Pascal Geldsetzer, MBChB, ScD, MPH
Disclosures: The author has disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-0912.
Reproducible Research Statement: Study protocol: Available from Dr. Geldsetzer (e-mail, email@example.com). Statistical code and data set: Available from https://purl.stanford.edu/zx357dw0759.
Previous Posting: This manuscript was posted as a preprint on medRxiv on 17 March 2020. doi:10.1101/2020.03.13.20035568
Table 1. Sample Characteristics
Table 2. Summary of Survey Findings
Richard M Fleming, PhD, MD, JD (FHHI-OI-Camelot); Matthew R Fleming, BS, NRP (FHHI-OI-Camelot); Tapan K Chaudhuri, MD (Eastern Virginia Medical School)
FHHI-OI-Camelot & EVMS
March 24, 2020
Conflict of Interest:
FMTVDM issued to first author.
Increasing our Knowledge, Understanding and Treatment of CoVid-19 and CoVid-19 pneumonia (CVP).
The sensitivity of CoVid-19 PCR throat and nasal swabs has been reported as ranging between 30 and 73%, which means that only 30-73% of the people with CoVid-19 will test positive [1,2] - at least initially. Part of the reason for this is the inclusion of people with low probability of having CoVid-19. The likelihood of these tests having a greater positive predictive value (PPV), and therefore being more meaningful, increases as we limit the use of this tool to those who are more likely to have CoVid-19, rather than merely testing everyone.Testing everyone might make people feel safer, but it will only reduce the PPV of this screening test while providing misinformation and decreasing the sensitivity and specificity of CoVid-19 screening. By focusing our screening on those who present with symptoms consistent with CoVid-19, we will reduce the numbers of errors made by screening for CoVid-19 and increase the accuracy and our understanding of CoVid-19; including the associated morbidity and mortality.The greatest concern for most people is not acquiring CoVid-19 - but dying from CVP. With multiple potential treatments being recommended, and with no prior evidence to direct our treatment of patients, it is critical that we quantify the treatment response [3,4] to determine which treatment is best tolerated - thereby saving time, money, resources and lives. References:1. Radiological Society of North America. "CT provides best diagnosis for COVID-19." ScienceDaily. ScienceDaily, 26 February 2020. www.sciencedaily.com/releases/2020/02/200226151951.htm.2. Ai T, Yang Z, Hou H, et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology 2020;200642. DOI:10.1148/radiol.2020200642.3. The Fleming Method for Tissue and Vascular Differentiation and Metabolism (FMTVDM) using same state single or sequential quantification comparisons. Patent Number 9566037. Issued 02/14/2017. 4. Fleming RM, Fleming MR, Dooley WC, Chaudhuri TK. Invited Editorial. The Importance of Differentiating Between Qualitative, Semi-Quantitative and Quantitative Imaging – Close Only Counts in Horseshoes. Eur J Nucl Med Mol Imaging. 2020;47(4):753-755. DOI:10.1007/s00259-019-04668-y. Published online 17 January 2020 https://link.springer.com/article/10.1007/s00259-019- 04668-y https://rdcu.be/b22Dd
1. Chong Yau Ong, 2. Jin Lee Lim
1. SingHealth Community Hospitals, Singapore 2. Hospital Sultanah Aminah Johor, Malaysia
April 5, 2020
Dynamicity of Knowledge and Perception of Public on COVID-19
We read with interest the survey conducted by Geldsetzer  on the public’s general knowledge and perception on COVID-19. One of the most striking concerns was found in the subscale of the current state of the disease whereby estimation of number of death in US/UK given by the majority was less than 500. It is very likely that this survey was done during the epidemic when the cases outside China was not alarming enough for the public in both countries to be adequately concerned. Prospectively, even before the day WHO declared this as virus as pandemic; the numbers of affected and succumbed victim has been doubling in every few days for many countries, showing no signs of slowing down since. Today the death tolls reported in US and UK has exceeded 8400 and 4300 respectively . These numbers surpassed the deaths in China, the first affected epicentre. Given the crisis situation now in both countries, it would be interesting if the same survey is to be conducted again to know the public’s latest understanding. The healthcare-seeking behaviour could have been changed by now that the public is more informed presently than before through the media. Likewise, change is also likely to be noticed in the perception and behaviour in the preventive subscales such as mask-wearing, and measures government would take. It is with great effort that the survey captured the perceived risk imposed by East Asia community. Although the fatality from COVID-19 has been severely underestimated, a significant proportion of the responders would want to avoid contact (direct, and indirectly via parcel received) with the East Asia community. While it may beyond the scope of the survey to expound the reasons behind the perceived risk, future studies could look into this issue. It is important to address and mitigate fear before it ripples into xenophobia and social stigma [3, 4].Qualitative and narrative documentation of the public’s perception can also help in understanding readiness to cooperate with measurements placed by the authorities, their coping strategies, and challenges faced.It will be also helpful if the knowledge and perception of COVID-19 of the public outside the world’s biggest English-speaking community is made available. References:1. Geldsetzer P. Knowledge and Perceptions of COVID-19 Among the General Public in the United States and the United Kingdom: A Cross-sectional Online Survey. Annals Int Med. 2020 Mar 20. [PMID: 32196071]2. John Hopkins University and Medicine. Covid-19 Data Visualisation Center. Mortality Analyses. March 2020. Accessed at https://coronavirus.jhu.edu/data/mortality on 5 April 2020.3. Person B, Sy F, Holton K, Govert B, Liang A. Fear and stigma: the epidemic within the SARS outbreak. Emerg Infect Dis. 2004;10(2):358. [PMID: 15030713]4. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19): Reducing Stigma. March 2020. Accessed at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/reducing-stigma.html on 5 April 2020.
Geldsetzer P. Knowledge and Perceptions of COVID-19 Among the General Public in the United States and the United Kingdom: A Cross-sectional Online Survey. Ann Intern Med. 2020;:. [Epub ahead of print 20 March 2020]. doi: https://doi.org/10.7326/M20-0912
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Published: Ann Intern Med. 2020.
Published at www.annals.org on 20 March 2020
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