IOWA CITY — In hopes of capitalizing on the research opportunities this pandemic affords while also finding best practices for the current COVID-19 response, the University of Iowa is collaborating with UCLA on a new study to evaluate safety measures for front-line workers in hospital emergency rooms.
The “COVID-19 Evaluation of Risk for Emergency Departments” project — which researchers are calling “COVERED” — is funded by a $3.7 million grant from the U.S. Centers for Disease Control and Prevention.
The study will last 12 weeks and involve 1,600 emergency department workers in 20 academic medical centers nationally — including doctors, nurses and support staff, like clerks, social workers and case managers.
The UI Carver College of Medicine and David Geffen School of Medicine at the University of California-Los Angeles are teaming up on the research aimed at identifying the best way to reduce the risk of COVID-19 infection among ER workers.
Nicholas Mohr, COVERED co-principal investigator and vice chairman for research in the UI Department of Emergency Medicine, said opportunities to gauge transmission risk during a global pandemic rarely present — despite the need for answers to how to keep front-line workers safe.
In a statement, Mohr called it critical “to identify ways to reduce the risk of infection transmission to health care workers so that we can continue to take care of the people in our communities who need our help.”
Identifying the need, brainstorming about the research, writing a grant application, securing funding and enrolling participating institutions took just three weeks, according to Mohr.
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“It was all done in record time because the CDC has deemed this information critical to protecting health care workers and the health care system in this and in future epidemics and pandemics,” he said in a statement.
The study aims to determine which practices and personal protective equipment are most effective in preventing the spread and acquisition of COVID-19 in an emergency setting, complicated by health care providers often not knowing if patients have the virus.
Emergency procedures — like intubation — also can increase the risk of spreading the virus.
The study, which could be relevant for other coronaviruses, like SARS and MERS, considers personal protective equipment to be masks, face shields, gowns and gloves, among other things.
Researchers are enrolling four groups of ER workers, including physicians who perform intubation — like a breathing tube — in confirmed COVID-19 patients; physicians who don’t perform intubation; nurses; and non-clinical staff in emergency departments.
The study is focused on the breathing tube procedures because those are aerosol-generating and have been shown in past SARS and MERS outbreaks to increase the risk of transmission to health care workers, according to Mohr.
Researchers will follow health care workers enrolled in the study for three months, putting them through regular screenings and biweekly blood tests to check for COVID-19 exposure. The participants also will complete questionnaires weekly to document their procedural practices.
The COVERED study is a partnership between EMERGEncy ID Net and the National Emergency Airway Registry. The University of Iowa participates in both networks and will serve as the national data coordinating center for the COVERED project.
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Mohr is working with co-principal investigator David Talan, a professor of emergency medicine and infectious diseases at UCLA and the UI.
Talan leads EMERGEncy ID NET, a network of 12 U.S. emergency departments that has studied emerging infectious diseases with support from the CDC since 1995.
In a statement, Mohr said the UI is well-positioned to co-lead this new research.
“We have trained for years on how to deal with the emergence of highly transmissible infections, as have other institutions,” he said. “This is a chance to see how our collective best practices work and to share the best methods so that we can keep health care workers healthy and on the front lines of care.”
The University of Iowa, additionally, is engaged in a handful of other COVID-19-related research, including trials allowing its physicians to treat patients with the drug Remdesivir and with plasma from recovered COVID-19 patients.
As of Thursday, UIHC was reporting 22 current COVID-19 patients and 125 total to date. It has confirmed COVID-19 in 80 of its 15,000 employees, including two who were diagnosed Wednesday.
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