Baylor University Medical Center, Dallas TX 75226, USA.
Baylor Heart and Vascular Institute, Dallas TX 75226, USA.
Rev Cardiovasc Med. 2020 Mar 30;21(1):1-7. doi: 10.31083/j.rcm.2020.01.42.
Approximately 90 days of the SARS-CoV-2 (COVID-19) spreading originally from Wuhan, China, and across the globe has led to a widespread chain of events with imminent threats to the fragile relationship between community health and economic health. Despite near hourly reporting on this crisis, there has been no regular, updated, or accurate reporting of hospitalizations for COVID-19. It is known that many test-positive individuals may not develop symptoms or have a mild self-limited viral syndrome consisting of fever, malaise, dry cough, and constitutional symptoms. However some individuals develop a more fulminant syndrome including viral pneumonia, respiratory failure requiring oxygen, acute respiratory distress syndrome requiring mechanical ventilation, and in substantial fractions leading to death attributable to COVID-19. The pandemic is evolving in a clustered, non-inform fashion resulting in many hospitals with preparedness but few or no cases, and others that are completely overwhelmed. Thus, a considerable risk of spread when personal protection equipment becomes exhausted and a large fraction of mortality in those not offered mechanical ventilation are both attributable to a crisis due to maldistribution of resources. The pandemic is amenable to self-reporting through a mobile phone application that could obtain critical information on suspected cases and report on the results of self testing and actions taken. The only method to understand the clustering and the immediate hospital resource needs is mandatory, uniform, daily reporting of hospital censuses of COVID-19 cases admitted to hospital wards and intensive care units. Current reports of hospitalizations are delayed, uncertain, and wholly inadequate. This paper urges all the relevant stakeholders to take up self-reporting and reporting of hospitalizations of COVID-19 as an urgent task in combating this devastating pandemic.
大约 90 天的 SARS-CoV-2(COVID-19)传播最初源自中国武汉,并蔓延到全球,引发了一连串迫在眉睫的事件,对社区健康和经济健康之间的脆弱关系构成了威胁。尽管几乎每小时都在报告这一危机,但 COVID-19 的住院情况却没有得到定期、更新或准确的报告。众所周知,许多检测呈阳性的个体可能不会出现症状,或者只有轻微的自限性病毒综合征,包括发热、不适、干咳和全身症状。然而,一些人会发展出更严重的综合征,包括病毒性肺炎、需要吸氧的呼吸衰竭、需要机械通气的急性呼吸窘迫综合征,并且在很大程度上导致 COVID-19 死亡。大流行以集群、非信息的方式演变,导致许多医院有准备但几乎没有或没有病例,而其他医院则完全不堪重负。因此,当个人防护设备用尽时,传播的风险相当大,而那些没有接受机械通气的人的死亡率很高,这两者都归因于资源分配不均造成的危机。大流行可以通过手机应用程序进行自我报告,从而获取疑似病例的关键信息,并报告自我检测结果和采取的措施。了解集群和医院资源即时需求的唯一方法是强制性、统一、每日报告住院的 COVID-19 病例和重症监护病房。目前的住院报告是延迟的、不确定的,而且完全不足。本文敦促所有相关利益攸关方将自我报告和报告 COVID-19 住院情况作为抗击这一毁灭性大流行的紧急任务。