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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
    Click to Tweet

     

    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • April 09, 2020

    By Pam Farrare-Wilmore

    Keeping your hands clean is the best way to protect you and your family from COVID-19. Here’s a quick look at best practices you can implement right away.

    Hand Soap or Sanitizer?

    Either one! Both are equally effective for coronavirus protection if you follow the proper steps for use.

    For handwashing:

    • Run hands under water (any temperature) and use enough soap to work up a good lather to cover your hands
    • Vigorously scrub every surface of your hands and fingers for 20 seconds minimum (you probably already know that’s the Happy Birthday song, sung twice!)
    • Pay careful attention to often-missed spots, like the back of your hands, your fingertips, and your fingernails
    • Rinse well, but don’t turn off the faucet yet! (Remember: Your hands weren’t clean when you first turned it on)
    • Dry your hands well with a clean towel, THEN use the towel to turn off the faucet…and to open the door, if applicable

    Extra Tip: I personally recommend placing paper towels by your sinks if more than a couple of people share them. Otherwise, replace your cloth hand towels daily.

    For hand sanitizing:                                                                                                       

    • Choose a hand sanitizer that’s at least 60% alcohol
    • Dispense enough into your hands to cover all parts of your hands and fingers
    • Scrub every surface as you would for hand washing (see above)
    • Continue to rub the sanitizer into your skin until it dries completely

    Extra Tip: Check the expiration date on your hand sanitizer. If it’s expired, the alcohol content may be reduced, so it may no longer contain the minimum 60% alcohol concentration needed to effectively kill germs.

    Hand hygiene is the number one way to prevent transmission of diseases such as #coronavirus. Hand soap or sanitizer? Either one if done properly, says infection control expert Pam Farrare-Wilmore. https://bit.ly/2USn2Ly via @MedStarWHC
    Click to Tweet
     

    Six Feet, Really? Even If I’m Not Sick?

    Yes! We all know that a cough or sneeze can send respiratory droplets into the air. But people also spray these tiny droplets just by talking. Because COVID-19 is widespread in the region, people may be contagious before any obvious symptoms appear. So play it safe and keep your distance.

    The six-foot separation is recommended by the Centers for Disease Control and Prevention based on scientific studies of how far respiratory droplets typically travel by air before dropping.

    Housecleaning Every Week? Every Day?

    You don’t have to do a full housecleaning every day, but make sure to wipe off high-touch surfaces with a disinfecting agent frequently—especially surfaces other people touch. COVID-19 can linger on certain surfaces for up to two or three days once it lands there.

    Don’t forget these frequently touched surfaces in and near your home:

    • Table and counter tops (wipe clean before disinfecting)
    • Backs of chairs
    • Faucets and flush handles
    • Doorknobs, kitchen handles, drawer pulls
    • Banisters/railings
    • Remotes and touchpads
    • Light switches
    • Pet leashes and cages
    • Car handles, knobs, steering wheels
    • For electronics—phones, tablets, laptops—look up the manufacturer’s recommendations to clean safely

    Many brands of ready-to-use, household “disinfectant” or “germicidal” cleaners or wipes will provide effective cleansing. To ensure a product is proven effective for novel coronavirus disinfection, review the Environmental Protection Agency’s list of Disinfectants for Use Against SARS-CoV-2. Products on this list always carry an assigned “EPA registration number” on their package.

    Extra Tip: You can make your own highly effective disinfectant solution with bleach and water. The CDC recommends mixing 1/3 cup bleach per gallon of water or 4 teaspoons bleach per quart of water.

    Are Stronger Cleaning Solutions Better?

    Not necessarily. It’s important to remember that the water component of any hand sanitizer or disinfecting cleaner is important as well! Water is an essential ingredient in these solutions; higher concentrations are less potent because proteins are not denatured easily in the absence of water.

    So avoid using straight alcohol on your hands or undiluted bleach on household surfaces. It’s not as effective for coronavirus protection and can also be harmful.

    What Can I Learn From What MedStar Washington Hospital Center Is Doing?

    Maintaining a clean and safe environment is a priority for our patients, visitors, and associates. In addition to routine environmental cleaning, we are keenly aware of high-touch surfaces, such as railings, door handles, tabletops, and bathroom fixtures. We clean these areas frequently each day. This is the same approach you should take in your home.

    A few years ago, we also started using a technique known as no-touch disinfection. This technique uses ultraviolet light technology as an added measure to decontaminate surfaces in patient rooms, procedural areas, and public restrooms. Of course, you can’t do that kind of thing at home. But staying on top of a regular cleaning routine—and doing a thorough job of it—can go a long way to protect against virus transmission.

  • April 07, 2020

    By Matthew L. Pierce, MD

    You may be surprised to learn that oral cancer is one of the deadliest and most disfiguring forms of cancer.

    About 53,000 Americans are affected by it each year, including men and women, smokers and non-smokers, young adults and older ones. April is Oral Cancer Awareness Month, a great reminder to review the basics about who’s at risk for this disease and what you can do to monitor for it, so you’re able to spot the signs in the early stages when this cancer is easiest to treat.

    FACT 1:  The phrase “oral cancer” can often refer to two very different kinds of cancer.

    Oral cavity cancer occurs in the front part of the mouth—most commonly the tongue, floor of the mouth, inside of cheeks, and lips. The primary culprit is tobacco use (smoking or chewing varieties), followed by frequent alcohol consumption, and repeated trauma within the mouth from problems like poor-fitting dentures, loose teeth, or even chronic tongue biting. This type of cancer can be very aggressive and difficult to treat successfully.

    Oropharyngeal cancer affects the back of the mouth, including the tonsils, back of the tongue, larynx, and upper throat. While tobacco, alcohol, and mouth trauma can play a role in oropharyngeal cancer, we now recognize that human papillomavirus, or HPV, is the most common underlying cause of this condition. HPV is in the same family of sexually transmitted viruses—often better known to patients as a cause of cervical cancer—for which we now have a widely recommended vaccine for adolescents and young adults. This type of cancer often responds better to available treatments.

    FACT 2:  While one type of this cancer is trending downward, the other is on the rise—especially in younger adults.

    Decreases in tobacco use in the U.S. have no doubt fueled a decrease in the number of oral cavity cancers. We typically see these among people in their 60s and 70s.

    On the other hand, however, we’re seeing a rise in oropharyngeal, or back-of-the-mouth cancers, especially in adults in their 50s and 60s and sometimes much younger. This increase is directly related to certain types of sexually transmitted HPV infections, which can be passed during oral contact. Because these cancers may not appear for decades after exposure to HPV, it’s hard to tell how the HPV vaccine—which debuted in 2006—will affect these numbers in the years ahead, but we’ll likely see fewer cases as more people get vaccinated.

    For now, the Centers for Disease Control and Prevention (CDC) recommends routine HPV vaccination for everyone up to age 26, ideally starting before sexual activity. The vaccine is also recommended for other individuals in some cases, so ask your healthcare provider about it.

    Oral cancers don’t just affect smokers and seniors anymore, says Dr. Matthew Pierce. Find out who else is at risk. https://bit.ly/2xH8aI9 via @MedStarWHC
    Click to Tweet

    FACT 3: Oral cancer is often extremely serious.

    According to the Oral Cancer Foundation, just over half of people diagnosed with this cancer will live longer than five years, making it the sixth leading cause of cancer death in the U.S. That troubling statistic stems mainly from the fact that these cancers are often not diagnosed early, and the signs can be easy to miss. These can also be fast-growing cancers, especially when related to tobacco and/or alcohol use. (HPV-related back-of-the-mouth cancers have a better prognosis, with 80% to 90% of patients still alive after five years.)

    Required surgeries and other treatments can also be challenging and traumatic for a later-stage cancer. They can lead to disfigurements, such as removal of part of the tongue or other tissues, as well as problems with swallowing and speaking. It can be very difficult to return to a normal life after this type of cancer, so prevention and early detection are critical.

    FACT 4: You should check regularly for early signs.

    This is true for every adult but is even more important if you use tobacco or drink alcohol regularly. Take a look inside your mouth and feel around your neck every so often to be sure nothing has changed.

    Here are the signs to act on if they persist longer than two weeks:

    • A flat white or red patch anywhere in your mouth (note that, in its early stages, these cancers rarely cause discomfort)
    • A lip or mouth sore
    • A growth or lump inside your mouth or in your neck
    • Discomfort with swallowing
    • Hoarseness

    Regular twice-yearly dental visits are also an excellent way to monitor this cancer, as dentists are uniquely qualified to spot early signs of it. This kind of examination is typically part of a routine check-up and doesn’t cost extra. Primary care physicians also tend to do oral exams as part of their routine wellness exams.

    FACT 5: Early action and a good care team can make a life-saving difference.

    If you detect any potential signs of this cancer, don’t wait. Make an appointment with either your dentist, primary care physician, or an otolaryngologist. Your dentist or a medical specialist you’d be referred to would typically do a simple biopsy in their office and refer you for additional testing as needed. The biopsy requires a small sample of cells from the questionable area, and it’s quick and inexpensive. You’ll have results within a few days and, if anything is detected, an imaging test—such as a CT scan or PET scan—can provide more details.

    Because this diagnosis can affect many aspects of your life, it’s essential to choose a treatment center that offers a team approach. At MedStar Washington Hospital Center, our otolaryngologists are supported by a coordinated care team that includes medical oncologists, radiation oncologists, speech and physical therapists, oral surgeons, and counselors who can assist with the emotional impact this type of cancer can bring. This approach allows us to consider our patients holistically, recommend the best treatment options, and ensure they’re well cared for every step of the way.

    As more people recognize the early signs and take steps to prevent them—such as avoiding tobacco, minimizing alcohol, and getting the HPV vaccine for themselves and their children as recommended—there's hope that the statistics for oral cancer may improve significantly in the years ahead.

    Concerned about your mouth?

    Our specialists are here to help.

    Call 202-644-9526 or  Request an Appointment

  • April 06, 2020

    By MedStar Health

    When an unfamiliar disease strikes, it can cause tremendous fear and anxiety. We’ve seen it before—during the 1918 Spanish flu epidemic and, in more recent times, with HIV, SARS and the anthrax scare after 9/11.

    Fear and anxiety breed uncertainty, and that uncertainty tends to be most intense in the earliest phase of any crisis. As COVID-19 spreads across the country, we see the same concerns—fear of infection and of spreading the disease, and the stress of not knowing if you’ve been exposed.

    The good news: we are resilient, we will prevail. This storm will pass, as we are already witnessing in the nations that were affected first. Until then, apply these tips, tools and techniques to reduce anxiety and help you and your loved ones weather the COVID-19 pandemic.

    Breathe. Literally.

    Breathe deeply, 10 times, through the nose.

    I recommend practicing this daily, both on a routine basis and then whenever anxiety levels begin to rise. Deep breathing can calm you and give your brain time to pause, reset and slow down.

    Short-Term Focus, Long-Term Plan

    Anxiety often results when you feel you’re losing control. When events are bigger than us and changing rapidly, it’s easy to feel overwhelmed and powerless.

    Rather than dwell on all the things you cannot control, think about the things you can. What can you do, right now? Focusing on what you will do today, or even over the next few hours, can help you regain a sense of control and prevent the big picture from looming even larger. Some of those answers are clearly laid out: maintain social distance, limit travel, wash your hands often—all guidelines we have been following.

    Short-term planning is especially important when supervising children who are out of school. Planning the day, doing what and when, is a healthy focus. But understand that the schedule may get knocked off-track, so flexibility is key as well.

    Long-term planning is OK as long as we don’t obsess over an unpredictable future. Take care of your health. If you are on prescription medications, be sure you have enough on hand. If you have an urgent medical need, reach out to your provider. MedStar Health is doing what needs to be done to maintain business as usual while assuring preparedness to manage any virus situations that may arise. Communication is key. Call or use MedStar eVisit, if you need it.

    Do More of What Makes You Happy

    Though quite out of the ordinary, today’s situation is not without precedent. People have coped in similar circumstances.

    Most of us are lucky to have the basics—food, power and shelter. Look at the current scenario as an opportunity. What hobbies or other forms of personal development can you pursue, now that you have more time?

    • Spring is blossoming and the weather is warming up. Many will find gardening and yard work calming and productive
    • Get outside when the weather is good, as long as you maintain social distance
    • Get the guitar out of the closet, or dust off the piano. I grew up singing (poorly) and I find myself singing a lot more. It makes me feel good. I still sing poorly but I do it anyway
    • Spend quality time with your pets
    • Writing, art, cooking—devote time to anything creative that you enjoy

    Distance, Not Isolation

    Remember that distancing doesn’t mean isolation. We are going through this with technology that makes staying connected easier than ever.

    Stay in touch with friends and loved ones, by phone, email and social media—especially those with more restrictive limits, like the elderly in nursing homes.

    Occasionally Disconnect From TV and Social Media

    The illness is dominating the news cycle and it’s difficult to escape. It’s a good idea to limit news and social media. In the evenings, after answering COVID-19 emails for 30 minutes, I spend 30 minutes reading. Then I go to bed early. Turning off the barrage of information can be good for your mental health.

    Caring for others is an excellent way to care for yourself during the COVID-19 pandemic. Learn more via @MedStarHealth.

    Click to Tweet

    Put Others First

    No one individual alone can solve a crisis. But each of us can take action that benefits those around us. This powerful tool can actually improve your own outlook. Caring about others is a very effective way to care for yourself. Here are some examples:

    • Help the kids with schoolwork
    • Check—from a distance—on elderly neighbors and look for ways to help them cope
    • Reach out to family at a distance and any others at higher medical risk
    • Take a moment to contact anyone in your circle who may feel lonely or isolated

    Nobody Has All the Answers

    As the COVID-19 situation evolves, it is OK to feel anxious and not have all the answers. Do what you can, right now.

    We are all leaders. So we must act like leaders, with a mission and a sense of purpose. That will empower you and those around you to stay calm and focused.

  • April 05, 2020

    By MedStar Health

    Under the Affordable Care Act, large numbers of homeless adults gained Medicaid coverage and policymakers began to identify strategies to improve care and reduce avoidable hospital costs for homeless populations. “Medicaid Utilization and Spending among Homeless Adults in New Jersey: Implications for Medicaid‐Funded Tenancy Support Services” was published in The Milbank Quarterly by MedStar investigator Dr. Derek Delia, Director of Health Economics Research at MHRI. The study sought to examine data that would suggest tenancy support services (TSS) can reduce avoidable health care spending.

    The study utilized linked data from the Homeless Management Information System and Medicaid claims to identify homeless adults who could be eligible for Medicaid TSS in New Jersey.  The data compares their Medicaid utilization and spending patterns to matched non-homeless beneficiaries. Homeless adult beneficiaries have higher levels of health care needs compared to non-homeless adult Medicaid beneficiaries. 

    In 2016, more than 8,400 adults in New Jersey were estimated to be eligible for Medicaid TSS. Approximately 4,000 adults were living in permanent supportive housing, 800 formally designated as chronically homeless and 1,300 who were likely eligible for the chronically homeless designation, and over 2,000 who were at risk of becoming chronically homeless. In this study, the homeless adults tended to have substantial difficulties with mental health and substance abuse disorders and are more inclined to visit the emergency department or require inpatient admission. The results showed that Medicaid spending for a homeless beneficiary eligible for TSS ranged from 10% to 27% ($1,362 - $5,727) over what was spent on a non-homeless Medicaid beneficiary.

    The study found emergency care and inpatient admissions can possibly be avoided when individuals have access to high-quality, community-based care.  Providing tenancy support services to homeless adults may help the population achieve stable housing and other healthy living conditions.  In conclusion, Medicaid funding for TSS could reduce avoidable Medicaid utilization and spending.

    The research team included Derek DeLia, PhD, from MedStar Health Research Institute in collaboration with researchers from the Rutgers Center for State Health Policy, Monarch Housing Associates, and Rutgers School of Social Work.

    The Milibank Quarterly, DOI: 10.1111/1468-0009.12446

  • April 05, 2020

    By MedStar Health

    Congratulations to all MedStar researchers who had articles published in March 2020. The selected articles and link to PubMed provided below represent the body of work completed by MedStar Health investigators, physicians, and associates and published in peer-reviewed journals last month. The list is compiled from PubMed for any author using “MedStar” in the author affiliation. Congratulations to this month’s authors. We look forward to seeing your future research.

    View the full list of publications on PubMed.gov here.

    Selected research:

    1. Combined Vascular Brachytherapy and Stenting for the Treatment of In-Stent Restenosis
      The American Journal of Cardiology, 2020. DOI: 10.1016/j.amjcard.2019.11.035
      Chen Y, Buchanan KD, Chan RC, Zhang C, Torguson R, Satler LF, Waksman R.
    1. Ten Best Practices for Improving Emergency Medicine Provider-Nurse Communication.
      Journal of Emergency Medicine, 2020. DOI: 10.1016/j.jemermed.2019.10.035
      Hettinger AZ, Benda N, Roth E, Hoffman D, Iyer A, Franklin E, Perry S, Fairbanks RJ, Bisantz AM.
    1. The Effects of Global Budgeting on Emergency Department Admission Rates in Maryland.
      Annals of Emergency Medicine, 2020. DOI: 10.1016/j.annemergmed.2019.06.009
      Galarraga JE, Black B, Pimentel L, Venkat A, Sverha JP, Frohna WJ, Lemkin DL, Pines JM.
    1. Nationwide Survey on Implementation of 2011 Nuclear Regulatory Commission Policy on Release of Patients After 131I Therapy for Thyroid Cancer.
      The Journal of Nuclear Medicine,  2020. DOI: 10.2967/jnumed.119.230730
      Wu D, Gomes Lima CJ, Bloom G, Burman KD, Wartofsky L, Van Nostrand D.
    1. Racial differences in takotsubo cardiomyopathy outcomes in a large nationwide sample.
      ESC Heart Failure, 2020. DOI: 10.1002/ehf2.12664
      Zaghlol R, Dey AK, Desale S, Barac A.
  • April 05, 2020

    By MedStar Health

    Researchers from MedStar Washington Hospital Center and MedStar Georgetown University Hospital successfully delivered a healthy baby to a mom and dad who both tested positive for COVID-19. The case report, “An Uncomplicated Delivery in a Patient with COVID-19 in the United States” was published in the April 1 edition of The New England Journal of Medicine.

    This case describes uncomplicated labor and delivery in a 34-year old woman, at 39 weeks of gestation who was tested positive for COVID-19.  When presenting to the hospital, the mother had experienced a 3-day history of fever, chills, dry cough, and myalgia. She also reported decreased fetal movements over the previous day. The patient had not recently traveled, and her husband shared similar symptoms.

    The appropriate measures for care were initiated and she was transferred to the emergency department after no obstetrical intervention was determined to be needed.  The patient’s history and findings on the chest radiography were consistent with COVID-19.  On day two of her hospitalization, the patient began to experience irregular contractions and oxytocin was provided to initiate labor. Prior to delivery, neonatal intensive care physicians consulted with the patient to review hospital protocol for mother and baby separation in setting of COVID-19.  During her labor, the patient’s test results confirmed a positive result for COVID-19.

    Personal Protective Equipment (PPE) of hospital staff included gown, gloves, bouffant disposable surgical cap, knee high shoe covers, eye protection, and N95 mask. The patient always wore a facemask and was able to have a vaginal delivery without complications.

    The infant’s first COVID-19 test was performed at 24 hours of age, with a negative result and the second test at 48 hours is currently pending. The mother showed no subsequent fevers or increased symptoms and the infant was allowed home with parents after clearance given by the infectious disease service. The husband relocated to a hotel nearby to complete his quarantine period.

    The pediatric team followed up with the family and confirmed the baby is doing well and remains asymptomatic. The patient has a mild dry cough without fever or shortness of breath. The father of the infant is also doing well.  7 days after delivery, no caregivers appeared to be infected.

    The team included Sara N. Iqbal, M.D.; Rachael Overcash, M.D.; Neggin Mokhtari, M.D.; Haleema Saeed, M.D.; Stacey Gold, M.D.; Tamika Auguste, M.D.; Muhammad-Usman Mirza, M.D.; Maria-Elena Ruiz, M.D.; Masashi Waga, M.S.; Glenn Wortmann, M.D.; and Joeffrey J. Chahine, M.S.

    Congratulations to the team on the successful patient outcome, successful provider precautions, and on publication of this case report.

    The New England Journal of Medicine, DOI: 10.1056/NEJMc2007605