The cumulative incidence of coronavirus disease (COVID-19) cases is showing similar trends in European Union/European Economic Area countries and the United Kingdom confirming that, while at a different stage depending on the country, the COVID-19 pandemic is progressing rapidly in all countries. Based on the experience from Italy, countries, hospitals and intensive care units should increase their preparedness for a surge of patients with COVID-19 who will require healthcare, and in particular intensive care.
Coronavirus testing will help countries manage COVID-19 but will raise questions about how to counsel patients about their test results. The CDC’s Deputy Director for Infectious Diseases Jay Butler talks with JAMA Editor Howard Bauchner about what to advise healthy patients with positive tests, sick patients with negative test results, and more.
Topics covered in this interview:
What's the most common test that's currently available? (1:40)
Positive predictive value (PPV) of COVID-19 tests (2:29)
Data on sensitivity (3:05)
Do patients test positive early in the course of the disease when they are exhibiting a few minor symptoms like runny nose or cough? (4:03)
Is the expectation that if someone has symptoms, they're likely to have a positive test? (4:50)
If someone with a runny nose, cough, fever tests negative, can they come back to work? (5:44)
If someone tests positive, how long should they stay home and when can they go back to work? (7:10)
Is there a minimum time period someone should be out of work or should they be relying on a negative test result? (9:59)
If someone tests negative, can they still shed the SARS-CoV-2 virus? (11:08)
What's the recommendation about who should and shouldn't be tested? (12:26)
Are any of the recommendations different for health care workers? (13:43)
Do health care workers, who previously tested positive, need to wait for a negative test before returning to work? (15:00)
What do we know about reinfection? (16:04)
Any new data on why younger children seem to be at low risk for the disease? (17:38)
What are the risks for women who are pregnant? (20:07)
What are the recommendations for health care workers who are pregnant? (21:08)
Can you talk about limiting the size of social gatherings? Where did the 50 person limit come from? (21:40)
The importance of community mitigation (24:00)
Any updates on treatments or therapies? Any updates on the use of NSAIDs? (25:53)
Any concerns about supply chain issues with regards to reagents for the tests? (27:41)
How viable is the virus on various surfaces? (29:16)
Any concerns patients taking ACE inhibitors and ARBs? (30:59)
General recommendations for people who are sick (32:03)
Can you summarize the current recommendations for people who tests positive? (33:16)
The next two weeks are critical. Do you think we'll flatten the curve? (34:52)
--------------------------------------------------------------- Coronavirus Resource page from the JAMA Network ✔https://ja.ma/covidyt
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