Front-line Worker Story: Ebony Hunter — Teamwork Will Get Us Through
VIDEO: COVID-19 Frontline Healthcare Story — Ebony Hunter – Teamwork Will Get Us Through
It seems there will never be enough “thank-you’s” for the incredible doctors, nurses, technicians and support staff members who are working around the clock to help patients who have COVID-19, the dangerous coronavirus disease. Their dedication, determination and spirit enable Johns Hopkins to deliver the promise of medicine.
Ebony Hunter, M.D., is a pediatric emergency medicine physician at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida. Hunter’s experience with the coronavirus has been both personal and professional. While caring for children and families fighting COVID-19 in Florida, her family in Louisiana was one of the first to lose a loved one to the disease. “My family’s introduction to COVID-19 was a death. There are still moments where it feels surreal,” says Hunter. Despite this, she maintains a positive outlook for her co-workers, patients, family and friends. “I’m going to keep doing what I was made to do, which is help take care of people in my community and make sure others are safe.”
Ebony Hunter is available for interviews about her work.
Researchers Expect Viral Transmission of COVID-19 May Increase as Temperatures Drop
Last winter, infectious disease specialists hoped the transmission rates of SARS-CoV-2 — the virus behind COVID-19 — would rapidly decline like the seasonal flu with the coming of warmer months. Unfortunately, this big drop didn’t materialize, or so we thought.
Preliminary results from research at Johns Hopkins Medicine suggest that a large component of the pandemic’s initial spread was indeed dependent on temperature. In unpublished findings, the researchers found that warmer temperatures were linked to reduced viral spread in regions that had yet to enact social policies, such as physical distancing or mask requirements.
The researchers say if the virus follows a pattern similar to other respiratory infections, the rate of viral spread could increase as the season changes and temperatures drop.
“Based on our early findings, we believe we’re going to be fighting an even greater uphill battle this fall, because the same level of social interventions used to prevent the spread of the virus this summer isn’t going to contain it come autumn or winter due to lower temperatures,” says Adam Kaplin, M.D., Ph.D., assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “We have to consider whether or not opening things up for short-term financial gains now is worth the significant loss of lives and dollars that could occur if we don’t act to contain the viral spread before temperatures begin to drop.”
Kaplin isn’t typically a researcher of infectious diseases or their spread. But, during a trip to Brazil this past February for his wedding, he noticed a seemingly lower rate of viral transmission in that summer environment than during the winter season back home in the United States. Based on those observations, Kaplin enlisted statistician colleagues to take data from the Johns Hopkins COVID-19 dashboard and compare the transmission rates in each country to the local temperature.
After controlling for population and land area, they found a pattern. From January to April, places such as Singapore with average temperatures in the 80s had much lower rates of viral spread than locales such as Turkey with average temperatures in the 20s.
In New York City, daily temperatures hovered around 40 and fell well into the 20s at night. Due to a large number of visitors and a lack of testing, the virus spread unchecked and quickly overwhelmed the city, says Kaplin.
He is available to discuss with reporters his early findings and what they may mean for the upcoming change in season.
International Team Creates Guidelines on How to Best Virtually Assess Dizziness During Pandemic
Symptoms like vertigo, motion sickness, nausea and vomiting result in about 2.6 million visits to United States emergency rooms each year, according to previous Johns Hopkins studies. During the pandemic, patients are avoiding doctors’ offices and hospitals, and Amir Kheradmand, M.D., an assistant professor of neurology and otolaryngology at the Johns Hopkins University School of Medicine, wanted to help providers decide if a dizzy patient needs to go in-person to an emergency room.
Kheradmand and Aasef Shaikh, M.D., Ph.D., of the Cleveland VA Medical Center, and their team found that it is critical to define guidelines for remote methods to determine if dizziness is urgent or less serious. Some causes of dizziness, like a stroke, require urgent care, and other less critical causes of dizziness come from issues in the inner ear. A stroke must be identified as soon as possible, because the earlier the treatment, the more effectively physicians can prevent damage to the brain.
“When the pandemic hit, we were forced to change how we do exams, so we had to rapidly triage patients,” Kheradmand says. “As this wasn’t how we typically practiced medicine, we each had to determine how to move our practices to virtual consultations. The idea here was to compile worldwide experts’ experiences of what worked and what didn’t into this new set of guidelines for virtual consultations that we could share to standardize the practice, as it seems virtual medicine is here to stay.”
A variety of expert clinicians from throughout the United States and from other countries shared the ways they adapted to virtual care to assess these medical issues. To standardize an effective approach across countries, Kheradmand’s team consolidated the information and created guidelines for how to evaluate patients with dizziness remotely.
Kheradmand’s team hopes to standardize the basic elements of the exam for evaluating dizziness to include not only taking the patient’s history but also examination of eye movements, hearing, coordination, balance and walking.
For example, during a virtual exam, a physician might ask the patient to walk across the room toward the camera to assess balance, and then ask the patient to get close to the webcam so the provider can watch the person’s eye movements. If, for example, the doctor notices shaking of the eye, the pattern of this abnormal eye movement could help distinguish less serious dizziness due to impaired ear function from a more serious condition such as stroke, which requires immediate medical attention. A full virtual exam will help triage patients more effectively and get them the care they need as soon as possible.
“This is just the beginning of laying the groundwork and considering the challenges related to virtual assessments so we can continually improve telemedicine capabilities to better help our patients,” Kheradmand says.
Kheradmand is available for interviews with the media to discuss these guidelines for virtual dizziness exams.
Racism Amid the COVID-19 Pandemic — a Path Forward
Because SARS-CoV-2, the virus that causes COVID-19, was first discovered in China, Chinese American families in the United States have reported an increase in racist experiences during the ongoing pandemic. Tina Cheng, M.D., M.P.H., director of the Department of Pediatrics at Johns Hopkins Children’s Center and a Chinese academic pediatrician, and her daughter, Alison Conca-Cheng, a third-year medical student, wrote a commentary published in Pediatrics on Sept. 1 in response to a study on racism affecting Chinese American parents and children. Both Cheng and Conca-Cheng report that they have experienced — both inside and outside the health care setting — implicit and explicit bias.
In their commentary, Cheng and Conca-Cheng say racism against any group is an “enduring crisis which is inflamed in the presence of other crises,” adding that addressing such racism is necessary to achieve health equity. They offer critical steps to combat the problem, including calling on people to learn about the history of racial bias and how it affects families, as well as urging parents and schools to teach children about it. They also urge clinicians to understand how race is a social determinant of health and how racial biases continue to be correlated with poorer health outcomes. They ask clinicians to learn about and address their own biases, which they say can affect patient interactions, medical training and workplace conditions.
Cheng has limited availability for media interviews about racism and COVID-19.
For information from Johns Hopkins Medicine about the coronavirus pandemic, visit hopkinsmedicine.org/coronavirus. 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 coronavirus.jhu.edu.
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