PHYSICIAN’S CORNER: NEJM “COVID-19 PRIMER – VIRTUAL PATIENT SIMULATION” (2020)

CLICK ON PATIENT BELOW TO LAUNCH “VIRTUAL PATIENT SIMULATION”

COMMENTARY

This interactive simulated case of Covid 19 (SARS CoV-2) is remarkable: a unique opportunity to stand in the shoes of a ER Doctor without any risk, except to our egos.

This is meant for doctors, but the intellectually curious  Guests of this site might enjoy the experience, especially Doctor Lisa Sanders fans.
The vocabulary is full Medical, and will give a foretaste of the words I will slowly be exploring. I believe that patients should not be intimidated by their lab reports.

I’ll start the vocabulary journey with FERRITIN which is a marker for IRON STORES in the body. You can have too much iron, which is dangerous (iron overload), in which case the ferritin is high.

There was a time when I had too little iron ( was anemic, with a hemoglobin of 8.6, and felt terrible) and my ferritin was low. I now check my ferritin every 6 months to make sure I am taking enough iron to offset my blood loss, which is another story I will tell when I start go through my medicine cabinet and discuss the Meds one at a time.

The reason for testing ferritin in our interactive Covid 19 case was because ferritin is markedly elevated in cases of inflammation/ infection. It is an “acute phase reactant”, and may reflect the “cytokines storm” that may be a contributor to the lethality of Covid 19.

There is another way to benefit from this simulation: the train-wreck of a patient serves as a cautionary tale of what you wish NOT to become. Our present medical profession is so DISEASE oriented. How much better if our society and our medical profession were HEALTH oriented instead.

—Dr. C.

CORONAVIRUS PODCAST: TRACING APPS, Antiviral remdesivir’S PROMISE

The Coronapod team pick through the latest news, plus we hear from the researchers making lemonade out of lockdown lemons.

In this episode:

01:10 Can contact-tracing apps help?

Governments around the world are banking on smartphone apps to help end the spread of the coronavirus. But how effective might these apps might be? What are the risks? And how should they fit into wider public health strategies?

Editorial: Show evidence that apps for COVID-19 contact-tracing are secure and effective

13:30 Antiviral remdesivir shows promise

Early results from a US trial of the antiviral drug remdesivir suggest it shortens recovery time for patients with COVID-19. We unpick the findings.

News: Hopes rise for coronavirus drug remdesivir

16:52 One good thing

Our hosts pick out things that have made them smile in the last week, including blooming trust in scientists, cooking experiments, and a neighbourhood coming together to clap for healthcare workers.

21:34 Unexpected opportunities

We hear from three researchers making the most of lockdown, studying tiny earthquakes, building balcony-based citizen science projects, or enlisting gamers to fight the coronavirus.

Fold-it, the protein-folding computer game

TELEMEDICINE: 80% OF PEDIATRIC PATIENTS SEEN REMOTELY AT JOHNS HOPKINS CHILDREN’S CENTER

From Johns Hopkins Medicine (April 30, 2020):

“A lot of our pediatric divisions are now seeing 80% or more of their patients by video or telephone,” says Hughes.

The Children’s Center’s preparations for the virus and the disease it causes, COVID-19, were unwittingly sparked by pediatrician Helen Hughes and her early work in telemedicine outreach for pediatric subspecialists. In 2018, she spearheaded development of a telemedicine collaboration with the Talbot County Health Department on Maryland’s Eastern Shore.

Pediatrician Helen Hughes during a video visit with a young patient and mom.. Johns Hopkins Medicine

The goal was to ease the burden of long treks to Johns Hopkins’ Baltimore campus for young patients — especially medically complex patients — for follow-up visits. At the time, she said, “This is where the future of health care is headed. Video technologies can allow us to do so many things for our patients without having to see them in person every time.”

The Children’s Center, notes Hughes, had been conducting between zero and eight video visits per month for the past two years. In the second half of March, after the coronavirus had clearly arrived, Johns Hopkins pediatricians and pediatric subspecialists saw 800 patients via telemedicine. That number increased to 1,400 telemedicine visits in the first half of April. Additionally, MyChart users in April jumped to 71%.

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