COVID Anchoring Bias & Tick-Borne Disease Diagnosis

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses.
(Photo Credit: Alissa Eckert, MS; Dan Higgins, MAMS)

Harold W. Horowitz, et al., published the research letter, “COVID-19 and the Consequences of Anchoring Bias” in the CDC’s August publication of the monthly journal, Emerging Infectious Diseases. The authors disclose how suspected coronavirus disease in febrile patients can influence healthcare providers’ decisions and may result in misdiagnosing other serious infections with epidemiologic risk.

The paper provides two patient cases illustrating how this biased mindset can have potentially severe consequences. This was demonstrated by human granulocytic anaplasmosis, and Lyme disease detected in a pregnant woman, and human granulocytic anaplasmosis in another person.

The article’s contributors acknowledge the devastating effects caused by a missed COVID-19 diagnosis, including the epidemiologic impacts. However, they emphasize that failing to diagnose tick-borne illnesses, as well as other infections, can also have harmful patient outcomes. They urge healthcare providers to keep an open mind despite pressure to evaluate for COVID-19 and to also consider other diagnoses when evaluating febrile patients.

Read the research letter.

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