COVID-19 Update: Conspiracy Theories, Cutaneous Clues

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today: 

Docs Fight Back Against Conspiracy Theories

Last week, a self-branded collection of “America’s Frontline Doctors” held a “White Coat Summit” in front of the US Supreme Court building to address a “massive disinformation campaign” around COVID-19. They touted the miracle powers of hydroxychloroquine, contested the importance of masks, and pushed for a broader reopening of the economy, Ranit Mishori, MD, MHS, points out in a Medscape expert commentary. 

These types of ungrounded beliefs are not outliers or aberrations, Mishori says, adding that the public cannot and should not dismiss them. Rather, the health and scientific community must recognize that they resonate with a significant and dauntingly large swath of the public, she says.

Although the claims of America’s Frontline Doctors are easily dismissed by medical professionals, the effect of their pseudoscience on the public is nothing to scoff at, adds Mishori, professor of family medicine at Georgetown University School of Medicine. Instead, she offers strategies clinicians can adopt to set the record straight, pointing out that “lives are at stake.”

Cutaneous Clues Connected to Coagulation Risk

Dermatologists in New York City report a case series of people with severe COVID-19 who presented with livedoid and purpuric skin rashes. Interestingly, all four patients later develop suspected pulmonary emboli, suggesting the skin manifestations could be a warning sign of coagulopathies. 

Skin biopsies confirmed compromise of capillaries and other small vessels supplying blood associated with the skin eruptions. A dermatology consult and more aggressive anticoagulation therapies may be indicated when frontline health care workers spot such a rash in a person with COVID-19. 

HCQ RCTs: “Ethically, the Choice Is Clear”

Starting off by noting he is a “glutton for punishment,” F. Perry Wilson, MD, from the Yale School of Medicine, tackles a controversial topic in his latest Impact Factor video commentary. 

Wilson examines the randomized trial evidence for why doctors like he and Anthony Fauci do not think hydroxychloroquine works for COVID-19. He points out that the majority of the approximately 900 studies published to date on HCQ to treat COVID-19 are observational in design. He outlines why such evidence is limited and how people should look to randomized controlled trials to guide therapy. 

There’s No “Silver Bullet” for COVID-19

Getting COVID-19 under control will require a multifaceted strategy because no single intervention is going to work on its own, said World Health Organization Director-General Tedros Adhanom Ghebreyesus, MD.

Although several vaccine candidates have entered late-stage clinical trials, widespread vaccine distribution likely will not occur for some time, he said. In the meantime, he re-emphasized the importance of existing public health measures, including wearing masks and social distancing.

“Keep safeguards and monitoring in place because lifting restrictions too quickly can lead to a resurgence,” Tedros said.

Contract Tracing Issues Rise, Testing Declines

The soaring number of US COVID-19 cases is outstripping the ability of many local health departments to trace contacts of those infected, a step critical in containing the virus’ spread.

With the pandemic claiming about a thousand American lives a day, many city and county health departments say they lack the money and staff they need to expeditiously identify people who have been exposed, according to a Reuters survey.

At the same time cases are rising, testing rates are on the decline, an Associated Press analysis reveals. 

Officials largely attribute this worrisome trend to Americans getting discouraged over having to wait hours to get a test and days or weeks to find out the results.

The number of tests per day dropped 3.6% over the past 2 weeks to 750,000. The count fell in 22 states, including in Alabama, Mississippi, Missouri, and Iowa. These states report a high rate of positive testing that continues to climb, an indicator that the virus is still spreading uncontrolled.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. Thousands throughout the world have died.

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form.

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Damian McNamara is a journalist at Medscape Medical News and MDEdge, focusing on GI, surgery, dermatology, rheumatology, primary care, obstetrics & gynecology, pediatrics, and more.

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