Becker's Hospital Review

23 CMO / CARE DELIVERY COVID gets tougher to distinguish By Erica Carbajal G one are the days of hallmark COVID-19 symptoms. While loss of taste and smell, and persistent cough were once tell- tale signs of the respiratory infection, symptoms today vary widely, with tests being the only sure-fire way to confirm a diagnosis, physicians told NBC News in a June 27 report. "Every week, we test someone for COVID who I didn't think had it who tests positive," Steven Furr, MD, president of the American Academy of Family Physicians and family physician in Jackson, Ala., told the news outlet. "en we have others who I'm pretty sure have COVID who test negative … It's really hard to separate COVID from any other respiratory illness right now." Physicians say patients who end up testing positive have symptoms that "vary from A to Z and beyond." Some do have classic respiratory virus symptoms: Sore through, congestion and low-fever. Others have gastrointestinal symptoms, but nearly no respiratory symptoms. Sans one major signal, physicians have largely abandoned "you probably have COVID" diagnoses in favor of test-confirmed diagnoses only. Shis in symptom patterns have occurred over time as people gained exposure, and thus, some level of immunity to the virus. Virus mutations also play a role, experts say. In the spring, COVID-19 activity in the U.S. hit its lowest levels since the pandemic began. As of June 25, the CDC said infections "are growing or likely growing" in most states, stable or uncertain in five states, and "declining or likely declining in 1 state or territory." Hospitalization and death rates remain low, though test positivity and emergency department visits related to COVID have risen in recent weeks. On June 27, the CDC recommended everyone 6 months and older receive an updated vaccine. Officials have said new shots are expected to be available in August and September, according to NBC. Earlier this month, the FDA instructed vaccine manufacturers to target JN.1, a strain that dominated this past winter. Within a week, the agency circled back with manufacturers to say a specific offshoot of the JN.1 lineage — KP.2 — may be a better target, since it now makes up a higher proportion of cases. KP. 3, another JN. 1 relative, currently makes up about 33% of cases in the U.S., followed by KP. 2 at around 21%, and LB.1 at 18%. n Surgeon general: Gun violence is a public health crisis By Erica Carbajal T he U.S. surgeon general has issued a 32-page advisory declaring gun violence an urgent public health crisis that necessitates a multi-pronged effort to reduce and prevent gun-related deaths and injuries. "I've long believed this is a public health issue," Vivek Murphy, MD, said in an interview with e New York Times following the June 25 release of the advisory. "is issue has been politicized, has been polarized over time. But I think when we understand that this is a public health issue, we have the opportunity to take it out of the realm Practice before taking the NCLEX? Nurses in Rhode Island can By Ashleigh Hollowell N urse graduates in Rhode Island can now begin to practice before taking and while awaiting NCLEX results, but they must become licensed within 90 days, according to a new state law. The bill was signed into law June 29 by Gov. Daniel McKee, as part of the Rhode Island Holistic Enhancement and Access Legislation for Total Health (HEALTH) Initiative. The impetus for the initiative was brought on by a statewide need for more nurses. "Allowing registered nurses who have graduated their programs to begin their on-the-job training before their test results is one of those tools, one that nurses and health care facilities have been asking for," Ms. Lawson said in a June news release. The law has also received support from the state's hospital association. "By allowing nursing graduates to practice pending the results of their NCLEX, this law provides a critical buffer that helps bridge the gap between academic preparation and full licensure," M. Teresa Paiva Weed, president of the Hospital Association of Rhode Island, stated in the release. "This change will not only bolster our health care workforce but also support new graduates as they transition into their professional roles, reducing administrative delays that currently hinder immediate employment and practice." n

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