, more than 23 000 athletes gathered in Hopkinton, Massachusetts, and began the 26.2-mile course of the Boston Marathon. 1,2 Less than 6 hours after the start of the race, as runners continued to cross the finish line, 2 explosions, 12 seconds apart, sent shrapnel and debris through the crowd of families, friends, spectators, and runners gathered to cheer on those finishing the race. 3 At the BWH emergency department (ED), the first notification of the bombings came at 2:50 PM through the Boston Fire and EMS radio frequency. At 2: 54 PM, Central Medical Emergency Direction (CMED)

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The coronavirus disease 2019 (COVID-19) pandemic is exposing the fragility of health care in rural areas of the US. The pandemic-related hospital financial crisis may exacerbate the long-standing rural hospital closure crisis, worsening preexisting rural health disparities. 1 COVID-19 is spreading in a "checkerboard" pattern through hot spots in rural areas. Rural health care facilities have undergone

Objectives Navajo Nation is disproportionately affected by hantavirus cardiopulmonary syndrome (HCPS), a severe respiratory disease that can quickly progress to respiratory failure and cardiogenic shock. The initial signs and symptoms of HCPS are indistinguishable from coronavirus disease 2019 (COVID-19). However, this distinction is critical, as the disease course differs greatly, with most patients with COVID-19 experiencing mild to moderate illness. We set out to determine if the evaluation of peripheral blood smears for five hematopathologic criteria previously identified as hallmarks of hantavirus infection, or “the hantavirus 5-point screen,” could distinguish between COVID-19 and HCPS. Methods The hantavirus 5-point screen was performed on peripheral blood smears from 139 patients positive for COVID-19 seeking treatment from Tséhootsooí Medical Center and two Emory University hospitals. Results Of these 139 individuals, 136 (98%) received a score of 3/5 or below, indicating low suspicion for HCPS. While thrombocytopenia, one of the key signs of HCPS, was seen in the patients with COVID-19, it was generally mild and remained stable on repeat specimens collected 12 to 24 hours later. Conclusions Given these findings, the 5-point screen remains a useful rapid screening tool for potential HCPS cases and may be useful to distinguish early HCPS from COVID-19 in HCPS endemic regions.