Becker's Clinical Quality & Infection Control

27 PATIENT SAFETY & OUTCOMES Delta variant may cause hearing loss, gangrene By Mackenzie Bean T he delta coronavirus variant, first dis- covered in India, may be causing symp- toms not typically seen in COVID-19 patients, Bloomberg reported June 7. ese symptoms include stomach pain, nausea, vomiting, loss of appetite, hearing loss and joint pain, according to six phy- sicians treating COVID-19 patients across the country. Dr. Ganesh Manudhane, a cardiologist in Mumbai, said some patients are also devel- oping small blood clots that are so severe, they lead to gangrene. "I saw three to four cases the whole of last year, and now it's one patient a week," Dr. Manudhane said of the complication. In several cases, he said, amputation of a finger or foot was required. India's unprecedented surge in cases could be driving an increase in rare COVID-19 com- plications such as the blood clots, according to Bloomberg. However, Dr. Manudhane said it's unusual to see blood clots in patients of all age groups with no history of coagulation issues. Similarly, Abdul Ghafur, an infectious disease physician in Chennai, India, said he's seeing more COVID-19 patients with diar- rhea than during the pandemic's first wave. "We need more scientific research to analyze if these newer clinical presentations are linked to B.1.617 or not," he told Bloomberg, referring to the delta variant. e delta variant has been identified in more than 100 countries since emerging in India last December. Scientists have confirmed the variant is highly transmissi- ble, and early evidence from the U.K. and Scotland suggests it may also increase the risk of hospital admission. n Arizona revises crisis standards of care after federal complaint By Mackenzie Bean A rizona revised guidelines on allocating scarce medical resources during crises such as the COVID-19 pandemic to resolve a federal com- plaint filed last summer, the HHS Office of Civil Rights said May 25. Several advocacy groups filed the complaint in July 2020, claiming the state's crisis standards of care and a pandemic-related addendum discriminated against older adults, people of color and people with disabili- ties. The protocols are intended to help healthcare or- ganizations ration care and resources to patients based on various factors, including their likelihood of survival. In the complaint, the advocacy groups said the origi- nal protocols made it possible for some people with disabilities to be "erroneously perceived as having a shorter life expectancy." The updated guidelines prohibit the use of a patient's long-term life ex- pectancy as a factor in resource allocation, among other revisions. "We are pleased to have worked collaboratively with our advocacy partners and the OCR to ensure the language represents the true intent of our health- care workers, making very difficult decisions during the pandemic without discriminating against any pa- tient," Cara Christ, MD, director of the Arizona De- partment of Health Services, said in a May 25 state- ment cited by AZCentral. Dr. Christ said the state authorized hospitals to use cri- sis standards of care last June. While some hospitals got close to using them during the summer COVID-19 surge, none did, she said. n Young people drove spike in ED visits for suspected suicide attempts during pandemic, CDC finds By Erica Carbajal A mong people ages 12-17, visits for suspected suicide attempts across U.S. emergency departments soared earlier this year, and were largely driven by girls in this age group, according to the CDC's June 11 Morbidity and Mortality Weekly Report. Using data from the National Syndromic Surveillance Pro- gram, which includes information from most of the country's EDs, researchers examined trends in visits for suspected sui- cide attempts among people ages 12-25 across three peri- ods during the pandemic, and compared them to the same periods in 2019. Overall, the average number of weekly ED visits for suspected sucide attempts among adolescents ages 12-17 was 22.3 per- cent higher in summer 2020, and 39 percent higher during winter 2021, compared to the same periods in 2019. The increase was largely driven by girls ages 12-15, the find- ings showed. Among this group, visits were nearly 51 percent higher during winter 2021. During the same period, visits among adolescent boys rose 3.7 percent. For those ages 18-25, visits dropped 16.8 percent and 5.6 percent in the spring and summer of 2021, respectively. In the winter, however, there was a 1.7 percent increase, compared to 2019 data. "Importantly, although this report found increases in ED visits for suspected suicide attempts among adolescent females during 2020 and early 2021, this does not mean that suicide deaths have increased," the CDC said. Young people were particularly affected by pandemic safety measures, such as school closures, which may have increased suicide risk factors, researchers said. n

• Cover