News Release 

COVID-19 tip sheet: Story ideas from Johns Hopkins

Johns Hopkins Medicine

Effectively Communicating with Older Adults Who Have Hearing Loss During COVID-19

Media Contact: Waun'Shae Blount, wblount1@jhmi.edu

The COVID-19 pandemic has caused a variety of challenges for older adults with hearing trouble across different health care settings, including the inpatient hospital setting and nursing homes, assisted living facilities and home environments. Research from Johns Hopkins suggests that nearly half of adults over age 60 have hearing loss, which indicates a significant portion of the population may be experiencing these challenges as a result of COVID-19.

During the COVID-19 pandemic, those with hearing difficulties who are accustomed to reading lips may face challenges because they cannot read the lips of people wearing a face mask. Additionally, following the 6 foot physical distancing recommendation can make communicating by sign language more difficult. To address these communication barriers, Johns Hopkins researchers have developed a checklist for clinicians to use while treating patients with hearing loss. Published online in the June 17, 2020, issue of the Journal of the American Geriatrics Society, the checklist provides recommendations for both inpatient and telehealth visits, such as using hand-held devices and telephones that enable the older adult to see and hear the provider clearly. The checklist also includes tips for the patient's environment, including decreasing background noise, improving lighting, and ensuring providers effectively communicate via verbal and nonverbal ways such as speaking slowly or wearing a clear mask when permissible.

Nicholas Reed, Au.D., assistant professor of audiology in the Department of Otolaryngology-Head and Neck Surgery at the Johns Hopkins University School of Medicine, and of epidemiology at the Johns Hopkins Bloomberg School of Public Health, is available for comment.

Universal Testing May Help Reduce COVID-19 Infections, Deaths in Long-Term Care Facilities

Media Contact: Michael E. Newman, mnewma25@jhmi.edu

Throughout the COVID-19 pandemic, residents in long-term care facilities -- including nursing homes and assisted living centers -- have been at particularly high risk of infection by and spread of SARS-CoV-2 (the virus that causes COVID-19), and with a disproportionally tragic outcome. According to estimates in an article in The New York Times, although only 10% of COVID-19 cases in the United States have occurred in long-term care facilities, they are responsible for 42% of deaths from the disease.

However, a team of infectious disease experts at Johns Hopkins Medicine believes the actual number of COVID-19 infections nationally in long-term care facilities may be much higher because health care providers are missing asymptomatic cases. This discrepancy, they warn in a new study published July 14 in JAMA Internal Medicine, may make it more difficult to reduce or prevent the spread of COVID-19 in the very susceptible population living in these centers.

In their study, the researchers performed "universal testing" for SARS-CoV-2 among all 893 men and women living at 11 long-term care facilities in Maryland. Previously, only residents who showed symptoms of COVID-19 had been "target tested" by local health departments.

Among the 893 universally tested, 354 people -- nearly 40% --were found to be positive for SARS-CoV-2 RNA, compared with 153 (17%) identified in earlier target testing based on symptoms. The universal screening, therefore, raised the number of COVID-19 cases among the residents in the state's long-term care facilities from 153 to 507 (57%), a 231% increase. Of those who tested positive, the researchers report that 281 (55%) were asymptomatic.

"These results underscore the importance of universal testing, as symptom-based approaches may miss a substantial number of cases in long-term care facilities," says Benjamin Bigelow, a fourth-year medical student at the Johns Hopkins University School of Medicine and the study's lead author. "Unrecognized asymptomatic cases among residents can severely hinder preventive strategies and increase the risk of the virus dangerously spreading."

"More testing resources are urgently needed to identify the true burden of COVID-19 in long-term care facilities, so that we can be more successful in curbing infection and mortality in one of the disease's major hot spots," adds Morgan Katz, M.D., M.H.S., assistant professor of medicine at the Johns Hopkins University School of Medicine and senior author of the study.

Study Says Twitter Effectively Communicates Pediatric Critical Care Info during a Pandemic

Media Contact: Michael E. Newman, mnewma25@jhmi.edu

Ever since the microblogging and social networking platform Twitter emerged in 2006, it has consistently ranked among the top ways that people around the world communicate with one another, with some 500 million tweets sent per day. According to the Twitter monitoring company, Tweet Binder, the COVID-19 pandemic has dominated the Twitterverse with about 600 million tweets alone using the hashtag #COVID19, #coronavirus or something similar between February and May of this year.

Among the massive volume of COVID-19 tweets posted during that time were ones teamed with a second hashtag, #PedsICU -- a social media designation created long before the pandemic to foster international collaboration, rapidly disseminate information and keep the lines of professional communication flowing among members of the pediatric critical care community. How effectively this hashtag twinning actually "spreads the word" about COVID-19 to those serving in pediatric intensive care units (PICUs) worldwide is the subject of a recent study posted online May 27 in the journal Pediatric Critical Care Medicine.

"We wanted to determine if leveraging social media, specifically Twitter, was a solid strategy for keeping PICUs across the globe connected and informed on the most current information during a pandemic," says Sapna Kudchadkar, M.D., Ph.D., associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine and co-investigator for the study.

To conduct their study, Kudchadkar and co-investigator Christopher Carroll, M.D., M.S., research director of pediatric critical care at the Connecticut Children's Medical Center, collected data on all tweets posted worldwide from Feb. 1 to May 2 that contained the hashtag #PedsICU, along with those containing both #PedsICU and a recognizable COVID-19 hashtag.

During that span, there were 49,865 #PedsICU tweets, with 21,538 (43%) of them also including a COVID-19 hashtag. Of the latter, #COVID19 was the most commonly used pandemic-related tag (69%). Geographic distribution for tweeters using the tandem hashtags spanned six continents, with the majority of tweets coming from North America and Australia.

There was a sharp rise in tweets with both hashtags around mid-March, which coincided with the World Health Organization raising COVID-19 to pandemic status. Since then, more than two-thirds of #PedsICU tweets were about the disease. About a third of the tweeters were physicians, but the researchers note there also was "robust engagement" from other PICU team members, including nurses, nurse practitioners, respiratory therapists and pharmacists.

One example of social media quickly disseminating COVID-19 news globally occurred April 26, when clinicians in the United Kingdom first recognized multisystem inflammatory syndrome in children (MIS-C) was potentially related to COVID-19. Tweets on this announcement with the hashtags #PedsICU and #COVID19 received some 3,500 shares within a few hours of the initial post.

The most popular tweets during the study period, the researchers say, were links to medical literature, reviews, educational videos and other open-access resources.

"Our study demonstrates that during a pandemic such as COVID-19, targeted use of #PedsICU combined with a specific disease-related hashtag significantly helps combat misinformation, quickly spreads useful data and news, and optimizes the reach of pediatric critical care stakeholders to others around the world," says Kudchadkar, who is available for interviews.

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