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      Rapid Scholarly Dissemination and Cardiovascular Community Engagement to Combat the Infodemic of the COVID-19 Pandemic

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          Abstract

          To the Editor: While the body of literature on the novel coronavirus disease 2019 (COVID-19)-related cardiac complications rapidly expands alongside the exponential surge of confirmed cases, 1 print and social media pose significant challenges and opportunities in propagating an infodemic during the COVID-19 pandemic. As #COVID19 takes to trending on social media, #CardioTwitter steps up to combat misinformation. Within 24 hours, COVID-19-related hashtags accompanied #CardioTwitter in 124 of 560 (22%) tweets reaching over 600,000 individuals (Fig. 1 ). These were exemplified in health care professionals correcting preliminary and false assumptions online in the treatment of COVID-19, which included (1) the improper cessation of angiotensin-converting enzyme-inhibitors, angiotensin receptor blockers, and low-dose acetylsalicylic acid in patients with stable cardiovascular disease, and 2 ; (2) the ingestion of hydroxychloroquine with azithromycin as treatment of COVID-19, which is not recommended without proper physician supervision because of the risk of QT prolongation. 3 In this setting, the role of preprints, open-access information, and asynchronous global scholarly dissemination becomes ever so apparent. Figure 1 Word cloud of most frequently mentioned hashtags with tweets of #CardioTwitter within 24 hours (March 26, 2020). The Canadian Cardiovascular Society (CCS) established a COVID-19 Rapid Response Team led by President Dr Andrew Krahn, and swiftly put forward evidence-based and consensus-based recommendations to guide management and prepare for the surge of COVID-19-positive cardiovascular patients. 4 In collaboration with Elsevier, and together with other leading cardiology and cardiac surgery journals, the Canadian Journal of Cardiology lifted its paywall on COVID-19-related publications and instituted expedited peer-review of pertinent submissions to accelerate the generation and dissemination of groundbreaking research. In response to public demand, the CCS hosted a live-virtual townhall to provide practical advice to the cardiovascular community on how to implement their recommendations, address issues encountered, and offer potential solutions. In turn, on social media, medical professionals pool knowledge regarding COVID-19, propel open-source hackathons to address shortages in necessary medical equipment (eg, #BuildForCOVID19), raise awareness of challenges faced on the front line (eg, #GetMePPE), and empower the public to take charge of their own health (eg, #StayHomeSaveLives). Critical medical leadership is urgently required at all levels of our health systems. Now is the time for collaboration, rather than fragmentation, to provide the necessary care for our patients, while bettering our understanding of the complexities brought upon individuals’ cardiovascular health due to COVID-19. We applaud the CCS and the Canadian Journal of Cardiology for their efforts to promote cardiovascular physician engagement on social media and encourage all to join in to combat the infodemic of the era by using your voices as physicians to educate during the COVID-19 pandemic. Disclosures The authors have no conflicts of interest to disclose.

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          An interactive web-based dashboard to track COVID-19 in real time

          In December, 2019, a local outbreak of pneumonia of initially unknown cause was detected in Wuhan (Hubei, China), and was quickly determined to be caused by a novel coronavirus, 1 namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The outbreak has since spread to every province of mainland China as well as 27 other countries and regions, with more than 70 000 confirmed cases as of Feb 17, 2020. 2 In response to this ongoing public health emergency, we developed an online interactive dashboard, hosted by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University, Baltimore, MD, USA, to visualise and track reported cases of coronavirus disease 2019 (COVID-19) in real time. The dashboard, first shared publicly on Jan 22, illustrates the location and number of confirmed COVID-19 cases, deaths, and recoveries for all affected countries. It was developed to provide researchers, public health authorities, and the general public with a user-friendly tool to track the outbreak as it unfolds. All data collected and displayed are made freely available, initially through Google Sheets and now through a GitHub repository, along with the feature layers of the dashboard, which are now included in the Esri Living Atlas. The dashboard reports cases at the province level in China; at the city level in the USA, Australia, and Canada; and at the country level otherwise. During Jan 22–31, all data collection and processing were done manually, and updates were typically done twice a day, morning and night (US Eastern Time). As the outbreak evolved, the manual reporting process became unsustainable; therefore, on Feb 1, we adopted a semi-automated living data stream strategy. Our primary data source is DXY, an online platform run by members of the Chinese medical community, which aggregates local media and government reports to provide cumulative totals of COVID-19 cases in near real time at the province level in China and at the country level otherwise. Every 15 min, the cumulative case counts are updated from DXY for all provinces in China and for other affected countries and regions. For countries and regions outside mainland China (including Hong Kong, Macau, and Taiwan), we found DXY cumulative case counts to frequently lag behind other sources; we therefore manually update these case numbers throughout the day when new cases are identified. To identify new cases, we monitor various Twitter feeds, online news services, and direct communication sent through the dashboard. Before manually updating the dashboard, we confirm the case numbers with regional and local health departments, including the respective centres for disease control and prevention (CDC) of China, Taiwan, and Europe, the Hong Kong Department of Health, the Macau Government, and WHO, as well as city-level and state-level health authorities. For city-level case reports in the USA, Australia, and Canada, which we began reporting on Feb 1, we rely on the US CDC, the government of Canada, the Australian Government Department of Health, and various state or territory health authorities. All manual updates (for countries and regions outside mainland China) are coordinated by a team at Johns Hopkins University. The case data reported on the dashboard aligns with the daily Chinese CDC 3 and WHO situation reports 2 for within and outside of mainland China, respectively (figure ). Furthermore, the dashboard is particularly effective at capturing the timing of the first reported case of COVID-19 in new countries or regions (appendix). With the exception of Australia, Hong Kong, and Italy, the CSSE at Johns Hopkins University has reported newly infected countries ahead of WHO, with Hong Kong and Italy reported within hours of the corresponding WHO situation report. Figure Comparison of COVID-19 case reporting from different sources Daily cumulative case numbers (starting Jan 22, 2020) reported by the Johns Hopkins University Center for Systems Science and Engineering (CSSE), WHO situation reports, and the Chinese Center for Disease Control and Prevention (Chinese CDC) for within (A) and outside (B) mainland China. Given the popularity and impact of the dashboard to date, we plan to continue hosting and managing the tool throughout the entirety of the COVID-19 outbreak and to build out its capabilities to establish a standing tool to monitor and report on future outbreaks. We believe our efforts are crucial to help inform modelling efforts and control measures during the earliest stages of the outbreak.
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            Author and article information

            Contributors
            Journal
            Can J Cardiol
            Can J Cardiol
            The Canadian Journal of Cardiology
            Canadian Cardiovascular Society. Published by Elsevier Inc.
            0828-282X
            1916-7075
            4 April 2020
            4 April 2020
            Article
            S0828-282X(20)30315-9
            10.1016/j.cjca.2020.03.042
            7270554
            32299782
            55f190be-460e-4e56-90ed-5b66801b2a98
            © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

            Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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