This Viewpoint reviews progress to date on drug and vaccine development for COVID-19, antibody testing for demonstration of immunity and seroprevalence, and the continuing need for testing capacity to more precisely manage the public’s health as mitigation restrictions loosen during summer 2020.
This Viewpoint reviews the policies, challenges, and ethics of allowing visitors of women while laboring in a hospital from the perspective of the woman, the visitor, the hospital staff, the community, and the infant.
This Viewpoint discusses the long-standing deficiencies in nursing home financing and organization made worse by the spread of coronavirus disease 2019 (COVID-19), and proposes ways to improve testing and personal protective equipment availability, and payment reforms to incentivize quality care for residents and decrease emergency department and hospital use.
This JAMA Insights Clinical Update reviews indications and timing of insulin therapy for management of type 2 diabetes, emphasizing the likely benefit of its use as first-line therapy in patients with HbA1c levels less than 9.0%.
A woman from the Southeastern US with a history of smoking, poorly controlled diabetes, and inhalational medical marijuana use had 4 months of productive cough, weight loss, subjective fevers, 3 days of worsening chest pain, and a large right upper lobe cavitary mass on chest CT unresponsive to antibiotics. AFB smear and GeneXpert MTB/RIF testing were negative; she developed a right-sided tension pneumothorax after intubation for hypoxemia, and chest tube placement yielded charcoal-colored pleural fluid. What is the diagnosis and what would you do next?
This case series describes autopsy findings in 10 patients with proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who died at a university medical center in Germany.
This Viewpoint discusses the need for new payment models to incentivize innovations in personalized home care and facilitate transitions already occurring in response to the COVID-19 pandemic, and to develop lower-cost higher-quality approaches to home-based management of chronic illnesses such as heart failure and Parkinson disease.
This Medical News feature discusses the role of contact tracing in containing coronavirus disease 2019.
This Arts and Medicine feature draws lessons from Sophocles’ classic tragedies Oedipus Rex and Oedipus at Colonus about the limits of medicine and the importance of community in the midst of the coronavirus (COVID-19) pandemic.
This study compares angiotensin-converting enzyme 2 (ACE2) gene expression, which has been associated with SARS-CoV-2 cell entry, in the nasal epithelium of children vs adults.
This Viewpoint discusses the role academic health systems can play in response to public health deficiencies identified in the coronavirus disease 2019 (COVID-19) pandemic, including developing early warning systems to identify future outbreaks, addressing community mental health needs more broadly, and working to reduce structural health inequities.
This Viewpoint summarizes the 2020 report from the US Surgeon General, summarizing updated scientific evidence on the benefits of smoking cessation and individual, health systems, and population strategies that can facilitate smoking cessation.
This JAMA Insights Clinical Update discusses the presumed mechanism of COVID-19–related olfactory dysfunction and proposes assessment and management strategies, including olfactory training and adjuvant medication treatments.
This Medical News article is an interview with the University of New Mexico’s Eileen Barrett, MD, MPH, about the pandemic’s mental toll on health care workers—and how they and their employers can safeguard their emotional well-being.
This population epidemiology study investigates the prevalence of IgG and IgM antibodies to SARS-CoV-2 in Los Angeles County, California, as a marker of both active and past infections.
This Viewpoint describes the categories of concerns underlying vaccine hesitancy (necessity, safety, and freedom of choice), and proposes ways to educate the public now about the public health and individual benefits of a COVID-19 vaccine to enhance its rapid, widespread uptake when it becomes available.
This Viewpoint describes how the National Institutes of Health is partnering with more than a dozen biopharmaceutical companies and multiple other agencies to develop an international strategy for a coordinated research response to the COVID-19 pandemic, including prioritizing vaccine and drug candidates.
This Viewpoint describes changes in reimbursement standards, patient privacy (HIPAA) regulations, and licensing requirements that have occurred around provision of telehealth in the US in response to the COVID-19 pandemic and highlights opportunities to further standardize regulations and facilitate use of telehealth after the pandemic.
This Viewpoint emphasizes the need for efficient and accurate data collection, aggregation, and analysis at the national level to properly manage the coronavirus pandemic, and proposes responses to the legal, ethical, and financial barriers that have historically delayed development of a national HIT infrastructure.
This study measured respiratory parameters of 15 non-ICU patients before, during, and after receiving noninvasive ventilation in the prone position.
This case series describes the proportion of awake, nonintubated inpatients with COVID-19 and hypoxemic respiratory failure requiring oxygen supplementation whose Pao2 increased ≥20% with prone positioning, and their respiratory status after resuming supine positioning.
This Viewpoint discusses the need for population COVID-19 PCR and antibody surveys to better understand where communities are on the continuum of COVID-19 incidence and prevalence, to determine the effectiveness of mitigation strategies, and to plan for future mitigation strategies and development of vaccines and therapeutics.
This Viewpoint proposes ethical principles to guide allocation of scarce inpatient therapies for hospitalized COVID-19 patients to maximize patient benefit, mitigate disparities, and minimize clinician burden.
This case series describes subclinical development of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in some patients and health care workers in a pediatric dialysis unit after contact with a seropositive patient.
This Viewpoint reviews the FDA’s May 2020 Emergency Use Authorization of the antiviral drug remdesivir for treatment of COVID-19 and discusses the need for a transparent distribution plan of a drug not otherwise available in the US and for which demand will likely exceed supply.
This cohort study compares rates of coronavirus PCR test positivity among Israelis with symptoms suspicious for COVID-19 who did and did not receive BCG vaccination as part of routine childhood immunization in the early 1980s.
This Medical News feature describes an international effort to compile data about ventilated patients with COVID-19.
This study examines associations between use of hydroxychloroquine, azithromycin, or both and in-hospital mortality, ECG changes, and cardiac arrest among patients with COVID-19 hospitalized in the metropolitan New York area in March 2020.
This Viewpoint describes what is currently known about the immune response to coronavirus disease 2019 (COVID-19), highlights important gaps in knowledge, and identifies opportunities for future research.
This Viewpoint reviews possible reasons for reported excess mortality and poor outcomes in racial/ethnic minority populations with COVID-19 and proposes research, public health, and clinical interventions to decrease health inequities in and beyond the pandemic.
This population epidemiology study characterizes trends in polymerase chain reaction (PCR) test positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Washington State and the Seattle area between March 1 and April 16, 2020, before and after statewide physical distancing guidelines and stay-at-home orders.
This Viewpoint discusses considerations that might lead physicians to change their practice based on RCTs reporting non–statistically significant differences in primary outcomes, including trial methodology, totality of evidence, cost, invasiveness, and labor-intensiveness of the interventions being compared.
This Viewpoint proposes that universal respiratory precautions in the operating room—use of respirators with face masks and eye protection—could protect staff from possible coronavirus disease 2019 (COVID-19) infection and facilitate resumption of elective surgeries canceled during the first wave of the pandemic.
This Viewpoint proposes a framework for international cooperation among governments and organizations to replace competition and hoarding with equitable global distribution of COVID-19 therapeutics and vaccines as they are developed.
This Viewpoint attributes improved understanding of the role of autoantibodies and B-cell activity in MS pathogenesis and the development of effective therapies to the ability of physician-scientists to bring clinical insights to laboratory research and it emphasizes the importance of supporting and encouraging these investigators to reinvigorate science at the bedside.
This JAMA Clinical Guidelines Synopsis summarizes the American Gastroenterological Association Institute’s 2018 guideline on initial management of acute pancreatitis.
This Viewpoint explains the ethics of implementing licensing or certification of coronavirus immunity as basis for permitting public activities, anticipates challenges to effectively implementing such a system, and proposes potential policy solutions.
This Viewpoint explains the ethical basis for implementing immunity-based licensing—certification of coronavirus immunity as a basis for permitting public activities—and anticipates challenges to effective implementing such a system, and potential solutions.
This Viewpoint discusses the 2 most common categories of testing to diagnose SARS-CoV-2—real-time PCR to identify viral RNA and serological diagnosis of IgG and IgM antibodies to assess immune response—and estimates time intervals for test positivity by specimen source to help clinicians interpret results relative to symptom onset.
This case series describes outcomes for 5 patients with VT storm refractory to drug therapy treated with left stellate ganglion transcutaneous magnetic stimulation (TCMS) to reduce cardiac sympathetic input.
This JAMA Guide to Statistics and Methods reviews overlap weighting, a technique to reduce the influence of patients who are nearly always treated or never treated on propensity score estimates, when attempting to reduce bias associated with nonrandomized treatment in observational study populations.
This Viewpoint reviews the revenue sources and financial liquidity of nonfederal US general hospitals to estimate the economic effects pandemic-related reductions in elective procedures and outpatient revenues might have, and argues for targeted government financial support for smaller, independent, and more rural institutions.
In this Viewpoint, Donald Berwick summarizes the rapid changes the COVID-19 pandemic has wrought on the pace, scientific standards, delivery mechanisms, and working conditions of health care and how it has sharply increased awareness of the societal costs of poor public health preparedness and health inequities.
This JAMA Patient Page describes practices for keeping household medicine safely stored away from children and what to do if an unintentional medicine exposure happens.
This Viewpoint discusses the shifting landscape of health care financing, regulation, and delivery as a result of the coronavirus pandemic, and discusses regulatory and other changes that need to be in place if telehealth and physician practice and hospital mergers become the “new normal” once the pandemic is controlled.
This Viewpoint examines the need to reconcile discrepancies between the definition of brain death in the 1981 Uniform Determination of Death Act and current diagnostic standards in the US given legal challenges arising from the differences.
This Viewpoint discusses ways in which artificial intelligence (AI) methods can enhance the use of health care data in detection, prognostication, and prediction; suggests ways in which AI tools might be better developed and deployed; and calls for increased focus on anticipated changes that will be made in the health care system to better benefit from the use of AI.
This JAMA Insights review explains the use of the effective reproduction number (Rt) as a measure of the number of secondary infectious disease cases spread from an initial case, and how this number is used to assess the effects of public containment and mitigation efforts to control SARS-CoV-2 transmission.
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