Doctors must check travel history to slow COVID-19
Integrating travel history information into routine medical assessments could help stem the rapidly widening novel coronavirus (COVID-19) epidemic, as well as future pandemics, say researchers. COVID-19 has taken over 3,200 lives globally. At 3,012 deaths and 80,409 confirmed cases, China remains by far the worst hit from the deadly virus.
According to the study, published in the journalAnnals of Internal Medicine, the infectious disease specialists recommended that it's time to add travel history to routine information such as temperature and blood pressure collected in electronic medical records. "We have the infrastructure to do this easily with the electronic medical record, we just need to implement it in a way to make it useful to the care teams," said study researcher Trish Perl from University of Texas in the US.
"Once the infrastructure is built, we'll also need to communicate what is called 'situational awareness' to ensure that providers know what geographic areas have infections so that they can act accordingly," Perl added. According to the researchers, a simple, targeted travel history can help put infectious symptoms in context for physicians and caregiver teams. Shared electronic health records also can integrate travel history with computerised decision-making support to suggest specific diagnoses in recent travellers, the authors noted.
The emergence of novel respiratory diseases in the past two decades - including Severe Acute Respiratory Syndrome (SARS) in 2002-2003, Middle East Respiratory Syndrome (MERS) in 2012-2013, Western Africa-based Ebola in 2014, and now COVID-19 from China - demonstrated the need for change, the researchers said. With each wave, "the urgent threat of communicable diseases comes with significant morbidity and mortality, tremendous health care disruptions and resource utilization, and collateral economic and societal costs," the authors wrote.
"MERS and SARS were associated with very specific travel. MERS was associated with travel to the Arabian Peninsula, and SARS was associated with travel primarily to Hong Kong, Singapore, and Beijing," Perl said. According to the researchers, currently COVID is similar in that there are geographic clusters, but those lines may be blurring as the outbreak expands.
The challenges and potential stress on the public health infrastructure, including the hospitals which are part of this, will be notable in that we could see large numbers of patients, they added. "Our role will not only be to care for these patients but to communicate to them the strategies that they can use to protect themselves," Perl added.
The researchers suggest that a simple script could be strategically and carefully developed to elicit clues for emerging infectious diseases and information about current emerging pathogen threats. The information could be collected along with the four gold standard vital signs - temperature, heart rate, respiratory rate, and blood pressure - currently used to help US-based medical teams assess patients' health status, triage to appropriate care, determine potential diagnoses, and predict recovery.
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