COVID-19 Alaska Daily Clinical Update, May 24

Alaska Department of Health sent this bulletin at 05/24/2020 01:00 PM AKDT

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Sunday, May 24, 2020
Liz Conway Ohlsen, MD
With information from Anne Zink, MD, FACEP, Alaska Chief Medical Officer

May 23 case count

Alaska public health news: Fewer than 1.2% of all AK tests have been positive, decreased from around 3.4% in late March, likely because we are increasing testing faster than cases are increasing. Over the last 3 days, 0.25% of tests performed have been positive, and the percent of tests positive has been below 1% since late April. Continuing to increase testing will be critical as Alaska reopens, and nearly 40,000 tests have been performed in AK already. More than 85% of the Alaskans known to have had COVID-19 have now recovered, and only 44 have required hospitalization, around 11%. DHSS also tracks cases discovered in Alaska in residents of other states. 12 nonresident cases are known. 


National public health news: Total known US cases: 1.6 million; 95 thousandUS deaths. There are now 5.2 million COVID-19 cases diagnosed worldwide and over 330,000 confirmed deaths- around 7% of the total confirmed cases.

 

IBD, immunosuppression and the impact of COVID-19
A small survey of 18 children from 16 European pediatric nephrology centers who had COVID-19 while on immunosuppressive treatments for kidney disease reported that all 18 had mild clinical courses. While 11 (61%) were admitted to the hospital, none required intensive care. Three required oxygen. This was similar to a previous survey of 8 children on immunosuppressive therapy for inflammatory bowel disease who acquired COVID-19, all of whom also had mild clinical courses. Adults with inflammatory bowel disease do not seem to have significantly more severe courses of COVID-19 than the general population (indeed, COVID-19 outcomes in IBD surveillance conducted through the University of Calgary currently shows a mortality rate with COVID-19 of close to half the worldwide known rate, although that number should be interpreted with caution since there are many confounding factors). However, as with many chronic illnesses requiring medications and regular follow-up, patients face challenges related to the pandemic ranging from increased logistic challenges of accessing medication and medical care to new or worse mental health problems. One recent survey of patients with IBD in China found that more than 50% of respondents had mood changes, while 40% of respondents had reduced income due to the pandemic. Authors noted that the financial impacts of COVID-19 will likely affect the affordability of and adherence to medical care.

AK Clinical Reminders:

COVID-19 testing guidelines and  testing site locator

Report any positive test to the state Section of Epidemiology using the COVID Reporting Hotline at 1-877-469-8067 or by faxing in the Infectious Disease report form. If you suspect COVID-19 in an outpatient who cannot isolate in their own home (for example they are unsheltered or from out of town) or for another urgent situation call SOE at 907-269-8000 or 800-478-0084 (after-hours).

DHSS hosts an AK COVID-19 Update on Zoom Tuesdays at 7PM. Register here for the link to join.

AK COVID-19 clinical information hotline for physicians: 883-751-4212. Staffed 24/7. 8PM-8AM is for urgent/emergent questions only.