Abstract:
:Although the benefit of population-level public facial masking to protect others during the COVID-19 pandemic has received a great deal of attention, we discuss for one of the first times the hypothesis that universal masking reduces the "inoculum" or dose of the virus for the mask-wearer, leading to more mild and asymptomatic infection manifestations. Masks, depending on type, filter out the majority of viral particles, but not all. We first discuss the near-century-old literature around the viral inoculum and severity of disease (conceptualized as the LD50 or lethal dose of the virus). We include examples of rising rates of asymptomatic infection with population-level masking, including in closed settings (e.g., cruise ships) with and without universal masking. Asymptomatic infections may be harmful for spread but could actually be beneficial if they lead to higher rates of exposure. Exposing society to SARS-CoV-2 without the unacceptable consequences of severe illness with public masking could lead to greater community-level immunity and slower spread as we await a vaccine. This theory of viral inoculum and mild or asymptomatic disease with SARS-CoV-2 in light of population-level masking has received little attention so this is one of the first perspectives to discuss the evidence supporting this theory.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Gandhi M,Beyrer C,Goosby Edoi
10.1007/s11606-020-06067-8subject
Has Abstractpub_date
2020-10-01 00:00:00pages
3063-3066issue
10eissn
0884-8734issn
1525-1497pii
10.1007/s11606-020-06067-8journal_volume
35pub_type
杂志文章abstract:BACKGROUND:Twenty-eight states have passed breast density notification laws, which require physicians to inform women of a finding of dense breasts on mammography. OBJECTIVE:To evaluate changes in breast cancer stage at diagnosis after enactment of breast density notification legislation. DESIGN:Using a difference-in...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3904-y
更新日期:2017-06-01 00:00:00
abstract::African Americans and Latinos use services that require a doctor's order at lower rates than do whites. Racial bias and patient preferences contribute to disparities, but their effects appear small. Communication during the medical interaction plays a central role in decision making about subsequent interventions and ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2003.20532.x
更新日期:2003-02-01 00:00:00
abstract:PURPOSE:Middle-aged men are at high risk of suicide. While about half of those who kill themselves visit a primary care clinician (PCC) shortly before death, in current practice, few spontaneously disclose their thoughts of suicide during the visits, and PCCs seldom inquire about such thoughts. In a randomized controll...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05769-3
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:In our ever-increasingly multicultural, multilingual society, medical interpreters serve an important role in the provision of care. Though it is known that using untrained interpreters leads to decreased quality of care for limited English proficiency patients, because of a short supply of professionals and...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2502-5
更新日期:2013-12-01 00:00:00
abstract::This paper presents a case for careful consideration of theory in planning to implement evidence-based practices into clinical care. As described, theory should be tightly linked to strategic planning through careful choice or creation of an implementation framework. Strategies should be linked to specific interventio...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00362.x
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Post-hospital discharge follow-up appointments are intended to evaluate patients' recovery following a hospitalization, but it is unclear how appointment statuses are associated with readmissions. OBJECTIVE:To examine the association between post-discharge ambulatory follow-up status, (1) having a scheduled...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06569-5
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:Fluid resuscitation is a widely used intervention that is mandated in the management of sepsis. While its use can be life-saving, its overuse is associated with harm. Despite this, the best means of assessing a need for fluid resuscitation in an acute medical setting is unclear. OBJECTIVE:To assess studies ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05073-9
更新日期:2019-09-01 00:00:00
abstract::Despite improved knowledge about the benefits and harms of treatments for chronic back pain in the past several decades, there is a large and consequential mismatch between treatments found safe and effective and those routinely covered by health insurance. As a result, care for back pain has, if anything, deteriorate...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05099-z
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Extension for Community Healthcare Outcomes (ECHO) and related models of medical tele-education are rapidly expanding; however, their effectiveness remains unclear. This systematic review examines the effectiveness of ECHO and ECHO-like medical tele-education models of healthcare delivery in terms of improve...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05291-1
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Data on patients with coronavirus disease 2019 (COVID-19) who return to hospital after discharge are scarce. Characterization of these patients may inform post-hospitalization care. OBJECTIVE:To describe clinical characteristics of patients with COVID-19 who returned to the emergency department (ED) or requ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-020-06120-6
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To develop and evaluate a web-based curriculum to introduce first year medical students to the knowledge and attitudes necessary for working with limited English proficient (LEP) patients through interpreters. METHOD:Six hundred and forty first year medical students over 4 consecutive years took this curric...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.0193.x
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Multiple payment reform efforts are under way to improve the value of care delivered to Medicare beneficiaries, yet few directly address the interface between primary and specialty care. OBJECTIVE:To describe regional variation in outpatient visits for individual specialties and the association between spec...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3745-8
更新日期:2016-11-01 00:00:00
abstract::The authors surveyed 112 recent alumni and 92 current residents (70% responded) at a residency program that requires original research. Most alumni felt that the research project was a valuable learning experience, particularly in improving their abilities to critically review the medical literature. Almost a third fe...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599759
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Continuity clinics are a critical component of outpatient internal medicine training. Little is known about the population of patients cared for by residents and how these physicians perform. OBJECTIVES:To compare resident and faculty performance on standard population health measures. To identify potential...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06420-x
更新日期:2021-01-21 00:00:00
abstract::Starfield and colleagues have suggested four overarching attributes of good primary care: "first-contact access for each need; long-term person- (not disease) focused care; comprehensive care for most health needs; and coordinated care when it must be sought elsewhere." As this series on reinventing primary care highl...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3945-2
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Little is known about pain care offered to patients discontinued from long-term opioid therapy (LTOT) by their prescriber due to aberrant behaviors versus other reasons. OBJECTIVE:This study aimed to compare rates of non-opioid analgesic pharmacotherapy initiation and clinician referrals for non-pharmacolog...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4329-6
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Medicare has selected 10 hospital-acquired conditions for which it will not reimburse hospitals unless the condition was documented as "present on admission." This "no pay for errors" rule may have a profound effect on the clinical practice of physicians. OBJECTIVE:To determine how physicians might change t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-010-1395-9
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:There is a growing focus on improving the quality and value of health care delivery for high-cost patients. Compared to fee-for-service Medicare, less is known about the clinical composition of high-cost Medicare Advantage populations. OBJECTIVE:To describe a high-cost Medicare Advantage population and iden...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4759-1
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:Determine patient and hospital-level variation in proportions of low-severity admissions. DESIGN:Retrospective cohort study. SETTING:Thirty hospitals in a large metropolitan region. PATIENTS:A total of 43,209 consecutive eligible patients discharged in 1991 through 1993 with congestive heart failure (n = 2...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1525-1497.1997.00073.x
更新日期:1997-07-01 00:00:00
abstract::LM Montgomery's The Blue Castle was first published in 1926, yet contains many insights into medical practice that remain relevant today. The protagonist, Valancy, mistakenly receives a terminal diagnosis in a letter from her physician, who has sent her a note intended for another patient. Her interactions with the ph...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1394-x
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Few patient-centered interventions exist to improve year-end residency clinic handoffs. AIM:Our purpose was to assess the impact of a patient-centered transition packet and comic on clinic handoff outcomes. SETTING:The study was conducted at an academic medicine residency clinic. PARTICIPANTS:Participants...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3009-4
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:To determine whether the results of the Internal Medicine In-Training Examination (ITE) can predict subsequent performance on the American Board of Internal Medicine certifying examination (ABIMCE). DESIGN:Retrospective data review. SETTING:A mixture of six community hospital and university-based internal m...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599105
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:African-American (black) and white individuals have been shown to differ in their desire for life-sustaining treatments and their use of living wills for end-of-life care, but the reasons for these differences are unclear. This study was designed to test the hypothesis that these ethnic differences exist beca...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600155
更新日期:1996-11-01 00:00:00
abstract::Three hundred ninety-one cases of chronic lymphocytic leukemia (CLL) from the Tumour Registry of Manitoba, spanning a 20-year period from January 1960 to December 1979, were reviewed. Survival curves were developed using the staging systems of Rai and Binet. A clear separation in survival was found utilizing the syste...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596118
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVE:To determine the incremental cost-effectiveness of a quality improvement depression intervention (enhanced care) in primary care settings relative to usual care. DESIGN:Following stratification, we randomized 12 primary care practices to enhanced or usual care conditions and followed patients for 12 months. ...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1525-1497.2003.20611.x
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Patients frequently experience suboptimal transitions from the hospital to the community, which can increase the likelihood of readmission. It is not known which care coordination services can lead to improvements in readmission rates. OBJECTIVE:To evaluate the effects of two care coordination interventions...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-017-4218-4
更新日期:2018-05-01 00:00:00
abstract:INTRODUCTION:US adults with serious mental illness (SMI), compared to those without SMI, have a higher prevalence of smoking, which contributes to a shorter life expectancy. This study compared current smoking and quitting-related characteristics of low-income US adults with and without SMI who received healthcare at f...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-04857-3
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Depression is common among older patients yet is often inadequately treated. Patient beliefs about antidepressants are known to affect treatment initiation and adherence, but are often not expressed in clinical settings. OBJECTIVE:To explore attitudes toward antidepressants in a sample of depressed, communi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.00296.x
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:In 1996, the Health Care Financing Administration (HCFA) introduced new evaluation and management (E&M) guidelines mandating more intensive supervision and documentation by attending physicians. We assessed the effects of the guidelines on inpatient teaching. DESIGN:Pretest-posttest, nonequivalent control gr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1525-1497.2000.07001.x
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Despite the availability and demonstrated effectiveness of office-based buprenorphine maintenance treatment (BMT), the systematic examination of physicians' attitudes towards this new medical practice has been largely neglected. OBJECTIVE:To identify facilitators and barriers to the potential or actual impl...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0881-9
更新日期:2009-02-01 00:00:00