Author Interviews, COVID -19 Coronavirus / 23.04.2020

MedicalResearch.com Interview with: David B. Douglas, M.D., M.P.H. Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Health care workers are facing the major threat of catching COVID-19 through their eyes, yet currently available eye protection is inadequate. Specifically, the use of open-type eye protection allows airborne viruses to float over the top, around the sides or under the bottom of the lenses and contact the eyes. Additionally, eye protection is well known to fog up, which limits usability by making even the most basic tasks challenging. In fact, fogged goggles is a major barrier to use. (more…)
COVID -19 Coronavirus, FDA / 21.04.2020

'The U.S. Food and Drug Administration authorized the first diagnostic test with a home collection option for COVID-19. Specifically, the FDA re-issued the emergency use authorization (EUA) for the Laboratory Corporation of America (LabCorp) COVID-19 RT-PCR Test to permit testing of samples self-collected by patients at home using LabCorp’s Pixel by LabCorp COVID-19 Test home collection kit. “Throughout this pandemic we have been facilitating test development to ensure patients access to accurate diagnostics, which includes supporting the development of reliable and accurate at-home sample collection options,” said FDA Commissioner Stephen M. Hahn, M.D. “The FDA’s around-the-clock work since this outbreak began has resulted in the authorization of more than 50 diagnostic tests and engagement with over 350 test developers. Specifically, for tests that include home sample collection, we worked with LabCorp to ensure the data demonstrated from at-home patient sample collection is as safe and accurate as sample collection at a doctor’s office, hospital or other testing site. With this action, there is now a convenient and reliable option for patient sample collection from the comfort and safety of their home.” (more…)
Author Interviews, COVID -19 Coronavirus / 21.04.2020

MedicalResearch.com Interview with: Dr. med. Manuel Döhla Associate Researcher, AG "One Health" Institute for Hygiene and Public Health Medical Faculty, University of Bonn Bonn, Germany MedicalResearch.com: What is the background for this study? Response: Rapid and reliable testing of suspected cases is an important measure in the fight against the corona pandemic. In PCR diagnostics, 24 hours and sometimes more elapse between testing and notification of the test result. During this period, suspect cases must be isolated pre-emptively so that they do not cause further transmission. This is logistically and personnel-intensive and highly error-prone. The shorter the time between test and result, the more effective containment measures can be. This is why the test we have evaluated, which shows a result within 20 minutes, has aroused our interest. The manufacturer's specifications (sensitivity 70 % in early stage disease (day 4-10), 100 % in late stage disease (day 11-24), specificity 100 %) were promising. (more…)
Annals Internal Medicine, Author Interviews, COVID -19 Coronavirus / 18.04.2020

MedicalResearch.com Interview with: Nathan Stall, MD, FRCPC Geriatrics and Internal Medicine (Clinical Associate) Sinai Health System and the University Health Network Hospitals PhD Candidate, Clinical Epidemiology & Health Care Research Institute of Health Policy, Management and Evaluation Eliot Phillipson Clinician-Scientist Training Program
Vasily Giannakeas, MPH Epidemiologist/ Dedicated ICES Analyst Women's College Hospital Toronto, Ontario, Canada   MedicalResearch.com: What is the background for this study? Response: As some health care systems approach collapse, a pressing need exists for tools modeling the capacity of acute and critical care systems during the COVID-19 pandemic. We developed an online tool to estimate the maximum number of COVID-19 cases that could be managed per day within the catchment area served by a health care system, given acute and critical care resource availability. The COVID-19 Acute and Intensive Care Resource Tool (CAIC-RT) is open access and available at https://caic-rt.shinyapps.io/CAIC-RT. (more…)
Author Interviews, COVID -19 Coronavirus, Rheumatology / 16.04.2020

MedicalResearch.com Interview with: Ellen M. Gravallese M.D. President, American College of Rheumatology Dr. Gravallese discusses the recent guidance document issued by ACR for the treatment of rheumatic disease patients during the COVID-19 pandemic. MedicalResearch.com: What is the background for this announcement? Are patients with rheumatic disease at greater risk of severe illness or death from the SARS-CoV-2 virus?  Response: This week the ACR issued a guidance document that is the product of the ACR’s Clinical Guidance Task Force, a newly appointed task force that includes experts in infectious disease, as well as experts in biologic and non-biologic rheumatic disease therapies. This clinical guidance document was prepared to assist rheumatology professionals in the care of their patients during this novel pandemic, and to advise as to how to handle rheumatic disease therapies. There is no data to suggest that patients with rheumatic disease are at greater risk of severe illness or death simply because they have a rheumatic disease. Rheumatic disease patients appear to be at risk for poor outcomes if they become infected primarily because of general risk factors such as older age or comorbid medical conditions, such as significant heart or lung disease. A global alliance has been created by the rheumatology community that has developed an international case-reporting registry to collect information pertinent to COVID-19 infection in patients with rheumatic disease. The ACR has played an active role in helping the Alliance get their message out to the rheumatology community, and we continue to support the Alliance with its data dissemination and communication efforts. We hope this registry will provide valuable data to address additional questions about the best way to manage rheumatology patients affected by COVID-19 and we encourage providers to submit their COVID-19-related cases to the Alliance website at www.rheum-covid.org. (more…)
Author Interviews, COVID -19 Coronavirus, ENT / 15.04.2020

MedicalResearch.com Interview with: Ahmad R. Sedaghat, MD, PhD, FACS Associate Professor Department of Otolaryngology - Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati, OH, USA   MedicalResearch.com: What is the background for this study? Response: The novel coronavirus, SARS-CoV-2, which causes COVID-19 infects the respiratory tract.  As a rhinologist, I am an expert in diseases of the nose and paranasal sinuses, and as the nose and paranasal sinuses (sinonasal cavities) are a major component of the upper airway, we decided to do a systematic review of the scientific literature on the role of the sinonasal cavities in COVID-19. (more…)
Author Interviews, COVID -19 Coronavirus, Diabetes / 14.04.2020

MedicalResearch.com Interview with: Daniel J. Drucker, M.D. Lunenfeld-Tanenbaum Research Institute Mount Sinai Hospital Toronto  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This review was prompted by shared mechanistic pathways linking actions of molecules such as ACE2 and DPP4, which are important enzymes with cardiometabolic actions, yet also function as coronavirus receptors. The recognition that people with diabetes and obesity are more prone to severe infection also highlights the importance of understanding the biology We highlight the intersection of pathways shared by coronavirus infection, and how these might impact our understanding of diabetes and its therapies. (more…)
Abuse and Neglect, Author Interviews, COVID -19 Coronavirus / 14.04.2020

MedicalResearch.com Interview with: Dr. Naveen Vankadari PhD Research Fellow Monash University, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: The recent outbreak of pneumonia-causing COVID-19 pandemic is an urgent global public health issue. It is critical to understand and unravel the key difference of COVID-19 or SARS-CoV-2 with the previous coronavirus (SARS and MERS) infections. Specifically, structural and molecular dynamics which underline the mechanism of viral infection. The study first addresses the structure of COVID-19 spike glycoprotein in both closed (ligand-free) and open (ligand-bound) conformation, which open the arena in understating the viral attachment to the host cell. The study also provides the first and complete sequence alignment of spike glycol protein from COVID19 and SARA-1, showing novel insertions and deletions that highlights the uniqueness of COVID19 and underlies the differential interaction mode. The study also unravels how this new coronavirus camouflages in humans through its unique glycosylation of spike glycoprotein, which makes the most of neutralizing antibodies useless. Furthermore, In addition to known ACE2 receptor in human, the study discovers the human CD26 as another potential receptor of COVID-19 for host adhesion and hijacking.  (more…)
Anesthesiology, Author Interviews, COVID -19 Coronavirus, OBGYNE / 13.04.2020

MedicalResearch.com Interview with: Dr. Alicia Warlick, MD Anesthesiologist at UNC/Rex, American Anesthesiology Raleigh, North Carolina MedicalResearch.com: As a physician working on the frontlines of the COVID-19 battle, how are you addressing expecting mothers’ concerns about the disease and how it might impact their pregnancy? Response: While COVID-19 has disrupted nearly every aspect of healthcare, whether its virtual appointments or delayed surgeries; there are certain things that are inevitable – like childbirth. As this virus continues to take over the country and we learn more about it each day, pregnant women are facing new challenges and fears. For women approaching their due dates, questions about staying healthy, keeping their baby safe and limiting their risk of exposure while in the hospital are all leading to anxiety and stress. And while policies and guidelines are constantly changing, as physicians we need to remind our patients that we are there to alleviate their concerns, address their questions and remind them to not lose sight of the joy the comes with bringing a child into the world. It’s a scary time for everyone, but by working together and supporting one another, we will get through this. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease / 12.04.2020

MedicalResearch.com Interview with: Santiago Garcia, MD FACC Interventional Cardiologist, Minneapolis Heart Institute® Researcher, Minneapolis Heart Institute Foundation® MedicalResearch.com: What is the background for this study?  Response: We analyzed and quantified ST-segment elevation myocardial infarction (STEMI) activations for 9 high-volume (>100 primary percutaneous angioplasties per year) cardiac catheterization laboratories in the US. These centers represent different geographic areas and levels of COVID-19 exposure in the US. The data analyzed was from January 1, 2019 to March 31, 2020. Participating centers included 1-Minneapolis Heart Institute, Minneapolis, MN, 2- Beaumont Hospital Royal Oak, Royal Oak, MI, 3- The Christ Hospital, Cincinnati, OH, 4- Massachusetts General Hospital, Boston, MA, 5- UMass Memorial Medical Center, Worcester, MA, 6- Iowa Heart, Des Moines, IA, 7- Northwell Health Hospital, Manhasset, NY, 8- Prairie Cardiovascular, Springfield, IL, and 9- Swedish Medical Center, Seattle, WA. (more…)
Author Interviews, COVID -19 Coronavirus / 12.04.2020

MedicalResearch.com Interview with: Bart van Straten, Tim Horeman and John van den Dobbelsteen Research team TU Delft, Delft University of Technology, Dpt. of BioMechanical Engineering The Netherlands  MedicalResearch.com: What is the background for this study? Response: The background for this study was the urgent shortages of mouth masks in several hospitals. Franciscus Hospital, Rotterdam, The Netherland requested on 17 March if face masks could be sterilized since they were facing these shortages. The COVID-19 pandemic and its rapid spread has led to imminent shortages of these masks. (more…)
Author Interviews, COVID -19 Coronavirus, Diabetes / 10.04.2020

MedicalResearch.com Interview with: Gian Paolo Fadini, MD PhD Associate Professor of Endocrinology Department of Medicine, University of Padova Venetian Institute of Molecular Medicine  MedicalResearch.com: What is the background for this study? Response: Since the very beginning of the SARS-CoV-2 pandemic, it was suggested that It has been initially suggested that diabetes mellitus is one of the most common comorbidities in infected people, but its exact prevalence is unclear. However, exact numbers were uncertain. We have addressed this issue in a study published as a letter in the Journal of Endocrinological Investigation. (more…)
Author Interviews, COVID -19 Coronavirus, Infections, University of Michigan / 08.04.2020

MedicalResearch.com Interview with: Arnold S. Monto, M.D. Professor, Epidemiology Professor, Global Public Health Thomas Francis, Jr. Collegiate Professor of Public Health University of Michigan  MedicalResearch.com: What is the background for this study? Response: This is part of a continuing study in families first designed to examine how influenza vaccine is working in the community  We have expanded it to look broadly at all respiratory viruses There are 4 coronaviruses which are known to cause respiratory illnesses each year and we had these data ready to go when the pandemic started. (more…)
Author Interviews, COVID -19 Coronavirus, Vaccine Studies / 07.04.2020

MedicalResearch.com Interview with: Paul B. McCray, Jr., M.D. Professor of Pediatrics, Microbiology, and Internal Medicine Executive Vice Chair of Pediatrics Associate Director: Center for Gene Therapy Roy J. Carver Chair in Pulmonary Medicine Pappajohn Biomedical Institute Carver College of Medicine University of Iowa, Iowa City, IA  52242 MedicalResearch.com: What is the background for this study? Response: In the face of the COVID-19 pandemic, there is great interest in developing a vaccine that could help protect people from infection with SARS-CoV-2.  Over the last 15 years, my laboratory has helped develop small animal models of the severe coronavirus diseases SARS and MERS to study disease pathogenesis and to test treatments.  In this study, we used a mouse model of the MERS coronavirus to test a vaccine idea in collaboration with Dr. Biao He at the University of Georgia. (more…)
Author Interviews, Baylor College of Medicine Houston, COVID -19 Coronavirus, JAMA, Stanford / 07.04.2020

MedicalResearch.com Interview with: Melissa Bondy, PhD Chair, Department of Epidemiology and Population Health Stanford University  MedicalResearch.com: What is the background for this study? Response: Faculty researchers in Stanford’s Department of Epidemiology & Population Health and collaborators from Baylor College of Medicine and Stanford’s Department of Dermatology developed an online survey aimed at rapidly assessing public concerns about the COVID-19 crisis. This survey, which was posted on 3 social media platforms (Twitter, Facebook, and Nextdoor) on March 14, 2020, collected invaluable data about COVID-19, including symptoms, concerns, and individual actions taken by respondents. Twitter and Facebook posts were sharable to facilitate snowball sampling. The survey was comprised of 21 (multiple-choice, single-choice, numeric, and open-ended) questions, which were designed to collect data concerning respondent demographics and recent cold and flu-like illnesses (if any), as well as information about participants’ concerns and any lifestyle changes that occurred as a result of the COVID-19 crisis. All questions were optional, so response rates were variable.  (more…)
Author Interviews, COVID -19 Coronavirus, Infections, Pediatrics / 07.04.2020

genentech MedicalResearch.com: What are the applicable pediatric and post-exposure indications? Response: We recently announced that the U.S. FDA has accepted a New Drug Application (NDA) as well as two supplemental New Drug Applications (sNDA) for Xofluza® (baloxavir marboxil). The FDA accepted an NDA for a new formulation of Xofluza as one-dose granules for oral suspension (2 mg/mL), potentially offering a more convenient option for children and those who have difficulty swallowing. In addition, the application seeks approval of Xofluza for the treatment of acute uncomplicated influenza in otherwise healthy children aged one to less than 12 years of age who have been symptomatic for no more than 48 hours. The FDA also accepted an sNDA for post-exposure prophylaxis of influenza in people one year of age and older for both the oral suspension and currently-available tablet formulation. (more…)
Author Interviews, COVID -19 Coronavirus, Dermatology / 04.04.2020

MedicalResearch.com Interview with: Amit Gefen PhD Professor of Biomedical Engineering The Herbert J. Berman Chair in Vascular Bioengineering Department of Biomedical Engineering, Faculty of Engineering Tel Aviv University, Tel Aviv, Israel MedicalResearch.com: What is the background for this study? Response: Although we are witnessing continuous progress in medical technologies, the design of many of the most commonly used medical devices e.g. oxygen masks or cervical collars has changed very little over a period of decades. Not surprisingly, these devices are also the ones which are frequently associated with device-related pressure ulcers (DRPUs). These DRPUs are frequently a hospital-acquired injury which involves risk of infections (including e.g. sepsis and antibiotic-resistant bacteria), scarring with serious psychological consequences, additional and significant healthcare costs and a basis for liability suits and litigation. The problem is massive in Europe and the US and is most frequently encountered in clinical environments where devices are used intensively, such as in operation theatres, intensive care units and emergency care settings (in both adult and pediatric medicine), but also, in elderly care facilities where patients often have fragile skin. With the current pandemic spread of the coronavirus, facilities worldwide are experiencing a considerable rise in usage of emergency and intensive care equipment, which will very likely considerably escalate the incidence of DRPUs. Early in 2019, a committee of global experts which I have chaired, has met for two days of intensive deliberation in London UK, to start developing the first-ever international consensus document on device-related pressure ulcers . After a rigorous review process by an international review committee of other experts, this consensus report has been published as a Special Edition of the Journal of Wound Care in February 2019 (https://doi.org/10.12968/jowc.2020.29.Sup2a.S1), under the name "Device-related pressure ulcers: SECURE prevention". The publisher has kindly made this publication freely downloadable and thereby accessible and available to anyone, including all professionals who may need guidance in this regard, including clinicians, industry, regulators and academic researches. (more…)
Author Interviews, COVID -19 Coronavirus, Pulmonary Disease / 04.04.2020

MedicalResearch.com Interview with: Aurika Savickaite RN Adult Gerontology Acute Care Nurse Practitioner Bulletproof Coach University of Chicago Medicine MedicalResearch.com: Would you briefly explain what is meant by helmet-based ventilation? How does it work?   Response: For patients in respiratory failure, noninvasive positive pressure ventilation (NIPPV) is usually delivered through a nasal mask or facemask. Many patients develop pain, discomfort – even claustrophobia -- from using NIPPV systems.  The transparent helmet was developed to improve the tolerance of noninvasive ventilation. It allows the patient to see, read, speak and drink without interrupting noninvasive positive-pressure ventilation (NPPV). The helmet has a sealed connection and a soft collar that adheres to the neck which helps prevent the air leaks that are very common with nasal- or face masks.  High positive end-expiratory pressure (PEEP) is vital in treating patients in respiratory failure and thanks to helmets “none to minimum air leak” system, PEEP can be set high (up to 25). NIPPV via a nasal- or full-face mask typically begins to show air leaks when the required pressure exceeds 15-20cm H2O. (more…)
Author Interviews, COVID -19 Coronavirus / 03.04.2020

MedicalResearch.com Interview with: Prof. Amitai Ziv, MD, MHA Deputy Director of Sheba Medical Center Founder and Director, The Israel Center for Medical Simulation MedicalResearch.com: Would you briefly describe the mission/history of Sheba Medical Center? Response: Born together with Israel in 1948, Sheba Medical Center, Tel HaShomer is the largest and most comprehensive medical center in the Middle East. Sheba is the only medical center in Israel that combines an acute care hospital and a rehabilitation hospital on one campus, and it is at the forefront of medical treatments, patient care, research and education. As a university teaching hospital affiliated with the Sackler School of Medicine at Tel-Aviv University, it welcomes people from all over the world indiscriminately. For the past two years (2019 and 2020), Newsweek Magazine has named Sheba one of the top ten hospitals in the world. MSR, the Israel Center for Medical Simulation at Sheba Medical Center, is the country’s only national multi-modality, interdisciplinary simulation center. Through MSR’s training courses, which can include sophisticated robotics, surgical simulators and role-playing actors, healthcare providers effectively improve their clinical and communication skills, creating a safer, more ethical, patient-centered culture of treatment. (more…)
Author Interviews, COVID -19 Coronavirus, Pharmaceutical Companies / 02.04.2020

MedicalResearch.com Interview with: Dr. Larry Schlesinger MD Professor, President and CEO Texas Biomed MedicalResearch.com: What is the background and mission of Texas Biomed? Response: Texas Biomedical Research Institute (Texas Biomed) is a not-for-profit, independent research institute with a strong history of pioneering, biomedical breakthroughs that have contributed to the world of science and human health for nearly 80 years. The Texas Biomed mission is to pioneer and share scientific breakthroughs that protect you, your families and our global community from the threat of infectious diseases. Texas Biomed is capitalizing on its strengths – outstanding collaborative scientists and unique assets and resources. Texas Biomed is home to the nation’s only privately-owned BSL4 facility, five fully outfitted BSL3 facilities with the latest technologies and the Southwest National Primate Research Center (SNPRC). The Institute focuses on a core understanding of the basic biology of infectious diseases, animal model development, and studies to move therapies and vaccines to human clinical trials. The Institute’s independent, nonprofit business model moves science from the bench to clinical trials faster and with less bureaucracy. (more…)
Author Interviews, Columbia, COVID -19 Coronavirus, NYU, Technology / 02.04.2020

MedicalResearch.com Interview with: Professor Anasse Bari PhD Courant Institute of Mathematical Sciences, Computer Science Department, New York University, New York, and Megan Coffee MD PhD Division of Infectious Diseases and Immunology, Department of Medicine New York University, Department of Population and Family Health Mailman School of Public Health Columbia University, New York MedicalResearch.com: What is the background for this study? Coffee and Bari:  This work is led by NYU Grossman School of Medicine and NYU’s Courant Institute of Mathematical Sciences, in partnership with Wenzhou Central Hospital and Cangnan People's Hospital, both in Wenzhou, China. This is a multi-disciplinary team with backgrounds in clinical infectious disease as well as artificial intelligence (AI) and computer science. There is a critical need to better understand COVID-19. Doctors learn from collective and individual clinical experiences. Here, no clinician has years of experience. All are learning as they go, having to make important decisions about clinical management with stretched resources. The goal here is to augment clinical learning with machine learning. In particular, the goal is to allow clinicians to identify early who from the many infected will need close medical attention. Most patients will first develop mild symptoms, yet some 5-8 days later will develop critical illness. It is hard to know who these people are who will need to be admitted and may need to be intubated until they become ill. Knowing this earlier would allow more attention and resources to be spent on those patients with worse prognoses. If there were ever treatments in the future that could be used early in the course of illness, it would be important to identify who would most benefit We present in this study a first step in building an artificial intelligence (AI) framework, with predictive analytics (PA) capabilities applied to real patient data, to provide rapid clinical decision-making support. It is at this point a proof of concept that it could be possible to identify future severity based on initial presentation in COVID-19. (more…)
Author Interviews, COVID -19 Coronavirus / 02.04.2020

MedicalResearch.com Interview with: Hongcui Cao, M.D. State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases National Clinical Research Center for Infectious Diseases The First Affiliated Hospital College of Medicine, Zhejiang University Hangzhou, China MedicalResearch.com: What is the background for this study? Response: The proportion of severe novel coronavirus disease (COVID-19) cases has dropped significantly. Specifically, this number has decreased from 32.4% on January 28 to 21.6% in Wuhan and to 7.2% in other provinces of China on February. Measures such as strengthened medical support and centralized isolation greatly contributed to the improved circumstances, and laid a solid foundation for further enhancing the cure rate and reducing the mortality rate. However, there are still hundreds of severe patients dying every day. It is extremely important to make timely and efficient diagnosis and initiate treatment for severe patients. (more…)
Author Interviews, COVID -19 Coronavirus / 02.04.2020

MedicalResearch.com Interview with: Dr Zhugen Yang Lecturer in Sensor Technology NERC Fellow School of Water, Energy and Environment Cranfield University MedicalResearch.com: What is the background for this study? Response: A recent outbreak of novel coronavirus pneumonia (COVID-19) caused by SARS-CoV-2 infection has spread rapidly around the globe. Some clinical cases have found that some carriers of the virus may be asymptomatic, with no fever, and no, or only slight symptoms of infection. Currently we have a constrained diagnostic testing capacity, Therefore wastewater analysis, also namely wastewater-based epidemiology (WBE), may offer another way to track the spread of the virus that causes the disease and identify the potential infections at the community. Wastewater-based epidemiology approach could provide an effective and rapid way to predict the potential spread of novel coronavirus pneumonia (COVID-19) by picking up on biomarkers in faeces and urine from disease carriers that enter the sewer system. WBE is already recognised as an effective way to trace illicit drugs and obtain information on health, disease, and pathogens  (more…)
Author Interviews, Blood Pressure - Hypertension, COVID -19 Coronavirus / 01.04.2020

MedicalResearch.com Interview with: Fabian Sanchis-Gomar, MD, MSc, PhD Department of Medicine Stanford University Medical Center Stanford, California Department of Physiology, School of Medicine, University of Valencia INCLIVA Biomedical Research Institute Valencia, Spain MedicalResearch.com: What is the background for this study? How does the RAAS system interface with the COVID-19 virus? Response: Angiotensin-converting enzyme (ACE)2 is a functional receptor for coronaviruses, including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The exponential growth of contagion by the SARS-CoV-2 all around the world has contributed to raising speculations and concerns about whether two commonly used anti-hypertensive drugs, i.e., ACE inhibitors and angiotensin receptor blockers (ARBs), have positive or negative effects in coronavirus disease 2019 (abbreviated “COVID-19”) patients with arterial hypertension on-going treatment with some of the former drugs. In effect, many professional health organizations have published statements claiming that there is not enough evidence to change the use of ACE-inhibitors or ARBs for the management of raised blood pressure (BP) in the context of avoiding or treating COVID-19 infection. (more…)
Author Interviews, COVID -19 Coronavirus / 31.03.2020

MedicalResearch.com Interview with: Professor Carl Coleman, JD Professor of Law Seton Hall Law School MedicalResearch.com: Do health care workers have an ethical and/or legal obligation to provide treatment during an infectious disease outbreak? Are there exceptions such as pregnancy, if the health care worker is her/himself immunocompromised or have young children at home?   Response: As a legal matter, health care workers can generally be required to fulfill pre-existing employment or contractual obligations during an infectious disease outbreak.  For example, an emergency room nurse who refuses to come to work during a pandemic can be disciplined or fired; a physician who breaches a contractual obligation to provide on-call services during an outbreak can be held liable for damages.  In addition to loss of employment and contractual damages, other potential consequences for failing to honor pre-existing commitments during a pandemic could include professional discipline for patient abandonment and, for physicians with on-call responsibilities in hospital emergency departments, civil fines under the federal Emergency Medical Treatment and Active Labor Act. This does not mean that health care workers are obligated to show up for work during a pandemic regardless of the circumstances.  For example, under the Americans with Disabilities Act, health care workers who are immunocompromised can ask for a "reasonable accommodation," such as the right to work remotely (if possible) or to take leave.  Under the Family and Medical Leave Act, employers with more than 50 employees must give workers up to 12 weeks of unpaid time off to care for a seriously ill immediate family member.  In addition, federal labor laws allow employees to refuse to work under "abnormally dangerous conditions," which might apply in situations where an employer fails to provide necessary protective equipment.  However, assuming protective equipment is available, it is not clear that an outbreak itself would be considered "abnormally dangerous," particularly in fields like emergency medicine, where exposure to contagious disease is always a foreseeable risk. In most states, health care workers without pre-existing employment or contractual obligations cannot be compelled to treat patients during a pandemic.  However, a few states have laws that authorize public health authorities to require health care professionals to work during public health emergencies.  I am not aware of any state that has invoked this authority so far. As for ethical obligations, in 2004, the American Medical Association (AMA) declared that "individual physicians have an obligation to provide urgent medical care during disasters," and that "this ethical obligation holds even in the face of greater than usual risks to their own safety, health or life."  Some academic ethicists have expressed similar views.  Common justifications for this position are that physicians "assumed the risk" of exposure to infectious diseases when they voluntarily committed themselves to the healing professions; that a "social contract" requires physicians to assume risks in exchange for their social status and privileges; and that individuals who are uniquely capable of providing life-saving care have an obligation to do so. However, I am not persuaded that all physicians -- let alone health care workers more generally -- have an ethical obligation to provide treatment when doing so involves significant risk.  A willingness to accept risk is not a condition of obtaining a medical license, nor is it part of the oaths that students commonly take at medical school graduation.  While I agree that physicians have ethical obligations to contribute to society, there are many ways they can fulfill these obligations without assuming personal health risks.  And even assuming that individuals who are in a unique position to provide life-saving care should normally do so, we generally do not expect people to rescue others from danger at significant risk to themselves.  (more…)
Author Interviews, COVID -19 Coronavirus, NEJM / 28.03.2020

MedicalResearch.com Interview with: Bin Cao, Yeming Wang, Guohui Fan, Lianghan Shang, Jiuyang Xu, DingyuZhang, Chen Wang on behalf of LOTUS-China Study Group China-Japan Friendship Hospital; Wuhan Jintinyan Hospital; Institute of Respiratory Medicine, Chinese Academy of Medical Science  MedicalResearch.com: What is the background for this study? Response: In the past two months, the outbreak of Coronavirus Disease 2019 (COVID-19) has been spreading rapidly across the world. Science and technology is the most powerful weapon for human to fight against diseases, especially in such a pandemic setting. Seeking for effective antiviral medication is the most critical and urgent among the many scientific tasks in the pandemic. At the most critical moment in the fight against COVID-19, Chinese clinical scientists have stepped forward under extremely difficult research conditions to carry out clinical trials in antiviral treatment including lopinavir–ritonavir and remdesivir, in a swift, decisive and effective manner. These trials have attracted worldwide attention. Recently, the Lopinavir–ritonavir Trial for suppression of SARS-CoV-2 in China (LOTUS-China) has been completed, which, with great clinical significance, can provide strong evidence for the treatment of COVID-19 both in China and around the world. (more…)