Published: April 28, 2020

Global Otolaryngology Community Comes Together in the Face of COVID-19 Pandemic

The healthcare community has been thrust into an unprecedented situation during the COVID-19 pandemic that has tested us mightily as we deal with supply shortages, the lack of adequate reliable testing, incomplete knowledge of COVID-19 transmission, and significant risks to those providing care.

We Are OneNote: This article reflects the current COVID-19 situation as of April 23, 2020. The fast-changing pace of information related to this pandemic may not all be reflected in this column due to the Bulletin’s publication schedule.

James C. Denneny III
MD AAO-HNS/F Executive Vice President and CEO

The healthcare community has been thrust into an unprecedented situation during the COVID-19 pandemic that has tested us mightily as we deal with supply shortages, the lack of adequate reliable testing, incomplete knowledge of COVID-19 transmission, and significant risks to those providing care. This has created extraordinary stress on our specialty as we strive to integrate necessary patient care while promoting public health measures to protect our communities, families, and friends, and at the same time struggling to maintain our practices. During this critical time, our members’ commitment to excellence in patient care through engagement with the Academy’s communications and recommendations has been remarkable and has made a difference.

I want to extend my sincere appreciation and admiration to our amazing physician community and the healthcare teams they work with for their dedication to research and best practices and incorporating them in the current rapidly changing scenario worldwide. Your Academy staff and leaders are dedicated to identifying applicable guidance documents to serve you, your practices, and the public. It is gratifying to be a small part of your team and observe how quickly you are accessing resources we are providing and adapting them to your personal situation. From new COVID-19 related Position Statements focusing on tracheotomy, elective surgery, and urgent and nonurgent patient care, to research tools such as the COVID-19 Anosmia Reporting Tool, our new podcast series, financial relief resources, and legislative and regulatory updates on the AAO-HNS COVID-19 Resource page, we thank you for looking to your Academy during these challenging times.

Your participation in the AAO-HNS community and the otolaryngology-head and neck surgery community worldwide has developed a reliable and trusted circle of peer-to-peer connection. We have seen this in extraordinary engagement on ENTConnect, providing support to each other, triggering Academy policies and position statements, sharing resources, and just being a sounding board for what you as individuals and the collective community are experiencing. In the last two weeks, we have seen participation in ENTConnect grow by 262 percent. It is heartening to see that you are consuming and absorbing resources. The website traffic is up 370 percent from March 18 – April 11, with increased attention to the AAO-HNS COVID-19 Resource page, Academy Position Statements related to COVID-19, and the research accepted for publication in Otolaryngology–Head and Neck Surgery. The AAO-HNS COVID-19 Podcast Series episodes have been downloaded over 11,500 times. These analytics tell us that this information is useful to you and your practice. This engagement with the Academy also extends to social media as we use various ways to get you the information you need. The Academy voice has been heard and further extended by exceptional media coverage around the world of our position on Anosmia, Hyposmia, and Dysgeusia Symptoms of Coronavirus Disease.

We urge you to continue being a part of the connected community that is your Academy. Your engagement is what pushes us to make sure that we are providing you the resources you need as a measure of support during this critical time. As always, We Are One and please stay safe!

Oto Journal Covid19

Otolaryngology–Head and Neck Surgery has accepted several COVID-19-related papers for publication. A special thank you to John H. Krouse, MD, PhD, MBA, Editor in Chief, for recognizing the value of making this research and these manuscripts available to the healthcare community in response to the COVID-19 pandemic. In an effort to expeditiously distribute this research, the authors have agreed to share their accepted manuscripts. A list of these manuscripts as well as those that are now published online can be found at https://www.entnet.org/content/oto-journal-covid-19-accepted-papers.

Covid19 Podcast

In March, the Academy launched a new podcast series specific to COVID-19. The series provides peer-to-peer connection on COVID-19 pandemic related topics. Episodes are continually being added to the series. Download the FREE official AAO-HNS podcast app frequENTcy to receive immediate access to the release of all COVID-19 podcasts. The app is available in the Apple Store, Apple Podcasts App, Google Play, and for Spotify subscribers. Download now at https://www.entnet.org/content/frequentcy-podcast-app.

As of April 23, 2020, the following episodes are available in the COVID-19 Podcast Series:

  • Episode 1: Patient Safety
  • Episode 2: CARES Act
  • Episode 3: Epidemiology
  • Episode 4: Business Topics and Practice Workflows
  • Episode 5: Telemedicine
  • Episode 6: ENTs Personal COVID-19 Experiences: Managing Your Wellness
  • Episode 7: Ethics
  • Episode 8: What to Expect as We Resume Practice: Learning from Katrina
  • Episode 9: Reopening Your Practice (Private Practice Focus)
  • Episode 10: Physician Wellness (Peer Support)
  • Episode 11: What Will Be the “New Normal” Otolaryngology Practice? And How has COVID-19 Affected It?

Anosmia and Dysgeusia: Research Effecting Change

The Centers for Disease Control and Prevention added “new loss of taste or smell” on April 17 to the list of symptoms that may appear 2-14 days after exposure to the virus on their Symptoms of Coronavirus web page.

This action follows the Academy’s extensive efforts on this issue, which include a public statement on March 22, the launch of a reporting tool for data collection on March 26, public outreach through substantial media coverage, and the publication of initial findings from the reporting tool in Otolaryngology–Head and Neck Surgery on April 10. This was all done in a few short weeks demonstrating the strength of the otolaryngology community voice.

Short Scientific Communication COVID-19 Anosmia Reporting Tool: Initial Findings

Authors: Rachel Kaye, MD, CW David Chang, MD, Ken Kazahaya, MD, MBA, Jean Brereton, MBA, and James Denneny, MD https://journals.sagepub.com/doi/full/10.1177/0194599820922992

According to the authors, “We analyzed the first 237 entries which revealed that anosmia was noted in 73% of subjects prior to COVID-19 diagnosis and was the initial symptom in 26.6%. Our findings suggest that anomia can be a presenting symptom of COVID-19, consistent with other emerging international reports. Anosmia may be critical in timely identification of individuals infected with SARS-CoV2 who may unwittingly be transmitting the virus.”

The AAO-HNS continues to collect data and further analysis will be done. Thank you to the members of the AAO-HNS Patient Safety Quality Improvement and Infectious Disease Committees as well as other involved Academy members for putting into action the necessary tools and research to effect change.

AAO-HNS Statements

The following statements have been issued by the Academy during the weeks since the COVID-19 pandemic:

  • Position Statement: Tracheotomy Recommendations During the COVID-19 Pandemic (REVISED APRIL 2, 2020)
  • AAO-HNS Responds to CMS Statement on Adult Elective Surgery and Procedures Recommendations (UPDATED: March 26, 2020)
  • Position Statement: Otolaryngologists and the COVID-19 Pandemic (March 23, 2020)
  • Anosmia, Hyposmia, and Dysgeusia Symptoms of Coronavirus Disease (March 22, 2020)
  • AAO-HNS New Recommendations Regarding Urgent and Nonurgent Patient Care (March 20, 2020)

More COVID-19 Resources

Please bookmark the AAO-HNS Coronavirus Disease 2019: Resources web page for access to the latest information and tools, including:

  • State and federal financial relief information
  • Updates from the CDC, CMS, FDA, NIH, and other federal agencies
  • Information for you, your practice, and your patients
  • Shared clinical research and news from around the specialty

Content is being added frequently to address the varying and timely needs of our global otolaryngology community. https://www.entnet.org/content/coronavirus-disease-2019-resources

More from May 2020 – Vol. 39, No. 4
Lee
Humanitarian Travel Grant: Janet Lee, MD
Since 2014, Jeremy D. Meier, MD, from the University of Utah and Peter Appiah-Thompson, MD, of Cape Coast Teaching Hospital at the School of Medical Sciences in the University of Cape Coast, Ghana, have worked together to provide the people of Western Ghana with otolarnygologic care. This year marked the fifth anniversary of their partnership.
1136917902
Emerging Data Support a Personalized Approach for Elderly Patients with Head and Neck Cancer
Head and neck surgeons are increasingly concerned about following best practices when caring for elderly individuals with head and neck cancer. At the AAO-HNSF 2019 Annual Meeting & OTO Experience, this topic organically arose during three separate oncologic committee meetings.
636207236
Transition to In-office Treatments: Sleep
Otolaryngologists are fast recognized by the public, government, and industry as leaders in the management of obstructive sleep apnea (OSA). With a prevalence that is estimated to approach 14 percent of the population, OSA is not simple to treat, and patients benefit from a personalized approach.
UpperAirwayStimulation
Upper Airway Stimulation: A New Frontier in the Treatment of OSA
Obstructive sleep apnea (OSA) affects a significant portion of the adult population. Many patients do not tolerate continuous positive airway pressure (CPAP), which is the gold-standard treatment. Over the past 30 years, numerous surgeries have been developed to enlarge the upper airway but fail to address the underlying loss of muscle tone associated with sleep onset, which is pivotal to the pathogenesis of obstructive sleep apnea.
GeriatricCochlear
Health Disparities in Geriatric Cochlear Implantation
Hearing loss is no longer considered a part of normal aging. The negative impact of hearing loss on mental, physical, and cognitive functioning has been well-documented in geriatric populations. Most notably, a recent study suggested hearing loss as a potentially modifiable risk factor responsible for 9 percent of dementia cases.
Stern
Incorporating Advanced Practice Providers into Your Practice
Hopefully you have been following this series, learning more about the physician-advanced practice provider (APP) team approach to healthcare, and are ready to get started with recruiting and contracting. Your practice profile and management will benefit from a variety of approaches, and to help parse out these ideas, I have asked my colleague Scott P. Stringer, MD, MS, to share his experience.
Scale
Disequilibrium of Aging
Disequilibrium and associated balance disorders are common in older patients, with a prevalence of about 30 percent in those over the age of 60 years, increasing to 50 percent in those over the age of 85 years.
AgingVoice
Changing the Dialogue about Aging Voice
Raspy. High-pitched. Low volume. Weak. Tired. Patients have described the progressive changes over time in their voices in myriad ways. Although some may simply assume that these changes are part of the “normal aging” process, about 10 million elderly people do report a voice problem each year. The reported prevalence of dysphonia in the elderly ranges between 6 and 29 percent.
Boston1
Bringing Together the World of Otolaryngology in Boston This Fall
The AAO-HNSF 2020 Annual Meeting & OTO Experience will unite the specialty as one this September to once again bring together thought leaders, offer unparalleled education, and provide access to the latest products and services to optimize ENT patient care.
md_all
Future Faces of Otolaryngology
Match Day 2020 was decidedly different from years past. The COVID-19 pandemic meant social distancing and cancelled receptions at medical schools across the country.
PracticeProfile1
Revolutionizing the Scope of Practice of Otolaryngology in Military Medicine
Dr. Joan T. Zajtchuk, COL (ret.) MC, U.S. Army, joined the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) when she returned from the Vietnam War in 1972. “My career trajectory in academic medicine after my residency was uncertain,” she explained. “A military career was unusual for a woman.
YPS
Uncertainty and Its Impact on the Young Otolaryngologist
Being a young otolaryngologist is simultaneously incredibly exciting and utterly terrifying even on a routine day-to-day basis. Keeping patients alive with precarious medical conditions, mastering your craft, building your practice, and discovering your preferences all while traversing the complex landscape of medicine in America is difficult in and of itself.
ASGO
Geriatric-Specific Otolaryngology Approaches
For decades, pediatric otolaryngologists have taught that children are not just small adults and that their care requires adopting unique approaches. It has become clear that geriatric patients are not just old adults but individuals who require diagnostic and therapeutic strategies different from those used for younger adults.
Lee
At the Forefront
In addition to serving multiple functions as the clinical data registry for otolaryngology-head and neck surgery, Reg-ent is also utilized by members to submit data to the Centers for Medicare & Medicaid Services (CMS) per the requirements of the Merit-based Incentive Payment System (MIPS).
Talk Bubbles
Peer Support: Taking Care of Ourselves and Each Other
Much of our identity is wrapped up in the culture of our profession as otolaryngologists, surgeons, healers. This is a good thing. It doesn’t negate our other core identities: mom, wife, daughter, sister, friend, activist, etc. We are all a synthesis of these various parts of our whole being.
James C. Denneny III, MD, AAO-HNS/F EVP/CEO
Our Otolaryngology Community: Collaborating and Sharing Experiences for Everyone’s Mutual Benefit
Our May issue typically has been used to promote our Annual Meeting & OTO Experience as well as other upcoming events. Clearly, this is the most atypical May I have experienced during my four decades of treating otolaryngology patients. Most of the world is beginning to see some needed light at the end of the tunnel, and physicians are either incrementally returning to practice or planning for that eventuality in the near future.
Duane J. Taylor, MD, AAO-HNS/F Past President
A Time for Our Equanimity under Duress
My hope is that you and your families are healthy and safe as you continue to manage, communicate with, and care for your patients in some way. I realize that difficult times like these can bring us closer as a specialty and make us more poised and better positioned to understand, research, educate, empathize, interact, and work through the challenges caused by this global pandemic.