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High-Flow Nasal Cannulas Promising Alternative to Ventilators in COVID-19 Treatment

Physicians at the University of Chicago Medicine are swapping ventilators and intubation for high-flow nasal cannulas and prone positioning to treat some patients with COVID-19. Their results have been encouraging.

High-flow nasal cannulas are noninvasive nasal prongs placed below the nostrils that blow warm, humidified oxygen into the nose and lungs. Emergency department physicians at the University of Chicago Medicine have treated dozens of COVID-19 patients with high-flow nasal cannulas rather than ventilators. After 10 days, only one patient required intubation.

This treatment combination has helped to avoid intubations and has decreased the rate of poor outcomes. "The proning and the high-flow nasal cannulas combined have brought patient oxygen levels from around 40 percent to 80 percent and 90 percent, so it's been fascinating and wonderful to see," Thomas Spiegel, M.D., medical director of the University of Chicago Medicine Emergency Department, said in a statement.

High-flow nasal cannulas are not without risks. Because they blow air out, they convert the COVID-19 virus into a spray in the air. Therefore, it is essential staff have proper personal protective equipment, negative pressure patient rooms and anterooms in front of the patient rooms where staff can change in and out of safety gear to avoid contamination.

Read the full press release.

HD Live!: COVID-19 and Flu Season — How to Lessen the Potential for a Twindemic

Our latest HD Live! discussion is on what could happen this flu season as COVID-19 still rages on across the country. How can we protect ourselves, and what can we and the health care system do to prepare for and potentially prevent a twindemic?

Mabel Jong from our liveblog team speaks with Dr. Nadia Eltaki, director of clinical operations at Sibley Memorial Hospital, on guidance on how to protect yourself and how a twindemic could impact the health care system.

Watch our in-depth discussion above, and see our past HD Lives and other videos on our YouTube channel.

HD Live! Videos

HealthDay Reports: COVID-19 Roundup for the Week of August 3-August 7

Each week, HealthDay's Physician's Briefing division rounds up the most important COVID-19 developments in the medical field. See this week's edition below for August 3-August 7.

U.S. Cancels Blanket Warning for International Travel

FRIDAY, Aug. 7, 2020 (HealthDay News) -- On Thursday, the Trump administration canceled its warnings against international travel because of the COVID-19 pandemic, the Associated Press reported.

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300,000 American Deaths Projected by December Without More Face Mask Use

FRIDAY, Aug. 7, 2020 (HealthDay News) -- As the U.S. COVID-19 case count neared 5 million on Thursday, a new model predicted that nearly 300,000 Americans could die of COVID-19 by December if more people do not wear masks or practice better social distancing.

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Telestroke Consultations Down During COVID-19 Pandemic

FRIDAY, Aug. 7, 2020 (HealthDay News) -- The median number of weekly consults seen through a telestroke network decreased during the COVID-19 pandemic, with Black patients significantly less likely to present with strokes, according to a study published online Aug. 5 in Stroke.

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SARS-CoV-2 Antibodies Detected in 13.7 Percent of NYC HCPs

FRIDAY, Aug. 7, 2020 (HealthDay News) -- Among health care providers in the New York City area, 13.7 percent have severe acute respiratory syndrome coronavirus 2 antibodies, a rate similar to adults randomly tested in New York state, according to a research letter published online Aug. 6 in the Journal of the American Medical Association.

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Moderna Charging Much More for COVID-19 Vaccine Than Others

FRIDAY, Aug. 7, 2020 (HealthDay News) -- Moderna is charging $37 a dose for its experimental vaccine, which is far more than what other companies say they plan to charge for their vaccines, CBS News reported Wednesday. Because two doses of the vaccine are needed to immunize people from COVID-19, total costs could be $74 per person.

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COVID-19 Tied to Higher Risk of Large Vessel Occlusion Strokes

FRIDAY, Aug. 7, 2020 (HealthDay News) -- COVID-19 is associated with large vessel occlusion strokes, according to a study published online July 29 in the American Journal of Roentgenology.

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Scientists Call for Broader Use of Faster COVID-19 Tests

THURSDAY, Aug. 6, 2020 (HealthDay News) -- As COVID-19 cases continue to surge across America, scientists on Wednesday called for widespread adoption of simpler, less accurate tests, as long as they are given often and quickly.

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Johnson & Johnson Makes $1 Billion Vaccine Deal

THURSDAY, Aug. 6, 2020 (HealthDay News) -- The U.S. government will pay Johnson & Johnson $1 billion for 100 million doses of its vaccine if it is approved by the U.S. Food and Drug Administration, the Washington Post reported Wednesday.

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Early Use of IL-6 Inhibitors May Improve COVID-19 Outcomes

THURSDAY, Aug. 6, 2020 (HealthDay News) -- For patients with severe COVID-19, administration of an interleukin-6 receptor inhibitor earlier in the disease course is associated with improved outcomes, according to a study published online July 25 in the International Journal of Infectious Diseases.

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ED Visits Decreased in Five States From January Through April 2020

THURSDAY, Aug. 6, 2020 (HealthDay News) -- As the COVID-19 pandemic intensified, there was a decrease in emergency department visits in five states from January through April 2020, according to a study published online Aug. 3 in JAMA Internal Medicine.

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Seven States Join Pact to Speed COVID-19 Testing

WEDNESDAY, Aug. 5, 2020 (HealthDay News) -- As the daily U.S. COVID-19 death toll averaged more than 1,000 for the ninth straight day on Tuesday, governors from seven states banded together to shorten turnaround time for COVID-19 test results.

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Experimental COVID-19 Vaccine Shows Encouraging Results

WEDNESDAY, Aug. 5, 2020 (HealthDay News) -- Maryland-based Novavax said Tuesday that preliminary trials of an experimental COVID-19 vaccine were promising.

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COVID-19 Case Fatality Rate 29 Percent in Multiple Myeloma Patients

WEDNESDAY, Aug. 5, 2020 (HealthDay News) -- For patients with multiple myeloma and COVID-19, the case fatality rate is 29 percent among hospitalized patients, with increased odds of adverse outcomes among racial/ethnic minorities, according to a study published online July 30 in Blood Cancer Discovery.

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Study Looks at Optimal Strategy for Reopening Schools in U.K.

WEDNESDAY, Aug. 5, 2020 (HealthDay News) -- Population-wide testing and effective contact tracing are necessary to prevent an epidemic rebound following school reopening in the United Kingdom; and severe acute respiratory syndrome coronavirus 2 transmission rates were low in an educational setting in Australia, according to two studies published online Aug. 3 in The Lancet Child & Adolescent Health.

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President Says Medicare Should Expand Telehealth Services

TUESDAY, Aug. 4, 2020 (HealthDay News) -- President Donald Trump signed an order on Monday that will broaden the role of telehealth for Medicare patients, the Associated Press reported.

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Trump's Plan Limits Free Nursing Home COVID-19 Tests

TUESDAY, Aug. 4, 2020 (HealthDay News) -- The plan to give every nursing home a fast COVID-19 testing machine has a catch, the Associated Press reported Tuesday. The catch is that under the Trump administration plan, the government will not give kits to check staff and residents more than a couple of times.

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Number of Newly ID'd U.S. Patients With Cancer Dropped During COVID-19

TUESDAY, Aug. 4, 2020 (HealthDay News) -- During the COVID-19 pandemic period, there was a significant decline in newly identified U.S. patients with six common types of cancer, according to a research letter published online Aug. 4 in JAMA Network Open.

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Burnout High Among Nonphysician Frontline Health Care Workers

TUESDAY, Aug. 4, 2020 (HealthDay News) -- More than 40 percent of nurses on the front lines during the pandemic may be experiencing burnout, according to a research letter published online Aug. 4 in JAMA Network Open.

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Risk for Positive COVID-19 Test Up for Health Care Workers

MONDAY, Aug. 3, 2020 (HealthDay News) -- Frontline health care workers have an increased risk for reporting a positive test for COVID-19, according to a study published online July 31 in The Lancet Public Health.

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Obesity Ups Risk for Intubation, Death With COVID-19 in Adults <65

MONDAY, Aug. 3, 2020 (HealthDay News) -- Obesity is associated with an increased risk for intubation or death among hospitalized adults with COVID-19, with the association observed in adults younger than 65 years but not in older adults, according to a study published online July 29 in the Annals of Internal Medicine.

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Risk for Acute Cerebrovascular Events Low in COVID-19 Patients

MONDAY, Aug. 3, 2020 (HealthDay News) -- For hospitalized COVID-19 patients, the risk for acute cerebrovascular events is low, according to a study published online July 20 in Stroke.

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HealthDay Reports: COVID-19 Roundup for the Week of July 27-July 31

Each week, HealthDay's Physician's Briefing division rounds up the most important COVID-19 developments in the medical field. See this week's edition below for July 27-July 31.

Plenty of COVID-19 Vaccine Coming, Fauci Says

FRIDAY, July 31, 2020 (HealthDay News) -- When a COVID-19 vaccine is approved, there should be plenty of it available, Anthony Fauci, M.D., infectious diseases chief at the U.S. National Institutes of Health, told a House panel Friday, the Associated Press reported.

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U.S. Puts Up Another $2.1 Billion for Potential COVID-19 Vaccine

FRIDAY, July 31, 2020 (HealthDay News) -- The U.S. is buying up another potential COVID-19 vaccine, the Associated Press reported Friday.

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Telemedicine Use Explodes During COVID-19 Pandemic

FRIDAY, July 31, 2020 (HealthDay News) -- The emergence of telemedicine has accelerated during the coronavirus pandemic. HD Live! sat down with Rujuta Saksena, M.D., an oncologist at Overlook Medical Center in Summit, New Jersey, and Ateev Mehrotra, M.D., associate professor of health care policy at Harvard Medical School in Boston, to discuss the future of telemedicine and its impact on health care.

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COVID-19 Testing Needed Every Two Days to Reopen Colleges

FRIDAY, July 31, 2020 (HealthDay News) -- Symptom-based screening alone is not sufficient to contain a COVID-19 outbreak on college campuses, according to a study published online July 31 in JAMA Network Open.

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Pandemic Causing Increased Anxiety Among MS Patients

FRIDAY, July 31, 2020 (HealthDay News) -- The COVID-19 pandemic is having an impact on the psychological health of patients with relapsing-remitting multiple sclerosis, according to a study published online July 21 in Multiple Sclerosis and Related Disorders.

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Bacterial, Fungal Coinfection Uncommon in COVID-19 Patients

FRIDAY, July 31, 2020 (HealthDay News) -- Bacterial and fungal infections are uncommon in hospitalized COVID-19 patients, but coinfection is associated with high mortality and antibiotic use is widespread, according to a study published in the July issue of Infection Control & Hospital Epidemiology.

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Global Epidemiology of COVID-19 Reported for Prepandemic Era

FRIDAY, July 31, 2020 (HealthDay News) -- Many of the first COVID-19 cases reported from affected countries outside of mainland China involved recent travel to affected countries, according to a study published online July 29 in The Lancet Infectious Diseases.

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School Closures Linked to Decreased COVID-19 Incidence, Death

THURSDAY, July 30, 2020 (HealthDay News) -- School closures in the United States were temporally associated with decreased COVID-19 incidence and mortality, according to a study published online July 29 in the Journal of the American Medical Association.

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Young Children Have Higher Amounts of SARS-CoV-2 RNA

THURSDAY, July 30, 2020 (HealthDay News) -- Young children with mild-to-moderate COVID-19 have higher amounts of severe acute respiratory syndrome coronavirus 2 viral RNA in their nasopharynx than older children and adults, according to a research letter published online July 30 in JAMA Pediatrics.

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Remdesivir Shortages Plague Some Hospitals, Pharmacists Say

THURSDAY, July 30, 2020 (HealthDay News) -- One-third of pharmacists say they do not have enough remdesivir to treat all COVID-19 patients who are eligible for it, according to the results of a survey released by the American Society of Health-System Pharmacists.

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Most Gynecologic Cancer Therapy Not Tied to Higher COVID-19 Risk

THURSDAY, July 30, 2020 (HealthDay News) -- For gynecologic oncology patients with COVID-19, the case fatality rate is 14.0 percent, and chemotherapy and recent major surgery do not predict COVID-19 severity or mortality, according to a study published online July 30 in Cancer.

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More Diabetic Foot Amputations Seen During COVID-19 Lockdown

WEDNESDAY, July 29, 2020 (HealthDay News) -- Patients with diabetes admitted to a tertiary care center for diabetic foot ulceration during the COVID-19 lockdown in Italy had a more than threefold risk for amputation versus patients seen in 2019, according to a study published online July 23 in Diabetes Care.

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Cancer-Related Encounters Down Since Start of COVID-19

WEDNESDAY, July 29, 2020 (HealthDay News) -- There has been a decrease in cancer-related encounters and in cancer screening since the start of the COVID-19 pandemic, according to a study published online July 27 in JCO: Clinical Cancer Informatics.

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Latino Communities at Higher Risk for COVID-19

WEDNESDAY, July 29, 2020 (HealthDay News) -- Factors linked to structural racism and social determinants of health are associated with an increased risk for COVID-19 in Latino communities, according to a study published online July 23 in the Annals of Epidemiology.

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Nearly Half of Hispanics, Blacks Scared to Go to Hospital During COVID-19

WEDNESDAY, July 29, 2020 (HealthDay News) -- Hispanics and blacks are most likely to stay home if experiencing medical emergencies, like a heart attack or stroke, to avoid the risk of contracting COVID-19 at the hospital, according to a poll released by the American Heart Association.

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Depression, Anxiety May Be Signs That COVID-19 Is Attacking Brain

WEDNESDAY, July 29, 2020 (HealthDay News) -- Depression and anxiety exhibited in COVID-19 patients may be a sign that the virus impacts the central nervous system, as these symptoms are closely associated with a loss of smell and taste rather than more severe manifestations of the virus, according to a study published online July 2 in The Laryngoscope.

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FDA Warns Again About Dangers of Methanol-Based Hand Sanitizers

TUESDAY, July 28, 2020 (HealthDay News) -- The U.S. Food and Drug Administration is warning consumers not to use alcohol-based hand sanitizers containing methanol, or wood alcohol, which is used in fuel and antifreeze and is toxic if absorbed through the skin or life-threatening if ingested.

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Myocardial Injury Seen in Many Early in Recovery From COVID-19

TUESDAY, July 28, 2020 (HealthDay News) -- Many patients recently recovered from COVID-19 infection have cardiac involvement, according to a study published online July 27 in JAMA Cardiology.

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One-Third of Individuals Stopping PrEP Meds During Pandemic

TUESDAY, July 28, 2020 (HealthDay News) -- According to the results of a survey, presented at this year's International AIDS Conference (AIDS 2020: Virtual), one-third of respondents stopped using preexposure prophylaxis medication during a COVID-19 shelter-in-place order.

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CDC to Address Inequalities in COVID-19 Reporting

MONDAY, July 27, 2020 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention plans to take steps to improve how it collects COVID-19 data for blacks, Hispanics, and Native Americans, the Associated Press reports.

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COVID-19 Vaccine Candidate Now in Final Phase Testing

MONDAY, July 27, 2020 (HealthDay News) -- A vaccine developed by the U.S. National Institutes of Health and Moderna has entered the final phase of testing, the Associated Press reported Monday.

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COVID-19 Can Result in Prolonged Illness Even in Milder Cases

MONDAY, July 27, 2020 (HealthDay News) -- Even among persons with milder outpatient illness, COVID-19 can result in prolonged illness, according to research published in the July 24 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Perinatal Transmission of COVID-19 Unlikely With Correct Hygiene

MONDAY, July 27, 2020 (HealthDay News) -- If correct hygiene procedures are undertaken, perinatal transmission of COVID-19 is unlikely to occur, according to a study published online July 23 in The Lancet Child & Adolescent Health.

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Large Proportion of COVID-19 Studies Have Low-Level Evidence

MONDAY, July 27, 2020 (HealthDay News) -- A large proportion of studies on COVID-19 have a low level of evidence, according to a research letter published online July 27 in JAMA Internal Medicine.

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Impact on Glucocorticoids in COVID-19 Varies With CRP Levels

MONDAY, July 27, 2020 (HealthDay News) -- The impact of glucocorticoid treatment on patients with COVID-19 varies according to C-reactive protein levels, according to a study published online July 22 in the Journal of Hospital Medicine.

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HealthDay Reports: There May Be 6 Types of COVID-19

Using a mix of symptoms, body weight and other factors, the researchers developed a model that predicts which patients will need to be hospitalized and need breathing support.

There May Be 6 Types of COVID-19

TUESDAY, July 28, 2020 (HealthDay News) -- COVID-19 may not be just one disease, but six distinct types, a new British study claims.

Each type differs in severity and in the need for respiratory support during hospitalization, the researchers added.

Cough, fever and loss of smell are the usual symptoms of COVID-19, but the range of symptoms can include headaches, muscle pain, fatigue, diarrhea, confusion, loss of appetite, shortness of breath and more.

Read the full HealthDay story.

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HealthDay Reports: Final Coronavirus Vaccine Trials Get Underway

Both vaccines require two doses, spaced several weeks apart. Then researchers will have to wait to see whether people get infected or sick with COVID-19.

Final Coronavirus Vaccine Trials Get Underway

TUESDAY, July 28, 2020 (HealthDay News) -- As the U.S. coronavirus case count passed 4.3 million on Monday, companies launched the final phase of testing for two potential COVID-19 vaccines.

In one trial begun on Monday, the first of 30,000 volunteers were either given a vaccine developed by Moderna Inc. and the U.S. National Institutes of Health or a placebo shot, the Washington Post reported.

Pharmaceutical giant Pfizer also announced Monday that it was starting a 30,000-person final phase vaccine trial, to be conducted at 120 sites globally.

Read the full HealthDay story.

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HealthDay Reports: COVID-19 'Super Spreaders' Quickly Fill Room With Virus — But Masks Help

These so-called super spreaders aren't very common, but if they are engaged in activities like loud speaking or singing, their viral emissions can increase by 1 to 2 orders of magnitude, the researchers said.

COVID-19 'Super Spreaders' Quickly Fill Room With Virus — But Masks Help

MONDAY, July 27, 2020 (HealthDay News) -- Face masks can help prevent the spread of COVID-19 among folks trapped in a room with an infected "super spreader," a new Swiss study claims.

Most infected people with a typical COVID viral load don't flood the air with coronavirus-infected respiratory droplets, and the risk of catching the virus from them tends to be low, estimates show.

But a severely infected person who's coughing frequently can fill a poorly ventilated room with as many as 7.4 million copies of the coronavirus for every cubic meter of air, according to researchers Michael Riediker and Dai-Hua Tsai, from the Swiss Centre for Occupational and Environmental Health in Winterthur.

Read the full HealthDay story.

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HealthDay Reports: More Layers Are Better With Homemade Face Masks

A video recording showed that the 3-ply surgical mask was the most effective, but even a single-layer mask reduced the spread of droplets.

More Layers Are Better With Homemade Face Masks

FRIDAY, July 24, 2020 (HealthDay News) -- When it comes to homemade face masks, two or three layers of fabric is best, researchers say.

That's what you need to keep droplets from your nose and mouth from spreading the virus, the Australian scientists found.

Several kinds of material have been suggested for making masks, but there's little or no evidence of how effective they are, the team noted.

Read the full HealthDay story.

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HealthDay Reports: CDC Issues Call to Reopen America's Schools This Fall

According to the CDC, just 7% of U.S. COVID-19 cases, and less than 0.1% of related deaths, have occurred in people under the age of 18.

CDC Issues Call to Reopen America's Schools This Fall

FRIDAY, July 24, 2020 (HealthDay News) -- Facing opposition from President Donald Trump and others, the U.S. Centers for Disease Control and Prevention has issued a document supporting a reopening of the nation's schools this fall.

"As families and policymakers make decisions about their children returning to school, it is important to consider the full spectrum of benefits and risks of both in-person and virtual learning options," the agency said in a document posted on its website Thursday night.

The COVID-19-related health risks to kids are minimal compared to those faced by adults, the CDC said.

Read the full HealthDay story.

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HealthDay Reports: Isolation, Quarantine Impossible in >20 Percent of U.S. Homes

Odds of occupying units being unsuitable for isolation and quarantine increased for racial/ethnic minorities.

Isolation, Quarantine Impossible in >20 Percent of U.S. Homes

FRIDAY, July 24, 2020 (HealthDay News) -- More than 20 percent of U.S. homes lack sufficient space or plumbing facilities to comply with recommendations to isolate or quarantine to prevent COVID-19 transmission, according to a research letter published online July 21 in the Annals of Internal Medicine.

Ashwini R. Sehgal, M.D., from Case Western Reserve University in Cleveland, and colleagues examined the feasibility of separate rooms for isolation and quarantine for housing units in the United States. Data on residential dwelling units and occupants were obtained from the 2017 American Housing Survey. The proportion of dwellings in which optimal isolation or quarantine was impossible due to unavailability of separate bedrooms and bathrooms was estimated.

The researchers found that in 25.29 million dwellings, isolation or quarantine was impossible, because they lacked sufficient bedrooms, bathrooms, or both; this accounted for 20.8 percent of all residential units. This included about 30 percent of the 88.2 million units that housed more than one occupant. A total of about 81 million persons lived in units that were unsuitable for isolation or quarantine. The odds of occupying units unsuitable for isolation or quarantine were twofold to threefold higher for Native American and Hispanic persons relative to non-Hispanic White persons and 1.7-fold higher for Black and Asian persons.

Read the full HealthDay story.

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