Do people lose their sense of smell or taste when they have SARS-CoV-2?
A research letter published in JAMA analyzed data from 202 patients with laboratory-confirmed SARS-CoV-2 infection in Italy to measure how common loss of smell ("anosmia") and loss of taste (dysgeusia) were. Anosmia and dysgeusia were assessed with a survey tool somewhat humorously called the SNOT-22 score. "The SNOT-22 grades symptom severity as none (0), very mild (1), mild or slight (2), moderate (3), severe (4), or as bad as it can be (5)." A total of 130 patients, or 64.4 percent, reported some change in their sense of smell or taste. The average SNOT-22 score was four. Many patients began to experience these symptoms either simultaneously with other covid-19 symptoms or after other covid-19 symptoms had already emerged (almost 50 percent). Only 11.9 percent experienced anosmia or dysgeusia prior to the start of other covid-19 symptoms. Importantly, only 3 percent of patients reported anosmia or dysgeusia as their only symptoms. Although this was a retrospective study that is biased by self-reported symptoms and whether a patient completed the survey, it provides the most compelling evidence to date that patients who develop anosmia or dysgeusia for the first time should potentially be considered as higher risk for covid-19 and tested accordingly.
Does confinement or shelter-in-place affect the mental health of children?
In a study from the epicenter of the covid-19 pandemic, researchers in Hubei in China assessed the prevalence of symptoms associated with depression and anxiety among students in the province. Published in JAMA Pediatrics, students grades 2 through 6 were invited to complete a survey. The survey asked questions to assess for depression and anxiety using the Children's Depression Inventory—Short Form (CDI-S) and the Screen for Child Anxiety Related Emotional Disorder, respectively. The survey was completed by 1,784 students who, at the time of the survey, had been at home for an average of 33.7 days. The prevalence of symptoms related to anxiety and depression were 18.9 percent and 22.6 percent, respectively. Children in the city of Wuhan were much more likely to have depressive symptoms than those outside of Wuhan. Students who were less worried about being affected by covid-19 and more optimistic about the epidemic had less severe depressive symptoms. Previous estimates of depressive symptoms among students in primary schools of China reported figures around 17 percent. The precision of these new higher numbers is difficult to evaluate. However, from a humanistic perspective, these trends provide important insight relevant to children and parents facing this pandemic now.
Navajo Nation continues to disproportionately suffer from covid-19
New Mexico's social distancing and comprehensive testing measures appear to be flattening the curve. The state is "no longer projected to face shortages of hospital beds or ventilators at the peak of the virus outbreak." In contrast, the Navajo Nation, which spans Arizona and New Mexico, ranks third in the United States for covid-19 infection rates. Navajo Nation President Jonathan Nez declared a state of emergency regarding covid-19 on March 11th. New Mexico Governor Michelle Lujan Grisham similarly sounded the alarm in early March regarding concerns for the Navajo Nation where multigenerational households can increase spread. Hot spots in the nation's McKinley, San Juan, and Sandoval counties have emerged. Meanwhile, Bernalillo County, New Mexico's most populous county, is the only county with an infection rate comparable to those rural counties of the Navajo Nation. Meanwhile, relief from the CARES Act has been delayed. Jonathan Nez, president of the Navajo Nation told CNN that "sometimes the first citizens of this country are at the bottom of the list when it comes to federal aid. That's what we have been trying to say for the past several weeks." Mr. Nez also highlighted negotiations to share PPE between the Navajo Nation and New York state, filling the gap left by the federal government. Various.
New York City, other cities release updated race data for covid-19 fatality and hospitalization rates
On April 6th, the NYC Department of Health (NYC DOH) released data showing that death rates of African Americans and Hispanic persons with covid-19 were twice their non-Hispanic white counterparts (NHWC). The data were age-adjusted, and based on lab-confirmed cases. As of April 22nd, which included probable deaths as well, these numbers held. Additionally, the data show that African Americans were twice as likely to be hospitalized, compared to their NHWC. As reported previously in Brief19, disproportionate covid-19 hospitalization and fatality rates of African Americans highlight ongoing health and economic disparities. For example, the Bronx borough's population is 43.6 percent African American, and contains the poorest congressional district in the U.S. It also has the highest rate of positive covid-19 cases in NYC. In Richmond, VA, all eight people who have died from covid-19 are African American (the city's African American population is 48 percent). Cases may be undercounted among Black people, as early covid-19 testing criteria appear to have been biased in ways that decreased the number of tests performed for Black people. Various.