits of intubation, we must use our best medical judgment to help patients understand realistic outcomes and make informed decisions. The role of the primary care doctor is to partner with our patients to help them find their voice in the medical system. It means helping many of our beloved patients understand that "do not intubate" is most likely the best choice for them.


id: cord-325181-d2cqarep
title: An Underused Treatment Strategy: Voter Enfranchisement
author: Kusner, Jonathan
date: 2020-10-19
txt: ./txt/cord-325181-d2cqarep.txt
cache: ./cache/cord-325181-d2cqarep.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33078299/
doi: 10.1007/s11606-020-06286-z
abstract: nan
summary:
  Providers at community health centers (CHCs) are facing unique challenges in this landscape, serving as essential workers themselves while looking for ways to support some of the most vulnerable patients in the nation-many of whom bear the greatest burden of COVID-19, economic recession, and racial injustice, but whose voices are also often left out of the national political conversation. VotER (https://vot-er.org/) is a nonpartisan voter readiness initiative that specifically seeks to engage healthcare professionals in "inviting (patient) voices into the democratic process." To facilitate this, they offer their Health Democracy Kit, which allows healthcare providers to direct patients to an online voter registration platform that walks patients through voter registration in a state-specific manner. Our experience demonstrated how easily healthcare-based non-partisan voter registration can be coordinated and offered to patients in a way that does not burden providers or interrupt clinic work flows.


id: cord-326399-ey8g4pom
title: Trends in Ambulatory Electronic Consultations During the COVID-19 Pandemic
author: Phadke, Neelam A.
date: 2020-05-18
txt: ./txt/cord-326399-ey8g4pom.txt
cache: ./cache/cord-326399-ey8g4pom.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32424786/
doi: 10.1007/s11606-020-05878-z
abstract: nan
summary:
  title: Trends in Ambulatory Electronic Consultations During the COVID-19 Pandemic Hypothesizing that e-consult requests would increase during the pandemic, we sought to define COVID-19associated changes in e-consult requests. We assessed daily volumes from February 1, 2020, through April 1, 2020; the defined date of "intervention" was March 11, 2020, when Massachusetts declared a COVID-19-related state of emergency. We describe a significant increase in e-consult utilization relative to traditional ambulatory referrals following the COVID-19-related state of emergency declaration in Massachusetts. These results suggest an increase in e-consult utilization associated with the COVID-19 pandemic in the USA. This question is electronically transmitted to a specialist physician who reviews the question and clinical information in the EHR and provides clinical guidance including recommendations for further diagnostic testing or therapeutic management via a note entered in the patient''s EHR.


id: cord-327463-uw3rhkf3
title: Price Transparency for COVID-19 Testing Among Top US Hospitals
author: Xiao, Roy
date: 2020-09-18
txt: ./txt/cord-327463-uw3rhkf3.txt
cache: ./cache/cord-327463-uw3rhkf3.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-06197-z
doi: 10.1007/s11606-020-06197-z
abstract: nan
summary:
  1 Under the CARES Act, private insurers are required to cover in vitro diagnostic testing for COVID-19 without patient cost sharing or other barriers during the public health emergency. To mitigate the risk of out-of-network billing for insurers that had not already negotiated rates, providers such as hospitals were required to publicly disclose the maximum "cash price" for tests online. We systematically reviewed the public websites of all hospitals in the 2019-2020 U.S. News and World Report "Best Regional Hospitals" list to determine whether the following information was available for in vitro COVID-19 tests: cash prices (yes/ no), hospital charges (yes/no), test type (molecular/serology/ unspecified; non-mutually exclusive). Among hospitals disclosing both cash prices and hospital charges, the median lowest bill balances for molecular (N = 27) and serology (N = 14) were $66.96 (IQR: $7.00-$120.00) and $6.00 (IQR: $6.00-$30.00), respectively.


id: cord-330368-rk31cwl4
title: Harnessing the Power of Hospitalists in Operational Disaster Planning: COVID-19
author: Bowden, Kasey
date: 2020-07-13
txt: ./txt/cord-330368-rk31cwl4.txt
cache: ./cache/cord-330368-rk31cwl4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32661930/
doi: 10.1007/s11606-020-05952-6
summary:
  Much of the disaster planning in hospitals around the country addresses overcrowded emergency departments and decompressing these locations; however, in the case of COVID-19, intensive care units, emergency departments, and medical wards ran the risk of being overwhelmed by a large influx of patients needing high-level medical care. In a matter of days, our Division of Hospital Medicine, in partnership with our hospital, health system, and academic institution, was able to modify and deploy existing disaster plans to quickly care for an influx of medically complex patients. Starting with preparedness models outlined by Persoff et al., 10 Frank et al., 8 the CHEST consensus statement, 11, 12 and our existing disaster plans, we developed a modified framework for hospital operations management and staffing, anticipating a massive influx of acutely ill, medically complex, and highly contagious patients with COVID-19.

abstract:
  Hospitalists are well poised to serve in key leadership roles and in frontline care in particular when facing a pandemic such as the SARS-CoV-2 (COVID-19) infection. Much of the disaster planning in hospitals around the country addresses overcrowded emergency departments and decompressing these locations; however, in the case of COVID-19, intensive care units, emergency departments, and medical wards ran the risk of being overwhelmed by a large influx of patients needing high-level medical care. In a matter of days, our Division of Hospital Medicine, in partnership with our hospital, health system, and academic institution, was able to modify and deploy existing disaster plans to quickly care for an influx of medically complex patients. We describe a scaled approach to managing hospitalist clinical operations during the COVID-19 pandemic.


id: cord-332728-72yq43sw
author: Flentje, Annesa
date: 2020-06-17
txt: ./txt/cord-332728-72yq43sw.txt
cache: ./cache/cord-332728-72yq43sw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32556877/
doi: 10.1007/s11606-020-05970-4
abstract: nan
summary:
  title: Depression and Anxiety Changes Among Sexual and Gender Minority People Coinciding with Onset of COVID-19 Pandemic Marginalized populations, such as sexual and gender minority people (i.e., non-heterosexual people and transgender or gender-expansive people, respectively) may be particularly at risk for adverse impacts of the pandemic due to preexisting economic and health factors. 1 We set out to document changes in depression and anxiety within The PRIDE Study, a longitudinal cohort of sexual and gender minority people, a vulnerable population. The PRIDE Study, a longitudinal cohort study of sexual and gender minority people, 2 were included if they completed mental health measures in the 2019 Annual Questionnaire (timepoint 1, June 2019-ongoing at time of data extraction) and in a COVID-19 impact ancillary study (timepoint 2, March 23, 2020, through April 19, 2020). A digital health research platform for community engagement, recruitment, and retention of sexual and gender minority adults in a national longitudinal cohort study-The PRIDE Study

title:
  Depression and Anxiety Changes Among Sexual and Gender Minority People Coinciding with Onset of COVID-19 Pandemic


id: cord-332729-f1e334g0
title: An Impact-Oriented Approach to Epidemiological Modeling
author: Shah, Nirav R.
date: 2020-09-21
txt: ./txt/cord-332729-f1e334g0.txt
cache: ./cache/cord-332729-f1e334g0.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-06230-1
doi: 10.1007/s11606-020-06230-1
abstract: nan
summary:
  5 The Centers for Disease Control and Prevention (CDC) recently added policy development as a sixth item in its list of the major tasks of epidemiology in public health, but there remains no mention of the impact on the general public. For instance, the Covid Act Now (CAN) model is fully open-source, along with its data inputs (available at https://covidactnow.org). Both the New York Times and Georgetown University''s Center for Global Health, Science, and Security (available at https://covidamp.org/) have begun to collect data on COVID-19 policies by state and effective dates, including shelter-in-place and reopening orders. These eight considerations may enable COVID-19 data and models to become better harbingers of actionable, behavior-changing, and even life-saving information; to bridge the gap between scientific public health expertise and mainstream, layperson Are the data and model''s mechanisms and data sources publicly available for fact-checking and validation?


id: cord-336577-uvnbgsds
title: Sunset Rounds: a Framework for Post-death Care in the Hospital
author: Salazar, James W.
date: 2020-10-01
txt: ./txt/cord-336577-uvnbgsds.txt
cache: ./cache/cord-336577-uvnbgsds.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33006080/
doi: 10.1007/s11606-020-06249-4
abstract: nan
summary:
  Notification of survivors -Determine the most appropriate patient contact and the team-member best suited to disclose -Use "SPIKES" 2 principles and the words "died" or "death" -Offer assistance in sharing the news with other friends or family -Consider saying a few closing words honoring the patient Care team should include primary physicians and nurses, relevant consultants (e.g., palliative care), spiritual personnel, and decedent affairs team members Death in the context of COVID-19: For specific guidance on the safe management of a dead body in the context of COVID-19 and how it may inform the above framework, please refer to the World Health Organization Interim Guidance 3 *State reporting guidelines can be found at: https://www.cdc.gov/phlp/publications/topic/coroner.html †Local Networks can be found at: https://www.organdonor.gov/awareness/organizations/local-opo.html is important that we work collectively to care for each other, support our survivors, and honor the sunsets of our patients.


id: cord-337120-irpm5g7g
title: The Role of Internists During Epidemics, Outbreaks, and Bioterrorist Attacks
author: Lee, Bruce Y.
date: 2007-01-13
txt: ./txt/cord-337120-irpm5g7g.txt
cache: ./cache/cord-337120-irpm5g7g.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/17351853/
doi: 10.1007/s11606-006-0030-2
summary:
  Therefore, Internists must understand early warning signs of different bioterrorist and infectious agents, proper reporting channels and measures, various ways that they can assist the public health response, and roles of different local, state, and federal agencies. During the past half decade, well-publicized events, including the anthrax mail attacks, 1 Hurricane Katrina, 2 and severe acute respiratory syndrome (SARS) 3, 4 have reminded us that epidemics, disease outbreaks, bioterrorist attacks, and natural disasters can occur. Therefore, Internists must understand early warning signs of bioterrorist and infectious agents, proper reporting channels and measures, and ways that they can help contain and treat the consequences of epidemics, outbreaks, and attacks. Internists suspecting an attack or epidemic should immediately inform the local or state health department and contain any possible threat in their clinics, especially if the agent is contagious. Bioterrorist attacks and epidemics require physicians to quickly transmit patient and case information to other health care personnel and appropriate authorities.

abstract:
  Internists are well-positioned to play significant roles in recognizing and responding to epidemics, outbreaks, and bioterrorist attacks. They see large numbers of patients with various health problems and may be the patients’ only interaction with the medical community for symptoms resulting from infectious diseases and injuries from radiation, chemicals, and/or burns. Therefore, Internists must understand early warning signs of different bioterrorist and infectious agents, proper reporting channels and measures, various ways that they can assist the public health response, and roles of different local, state, and federal agencies. In addition, it is important to understand effects of a public health disaster on clinic operations and relevant legal consequences.


id: cord-339508-nf6ov39g
author: Weil, Ana A.
date: 2020-09-01
txt: ./txt/cord-339508-nf6ov39g.txt
cache: ./cache/cord-339508-nf6ov39g.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32875494/
doi: 10.1007/s11606-020-06165-7
summary:
  In this study, we describe the results of cross-sectional resident and employee SARS-CoV-2 testing, and infection control and personnel policies associated with 16 Seattle area SNFs. Through two testing strategies, a total of 16 SNFs offered testing to either residents, employees, or both. For employees tested through the Seattle Flu Study, data included participant date of birth, date of testing, race and ethnicity, location and nature of work, new symptoms experienced during the last 7 days, and history of SARS-CoV-2 testing (Appendix 1 in the Supplementary Material). For employees, positive or inconclusive SARS-CoV-2 test results were reported directly to participants by phone within 48 h and to the Washington State Department of Health. We report the results of a large cross-sectional study evaluating SARS-CoV-2 prevalence in skilled nursing facilities (SNFs) in the Seattle area during the spring 2020 peak of the COVID-19 pandemic.

title:
  Cross-Sectional Prevalence of SARS-CoV-2 Among Skilled Nursing Facility Employees and Residents Across Facilities in Seattle

abstract:
  BACKGROUND: Skilled nursing facilities (SNFs) are high-risk settings for SARS-CoV-2 transmission. Infection rates among employees are infrequently described. OBJECTIVE: To describe SARS-CoV-2 rates among SNF employees and residents during a non-outbreak time period, we measured cross-sectional SARS-CoV-2 prevalence across multiple sites in the Seattle area. DESIGN: SARS-CoV-2 testing was performed for SNF employees and residents using quantitative real-time reverse transcription polymerase chain reaction. A subset of employees completed a sociodemographic and symptom questionnaire. PARTICIPANTS: Between March 29 and May 13, 2020, we tested 1583 employees and 1208 residents at 16 SNFs for SARS-CoV-2. MAIN MEASURE: SARS-CoV-2 testing results and symptom report among employees and residents. KEY RESULTS: Eleven of the 16 SNFs had one or more resident or employee test positive. Overall, 46 (2.9%) employees had positive or inconclusive testing for SARS-CoV-2, and among those who completed surveys, most were asymptomatic and involved in direct patient care. The majority of employees tested were female (934, 73%), and most employees were Asian (392, 30%), Black (360, 28%), or white (360, 28%). Among the 1208 residents tested, 110 (9.1%) had positive or inconclusive results. There was no association between the presence of positive residents and positive employees within a SNF (p = 0.62, McNemar’s test). CONCLUSIONS: In the largest study of SNFs to date, SARS-CoV-2 infections were detected among both employees and residents. Employees testing positive were often asymptomatic and involved in direct patient care. Surveillance testing is needed for SNF employees and residents during the pandemic response. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-020-06165-7) contains supplementary material, which is available to authorized users.


id: cord-339533-r0qsqjus
title: COVID-19 and Health Disparities: the Reality of “the Great Equalizer”
author: Mein, Stephen A
date: 2020-05-14
txt: ./txt/cord-339533-r0qsqjus.txt
cache: ./cache/cord-339533-r0qsqjus.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32410124/
doi: 10.1007/s11606-020-05880-5
abstract: nan
summary:
  Pandemics have the unique ability to amplify existing health inequalities, disproportionately affecting socially disadvantaged groups, including racial and ethnic minorities and low-income populations. Racial and ethnic minorities are at both a higher risk of contracting COVID-19 and suffering worse outcomes. 5, 6 Once infected, racial and ethnic minorities are at a greater risk of increased disease severity. 7 Previous epidemiological studies have consistently shown many of these conditions to be more prevalent in racial/ethnic minorities, likely contributing to the worse health outcomes seen from COVID-19. Until recently, there has been minimal comprehensive demographic data reported from the Centers for Disease Control and Prevention (CDC) or other governing bodies around the racial/ethnic characteristics of patients infected with COVID-19. Health disparities have long plagued our country and greatly impacted racial and ethnic minorities. Protection of racial/ethnic minority populations during an influenza pandemic


id: cord-339701-j0sr3ifq
title: Risk Factors for Mortality in Patients with COVID-19 in New York City
author: Mikami, Takahisa
date: 2020-06-30
txt: ./txt/cord-339701-j0sr3ifq.txt
cache: ./cache/cord-339701-j0sr3ifq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32607928/
doi: 10.1007/s11606-020-05983-z
summary:
  PARTICIPANTS: 6493 patients who had laboratory-confirmed COVID-19 with clinical outcomes between March 13 and April 17, 2020, who were seen in one of the 8 hospitals and/or over 400 ambulatory practices in the New York City metropolitan area MAIN MEASURES: Clinical characteristics and risk factors associated with in-hospital mortality. Cox proportional hazard regression modeling showed an increased risk of in-hospital mortality associated with age older than 50 years (hazard ratio [HR] 2.34, CI 1.47–3.71), systolic blood pressure less than 90 mmHg (HR 1.38, CI 1.06–1.80), a respiratory rate greater than 24 per min (HR 1.43, CI 1.13–1.83), peripheral oxygen saturation less than 92% (HR 2.12, CI 1.56–2.88), estimated glomerular filtration rate less than 60 mL/min/1.73m(2) (HR 1.80, CI 1.60–2.02), IL-6 greater than 100 pg/mL (HR 1.50, CI 1.12–2.03), D-dimer greater than 2 mcg/mL (HR 1.19, CI 1.02–1.39), and troponin greater than 0.03 ng/mL (HR 1.40, CI 1.23–1.62). In this study, we describe the clinical characteristics of COVID-19 in ambulatory and inpatient settings and identify risk factors associated with mortality in hospitalized patients.

abstract:
  BACKGROUND: New York City emerged as an epicenter of the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: To describe the clinical characteristics and risk factors associated with mortality in a large patient population in the USA. DESIGN: Retrospective cohort study. PARTICIPANTS: 6493 patients who had laboratory-confirmed COVID-19 with clinical outcomes between March 13 and April 17, 2020, who were seen in one of the 8 hospitals and/or over 400 ambulatory practices in the New York City metropolitan area MAIN MEASURES: Clinical characteristics and risk factors associated with in-hospital mortality. KEY RESULTS: A total of 858 of 6493 (13.2%) patients in our total cohort died: 52/2785 (1.9%) ambulatory patients and 806/3708 (21.7%) hospitalized patients. Cox proportional hazard regression modeling showed an increased risk of in-hospital mortality associated with age older than 50 years (hazard ratio [HR] 2.34, CI 1.47–3.71), systolic blood pressure less than 90 mmHg (HR 1.38, CI 1.06–1.80), a respiratory rate greater than 24 per min (HR 1.43, CI 1.13–1.83), peripheral oxygen saturation less than 92% (HR 2.12, CI 1.56–2.88), estimated glomerular filtration rate less than 60 mL/min/1.73m(2) (HR 1.80, CI 1.60–2.02), IL-6 greater than 100 pg/mL (HR 1.50, CI 1.12–2.03), D-dimer greater than 2 mcg/mL (HR 1.19, CI 1.02–1.39), and troponin greater than 0.03 ng/mL (HR 1.40, CI 1.23–1.62). Decreased risk of in-hospital mortality was associated with female sex (HR 0.84, CI 0.77–0.90), African American race (HR 0.78 CI 0.65–0.95), and hydroxychloroquine use (HR 0.53, CI 0.41–0.67). CONCLUSIONS: Among patients with COVID-19, older age, male sex, hypotension, tachypnea, hypoxia, impaired renal function, elevated D-dimer, and elevated troponin were associated with increased in-hospital mortality and hydroxychloroquine use was associated with decreased in-hospital mortality. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-020-05983-z) contains supplementary material, which is available to authorized users.


id: cord-347454-zs909ldm
author: DePuccio, Matthew J.
date: 2020-07-31
txt: ./txt/cord-347454-zs909ldm.txt
cache: ./cache/cord-347454-zs909ldm.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32737791/
doi: 10.1007/s11606-020-05998-6
abstract: nan
summary:
  title: Patients'' Perceptions About Medical Record Privacy and Security: Implications for Withholding of Information During the COVID-19 Pandemic As withholding information can compromise providers'' ability to deliver appropriate care, the accuracy of public health surveillance system data, and even population health efforts to mitigate the spread of COVID-19, we need to understand how patients'' concerns about the privacy and security of their medical information may lead to information-withholding behaviors. One survey section asked about patients'' attitudes toward use of health information technology, including their perceptions about information security risks and privacy. The dependent variable for this study was the answer to the question "Have you ever kept information from your healthcare provider because you were concerned about the privacy or security of your medical record?" (yes/no). Concern about security and privacy, and perceived control over collection and use of health information are related to withholding of health information from healthcare providers

title:
  Patients’ Perceptions About Medical Record Privacy and Security: Implications for Withholding of Information During the COVID-19 Pandemic


id: cord-348026-t1jkeu3d
title: Physician Supply During the Coronavirus Disease 2019 (COVID-19) Crisis: the Role of Hazard Pay
author: Ruhnke, Gregory W.
date: 2020-06-10
txt: ./txt/cord-348026-t1jkeu3d.txt
cache: ./cache/cord-348026-t1jkeu3d.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32524249/
doi: 10.1007/s11606-020-05931-x
abstract: nan
summary:
  7 As a result, hazard pay offered to medical students willing to risk exposure to COVID-19 now may reduce their debt burden and potentiate the creation of more primary care physicians, a dearth of whom has been a significant health policy concern. However, there are several ways in which hazard pay might be financed based on local considerations and institutional structures: (a) small compulsory contributions from physicians (perhaps exempting those required to take unpaid furloughs) at a given institution not caring for COVID-19 patients by choice or due to risk factors for bad outcomes if infected; (b) public funding, such as the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020; and (c) private foundations offering funding for COVID-19 response efforts. Hazard pay could of course be considered for all physicians risking their health to care for infected patients.


id: cord-349099-s33nd9hz
title: Home Sick with Coronavirus Symptoms: a National Study, April–May 2020
author: Gaffney, Adam W.
date: 2020-09-10
txt: ./txt/cord-349099-s33nd9hz.txt
cache: ./cache/cord-349099-s33nd9hz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32914273/
doi: 10.1007/s11606-020-06159-5
abstract: nan
summary:
  3 We compared the demographic characteristics, health insurance status, food insecurity, and prevalence of COVID-19 in their state of residence 4 (divided into quartiles), of those selecting this response to two other groups: (1) those working and (2) persons out-ofwork because of a non-coronavirus-related illness/ disability. We performed univariate logistic regressions to evaluate the association of each factor with being out-sick due to coronavirus symptoms relative to each comparator group. Our sample included 89,490 adults working the past week, 457 out-sick with coronavirus symptoms, and 3503 out-ofwork because of a non-coronavirus illness/disability. Minority race/ethnicity, low income, and residence in a state with high COVID prevalence were associated with work absence because of coronavirus symptoms in April-May 2020. This national-level evidence of the disparate impact of COVID-19 bolsters reports based on diagnoses from regions and hospital systems, 1 as well as our previous findings of an increase in illness-related work absence in April that disproportionately affected minorities.


id: cord-350321-jy4i403g
author: Ku, Benson S.
date: 2020-08-21
txt: ./txt/cord-350321-jy4i403g.txt
cache: ./cache/cord-350321-jy4i403g.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32827110/
doi: 10.1007/s11606-020-06130-4
abstract: nan
summary:
  title: Associations Between Primary Care Provider Shortage Areas and County-Level COVID-19 Infection and Mortality Rates in the USA 1 However, it is not known whether shortage areas are associated with higher COVID-19 infection or mortality rates. This study investigates the hypothesis that primary care HPSAs are associated with higher rates of COVID-19 infection and mortality. 3 The 2013 rural-urban continuum codes used to classify rurality and whole county primary care HPSAs were separately derived from the 2018 Area Health Resource File. Generalized linear mixed models with negative binomial distribution were used to test the associations of primary care HPSAs and COVID-19 rates, controlling for time, rurality, population, and six county-level socioeconomic variables. Our findings suggest that primary care provider shortage areas with reported COVID-19 cases face a higher burden of COVID-19 infections and death even after adjusting for socioeconomic and other county-level factors.

title:
  Associations Between Primary Care Provider Shortage Areas and County-Level COVID-19 Infection and Mortality Rates in the USA


id: cord-352726-ep0xfen2
title: Preparing Primary Care for COVID-20
author: Ali, Mohammed K.
date: 2020-06-09
txt: ./txt/cord-352726-ep0xfen2.txt
cache: ./cache/cord-352726-ep0xfen2.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11606-020-05945-5
doi: 10.1007/s11606-020-05945-5
abstract: nan
summary:
  Finally, primary care offices are capable of managing patients flow across home, clinic, hospital, and post-acute care; recent lifting of data sharing restrictions by the U.S. Department of Health and Human Services will enhance this coordination. Robust primary care infrastructure for ILI facilitates access and surge capacity; enables timely diagnosis and treatment; and could reduce health disparities in the incidence of pneumonias, hospitalizations, and related morbidity and mortality. (1) definitions and standards for evaluating and managing cases; (2) outbreak protocols giving primary care offices a central role in early detection, local safety, and surveillance; (3) clinical decision-making tools including rapid tests and prediction rules; and (4) supportive policies. At the national level, higher primary care participation in the CDC''s Outpatient Influenza-like Illness Surveillance Network (ILINet) will help identify regional hotspots where focused testing, contact tracing, and isolation in the next COVID outbreak can support rapid containment. Detection of excess influenza severity: associating respiratory hospitalization and mortality data with reports of influenza-like illness by primary care physicians


id: cord-355851-t8xh6327
title: Accessibility of Virtual Visits for Urgent Care Among US Hospitals: a Descriptive Analysis
author: Goodman, Christopher W.
date: 2020-05-18
txt: ./txt/cord-355851-t8xh6327.txt
cache: ./cache/cord-355851-t8xh6327.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32424785/
doi: 10.1007/s11606-020-05888-x
abstract: nan
summary:
  title: Accessibility of Virtual Visits for Urgent Care Among US Hospitals: a Descriptive Analysis 3 Many hospitals now offer real-time "virtual visits" for common urgent care through their websites, which offer an opportunity to assess the accessibility of a typical telehealth service. Many hospitals have begun offering virtual visits for urgent care with real-time connectivity through their websites. Hospitals used different names for these services such as "e-visits," "virtual urgent care," and "virtual visits." We included links to primary care visits if the website clearly indicated quick access for urgent care. We examined hospital websites and their virtual visit sites, focusing on three accessibility characteristics: general availability, language accommodations, and affordability. Even among hospitals with publicly accessible virtual visits, further limitations included geographic limitations (i.e., accessing care across state lines) and exclusions for chronic health conditions. Virtual visits were not easily or equitably accessible; in general, navigation of hospital websites was challenging.


