Story Tips From Johns Hopkins Experts on COVID-19

05/12/2020

The following are various story ideas regarding the COVID-19 illness. To interview experts in these tips or others at Johns Hopkins, contact JHMedia@jhmi.edu.

Johns Hopkins Medicine Staff Member Helps Mom Get Emergency Care for COVID-19

As the COVID-19 pandemic spread throughout the United States, Tye Clark, administrative services manager of the Johns Hopkins University School of Medicine Hospitalist Program, never expected that she would need the urgent help of the very team of providers whom she works with every day.

In late March, her mom, Miriam, who lives in New Jersey, had a fever for 10 days, lost her appetite and had no energy. She’d been unable to get tested for COVID-19, and her symptoms were deteriorating, causing her to have difficulty breathing. Tye spoke with her colleague Daniel Brotman, M.D., director of the Hospitalist Program, who told Tye to rush her mom to the hospital immediately. He instructed Tye about how to don personal protective gear to keep herself and her mother safe before the six-hour roundtrip journey to pick up her mom and bring her back to Baltimore to receive care at The Johns Hopkins Hospital.

When Tye and Miriam arrived at the hospital’s emergency room, Miriam, who was barely able to walk to the car before the drive, had to be pushed inside in a wheelchair, due to her worsening condition. Miriam tested positive for COVID-19, was admitted to The Johns Hopkins Hospital and remained there for 10 days. She was discharged on Easter Sunday, April 12.

Miriam credits the doctors, nurses and her daughter for saving her life. After a short stay in Maryland while recovering, Miriam is now back at home in New Jersey.

To learn more about their experience, please watch a video of Tye and Miriam retelling their story. A version without music is available for media use.

If you are interested in speaking with Tye and Miriam, please contact Kim Polyniak at kpolyni1@jhmi.edu or 443-510-5807.

With Boost from Johns Hopkins, Baltimore City Student Appears on Steve Harvey’s ‘Mentoring Monday’ Show

Dunbar High School freshman Marque Knox was surprised by a recent call from Steve Harvey regarding “Mentoring Monday.”

Knox has been serving on the Johns Hopkins Health System’s COVID-19 Anchor Strategy Youth Committee, a workgroup that is setting up a Johns Hopkins University COVID-19 fund. In that role, he organizes resources and activities for Baltimore City youth and their families; coordinates food distribution; provides updates and resources to community organizations; recruits volunteers for in-person and virtual engagement opportunities; and reviews requests for assistance and offers of support. Leaders in the workgroup say he has a natural gift for connecting with and supporting youth in the Baltimore City community.

Harvey invited Knox to be a guest May 11 on his “Mentoring Monday” Instagram, Facebook and YouTubeLive channels, which attract some 3 million viewers. Harvey said he would purchase a computer for Knox, pay his tuition to Cristo Rey Jesuit High School for the next three years and pay for his uniforms. Knox thought he was going to talk about his story and ask Harvey to mentor him.

This is all came about because Knox advocated for himself a few weeks ago, during one of the youth committee’s virtual meetings. At that meeting, Knox expressed anxiety about school to Alicia Wilson, Johns Hopkins University’s and Johns Hopkins Health System’s vice president for economic development. That evening, she received a heart-gripping text from Knox. He recounted being bullied at school, being robbed at gunpoint while walking to school and struggling to make sense of it all. He told her that his dream was to attend Cristo Rey but that many told him he was not smart enough or good enough to get into the school.

From there, Wilson called the president of Cristo Rey Jesuit High School to ask a favor. And now, Cristo Rey has admitted Knox for this fall, which he did not learn about until Monday.

Wilson has known Harvey for several years. She helps recruit and send young people to his mentoring camps and also volunteers to work with his team to create engaging programming.

Knox, Wilson and Cristo Rey’s director of development are available for interviews.

Front-Line Worker Story: Sapna Kudchadkar, M.D. — COVID-19 Survivor and Provider

It seems like there will never be enough “thank-you’s” for the incredible doctors, nurses technicians and support staff who are working round the clock to help patients with this dangerous disease. It is their dedication, determination and spirit that allow Johns Hopkins to deliver the promise of medicine.

Sapna Kudchadkar, M.D., is a physician and anesthesiologist at the Johns Hopkins Hospital. Typically, she works with pediatric patients, but when Maryland was hit with a coronavirus outbreak, she lent her skills to our adult care team. While working in our COVID-19 care unit, Kudchadkar fell ill from the disease and had to self-quarantine at home. Luckily, her symptoms remained mild, and she’s since recovered and is back at work caring for coronavirus patients in need. Her dedication to helping patients with this disease extends beyond her clinical role: She recently donated her blood plasma — full of helpful antibodies — to be used in experimental therapies for COVID-19.

VIDEO: https://www.youtube.com/watch?v=ZnzvkbGN3Kg

Keeping Immunizations Up to Date During the COVID-19 Pandemic

The coronavirus pandemic has led health care providers to move swiftly to keep nonessential health care staff members out of the office. Many health issues and concerns are now being addressed through virtual visits, where providers meet with families using technology, instead of seeing them in-person. While immensely important and valuable, virtual appointments cannot take the place of in-person visits for certain essential care, such as immunizations for children and adolescents. Yet, national data suggest that many children are missing scheduled vaccines that would have been administered through in-person visits.

Although some school-based clinics are closed, most pediatric practices are still open for immunizations, well-child visits and other medical needs. But many parents are concerned about potential exposure to COVID-19 for themselves or their children and may decide not to go to the doctors’ office for vaccines. Other barriers include lack of transportation, insurance lapses or inadequate child care for other children.

Staying up to date on immunizations is critical — especially during the current pandemic — to protect those who are vaccinated and others in public areas. In addition, immunizations protect other children who are unable to receive vaccinations due to certain health conditions or those who are too young to receive certain vaccines. Kids who do not receive immunizations on time will be susceptible to a number of diseases that would been prevented with a vaccine.

Children who miss immunizations may also face potential delays in physically returning to schools once they reopen. Experts are also concerned that an influx of children in need of vaccines after stay-at-home orders are lifted could overwhelm practices.

The following experts are available to discuss how the pandemic has impacted children receiving immunizations:

  • Katherine Connor, M.D., M.S.P.H., assistant professor of pediatrics, Johns Hopkins University School of Medicine; medical director, The Ruth and Norman Rales Center for the Integration of Health and Education, Johns Hopkins Children’s Center
  • Edith Dietz, M.D., general pediatrician, Johns Hopkins Bayview Medical Center’s Children's Medical Practice and Hopkins Bayview's combined Pediatric ER and Inpatient Unit.
  • Barry Solomon, M.D., M.P.H., chief, Division of General Pediatrics and Adolescent Medicine, Johns Hopkins Children’s Center
  • Rachel Thornton, M.D., Ph.D.
    Associate professor of pediatrics, Johns Hopkins University School of Medicine

COVID-19 Needs of Pregnant Women Addressed in New Society Guidelines

During the COVID-19 pandemic, physicians, nurses and other health care workers have quickly learned that the disease cannot be fought with a “one-size-fits-all” set of diagnostic, treatment and follow-up-care procedures. The special COVID-19 needs of one particular group — pregnant women — has now been addressed in a set of guidelines and clinical management considerations issued on April 29, by the Society for Maternal-Fetal Medicine, a national organization of high-risk pregnancy experts.

The authors of the new guidelines are Torre Halscott, M.D., M.S., and Arthur “Jason” Vaught, M.D., both assistant professors of gynecology and obstetrics, maternal-fetal medicine and critical care at the Johns Hopkins University School of Medicine. The two doctors are available for interviews.

Included in the 17-page document are guidance, recommendations and best practices on a variety of subjects and issues to optimize the care of pregnant women with or suspected of having COVID-19. These range from tips on how to identify accurately different levels of COVID-19 symptoms in these patients to a flowchart algorithm to better determine when they need intensive care.

One example of a question answered in the new guidelines is whether prone positioning, where a COVID-19 patient lies on her stomach to aid breathing, is appropriate for pregnant women. The guidelines say yes, using padding, pillows and other supports to increase comfort.

Another issue addressed is the timing of delivery for pregnant women with COVID-19. The guidelines cover this topic for both patients who are critically ill and for those who are asymptomatic or mildly ill, cautioning that each case must be considered individually;  wide range of factors must be weighed; and that a diagnosis of COVID-19 does not automatically call for an early delivery.

The Next Surge: ED Doctors Want to See Non-COVID19 Patients Now

The typically large numbers of patients coming in to the emergency room are down significantly as the COVID-19 pandemic endures. But that doesn’t mean there are fewer emergencies now. “For a variety of reasons, people are putting off seeking health care, and we all know that makes things worse,” says Gabor Kelen, M.D., director of the department of emergency medicine at The Johns Hopkins Hospital.

To avoid a surge of non-COVID19 patients, Kelen insists that patients who are experiencing medical emergencies should seek care right away. “Whatever would have concerned you to come to the emergency department before COVID-19, you should still be coming in for today: chest pain, shortness of breath, severe abdominal pain, uncontrolled vomiting, uncontrolled fever, slurred speech and droopy face,” he says.

Even if the numbers are 30%-to-50% below the normal average of ER visits, doctors are still seeing cases of ruptured appendixes and shoulder dislocations, where people have waited five days and now need procedures that require anesthesia and/or surgery Emergency Department physicians are also seeing infected wounds and serious pulmonary conditions unrelated to COVID-19.

Recognizing that the new coronavirus is deterring patients from seeking timely medical care, emergency departments across the Johns Hopkins Health System have implemented a series of measures to separate potential COVID-19 patients from those with unrelated medical emergencies.

“We have a very strong screening process that allows us to determine whether or not a patient may have COVID-19 — within five to seven seconds of a patient coming in the door,” Kelen says.

There are two streams for patients in the emergency department: one for those who may have COVID-19 and one for unrelated medical emergencies.

“Even with the patients that we are not concerned about COVID-19 and don’t need negative pressure rooms, we are still being very strict with infection control,” says Kelen.

There are limitations about who goes in and out of the rooms and a no-visitor policy in place, with few exceptions. Emergency room staff wear masks, face shields and personal protective equipment in all patient interactions, and everything gets wiped down with disinfectant between patients.

“You are safe coming to the ED,” Kelen says. “Probably safer than most places in society.”

Health Care Trend: Physical Medicine and Rehabilitation Vital to Recovery of COVID-19 Patients

On average, 70% of COVID-19 patients admitted to the hospital need rehabilitation to help them recover. With 30% of them needing more intensive, ongoing rehabilitation, the pandemic will likely thrust the field of physical medicine and rehabilitation into a resurgence as one of the most critically needed areas of medicine in responding to this pandemic.

Receiving care within a physical medicine and rehabilitation environment is critical, as it is common for patients to experience lingering health issues. These include muscle weakness, anxiety and post-traumatic stress disorder (PTSD), along with problems with memory and problem solving after recovering from COVID-19.

Rehabilitation as a field of medicine debuted during the polio epidemic, then experienced a boom during the First and Second World Wars. Now, the coronavirus pandemic is poised to cause another surge in demand for the specialty.

A collaboration between the rehabilitation team, including pulmonologists, physiatrists, physical therapists, occupational therapists, speech language therapists and psychologists will be crucial to ensure patients’ recoveries. Patients will likely require targeted, short- and long-term rehabilitation to restore their health and functional abilities.

Experts Pablo Celnik, M.D., professor of Physical Medicine and Rehabilitation; April Pruski, M.D., assistant professor of Physical Medicine and Rehabilitation; Annette Lavezza, acute rehabilitation occupational therapist; and Soo Kim, telemedicine post-acute care assistant professor of Physical Medicine and Rehabilitation, are available to speak to media about the specific needs of patients after surviving COVID-19 and how rehabilitation will play an integral role in their recovery.

Coronavirus Grant to Fund Remote Emergency Dizziness vs. Stroke Diagnosis

Since the onset of the COVID-19 pandemic in the United States, emergency departments have been reporting that people are avoiding visits due to fear of the virus. However, physicians warn that delaying prompt stroke care until it’s too late leads to worse outcomes, including a much higher risk of permanent disability or death.

One of the symptoms of a stroke can be dizziness or vertigo, but only about 5% of dizzy spells are due to stroke. To help patients determine if they need to get to a hospital or can avoid a visit, the American Heart Association awarded a grant to a Johns Hopkins research team to convert the process of analyzing eye movements -- which can distinguish between a stroke and dizziness -- from the clinic to the home, using a smartphone.

Previously, David Newman-Toker, M.D., Ph.D., developed an approach to stroke diagnosis, using goggles that record eye movements while patients perform three eye tests in the emergency room. A health care provider then analyzes the recorded data to determine if the person has a stroke or just benign, inner-ear dizziness. Newman-Toker dubbed this service Tele-Dizzy.

Now, with the help of the mobile technology company emocha, the Tele-Dizzy team will use an app that helps patients record these eye movement tests on their smartphones and transmit the data remotely to a health care provider. The health care provider will then call the patient and let them know whether they may be having a stroke and need to get to the hospital immediately, or if they can stay home.

Newman-Toker is available to discuss taking Tele-Dizzy from the clinic to the home.

(The Johns Hopkins University has a financial interest in emocha, a technology that was invented at the Johns Hopkins University. This financial interest includes equity in the company and entitlement to royalties.)

For information about the coronavirus pandemic from Johns Hopkins Medicine, visit the coronavirus information page. For information on the coronavirus from throughout the Johns Hopkins enterprise, including the Johns Hopkins Bloomberg School of Public Health and The Johns Hopkins University, visit the Coronavirus Resource Center.