Tag: Research

BMJ | Pfizer Second Dose Efficacy 95%

Covid-19: Pfizer vaccine efficacy was 52% after first dose and 95% after second dose, paper shows
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4826 (Published 11 December 2020)
Cite this as: BMJ 2020;371:m4826

The Pfizer and BioNTech covid-19 vaccine may provide some early protection, starting 12 days after the first dose, the peer reviewed results of a phase III trial have found.

The study, published in the New England Journal of Medicine,1 found that vaccine efficacy between the first and second doses was 52% (95% credible interval 29.5% to 68.4%), with 39 cases of covid-19 in the vaccine group and 82 cases in the placebo group.

Seven or more days after the second dose, vaccine efficacy then rose to 95% (90.3% to 97.6%), with eight covid-19 cases reported in the vaccine group and 162 cases in the placebo group.

The vaccine has so far been approved in Canada and in the UK, where it is already being rolled out to people over 80 and healthcare workers. In the US the Food and Drug Administration’s independent panel has voted in favour of emergency use authorisation for the vaccine, and the agency is expected to approve it within days.2

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NPR | COVID-19 In U.S. Weeks Earlier Than Previously Known

From NPR

Coronavirus Was In U.S. Weeks Earlier Than Previously Known, Study Says

The coronavirus was present in the U.S. weeks earlier than scientists and public health officials previously thought, and before cases in China were publicly identified, according to a new government study published Monday.

The virus and the illness that it causes, COVID-19, was first identified in Wuhan, China, in December 2019, but it wasn’t until Jan. 19 that the first confirmed COVID-19 case, from a traveler returning from China, was found in the U.S.

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EMS Sleep Health Study—Agencies Wanted

From the National Association of State EMS Officials

OMB Control Number: 2127-0742
ICR Reference Number: 201811-2127-003
Expiration Date: 08/31/2022

Who?

Daniel Patterson, PhD, NRP from the University of Pittsburgh Department of Emergency Medicine is leading a research study that seeks to examine the impact of a sleep health and fatigue education and training program tailored to Emergency Medical Services (EMS) clinicians. This research study has financial support from the National Highway Traffic Safety Administration to the National Association of State EMS Officials (NASEMSO). The University of Pittsburgh has partnered with the NASEMSO as a sub-contractor for purposes of conducting this research study.

What?

This research study is an experiment that will test the impact of a new sleep health and fatigue training education program. The program is designed to improve the individual EMS clinician’s sleep health and reduce work-related fatigue through education and training. The program will be administered entirely online (via the internet) and will be accessible to EMS clinicians located at the EMS agencies that agree to participate in this research study.

When?

The study team will begin recruiting EMS agencies to participate in this study in late January 2020. Each agency will be asked to participate for a total of 24 weeks. Participation is voluntary.

How?

Researchers will ask EMS agency administrators to help recruit individual EMS clinicians at their agency to participate in this research study. Participation will be completely voluntary and confidential. The study team will mostly use data collection tools available via the Internet. Some data collection will involve mobile phone text messages. The research study’s website will be secure and require a unique login (username and password) from each individual EMS clinician. Some EMS clinicians may be asked to wear a wrist actigraph to measure sleep and complete a reaction time test at the start and end of a few scheduled work shifts during the study period.

Who is Eligible?

The study team is seeking participation from EMS agencies located in the United States (including Alaska and Hawaii). Criteria for eligibility include: [1] The EMS agency provides EMS services (including 911 response and transport). [2] The EMS agency provides ground-based EMS services 24-hours a day. Agencies limited to air-medical services only are not eligible. [3] The EMS agency employs between 50 and 300 EMS paid full-time and part-time clinicians/personnel. Agencies that use an all-volunteer staffing model are not eligible. [4] Agencies restrict their EMS clinicians to use their personal mobile phones/smartphones during shifts are not eligible. [5] Operations that provide both fire suppression and EMS 911 response and transport are eligible and encouraged to participate.

Remuneration

Those who qualify for the study and choose to participate will receive remuneration worth approximately $35 U.S. dollars. All individual participants will receive remuneration in the form of a gift card totaling approximately $35 in value. A $5 gift card will be distributed at the beginning, when the individual enrolls, every month the individual is involved in the study, and at the end of the study (month 6). All gift cards will be distributed via U.S. Mail directly to individual participants.

Interested?

If you are the administrator/manager of an EMS agency that is eligible to participate, and wish to participate or wish to know more about this study, please contact the study principal investigator (Daniel Patterson, PhD, NRP) at: pdp3@pitt.edu or 412-864-3830.

Tracking the reach of COVID-19 kin loss

From the Proceedings of the National Academy of Sciences

“Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States”

Ashton M. Verdery, Emily Smith-Greenaway, Rachel Margolis, and Jonathan Daw
PNAS July 28, 2020 117 (30) 17695-17701; first published July 10, 2020 https://doi.org/10.1073/pnas.2007476117
Edited by Douglas S. Massey, Princeton University, Princeton, NJ, and approved June 19, 2020 (received for review April 18, 2020)

COVID-19 has created a mortality shock throughout the world, and it may yield a second wave of population health concerns tied to bereavement and social support reductions. We created the COVID-19 bereavement multiplier, an indicator that clarifies one downstream impact of COVID-19 mortality and can be applied to different epidemiological projections of death counts: How many people are at risk for losing a grandparent, parent, sibling, spouse, or child for each COVID-19 death. In the United States, we estimate that on average, under diverse epidemiological circumstances, every death from COVID-19 will leave approximately nine bereaved. Studying how acute mortality crises reverberate through a population in the form of bereavement multipliers expands understandings of the social impacts of health crises.

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Income Disparities In Access To Critical Care Services

From Health Affairs

Income Disparities In Access To Critical Care Services

Genevieve P. Kanter, Andrea G. Segal, and Peter W. Groeneveld

ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has highlighted the importance of intensive care unit (ICU) beds in preventing death from the severe respiratory illness associated with COVID-19. However, the availability of ICU beds is highly variable across the US, and health care resources are generally more plentiful in wealthier communities. We examined disparities in community ICU beds by US communities’ median household income. We found a large gap in access by income: 49 percent of the lowest-income communities had no ICU beds in their communities, whereas only 3 percent of the highest-income communities had no ICU beds. Income disparities in the availability of community ICU beds were more acute in rural areas than in urban areas. Policies that facilitate hospital coordination are urgently needed to address shortages in ICU hospital bed supply to mitigate the effects of the COVID-19 pandemic on mortality rates in low-income communities.

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JAMA | COVID-19 Medical Leave for EMS in NYC

From JAMA Network Open

Medical Leave Associated With COVID-19 Among Emergency Medical System Responders and Firefighters in New York City

In New York, New York, from March 1 to May 31, 2020, 201 102 individuals were diagnosed with coronavirus disease 2019 (COVID-19), resulting in 51 085 hospitalizations and 16 834 deaths.1 The Fire Department of the City of New York (FDNY), the largest in the US, responds to nearly 1.5 million emergency medical calls per year in a city of more than 8.4 million people. Active paid FDNY responders include 4408 emergency medical service (EMS) responders and 11 230 firefighters. These FDNY responders are required to don personal protective equipment before patient contact per US Centers for Disease Control and Prevention guidelines.2 In this cohort study, we compared medical leave of FDNY responders during the pandemic with prior years.

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Citation

Prezant DJ, Zeig-Owens R, Schwartz T, et al. Medical Leave Associated With COVID-19 Among Emergency Medical System Responders and Firefighters in New York City. JAMA Netw Open. 2020;3(7):e2016094. doi:10.1001/jamanetworkopen.2020.16094

ESO Announces Peer-Reviewed COVID-19 EMS Research

From Yahoo Finance via Cision

ESO Announces Peer-Reviewed Research Describing Characteristics of COVID-19 EMS Encounters with Linked Hospital Diagnoses

Key Findings from the Report Include:

  • COVID-19 Diagnoses and Ailments: Those with COVID-19 hospital diagnoses were more likely to present with elevated heart and respiratory rate, hypoxia and fever during the EMS encounter.
  • COVID-19 Suspicion: A COVID-19 EMS suspicion was documented for 78 percent of hospital-diagnosed COVID-19 patients.
  • Patient Origin: EMS responses for patients with COVID-19 were more likely to originate from a skilled nursing or assisted living facility.
  • PPE Usage: PPE usage by EMS was more frequently documented on records of patients who had hospital diagnosed COVID-19.
  • Dispatch Complaints: While dispatch complaints for hospital-confirmed COVID-19 patients most commonly included general illness and breathing difficulties, there were also cases dispatched as falls, chest pain, and strokes.
  • Demographic Insights: Consistent with reported in-hospital findings, African American and Hispanic patients made up a disproportionately larger number of COVID-19 diagnoses.

Colorado Natural Hazards Center Grants

The Colorado Natural Hazards Center is offering three grants of $4000 for original research.

  • 1) Communications, the Pandemic, and Local Transportation Resources: What strategies are being implemented, and how effective are they? What are best practices in communicating and messaging by transportation organizations?
  • 2) Transportation, Vulnerable Populations, and COVID-19: What are best practices in providing useful and safe transportation for various socially and economically vulnerable population groups that are traditionally heavily reliant on public transit such as low-income people and racial and ethnic minorities? What about newly vulnerable populations, such as seniors, transportation workers, bus drivers, and so forth? How can the needs of all be met while assuring health and safety among particularly medically fragile or economically marginalized people?
  • 3) Transportation and Emergency Management Policy: How should transportation leaders and emergency managers work together to deliver community services? Including but also beyond ESF-1, what are innovative ways and best practices within and among communities and transportation services to accomplish community objectives during the pandemic? For example: transit agencies have launched food delivery services for vulnerable populations using their idled vehicles and drivers; state DOT facilities have been used a COVID-19 testing sites; Wi-Fi equipped vehicles have been used as local community hot spots.

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Study | Nationwide EMS Calls Have Dropped 26%, Attended Deaths Doubled

From the University at Buffalo News Center

Since early March and the start of the COVID-19 pandemic in the U.S., 911 calls for emergency medical services have dropped by 26.1 % compared to the past two years, a new study led by a University at Buffalo researcher has found.

But the study also found that EMS-attended deaths have doubled, indicating that when EMS calls were made, they often involved a far more serious emergency.

Study Details

Effect of the Coronavirus Disease 2019 (COVID‐19) Pandemic on the United States Emergency Medical Services System: A Preliminary Report
E. Brooke Lerner PhD
Craig D. Newgard MD, MPH
N. Clay Mann PhD, MS, MBA

EMS Workforce and Job Experience Survey for Doctoral Candidate

The role of the affective domain is well studied among other medical and public safety professions, including its impact on provider physical and mental health,
quality and patient perception of care, occupational burnout, empathy fatigue, and organizational commitment. As part of a doctoral research study, a survey has been developed and approved through an Institutional Review Board (IRB). It is hoped the information gathered in this survey will help to develop a clearer understanding of the specific difficulties and needs of EMTs and paramedics.

Participants will be entered to win one of twenty (20) $20 gift cards raffled off at the end of the study (summer of 2020). In addition, the survey results will be shared with participating EMTs and paramedics so that they can learn about our findings and better understand how their work experiences compare to those of others. The survey should take approximately 25 minutes to finish.

Administrators interested in facilitating distribution of the survey may contact researcher Emily Kaplan at Emily_Kaplan@nymc.edu

Access the Survey

About the Researcher

Emily Kaplan, MPH, EMT-P is working to complete her Doctorate in Public Health at New York Medical College.  Her work seeks to understand the role of the affective domain in the out-of-hospital emergency services.

 

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NASEMSO 2020 National EMS Assessment Released!

The National Association of State EMS Officials (NASEMSO) has released its 2020 EMS Assessment, updating the 2011 report. This report  provides unparalleled insights into the EMS systems that  provide mobile healthcare across our nation. We highly recommend that you download the full report at  www.nasemso.org/2020-assessment.

(Falls Church, Va.) In the midst of the COVID-19 pandemic and applause for first responders in the United States, the National Association of State Emergency Medical Services Officials (NASEMSO) has released the 2020 National EMS Assessment updating the 2011 assessment. The 2020 assessment provides a comprehensive accounting by state/territory of the numbers and types of all 911 ambulance services and emergency medical services (EMS) professionals.

The 2020 National EMS Assessment is the first set of documentation about these critical emergency medical response personnel and agencies to be published in nearly 20 years. Every year in times of disasters, disease outbreaks and daily medical emergencies, such as heart attacks and car crashes, out-of-hospital emergency medical care systems make life-and-death differences in the lives of millions of Americans. EMS systems are the safety net for hospital emergency departments and public health as the front lines of response to 911 calls. Additionally, responders place themselves in high risk situations on a daily basis, as well as during communicable disease outbreaks and pandemics.

Data collection for this assessment was completed in 2019 by NASEMSO members, who are the staff of the state agencies that license America’s critical EMS personnel and agencies. State EMS offices protect the public by regulating the human and organizational components of EMS systems across the United States, as well as executing their legislative mandates to implement and improve systems of care for time-sensitive emergencies in order to offer every patient an opportunity for survival and optimal outcomes. The assessment provides the following key findings:

  • More than 18,200 local EMS agencies respond to 911 calls for medical emergencies and injuries, utilizing nearly 73,500 ground vehicles such as ambulances and fire engines.

  • Local EMS agencies respond to nearly 28.5 million 911 dispatches every year in 41 states.

  • More than 750 services are licensed by state EMS offices to fly patients, using helicopters and fixed-wing aircraft to provide rapid transportation to critical care.

  • More than 1.03 million personnel are licensed as emergency medical technicians, paramedics, and other levels of EMS patient care capability within all 50 states, the District of Columbia, Puerto Rico and American Samoa.

  • More than 9,300 physicians serve as local EMS Medical Directors, assuring that contemporary and quality care is provided to patients.

  • Sixty percent of 53 state EMS offices participated or expect to participate in mass casualty exercises involving a biological threat during the 18-month evaluation period.

  • The report is available from NASEMSO at www.nasemso.org/2020-assessment.