Read AMA Morning Rounds®’ most popular stories in medicine and public health from the week of April 20, 2020 – April 24, 2020.

The New York Times (4/18, A1, Abelson, Fink, Kulish, Thomas) reported physicians say there is a shortage of materials needed for kidney dialysis as a significant number of patients with COVID-19 experience kidney failure. The Times added that the “surge in [COVID-19] patients with kidney leading to shortages of machines, supplies and staff required for emergency dialysis.”

ProPublica (4/19, Pearson, Kaplan, Campbell) reports research suggests that 14% to 30% of patients with COVID-19 in ICUs experience acute kidney injury, which “has taxed the supply of materials like fluids, cartridges and other machine components that are used to facilitate dialysis treatments that filter toxins out of sick patients’ bloodstreams continuously for 24 hours, called continuous renal replacement therapy, or CRRT.”

The AP (4/20, Stobbe) reports that “reports of accidental poisonings from cleaners and disinfectants are up this year, and researchers believe it’s related to the coronavirus epidemic.” According to a Monday report from the CDC, these types of poisonings increased approximately 20% in the first three months of 2020, compared with the same time period in 2019 and 2018. Specifically, “bleach accounted for the largest share of the increase overall, but for young children the rise was mainly in mishaps involving nonalcohol disinfectants and hand sanitizers, the CDC reported.”

TIME (4/20, Kluger) reports that among “all means of ingestion, inhalation of fumes represented the largest increase in exposure routes, jumping 35.3% for all forms of cleaners and a whopping 108.8% for disinfectants specifically.”

The Hill (4/20, Weixel) reports “the sharpest increase in the daily number of calls to poison centers happened at the beginning of March, the agency said.” Although “the CDC said the data does not show a definite link between exposures and coronavirus cleaning efforts, the report said it seems likely the two are linked, given the number of stay-at-home orders, shortages of cleaning products, and guidance to clean hands and dirty surfaces.” In addition, “the agency said its data also likely underestimates the total incidence and severity of poisonings because it is limited to people calling poison centers for assistance.”

The Washington Post (4/21, Sun) reports CDC Director Robert Redfield “warned Tuesday that a second wave of the novel coronavirus will be far more deadly because it is likely to coincide with the start of flu season.” In an interview with The Washington Post, Redfield said, “There’s a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through.”

Newsweek (4/22, Kim) reports the latest data from Johns Hopkins University suggests that only 1% of the U.S. population has been tested for coronavirus. In comments to “Newsweek, Mark Hayward, an expert on mortality statistics who is a member of a CDC advisory council on vital statistics,” explained, “The biggest challenge in obtaining an accurate tally of COVID-19 deaths is to [be able to] implement widespread testing. Locales that lack testing and where populations are rural, reside in nursing homes, or people live alone are likely to be major contributors to the undercount; note that these are not mutually exclusive categories.” He also said, “There are also varying standards [and timing of rollouts] of testing by state. Cause-of death classification schemes have also been evolving and it’s not always straightforward in assigning COVID-19 as a cause of death. I think the biggest barrier, though, is the lack of testing.”

The Washington Post (4/23, Wan) reports the CDC “announced Thursday that it is sending $631 million to state and local health departments to increase their capacity to do contact tracing and testing for the novel coronavirus – a fraction of what many officials say they need to safely restart their economies.” State and local health officials “are also pressing to use this moment to build back up public health capacities that they say have been insufficient for years.”

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