127. Guidelines, COVID, Econsults, COVID19, CDC

https://covid19treatmentguidelines.nih.gov/A National Institutes of Health panel has released new guidelinesagainst use of hydroxychloroquine plus azithromycin outside of clinical trials https://www.ncbi.nlm.nih.gov/pubmed/32001253Anaphylaxis—a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysisEpinephrine is the cornerstone of anaphylaxis management but continues to be underutilized ANTIBODY—https://jamanetwork.com/journals/jama/fullarticle/2764954 “Yet, according to Theel, several companies are marketing lateral flow assays as rapid point-of-care tests to identify active COVID-19, something the FDA announced it will take action against. “We do not really know how well these assays work at this point,” Theel said in a follow-up email.” https://www.sccgov.org/sites/covid19/Pages/press-release-04-21-20-early.aspxThey say the Santa Clara Medical Examiner identified two individuals who died at home on February 6, 2020 and February 17, 2020. And the autopsy came with……..positive for SARS-CoV-2. https://www.cdc.gov/mmwr/index.htmlTitled – Assessment of SARS-CoV-2 Infection Prevalence in Homeless Shelters — Four U.S. Cities, March 27–April 15, 2020They used PCR to test resident and staff members at 19 homeless shelters- almost 1500 people in total and it was impressive that in those locations for which there was already at least two previous COVID19 test found the rate of positive cases was extremely high — 17% of residents and staff members in Seattle; roughly 35% of those tested in Boston; and 66% of the residents in san Francisco. This tells us what we already know, this disease spreads like wild fire, of those that it spreads not https://annals.org/aim/fullarticle/2764585/utility-appropriateness-content-electronic-consultations-across-medical-subspecialties-cohort-studyUtility, Appropriateness, and Content of Electronic Consultations Across Medical Subspecialties: A Cohort StudyObjective of this retrospective cohort study was to assess novel metrics of electronic consult appropriateness and utilityTo assess novel metrics of e-consult appropriateness and To assess novel metrics of e-consult appropriateness and To assess novel metrics of e-consult appropriateness and To assess novel metrics of e-consult appropriateness and To assess novel metrics of e-consult appropriateness.Most consultations were answered within one day and approximately 70% of the consultations that all 4 criteria for appropriateness indicating about 70% of time the patient could be spared a visit to a specialist and have a better conditions managed by the primary care provider with just subtle guidance from the specialistMost consultations were answered within 1 day, with variation across specialties (73.1% for psychiatry to 87.8% for infectious disease). Overall, 70.2% of e-consults met all 4 criteria for appropriateness; the frequency of unmet criteria varied among specialties.