COVID-19 Update: "Aerosol Box" During Intubation / Preventing Outbreaks in Retirement Communities / Guidance on Newborns

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Here are some of the latest developments on novel coronavirus disease (COVID-19):

• "Aerosol box" during intubation: In the New England Journal of Medicine, researchers describe an "aerosol box" that could help protect clinicians without access to standard personal protective equipment during endotracheal intubation. The clear plastic cube covers the patient's head and has two holes through which the clinician passes his or her hands to perform the procedure. During experiments with a simulated cough, only the inside of the box and the clinician's gloves and gowned forearms were contaminated. Without the box, contamination was seen as far as 2 meters from the patient.

• Outbreaks in retirement communities: Four seniors at an independent and assisted living community who tested positive for COVID-19 (after two initial cases were hospitalized) were asymptomatic at the time of testing. Writing in MMWR, researchers note that symptom-based screening in such settings "is unlikely to be sufficient," and "adherence to CDC guidance to prevent COVID-19 transmission in senior independent and assisted living communities could be instrumental in preventing a facility outbreak."

• Guidance on newborns: The American Academy of Pediatrics has issued guidance on managing infants born to mothers with COVID-19. Newborns of women with positive or pending COVID-19 test results should be considered persons under investigation, and clinicians should use gowns, gloves, and standard mask and eye protection during clinical encounters. Newborns should be bathed as soon as possible to remove any virus potentially on the skin, and temporary separation from the mother should be considered.

• Convalescent plasma: The FDA is working to enable access to convalescent plasma as a potential treatment for COVID-19, citing early research suggesting a benefit. The agency expects to "be able to move thousands of units of plasma to patients who need them in the coming weeks." A second treatment, hyperimmune globulin made from convalescent plasma, is also under development. People who have been symptom-free for at least 2 weeks may donate plasma.

• Respirators from China: The FDA has issued an emergency use authorization for non-NIOSH-approved respirators manufactured in China. This allows authorization of KN95 respirators if they meet certain criteria.