If the novel COVID-19 pandemic happened to be considered a crime scene, then at some point health detectives, also known as epidemiologists, would be called to investigate. Apart from the heroic efforts of respiratory therapists, dietitians, physical therapists, and other health professionals, such as physicians and nurses who are on the front lines administering care to patients, the efforts of epidemiologists will be necessary to explain what happened at key stages of this disease and the subsequent havoc that it wreaked.
It is worth noting that the eminent biologist J.B.S. Haldane in 1963 (Journal of Genetics) described important stages of acceptance in the advancement of science:
Stage 1: This is worthless nonsense.
Stage 2: This is an interesting, but perverse point of view.
Stage 3: This is true, but quite unimportant.
Stage 4: I always said so.
Since the dawn of recorded history, humans have been confronted with infectious disease outbreaks that have ravaged the population. Throughout the millennia, it has been common for mistakes to be made in understanding the true nature of invading agents and how best to treat their dire effects. The situation this time is quite similar. Errors have been made in several nations regarding whether COVID-19 was deemed to be a problem of deadly significance and whether constructive responses were and are being made in a timely manner.
Some epidemiology models are developed on the basis of collecting data involving four key building blocks: Susceptibility, Exposure, Infection, and Recovery (SEIR). Data in each category can undergo changes on a daily basis. A report from the CDC on April 8, 2020 sheds light on the susceptibility aspect of COVID-19 by providing age-stratified, disease–associated hospitalization rates for patients in March 2020. Among patients hospitalized: 74.5% are aged ≥50 years; 54.4% are male, and among adult patients with data on underlying conditions, 89.3% have one or more of them with the most common being hypertension (49.7%), obesity (48.3%), chronic lung disease (34.6%), diabetes mellitus (28.3%), and cardiovascular disease (27.8%). Moreover, among patients where race/ethnicity data were available, 33.1% are non-Hispanic black.
Linking data from the S component of an epidemiology model to both the E and the I portions creates an opportunity to employ some prevention measures to reduce exposure and the likelihood of infection (e.g., social distancing). For the R part of the SEIR model, a serological test may prove that an antibody response occurred after infection of a patient. Still unknown is whether individuals who test positive will remain immune either to infection or reinfection. Also, if the virus mutates, will those antibodies produce a comparable level of protection? Someday, epidemiologists will have answers for all these questions. It also will be interesting to see if any pundits eventually migrated from Haldane’s Stage 1 to Stage 4.
More April 2020 TRENDS Articles
CALLING ALL CARS AND HEALTH DETECTIVES
Indicates the important role that epidemiologists play in explaining what is transpiring at key stages of COVID-19. Read more
PRESIDENT’S CORNER
ASAHP President Phyllis King discusses how with the thrust into the digitization of healthcare, the question for higher education is how fast can we understand, adapt, anticipate and project patient care needs and healthcare innovations to prepare our students and meet the needs of this new world? Read more
FAST CHANGING LEGISLATIVE ENVIRONMENT
Depicts efforts by the federal government to provide additional funding through Paycheck Program Protection legislation, along with an increasing concern that the U.S. is too dependent on other nations for supplying minerals used in the production of pharmaceuticals and medical devices. Read more
HEALTH REFORM DEVELOPMENTS
Points out how the existence of accountable care organizations (ACOs) is threatened by the current pandemic; describes COVID-19 surveillance activities in relation to the Fourth Amendment of the U.S. Constitution; and loosening by the Center for Medicare & Medicaid Services (CMS) of telehealth and scope of practice regulations. Read more
DEVELOPMENTS IN HIGHER EDUCATION
Describes a recent ASAHP webinar on clinical education; a statement of principles on academic credit; and whether regional higher education accreditation should go national. Read more
QUICK STAT (SHORT, TIMELY, AND TOPICAL)
Lifetime Prevalence Of Self-Reported Work-Related Health Problems Among U.S. Workers
National Health Expenditure Projections, 2019-2028
Skin-Interfaced Biosensors For Wireless Physiological Monitoring In Neonatal And Pediatric Intensive-Care Units
Bacterial Colonization Reprograms The Neonatal Gut Metabolome Read more
AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY
Brain Health Across The Lifespan
Leading In A Time Of Crisis: Corporate America And COVID-19
Confronting Rural America’s Health Care Crisis Read more
RACIAL DISPARITIES IN AUTOMATED SPEECH RECOGNITION SYSTEMS
Mentions how these tools do not work equally well for all subgroups of the population, with study results showing that all five ASR systems in an investigation exhibited substantial racial disparities, with an average word error rate (WER) of 0.35 for black speakers compared with 0.19 for white speakers. Read More
ESTABLISHING HIGH PERFORMING TEAMS: HEALTH CARE LESSONS
Refers to a study that shows while both Functional Change and Cultural Change processes were individually important for enhancing team-based health care, they were most effective when mobilized in tandem. Read more