From The Front Lines: A Thank You from Johns Hopkins All Children's Hospital Physician Meghan Martin, M.D.

It seems like there will never be enough “thank-you’s” for the incredible doctors, nurses technicians and support staff who are working around the clock to help patients with this dangerous disease. It is their dedication, determination and spirit that allow Johns Hopkins to deliver the promise of medicine.

Meghan Martin, M.D., is an emergency medicine physician at Johns Hopkins All Children’s Hospital. In her role, she cares for some of Johns Hopkins’ youngest patients. Martin is available to speak with the press about the changes she’s had to make in patient care as the COVID-19 pandemic persists.

The COVID-19 tracker app is part of a research trial

Identifying the next COVID-19 outbreak may seem impossible to predict, but a new app that collects body temperature recordings may give researchers advance warning of an impending hotspot of illness.

The app, available through Google Play and the Apple App Store, asks users to record their body temperature and respond to questions about key COVID-19 symptoms. The anonymized data is linked to a randomly generated ID and stored on a secure server. Temperature and symptom data are mapped geographically to provide a display of anomalies occurring across the country.

“This type of data tracking could be really useful to enable targeted large-scale testing efforts,” says Robert Stevens, M.D., associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. “It could allow us to identify beforehand areas that are at increased or decreased risk and inform decisions regarding mitigation and lifting social distancing restrictions.” 

Stevens worked with epidemiologist Frank Curriero, of Johns Hopkins University’s Bloomberg School of Public Health, and electrical and computer engineer Ralph Etienne-Cummings, of the Whiting School for Engineering, to develop the app, which they dubbed “COVID Control — A Johns Hopkins University Study.”

The team will analyze the data collected to identify unexplained increases in body temperatures and generate real-time risk estimates of potential COVID-19 outbreaks. This predictive tool will allow health care systems and government agencies to better deploy resources to mitigate the effects of the disease.

Stevens is available to discuss this research trial.

Find more information on COVID Control here. And, read a recent article about the app in the HUB.

Obesity Linked to Severity of COVID-19 Infection in Younger Adults

As the COVID-19 pandemic was initially spreading, data from China and Italy suggested that only about 15% of people under the age of 50 were being hospitalized. However, when the disease reached the United States, physicians anecdotally noted what seemed like an uptick in the number of younger patients with disease serious enough to require intensive care.

Although preexisting conditions such as heart disease, diabetes or high blood pressure have been linked to greater susceptibility to the virus, obesity wasn’t on the radar as a risk factor early in the coronavirus outbreak. That’s because only about 6% of Chinese people and 20% of Italians are obese. The United States, on the other hand, has a 40% rate of obesity in adults, making researchers wonder if this might factor into the younger population’s showing up with severe disease.

In a new correspondence published on April 30, 2020, in The Lancet, Johns Hopkins researchers examined the link between age and obesity of American patients with COVID-19 hospitalized in intensive care units (ICUs). Seventy-five percent of the patients had a body mass index (BMI) of 26 or greater, indicating the person as overweight; and 25% had a BMI higher than 35, designating the person as morbidly obese. In general, they found that those patients in the ICU that were younger had higher BMIs, suggesting that younger Americans with obesity are likely at greater risk from COVID-19. The researchers say that young people should pay attention to social distancing and stay vigilant about when to seek medical treatment in the early stages of their disease to help reduce the risks.

The first author, David Kass, M.D., the Abraham and Virginia Weiss Professor of Cardiology at the Johns Hopkins University School of Medicine, is available to discuss the implications of his findings.

Be Aware of Lyme Disease Risks in The Midst of the COVID-19 Pandemic

Spring and summer are the highest risk seasons for contracting Lyme disease from the bite of an infected deer tick. With most of the country staying at home and social distancing, due to the COVID-19 pandemic, people are spending more time in their gardens and on walks in their neighborhoods and nearby woods — potentially putting them at higher risk for Lyme disease. There are over 300,000 new cases of Lyme disease reported each year in the United States. Daily practices are important in disease prevention.

Hand-washing is recognized as being helpful in preventing COVID-19. Likewise, daily tick checks are helpful in avoiding Lyme disease. Another effective Lyme disease tip is to treat clothing with tick pesticides, such as permethrin. It is important to take preventative measures as well as to recognize how early presentations of Lyme disease compare and contrast with those of COVID-19.

Flu-like symptoms of fever, severe fatigue, malaise, chills, sweats, body/muscle aches and headaches, are present in early Lyme disease, as well as in early COVID-19. Lyme disease can also present with a distinct large, expanding, bull’s eye-looking rash called erythema migrans, whereas COVID-19 rash presentations may include patchy red lesions that more resemble measles, chicken pox or frostbite. John Aucott, M.D., director of the Johns Hopkins Lyme Disease Research Center and associate professor of medicine at the Johns Hopkins University School of Medicine, is available to discuss prevention tips, as well as the clinical impact of Lyme disease and how to distinguish early Lyme disease signs and symptoms from COVID-19. Mark Soloski Ph.D., co-director for Basic Research for the Johns Hopkins Lyme Disease Research Center and professor of medicine at the Johns Hopkins University School of Medicine, is available to highlight details surrounding the immune response in Lyme disease and how it may be different from the response to COVID-19.

Don’t Skip Needed Care in Fear of COVID-19

With the stay-at-home measures and fear of catching the new coronavirus, people may be thinking twice before deciding what merits a visit to the doctor’s office, an urgent care clinic or the emergency room. There are ways to stay safe and protected when seeking needed care during the pandemic. It’s important for people to continue to obtain care in-person or remotely when medical attention is needed, especially for those with preexisting or chronic conditions who require follow-up with a health care provider. Not getting care, particularly for chronic illnesses and urgent or emergency conditions, puts people at high risk for complications later. These complications could end up being worse than the COVID-19 disease.

The following Johns Hopkins Medicine experts can address ways to stay safe during the pandemic, what to seek care for and why it’s important to follow up with a health care provider for certain conditions.

Heart Attack and Cardiovascular Issues

Erin Michos, M.D., M.H.S., Director of Women’s Cardiovascular Health

Stroke and Neurological Issues

Victor Urrutia, M.D., Director of the Johns Hopkins Hospital Comprehensive Stroke Center

Sickle Cell Anemia

Sophie Lanzkron, M.D., M.H.S., Director of the Sickle Cell Center for Adults at The Johns Hopkins Hospital

Older Adult Care

Asthma and COPD

William Checkley, M.D., Ph.D., Associate Professor of Medicine

HIV/AIDS

Kathleen Page, M.D., Associate Professor of Medicine

Emergency Medicine

Barbara Maliszewski, R.N., M.S., Assistant Director of Nursing, Department of Emergency Medicine

Tracking the Mental Health of Frontline Workers — and How Their Loved Ones Can Help

While the symptoms and effects of COVID-19 continue to develop in unexpected ways, the psychological patterns of frontline workers will follow a predictable pattern, according to Albert W. Wu, M.D., M.P.H., an internist at Johns Hopkins Medicine and director of the Center for Health Services and Outcomes Research. And, for many doctors and nurses treating coronavirus patients, “we’re at a dangerous point,” he says. “We’ve gone past the honeymoon phase.”

The adrenalin surge and group cohesion that marked the initial response to the pandemic is giving way to discouragement, exhaustion and burnout among health care workers, explains Wu, a professor of health policy and management, who conducts research on staff support.

Wu is available to trace the emotional highs and lows of frontline workers in a crisis, as well as offer advice as to what their loved ones can do to help — from organizing family conference calls to acknowledging they can unknowingly add stress. “By supporting them, you are supporting the fight against COVID-19,” he says.

Making Sure Vulnerable Communities Have Access to Reliable Information and COVID-19 Care

For many in the Latino community “there’s absolutely no safety net,” says Kathleen Page, M.D., who serves a large population of immigrant patients. “We’re seeing a rise in COVID-19 cases among Latino immigrants, particularly those with limited English proficiency (LEP), who most likely are undocumented.”

To bridge the gap, Page was instrumental in setting up — with the Esperanza Center in Baltimore—a hotline for Spanish speakers. She is also providing information to the Latino community through Facebook Live chats, with support from Johns Hopkins Centro Sol and other community partners. In addition, with collaboration from the Johns Hopkins Office of Diversity, Inclusion and Health Equity and the Office of Language Access Services, Page is establishing a bilingual provider consultation service to support the care of Spanish-speaking patients with LEP admitted to the Johns Hopkins Hospital and the Johns Hopkins Bayview Medical Center. Her team is also assisting the Baltimore City Health Department with contact investigations in this community.

“We’re in the midst of setting up a Spanish provider care team that will be embedded within other care teams in the hospital, to help improve communication with Spanish speaking patients and their families.”

Page is available for interview on this topic.

Mitigating Issues in Senior Care Facilities

Infectious disease specialist Morgan J. Katz, M.D., M.H.S., says 60 to 70 percent of long-term care facility (assisted living and skilled nursing) residents are testing positive for COVID-19 but are asymptomatic when they are tested. Katz is part of the Maryland Strike Team, a collaboration between the National Guard, Hospital Systems and the State that focuses efforts on stabilizing nursing homes struggling with COVID outbreaks by providing widespread testing, infection prevention recommendations and care delivery. Maryland’s strike teams were formed after the confirmation that hundreds of elderly care facilities in Maryland have confirmed cases of COVID-19.

Katz is available to discuss what the team is doing; the next steps; and needs for widespread regular testing of long-term care facilities to reduce mortality and a large influx of nursing home residents into acute health care systems.

For information about the coronavirus pandemic from Johns Hopkins Medicine, visit the coronavirus information page. 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 the Coronavirus Resource Center.