Separating facts and sound advice from lies and conspiracy theories has become a non-stop challenge for health care workers on the COVID-19 frontline.
To help them, medical students at McMaster University and a Canadian emergency medicine podcaster have come up with two internationally acclaimed digital resources.
The nine McMaster students, who like all their classmates were abruptly removed from clinical duties in mid-March, have spent a big chunk of their time developing COVID Review, a website with a searchable database of COVID-related scientific studies.
The students quickly review and organize every scientific publication they can find on the virus, weed out poor quality research and filter the results by specialty, allowing health care providers and researchers to search the literature efficiently.
As with the group at McMaster, Dr. Anton Helman, creator of the Emergency Medicine Cases podcast and an emergency physician in Toronto, felt an urgency to produce COVID-related podcasts. “There was an enormous amount of fear amongst emergency providers, especially early on, and I felt the earlier I could help educate the community, the sooner we could manage that fear and get going on managing the crisis effectively.”
EM Cases produces COVID-related podcasts, written material, push notifications, and videos – all from Helman’s in-home studio, a small study with makeshift sound-proofing and a devoted Portuguese water dog named Muddy.
Becky Jones, a second year McMaster student who leads COVID Review, says the project began as a simple idea from the chair of medicine, Dr. Mark Crowther, “to circulate summaries of relevant studies in an online newsletter to Hamilton-area frontline physicians.”
The students took the idea and ran. As of the final week of April, they had reviewed more than 3,000 COVID publications and users from more than 60 countries had visited the site.
“As we were working on it, we realized it would be beneficial for all physicians and researchers, regardless of location and specialty,” Jones says. COVID guideline committees, researchers and clinicians around the world have expressed appreciation.
Crowther, who has supervised the project, says the website is helping health care providers separate the wheat from the chaff. “There is so much published, and so little contains useful information,” he notes. “When your ratio of randomized controlled trials to fluff is 1,000 to 1, this is an incredibly useful tool.”
He adds that “the medical students have done an insanely good job. For us at the university it would have taken three and a half years to develop a website like this, and they did it in an afternoon.”
Launched 10 years ago, Helman’s EM Cases initiative is part of the Free, Open Access Medical Education movement, widely known as FOAM. The EM Cases website describes FOAM as “the exploding collection of constantly evolving, collaborative and interactive open access medical education resources being distributed on the web.”
Helman sees EM Cases as “a platform for emergency providers to learn practical, practice-changing things about emergency medicine.”
EM Cases normally produces one podcast a month but in March and April, at the height of COVID preparations across Canada, it put out eight in addition to various other online resources. The podcasts include interviews with 12 Canadian emergency, critical care, and infectious disease experts as well as reflections from an emergency physician who contracted SARS.
“I felt the earlier we were educated about PPE, surge capacity, screening and diagnosis, the earlier we could flatten the curve and keep ourselves, our families, our colleagues and our patients safe from the virus,” Helman says.
In the two months between late February and late April, EM Cases podcasts were downloaded more than 500,000 times by 100,000 users around the world. Dr. Andrea Unger, Brant Community Health System’s chief of emergency services, says EM Cases was her “go-to place because it was relevant to my community in southern Ontario.”
Emergency and critical care providers also rely on EM Cases for updates on COVID-related issues such as evolving treatments, airway management and personal protective equipment.
Unger also uses EM Cases to ensure that the Brant region’s COVID plans align with the rest of the country and to convince other hospital leaders of new policies. As she puts it: “When I have challenges, I just write down EM Cases and say, ‘You need to look at this.’ ”
Dr. Chris Keefer, a Toronto emergency physician and educator, lauds EM Cases’ timeliness in keeping up with fast-moving news: “The initial clinical recommendations for COVID came out of flawed studies. Now things are shifting in the opposite direction. You need a tool that can broadcast these changes in a quick and meaningful way.”
Yet, he notes, EM Cases is not just about up-to-date information. At a time of fear and anxiety, especially for frontline providers, “there is a real temptation to get negative. EM Cases has really helped people stay positive and engaged in our workplaces and beyond. Having a calm voice like Anton’s appealing to our better selves has a really major role for me.”
For the time being, the main purpose of both EM Cases and COVID Review is to give frontline providers authoritative and timely information on COVID-19.
In the longer term however, Keefer sees wider benefits from such cutting-edge resources. “An ethic and a culture are being established – by a movement based on altruism through free, open access medical education.”