Year: 2020
Type: letter
Abstract: entitled "COVID-19 and COPD: A Personal Reflection". 1 I especially focused on the line "Anxiety can drive malbehavior."Indeed, we healthcare personnel treating patients with respiratory diseases may not be completely absolved of anxiety-driven malbehavior in this COVID-19 world, as we try to come to grips with an indefatigable virus and wrap our heads around ways to slow it down and stop it.The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has brought into sharp focus how healthcare personnel must approach the treatment of patients with respiratory disease.While we wait for the clinical or quantitative evidence necessary to establish true best practices, there is a concern that healthcare personnel, patients, and healthcare systems are prioritizing one form of therapy over another based on assumptions or partial information rather than evidence.This is certainly an issue that requires further consideration.Consider the large-scale dispensing of albuterol metered-dose inhalers (MDIs) to hospitalized patients with COVID-19, which has resulted in severe shortages of albuterol MDIs in some parts of the United States. 2 This is not a supply chain problem but rather an acute crisis caused by the sharp increase in MDI use driven by the concern that nebulizers used by hospitalized patients with COVID-19 could potentially spread the SARS-CoV-2 virus.3 This concern could potentially extend to home use of nebulizers.But is this an appropriate use of now-limited resources, such as MDIs, or is this a reflexive reaction to a perceived risk with aerosol-generating procedures?Does the answer depend on the setting of care?Unfortunately, there is no precedent to guide the treatment of patients with respiratory disease in the current situation because experience from previous episodes of mass infection do not appear to be scalable to the worldwide SARS-CoV-2 pandemic.At a time when public health information is in a state of rapid flux, rather than using a one-size-fits-all policy, the more sensible approach would be to use a righttool-for-the-right-patient strategy based on what we know.Thus, nebulizers should remain the preferred option for patients who require that treatment, especially in light of the severe shortage of MDIs.This approach does not conflict with recent COVID-19 guidance and can serve as an example for encouraging best practices even after the pandemic.The National Institute for Health and Care Excellence (NICE) and the UK Government guidance from the New and Emerging Respiratory Virus
Source: International Journal of COPD
DOI: 10.2147/copd.s272382
Author: Michael W Hess
Institution: Western Michigan University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,836
Funder: Theravance Biopharma US
OpenAlex ID: W3083710180