The Evolving Pandemic of <scp>COVID</scp>‐19 and Interventional Cardiology
Bibliographic record
Abstract
The past month has been among the most tumultuous in modern American and world history. The spread of COVID-19 has developed into a worldwide pandemic, and our way of life has been dramatically altered. This national emergency has shuttered schools and restaurants, sports games, and music festivals. Here in California, an eerie quiet has taken over the streets, punctuated only by the rare child riding a bike or a couple walking their dog. I want to express solidarity with our colleagues who are on the front lines, addressing the response to the COVID-19 pandemic. Physicians, nurses and allied health care professionals in the emergency departments, intensive care units and inpatient wards are dealing directly with the sickest patients and are, in turn, greatly exposed. We in the interventional and invasive cardiology world are immensely grateful for their efforts and are here to offer support and help. This has been extraordinarily stressful for us as physicians, our families, and for the patients that we have taken an oath to take care of and treat. There are many unknowns, but the universal learning based on the China, Italy, Europe and now California experience is that personal hygiene, social distancing, appropriate personal protective equipment (PPE) (https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html), and isolating the highest risk group (age > 65, immunocompromised and/or those with medical comorbidities) have the greatest potential to mitigate the risk of COVID-19 spread and the associated morbidity/mortality. At times like this, we are forced to ask larger questions than those that pertain to just ourselves and determine the best way to move forward. There is a paucity of adequate data to guide our next steps, especially as they relate to the care of cardiovascular patients and those who require management in the catheterization laboratory (Cath Lab). We can leverage the lessons from China and determine how we might want to apply them to our health care systems. As we face the COVID-19 pandemic, The Society for Cardiovascular Angiography and Interventions (SCAI) is committed to ensuring the health, safety, and well-being of our members, healthcare teams and the patients they treat. SCAI and the American College of Cardiology Interventional Scientific Council have issued a joint statement regarding the management of COVID-19 patients who need Cath Lab services.3 Additionally, SCAI has launched the COVID-19 Resource Center to provide our members updated information for the management of patients with cardiovascular disease during this pandemic. In partnership with the Canadian Association of Interventional Cardiology (CAIC), we have also launched a series of webinars to educate our membership regarding the relevant issues. Furthermore, SCAI and CAIC have launched the North American COVID-19 Myocardial Infarction (NACMI) registry to investigate outcomes among COVID-19 patients who present with ST elevation. I am providing the above anecdotal example based on the decisions made due to the steadily increasing COVID-19 inpatients being managed at UC San Diego and newly issued state mandates. There are many reasons to reschedule elective procedures in the Cath and EP labs, but the primary driving force is the anticipated surge of patients infected with COVID-19. Each institution and administration will have to determine the best way to approach these decisions in concert with the Centers for Disease Control and Center for Medicare and Medicaid Services guidelines, and both infectious disease experts and critical care intensivists. This is an unprecedented medical challenge for all of us, and there are many questions for which we do not have immediate answers but have the tools and reach within SCAI to find them. Additionally, we cannot be effective physicians and interventionalists unless we take care of ourselves, our families, children, and senior colleagues. Collectively, we are all facing the anxiety of the unknown and will best be able to address it by remaining calm, organized and systematic in our approaches. We have to work together as an interventional cardiology community by supporting each other, remaining adaptable, and providing the best possible care for our patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".