Novel coronavirus (COVID-19): Leveraging telemedicine to optimize care while minimizing exposures and viral transmission

Abstract

The following Joint Position Statement represents a collective contribution of emergency and acute care experts from the World Academic Council of Emergency Medicine and the American College of Academic International Medicine Task Force on Telemedicine for COVID-19 Pandemic. Over the past 3 months, the world witnessed historic and dramatic developments related to the rapid emergence of a novel coronavirus. Real-time, detailed global media coverage brought live updates on the infection to every corner of the planet. Social media outlets are abuzz with minute-to-minute alerts, reflections, witness accounts, and personal reactions. We are witnessing stories of human suffering, including overwhelmed health-care systems, limited access to emergency care, vacationing passengers stranded on cruise ships, large-scale evacuations, overnight economic shutdown, and empty streets in China and Italy.[123] The imagery is comparable to an epic movie depicting martial law with large populations confined to their homes in the wake of a deadly virus. This time, it is a novel coronavirus, and the associated disease has been named COVID-19. Moreover, the current world-wide event has now been declared a pandemic by the World Health Organization (WHO).[45] Pneumonia of unknown cause detected in Wuhan, China, was first reported to the WHO on December 31, 2019. In turn, the WHO declared the event a Public Health Emergency of International Concern (PHEIC) on January 30, 2020.[5] Soon, there was a total shutdown of free travel between China and the rest of the world, expanding the human and medical dimensions of the outbreak into the economic and political spheres.[67] The epicenter of the current outbreak was the city of Wuhan in China's Hubei province. In an attempt to contain the spread of COVID-19, the Chinese government has implemented metropolitan-wide quarantine of Wuhan and several nearby cities, effectively forcing millions of people to remain indoors and avoid unnecessary outdoor travel.[8] In a record period of 10 days, a massive 1000-bed hospital was built to help cope with the rapidly increasing number of cases.[9] Despite these efforts, as of February 25th, there were 78,064 confirmed infections, 8752 patients in serious condition, and 2715 reported mortalities in Mainland China alone. Moreover, Chinese authorities estimate a total of 647,406 people who had close contact/proximity with infected people, and more than 79,000 individuals who are under medical observation.[10] There is also a case of a Chinese person who may face a jail sentence for lying about his movements in Singapore during the mandatory quarantine period.[11] Finally, there is a real possibility that the Federal Emergency Management Agency in the United States (US) may declare emergency over the COVID-19 infection.[12] At the time of this commentary, COVID-19 has spread throughout the world and has infected 37,371 confirmed cases in 113 countries with 1130 deaths outside of China.[5] A sudden increase in cases has been reported in Iran, Italy, and South Korea. Cases linked to travel to/from Iran have been found in Bahrain, Iraq, Kuwait, and Oman. Similarly, cases related to Italy have been found in Algeria, Austria, Croatia, Germany, Spain, and Switzerland.[513] Most recently, Nigeria confirmed its first case in Sub-Saharan Africa, whereas the US reported its first coronavirus-related death in Washington state.[1415] Thus, COVID-19 has established itself outside of China and now appears to be spreading across new regions, countries, and continents. The geographic diversity of the above locations suggested that a pandemic was imminent and ultimately, on 11th of March, 2020 WHO declared COVID-19 a pandemic.[516] In the meanwhile, various international and regional authorities are following the footsteps of China to impose movement restrictions on their populations with an aim to curb the human-to-human spread of the virus. Few health-care systems around the world are equip