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Progress Notes features doctors and medical students across the country on the frontlines of our health care system. Our views and experiences are diverse, but we share common goals and values. We speak up to move toward a future where everyone can have access to affordable, high-quality health care. Please share our posts, and follow us on Facebook and Twitter!


Weekly Rounds 08-09-2020


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DFA Action Item
Healthy Ballot

Doctors for America announced its Healthy Democracy Initiative this week as part of its Healing America 2020 Campaign in collaboration with our partners including VoteHealth2020 and RxVote. We ask you to join us in action to promote Healthy Democracy where you live.

We must change our nation’s narrative. We must act, before it’s too late.  We must ensure more doctors, medical students AND people most affected by COVID-19 VOTE in November.  

National Leadership Conference; Healing America 2020
NLC 2020

Register now to join your DFA colleagues for an inspiring virtual leadership conference during a pandemic and the most important election year of our lifetimes. The conference begins on Friday, August 28 at 5 pm ET with an intimate conversation with Vivek Murthey, MD, MBA about healers, our communities, and advocacy and will conclude on Saturday, August 29 at 8 pm ET with a powerful plenary on racism. In between there are plenaries and workshop sessions to train physicians and medical students to actively address structural racism, and issues of intersectionality The full agenda will be available soon. Register today!

DOCTORS FOR AMERICA AT WORK:

DFA Doctor Mona Mangat:We're living with the perils of American exceptionalism” Dr. Mangat, a longtime DFA leader, discusses dangers of reliance on American exceptionalism, with inequities in America’s healthcare system. (Mona V. Mangat, MD, Tampa Bay Times)

DFA Doctor Alice Chen:Why rural areas may be the next hotspot for COVID-19” Dr. Chen, co-founder of DFA, interviewed by Yahoo! Finance on the inconsistencies of leadership in America’s pandemic response. (Alice Chen, MD, Yahoo! Finance)

DFA Doctor Ranit Mishori:The United States needs a formal inquiry into our public health catastrophe” Dr. Mishori, writing on The BMJ’s Opinion blog, makes the case for a formal inquiry into the United States’s COVID 19 response in order to “produce a blueprint for preventing [the next pandemic]”. (Ranit Mishori, MD, FAAFP, theBMJopinion)

DFA Doctors Mara Divis, & Copello Fellow Juliana Morris: “Stop using false public health claims to attack immigrants” Drs. Divis and Morris, DFA Immigrant Health Justice leaders decry the Trump administration’s use of false public health claims to attack immigrants. File comments against latest DHS/DoJ effort to gut asylum by August 10 http://bit.ly/2DyABuX. (Mara Divis, DO, Juliana Morris, MD, Eva Raphael, MD, MPH, kevinmd.com)

Doctors For America is committed to healing America and building a system that makes health accessible to everyone. Please Make a Tax-Deductible Donation to Doctors for America to amplify the trusted voices of physicians and medical students on health and bring scientific expertise to the discourse on health policy. Together we must defeat structural racism. Please Click Here to Contribute.

 

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Weekly Rounds 08-02-2020


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DFA'S VIRTUAL NATIONAL LEADERSHIP CONFERENCE: 
Healing America 2020
August 28-29

DFA is pleased to open registration and introduce two of its keynote speakers at the upcoming virtual National Leadership Conference, Healing America 2020. 
On Friday, August 28 -- Dr. Vivek Murthy @VivekMurthy will talk about how critical physician advocacy is in 2020. Dr. Murthy is the Co-Founder of Doctors for America and was a U.S. Surgeon General under President Barack Obama.

On Saturday, August 29 -- Dr. Don Berwick @donberwick will talk about the moral determinants of health and the importance of  DFA’s Health for All work. Dr. Berwick is the longtime leader of the Institute for Healthcare Improvement and past administrator of CMS.
These two giant thought leaders in health care policy have been working to Heal America their entire careers.
~~ NLC registration

Please Make a Tax-Deductible Donation to Doctors for America so it can amplify the trusted voices of physicians and medical students in debates about the impact of structural racism and a pandemic on the health of the marginalized and the vulnerable in our country. DFA is committed to healing America and building a new system that will make health truly accessible to everyone; Please Click Here to Contribute.

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

Recent DFA Webinar: A Conversation with Don Berwick: Principled, Practical Approaches to Achieving Health for All.
July 27, 2020 - Hosted by Drs. Kate Kelley, and Meenakshi Bewtra; Health for All committee leaders
Webinar (Passcode: HFA-Berwick1!)  

DFA Doctor Pratima Gupta & advocate Libby Benedict  - One Hundred Years of Women's Suffrage - Health Care Advocacy, and Why We Vote - In recognition of the 100th anniversary of women's suffrage, we reviewed the difficulties reformists overcame in passing the 19th Amendment and discuss the similarities to current challenges in providing evidence-based, affordable, accessible women's health care. Many current health care problems arise from systemic, not medical, issues, and we can better focus on them through the lenses of the social determinants of health and reproductive justice. (William M Leininger, MD; Pratima Gupta, MD, MPH, The Green Journal)

DFA Doctor Leana S. Wen: Here’s What it Could Look Like If Schools Reopened Today - All of these steps are hard. They require strong leadership and substantial resources. But if we don’t take these actions and schools reopen prematurely, we will effectively have an uncontrolled experiment with students and teachers as the guinea pigs. Banks and airlines have been bailed out. Surely, we can dedicate the necessary resources to help our schools, too. (Washington Post)

THE WEEK IN QUOTES:

WALK WITH THE WIND, BROTHERS AND SISTERS: Like so many young people today, I was searching for a way out, or some might say a way in, and then I heard the voice of Dr. Martin Luther King Jr. on an old radio. He was talking about the philosophy and discipline of nonviolence. He said we are all complicit when we tolerate injustice. He said it is not enough to say it will get better by and by. He said each of us has a moral obligation to stand up, speak up and speak out. When you see something that is not right, you must say something. You must do something. Democracy is not a state. It is an act, and each generation must do its part to help build what we called the Beloved Community, a nation and world society at peace with itself.” - Rep. John Lewis, the Civil Rights Leader and Congressman Who Died on July 17, Wrote This Essay Shortly Before His Death.

A REVOLUTIONARY NOTION: "The life of John Lewis was, in so many ways, exceptional. It vindicated the faith in our founding, redeemed that faith; that most American of ideas; that idea that any of us ordinary people without rank or wealth or title or fame can somehow point out the imperfections of this nation, and come together, and challenge the status quo, and decide that it is in our power to remake this country that we love until it more closely aligns with our highest ideals. What a radical ideal. What a revolutionary notion. " - President Barack Obama - Eulogy of Civil Rights Icon John Lewis

VOTE: “Vote and let’s make this a democracy again.”  - Don Berwick - 54:25 of the Recording

I’M CONCERNED ABOUT YOU: Wearing a mask says: “I’m not just concerned about myself. I’m concerned about you, too. We are all part of the same community, the same country, and the same struggle to stay healthy.” - Thomas L. Friedman, NY Times Columnist

TRUSTED: “Doctors, nurses and hospitals have experienced a greater increase in consumer trust and confidence than any other industry during the coronavirus pandemic, according to a new Axios/Harris poll”  - Axios Vitals

ONE BIG WAVE: People are still thinking about seasons. What we all need to get our heads around is this is a new virus and ... this one is behaving differently, It’s going to be one big wave. It’s going to go up and down a bit, The best thing is to flatten it and turn it into just something lapping at your feet.” - WHO Spokesperson Margaret Harris

A TEXAS SIZED PROBLEM: "Texans who lose their health insurance that is tied to jobs simply have fewer options for new insurance because we do not have Medicaid expansion,"   - Elena Marks, Episcopal Health Foundation in Houston

AN ALZHEIMER'S BLOOD TEST This test really opens up the possibility of being able to use a blood test in the clinic to diagnose someone more definitely with Alzheimer’s, Amazing, isn’t it? I mean, really, five years ago, I would have told you it was science fiction.” - Maria Carrillo, Chief Science Officer at the Alzheimer’s Association 

ONE MORE TIME!: All of those claims are inaccurate. There is no known cure for COVID-19, hydroxychloroquine is not a proven treatment, and public health officials advise everyone to wear face masks in public”  - PolitiFact

Rx PRICES: Republicans say they won’t enact any changes that smack of price controls. Yet these same lawmakers also insist they firmly believe in the competitive power of free markets. A free market is when the country’s single largest purchaser of prescription drugs — Medicare — is able to exercise its economic clout in dealing with drugmakers. Until that happens, price controls are exactly what we have, except they favor corporations, not patients.” -David Lazarus - LA Times Columnist

REACH OUT: If you get an opinion piece, letter to the editor, or media appearance distributed PLEASE alert us at info@drsforamerica.org for publication in the next edition of the Physician Rounds. Your feedback is welcome.

MEDIA COVERAGE:

DOCTORS - MEDICINE & RESEARCH:
Aboard the Diamond Princess, a Case Study in Aerosol Transmission - A computer model of the cruise-ship outbreak found that the virus spread most readily in microscopic droplets light enough to linger in the air. … The Diamond Princess’ outbreak remains perhaps the most valuable case study available of coronavirus transmission — an experiment-in-a-bottle, rich in data, as well as a dark warning for what was to come in much of the world. (Benedict Carey and James Glanz, New York Times)

Study: Blood Test for Alzheimer's Detects Signs 20 Years Before Memory, Thinking Falter - A new blood test detected Alzheimer's disease as accurately as expensive brain scans or spinal taps, raising the possibility for a new, inexpensive option to diagnose the most common form of dementia, researchers said. (Ken Alltucker, USA Today)

Global Use of Broad-Spectrum Antibiotics Rising, Data Show - Global consumption of antibiotics that have a greater potential for driving antibiotic resistance nearly doubled from 2000 to 2015, according to a new analysis in The Lancet Infectious Diseases. (Chris Dall, Center for Infectious Disease Research and Policy)

Avoiding Care During the Pandemic Could Mean Life or Death - A study by the Centers for Disease Control and Prevention found that emergency room visits nationwide fell 42% in April, from a mean of 2.1 million a week to 1.2 million, compared with the same period in 2019. … Perhaps even more worrisome is the drastic falloff of routine screening, especially in regions hit hard by the virus.  (John M. Glionna, Kaiser Health News)

COVID-19:
More Than 1,000 Americans Are Dying of Covid-19 a Day - The daily count of confirmed Covid-19 deaths in the U.S. is showing how the world’s largest economy is struggling to contain the pandemic. The seven-day average of fatalities topped 1,000 for the first time since early June on Monday and has stayed above that level, following last month’s spike in infections. On Wednesday, the country marked another grim milestone: More than 150,000 Americans have succumbed to the virus. (Vivek Shankar, Bloomberg News)

The US Missed a Chance to Control Outbreak. Now It's 'impossible to Predict' How Long the Pandemic Will Last, Fauci Says - Without a national effort to adhere to preventative measures, the nation's top infectious disease doctor said, it will be impossible to predict how much longer the Covid-19 pandemic will last in the United States. (Madeline Holcombe, CNN)

Virus Testing Turnaround Times Reveal Wide Disparity - What’s happening in Florida is unfolding around the country. The pandemic is showing the problems created by a hodgepodge of public health systems that relies on private laboratories. Sometimes, local, state and federal public health officials don’t communicate well with each other, or with the private labs — or with the people waiting for results. (Tamara Lush, Associated Press)

Contact Tracing Is Failing in Many States. Here’s Why. - Contact tracing, a cornerstone of the public health arsenal to tamp down the coronavirus across the world, has largely failed in the United States; the virus’s pervasiveness and major lags in testing have rendered the system almost pointless. In some regions, large swaths of the population have refused to participate or cannot even be located, further hampering health care workers.  (Jennifer Steinhauer and Abby Goodnough, New York Times)

TRUMP ADMINISTRATION RESPONSE:
Millions to Lose $600 Weekly Jobless Aid Amid Senate Stalemate - With federal unemployment benefits expiring on Friday — a serious blow to millions of Americans who lost jobs due to the coronavirus pandemic — the Senate became bogged down in partisan fighting and left town without a resolution to the crisis. (John Bresnahan, Marianne Levine and Jake Sherman, Politico) 

‘Nobody Likes Me,’ Trump Complains, Renewing Defense of Dubious Science - Just over a week after he began a rebooted effort, driven by rising infection rates and sinking poll numbers, to talk about the virus in terms more in line with medical consensus, Mr. Trump was again making unfounded claims and defending discredited medical experts. It was the sort of eccentric, science-deficient performance that many of his aides believe unnerved the public during the spring and has come to gravely threaten his re-election prospects. (Michael Crowley, New York Times)

COVID-19 Hospital Data System That Bypasses CDC Plagued By Delays, Inaccuracies - Earlier this month, when the Trump administration told hospitals to send crucial data about coronavirus cases and intensive care capacity to a new online system, it promised the change would be worth it. The data would be more complete, transparent, and an improvement over the old platform run by the Centers for Disease Control and Prevention, administration officials said. Instead, the public data hub created under the new system is updated erratically and is rife with inconsistencies and errors, data analysts say. (Pien Huang & Selena Simmons-Duffin, National Public Radio)

AFFORDABLE CARE ACT AND COVERAGE ISSUES:
In Texas, 2 Big Problems Collide: Uninsured People and an Uncontrolled Pandemic - Texas' uninsured rate has been climbing along with its unemployment rate as COVID-19 cases surge in the state. Before the pandemic, Texas already had the highest rate and largest number of people without health insurance in the country. And 20 percent of all uninsured children in the U.S. live in Texas. This year the coverage gap in Texas has only gotten worse: 29 percent of Texas adults under 65 don't currently have health insurance, according to recent data from Families USA, a consumer health advocacy group that supports the Affordable Care Act. (Ashley Lopez, National Public Radio)

DRUG AFFORDABILITY:
Kodak Shifts Into Drug Production With Help of $765 Million U.S. Loan - Eastman Kodak Co. has won a $765 million government loan under the Defense Production Act, the first of its kind. The purpose: to help expedite domestic production of drugs that can treat a variety of medical conditions and loosen the U.S. reliance on foreign sources.(Rachael Levy, Wall Street Journal)

Pharmaceutical Executives Are Getting Multimillion-Dollar Payouts — Without Even Producing a Vaccine - Executives at pharmaceutical firms tasked with developing lifesaving drugs for the coronavirus — and receiving billions of dollars in federal funding — are taking home multimillion-dollar compensation packages even before their companies produce a working treatment…. “Drug companies are getting billions of dollars from taxpayers to develop a COVID-19 vaccine, so it's certainly concerning to see their executives cash out on their stock options before we know if the vaccine actually works,” said Eli Zupnick, a spokesman for Accountable.US, a progressive watchdog group, in an email. (Ben Popken, NBC News)

Pfizer Rethinking U.S. Expansion If Drug Pricing Orders Implemented - Pfizer Inc Chief Executive Albert Bourla said the drugmaker could rethink plans to expand in the United States if the country implements an executive order signed by President Donald Trump last week that would tie the prices Medicare patients pay for drugs to those paid by other countries. (Michael Erman, Reuters)

WOMXN’S HEALTH:
Federal Agencies Appeal Suspension of Abortion Pill Rule - The Trump administration has asked a federal appeals court to reinstate a rule that has required women to visit a hospital, clinic or medical office to obtain an abortion pill during the COVID-19 pandemic. A federal judge in Maryland agreed earlier this month to temporarily block enforcement of the rule. Justice Department attorneys asked U.S. District Judge Theodore Chuang to suspend his July 13 order while they appeal, but the judge refused on Thursday. The 4th U.S. Circuit Court of Appeals on Wednesday docketed the government’s appeal of Chuang’s decision. (Michael Kunzelman, Associated Press)




 


 

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Weekly Rounds 7-26-2020


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DFA’S WEEKLY ACTION ITEM: 

Please Make a Tax-Deductible Donation to Doctors for America so it can amplify the trusted voices of physicians and medical students in debates about the impact of structural racism and a pandemic on the health of the marginalized and the vulnerable in our country. DFA is committed to healing America and building a new system that will make health truly accessible to everyone; Please Click Here to Contribute.

Upcoming Webinar: 

A Conversation with Don Berwick: Principled, Practical Approaches to Achieving Health for All.  Join us for a webinar featuring Dr. Don Berwick, longtime leader of the Institute for Healthcare Improvement, past administrator of CMS, and author of the recent JAMA piece, The Moral Determinants of Health.

A Conversation with Don Berwick: Principled, Practical Approaches to Achieving Health for All. 
Monday, July 27 at 8 pm Eastern
Registration. If zoom is at capacity watch Facebook Live

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

Recent DFA Webinar: Quarentine’s Disproportionate Impact on Womxn - July 21, 2020
Deval Zaveri, MD; Libby Benedict, MPA;  Krista Niemczyk, MPP
Click to view our Webinar (Passcode: Womxn##4)

DFA Doctor Max Jordan and Nguemeni Tiako At Last, the Medical Profession Speaks Out for Black Lives - In July 2016, a month before I started medical school, Alton Sterling and Philando Castile were killed by police officers. Soon after came Terence Crutcher and Keith Lamont Scott. These instances of police brutality prompted a group of my classmates to attend a Black Lives Matter rally, donning their white coats. I didn’t attend because of a prior obligation. (MedScape)

THE WEEK IN QUOTES:

BACK TO SCHOOL? As a pediatrician and parent, I know how important it is to get students back in the classroom. We all want that. And with each day that passes, we know that communities of color — and students in those communities — likely will suffer disproportionately, just as we’ve seen with Blacks, Latinos and Native Americans across the nation in the first six months of this pandemic. In America, property taxes provide a large part of the funding for schools, so wealthy communities may be able to make the necessary changes while schools in lower income communities are left behind. We immediately need federal and state resources in place so that schools can reopen safely and equitably. Without adequate funding and better control of this pandemic, we’re setting ourselves up for failure. And tragically, we’ll be failing the students who can least afford this lost time to learn and thrive.”- Richard Besser, President and CEO Robert Wood Johnson Foundation

SOMETHING I DON’T LIKE TO SAY: It will probably, unfortunately, get worse before it gets better, Something I don’t like saying about things, but that’s the way it is.”....“Get a mask, Whether you like the mask or not, they have an impact. They will have an effect and we need everything we can get.”  - President Trump

THE TRUMP VIRUS: "Well, I think with the president's comments today, he recognized the mistakes he has made by now embracing mask-wearing and the recognition this is not a hoax. It is a pandemic that has gotten worse before it will get better because of his inaction, …”In fact, clearly, it is the Trump virus," -  Speaker Nancy Pelosi (D-Calif.)

ESSENTIAL WORKERS: "With most of the country reopening — whether it's safe or not — workers in so many occupations are put in the untenable position of having to choose between being able to sustain their families or putting their health at risk,"  Sharon Block, Executive Director of the Labor and Work-Life Program at Harvard Law School

THE SIDELINING OF SCIENCE: As current and former public health officials, researchers, and public health professionals, we call on our political leaders, members of the media and all Americans to reject the sidelining of science, to speak out against the silencing of scientists, and to champion open and public scientific discussions of the issues facing our country as we struggle to make progress against the SARS-CoV-2 pandemic. For that, we need the clear voices of government experts, including Dr. Fauci, to be available to the American public without limitation. That is the only path that can bring success in our efforts to control the virus.” - 3,500 Public Health Experts in a Letter in Support of Dr. Fauci

REACH OUT: If you get an opinion piece, letter to the editor, or media appearance distributed PLEASE alert Pete Van Vranken - pete@drsforamerica.org for publication in the next edition of the Physician Rounds. Your feedback is welcome.

MEDIA COVERAGE:

COVID-19:

U.S. Sees Spreading Infection, Spiking Deaths and Dwindling Supply of PPE - More deaths, more infections, and more restrictions. The spread of the coronavirus pandemic shows no sign of easing, and officials are scrambling to respond….All of this as testing delays, and shortages in personal protective equipment, are again growing acute. At a House hearing in Washington today, the head of the Federal Emergency Management Agency, Pete Gaynor, acknowledged shortcomings. (Stephanie Sy, PBS NewsHour)

Mistrust of a Coronavirus Vaccine Could Imperil Widespread Immunity - A growing number of polls find so many people saying they would not get a coronavirus vaccine that its potential to shut down the pandemic could be in jeopardy. Distrust of it is particularly pronounced in African-American communities, which have been disproportionately devastated by the virus. But even many staunch supporters of immunization say they are wary of this vaccine. (Jan Hoffman, New York Times)

True Number of U.S. Coronavirus Infections Likely 10 Times Larger Than Reported, CDC Data Shows - The true number of U.S. coronavirus cases so far could be six to 24 times larger than official figures show, according to CDC data. (David Lim, Politico)

Public Health Group Calls for Standardized Data Collection to More Clearly Track Covid-19- The assessment, released Tuesday by the nongovernmental organization Resolve to Save Lives, calls on states and communities to start recording and sharing standardized data on 15 key metrics, so that people — and health departments — can get a clearer picture of how the response to the pandemic is working in their area. (Helen Branswell, STAT)

COVID-19 TESTING:

US Labs Buckle Amid Testing Surge; World Virus Cases Top 15M - Laboratories across the U.S. are buckling under a surge of coronavirus tests, creating long processing delays that experts say are undercutting the pandemic response. (Matthew Perrone, Tammy Webber and Matt Sedensky, Associated Press)

US Lab Giant Warns of New Covid-19 Testing Crunch in Autumn - The largest laboratory company in the US has warned it will be impossible to increase coronavirus testing capacity to cope with a surge in demand during the autumn flu season, in a sign that crippling delays will continue to hamper the American response to the pandemic. (David Crow, Financial Times)

PERSONAL PROTECTIVE EQUIPMENT:

FEMA Head: 'We Have a Ways to Go' on Having Enough PPE - The head of the Federal Emergency Management Agency (FEMA) told Congress on Wednesday the country has “a ways to go” on getting enough protective equipment for health workers fighting coronavirus, though he said the situation has been improving. “I want to be clear: We have a ways to go on making sure we have enough PPE,” Administrator Pete Gaynor said at a congressional hearing, referring to personal protective equipment. “This is not as simple as just throwing a light switch and we just magically make more.” (Peter Sullivan, The Hill)

Nurses Place Shoes on Capitol Lawn for Every Colleague Who Died of Coronavirus - Members of a national nurses union laid pairs of shoes representing their colleagues who have died while treating coronavirus patients on the lawn of the U.S. Capitol on Tuesday. The demonstration, organized by National Nurses United (NNU), was designed to encourage Congress to invoke the Defense Production Act and mandate that U.S. manufacturing plants switch production to manufacture personal protective equipment (PPE), such as gloves and masks. (John Bowden, The Hill)

STRUCTURAL RACISM - THE PUBLIC HEALTH CRISIS:

The Virus Found a Crowded Houston Neighborhood, Sparing One Nearby - The starkly divergent ways in which the coronavirus has affected neighboring communities in the Houston area — one rich and one poor — underscore how it is a magnifier of inequities. To see how the virus can largely spare one neighborhood but upend one next door, look at Bellaire, with its tidy yards and spacious homes, and Gulfton, where apartment blocks pack residents in tight. (J. David Goodman, New York Times)

 'Crashing Down’: How the Child Care Crisis Is Magnifying Racial Disparities - The collapse of the child care industry is hitting women of color the hardest, threatening to stoke racial and gender inequities and putting pressure on Congress to address the crisis in its new round of coronavirus aid. Black and Latina women are suffering a double-barreled blow as coronavirus-induced shutdowns batter the industry, since they dominate the ranks of child care providers and have long struggled to gain access to the services for their own kids. (Eleanor Mueller, Politico)

TRUMP ADMINISTRATION RESPONSE: 

Trump’s End Run Around CDC Brings Threat of Fewer Drugs for Hospitals - A Trump administration change in the way hospitals report coronavirus data is bringing confusion and more work to medical centers and states as cases explode across the country. And hospitals that don’t get it right every day could end up receiving fewer critical drugs like remdesivir. (Darius Tahir and Rachel Roubein, Politico

AFFORDABLE CARE ACT AND COVERAGE ISSUES:

How Laid-Off Americans May ‘Fall Through the Cracks’ Of the Health Care System During COVID-19 - In a country where many rely on their employer for health care coverage, the economic crisis has also left a significant number of Americans uninsured. According to a report released by the nonpartisan organization Families USA during the week of July 13, an estimated 5.4 million workers in the U.S. are uninsured because of job losses they experienced from February to May this year. Another recent study by the Commonwealth Fund found that among people who lost a job or were furloughed because of the pandemic, two out of five had health care through their job, and one out of five of those respondents said that they or a spouse or partner was now uninsured. (Courtney Vinopal, PBS NewsHour)

‘Surprise’ Billing Fix Likely Out of Next Covid-19 Package as Fight Over Tests Plays Out - Congress looks unable to protect patients from "surprise" medical bills before the election, despite a push from key health committee chairs and the Trump administration to include a fix in a new coronavirus relief package. ..."Surprise" billing protections — once thought to be a bipartisan rallying point, and an increasing concern of patient advocates during the pandemic — appear as stuck as ever, with powerful health industry interests gridlocked. (Susannah Luthi and Rachel Roubein, Politico)

Democratic AGs Sue Trump Administration Over LGBTQ Health Protections Rollback - A coalition of 23 Democratic state attorneys general are suing the Trump administration over a rule that scraps ObamaCare's nondiscrimination protections for LGBTQ patients. ...The administration's rule, released in June, will roll back implementation of the Affordable Care Act's Section 1557, which prohibits federally funded health programs and facilities from discriminating against patients based on race, color, national origin, sex, disability or age. (Nathaniel Weixel, The Hill)

DRUG AFFORDABILITY:

Many Drug Companies Working on Covid-19 Vaccines and Treatments Are Lobbying Harder Than Usual - Pharmaceutical companies racing to develop coronavirus treatments and vaccines have upped their lobbying presence in the past three months, as drug companies work to combat the pandemic and fend off many lawmakers’ longstanding quest to lower drug prices via regulation. (Lev Facher, STAT)

US Signs Contract with Pfizer for COVID-19 Vaccine Doses - The Trump administration will pay Pfizer nearly $2 billion for a December delivery of 100 million doses of a COVID-19 vaccine the pharmaceutical company is developing, Health and Human Services Secretary Alex Azar announced Wednesday. The U.S. could buy another 500 million doses under the agreement, Azar said. … Americans will receive the vaccine for free, the companies said. … Pfizer is finishing an earlier stage of testing to determine which of four possible candidates to try in a larger, final study. (Darlene Superville, Associated Press)

Trump Likely to Sign Executive Orders on Drug Pricing Friday - President Trump is likely to sign executive orders on Friday aimed at lowering drug prices, elevating a key issue for voters in an election year. (Peter Sullivan, The Hill)

IMMIGRANT AND REFUGEE HEALTH JUSTICE:

DHS Experts Issue Warning as ICE Attempts to Reinstitute Family Separation - Government Accountability Project Clients Urge Congress to Prevent Imminent Harm - Government Accountability Project clients Drs. Scott Allen, Pamela McPherson, and Josiah ‘Jody’ Rich, medical and mental health experts for the Department of Homeland Security’s Office of Civil Rights and Civil Liberties (DHS CRCL), sent a letter last week to Congress urging them to prevent Immigration and Customs Enforcement  (ICE) from separating immigrant children from their families under the guise of a federal court order. The doctors warned that separating children from their families will exacerbate the physical and mental trauma already experienced by children in detention, as well as that of detained families who know they are unable to protect themselves from the deadly, rapidly spreading pandemic. (Government Accountability Project)

ICE Detainees Remain in Facility During Coronavirus Outbreak Despite Judge's Order Mandating Their Release - Nearly 350 migrant parents and children remain detained in facilities with coronavirus outbreaks nearly a month after a federal court ruled all children must be released “with all deliberate speed” from Immigration and Customs Enforcement (ICE) detention facilities. A total of 346 children and parents remain detained in the facilities, despite District Judge Dolly Gee’s order in June, NBC News reported. In her ruling, Gee said the facilities were “on fire, and there is no more time for half measures.” (Zack Budryk, The Hill)

SUBSTANCE USE DISORDER:

How the Pandemic is Complicating America’s Addiction Crisis - According to preliminary data, drug overdoses killed nearly 72,000 Americans in 2019, a record high. Now, it appears that 2020 is on track to be even worse, as the U.S. has witnessed a startling rise in overdoses during the pandemic. William Brangham reports on how increased isolation, economic uncertainty and reduced access to care have exacerbated American addiction -- with deadly consequences. (William Brangham & Mike Fritz PBS NewsHour)

FDA Tells Doctors to Discuss Overdose Antidote With Patients - Doctors who prescribe opioid painkillers should tell their patients about a potentially life-saving medication that can reverse drug overdoses, according to new federal guidelines issued Thursday. (Matthew Perrone, Associated Press)

DOCTORS - MEDICINE & RESEARCH:

CDC Now Recommends Coronavirus-Positive People Isolate For 10 Days, Not 14 Days - The CDC had previously recommended people who test positive isolate until they had two negative swabs for the coronavirus — but that turned out to be impractical given the shortage of tests. It now advises most people with active cases of COVID-19, the illness caused by the coronavirus, to isolate for 10 days after symptoms begin and 24 hours after their fever has broken. After that, they are free to leave isolation. (Ariana Eunjung Cha, Washington Post)

Plastics and Pesticides: Health Impacts of Synthetic Chemicals in Us Products Doubled in Last 5 Years, Study Finds - The proof is piling up: Many synthetic chemicals can harm your health and that of your children. Evidence has doubled in the last five years about the negative impact on our health of endocrine-disrupting chemicals in plastics, pesticides, flame retardants and other merchandise, according to a new review of recent literature. (Sandee LaMotte, CNN)


 

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Weekly Rounds 7-19-2020


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 DFA ACTION ITEM: 

Please sign change.org’s petition - We Need A Federal Mask Mandate. As doctors and medical students, we know first hand how important it is to follow science and keep our patients, ourselves and our loved ones safe. WEAR A MASK.   The science is clear - We are all safer if we all wear masks in public. This is a public health issue not a political issue.

We implore Congress to urgently implement a national mandate for masking to halt the spread of COVID-19.   A national mandate for universal masking will save lives, revitalize our economy, allow our children to return to school, and unite the country against our common enemy, COVID-19. SIGN THE PETITION HERE

Please Make a Tax-Deductible Donation to Doctors for America so it can amplify the trusted voices of physicians and medical students in debates about the impact of structural racism and a pandemic on the health of the marginalized and the vulnerable in our country. DFA is committed to healing America and building a new system that will make health truly accessible to everyone; Please Click Here to Contribute.

Upcoming Webinar:

Register; If Zoom is at capacity, join us on Facebook Live

Deval Zaveri, MD: Deval, following medical school in India, entered residency training in psychiatry at SUNY Downstate Medical Center in Brooklyn NY and has worked in acute care psychiatric settings, focused on underserved communities.

Libby Benedict, MPA: (she/her/my name) Libby is the Womxn’s Policy Institute Program Manager at the Womxn’s Foundation California. Prior to the Foundation, she was the Director of Physicians for Reproductive Health’s Leadership Training Academy, a national program that trains doctors to become reproductive health advocates. She graduated from UCLA (BA, Sociology/Criminology), and Golden Gate University (MPA). 

Krista Niemczyk, MPP: Krista is the Public Policy Director for the The California Partnership to End Domestic Violence (the Partnership) where she represents domestic violence programs at various government agencies, including the California State legislature. Through this advocacy, Krista ensures that the voices of domestic violence programs and survivors are heard and reflected in public policies.

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

Recent DFA Webinar: Abortion Under Attack During COVID - July 13, 2020
Pratima Gupta, MD; Bhavik Kumar, MD, MPH; Fabiola Carrion, JD
View a Recording (Passcode: Womxn##3)

DFA BOARD MEMBER CEDRIC DARK: Researchers Find New, More Contagious Coronavirus Strain - Emergency Medicine Physician, Dr. Cedric Dark, Weighs in on 'America's News HQ - Alarming new research may tell why Houston is having such a high spike in corona virus cases.Joining me now Cedric Dark emergency medicine physician assistant professor at Houston's Baylor College of Medicine is also the founder of Policy Prescriptions and a board member of Doctors for America.

DFA COPELLO FELLOW PRATIMA GUPTA: One Hundred Years of Women's Suffrage - Health Care Advocacy, and Why We Vote - In recognition of the 100th anniversary of women's suffrage, we reviewed the difficulties reformists overcame in passing the 19th Amendment and discuss the similarities to current challenges in providing evidence-based, affordable, accessible women's health care. (Obstetrics & Gynecology)

DFA COPELLO FELLOW CHRISTINE JAMES: People With COVID-19 Who Live in Highly Polluted Areas Are More Likely to Die -  The COVID-19 pandemic has shone a spotlight on the health inequities many Americans face because of where they live and the air they breathe. Physicians and other health care workers must advocate for more stringent air quality standards. (KevinMD)

DFA MEDICAL STUDENTS, ROB PALMER, ISAAC FREEDMAN, AND JOSH HYMAN: Doctors and Democracy: Why Vote-By-Mail is Good Public Health - Yale medical students working on vote-by-mail initiatives get published in (The Health Care Blog).

THE WEEK IN QUOTES:

SLAPPING THE FACE OF SCIENCE:When you disrespect Tony on matters of public health science, you’re slapping in the face all of U.S. science,” - Dr. David Relman, a Microbiologist at Stanford University

ZERO CREDIBILITY: "First of all, the people speaking out against Tony Fauci have absolutely no medical credibility, no public health credibility, and frankly, no policy credibility when it comes to any kind of disaster or situation involving human health, They are undermining not just Fauci but everyone in the administration. You cannot have a competent public health response without a clear communication strategy. This isn't it." Georges Benjamin, the Executive Director of the American Public Health Association

DR ANTHONY FAUCI: I cannot figure out in my wildest dreams why they would want to do that, (Attack Dr. Fauci)  I think they realize now that that was not a prudent thing to do, because it’s only reflecting negatively on them….  I think the problem is too important for me to get into those kinds of thoughts and discussions. I just want to do my job. I’m really good at it. I think I can contribute. And I’m going to keep doing it.” Dr. Anthony Fauci

BLOCKED: The district court blocked Georgia’s abortion ban, because it violates over 50 years of Supreme Court precedent and fails to trust women to make their own personal decisions,” Sean Young, American Civil Liberties Union of Georgia

WE STILL HAVE A TESTING PROBLEM: I know it isn’t popular to talk about in some Republican circles, but we still have a testing problem in this country. My son was tested recently; we had to wait 5 to 7 days for results. My daughter wanted to get tested before visiting her grandparents, but was told she didn’t qualify. That is simply inexcusable at this point in the pandemic.” - Former Trump White House Chief of Staff Mick Mulvaney

UNREAL: There are more guns than people in the United States (400 million are in circulation for a population of 330 million).  In just the first six months of 2020, approximately 19 million firearms have been sold, representing more than one firearm for every 20 Americans.” (Phillip Levine and Robin McKnight -Brookings Institute

AN UNNECESSARY DILEMMA: “So we’re now facing a terrible, unnecessary dilemma. If we reopen in-person education, we risk feeding an out-of-control pandemic. If we don’t, we impair the development of millions of American students, inflicting long-term damage on their lives and careers. And the reason we’re in this position is that states, cheered on by the Trump administration, rushed to allow large parties and reopen bars. In a real sense America drank away its children’s future.  - Paul Krugman New York Times Opinion Columnist

TRUMP ADMINISTRATION STRIPS C.D.C. OF CONTROL OF CORONAVIRUS DATA: Centralizing control of all data under the umbrella of an inherently political apparatus is dangerous and breeds distrust, It appears to cut off the ability of agencies like C.D.C. to do its basic job.” - Dr. Nicole Lurie, Who Served as Assistant Secretary for Preparedness and Response Under Former President Barack Obama

STRONG FEDERAL LEADERSHIP: If you look at every country that has been successful in managing this, it’s been strong federal leadership, While all public health is local, federal direction is huge.” - Michael Osterholm, Director of the University of Minnesota’s Center for Infectious Disease Research and Policy

REACH OUT: If you get an opinion piece, letter to the editor, or media appearance distributed PLEASE alert Pete Van Vranken - pete@drsforamerica.org for publication in the next edition of the Physician Rounds. Your feedback is welcome.

MEDIA COVERAGE: 

AFFORDABLE CARE ACT AND COVERAGE ISSUES:

Millions Have Lost Health Insurance in Pandemic-Driven Recession - The coronavirus pandemic stripped an estimated 5.4 million American workers of their health insurance between February and May, a stretch in which more adults became uninsured because of job losses than have ever lost coverage in a single year, according to a new analysis. (Sheryl Gay Stolberg, New York Times)

As Millions Lose Health Insurance, Trump Administration Offers Little Help - As millions of people lose jobs in the coronavirus outbreak, jeopardizing their health benefits, the Trump administration and many states are doing little if anything to connect Americans with other insurance coverage. The U.S. Health and Human Services Department hasn’t launched any special effort to publicize the availability of Medicaid, the Children’s Health Insurance Program or health plans being sold on marketplaces created by the Affordable Care Act. And federal officials haven’t made any substantial new commitment of money for outreach or to help people enroll in coverage. (Noam Levey, LA Times)

Imagine a World With a COVID-19 Pandemic and Without the Affordable Care Act. Trump Does. - If the Trump administration wants to cripple the nation’s ability to fight COVID-19, add to the suffering of the infected and  undermine our health care system over the long term, it could hardly pick a better strategy than repealing the Affordable Care Act in the throes of the worst health care crisis the nation has faced since 1918. (Dr. David Blumenthal, President of the Commonwealth Fund, USA Today)

Supreme Court Appears Likely to Sidestep Obamacare Hearing Before Election - The Supreme Court has all but ruled out hearing a GOP-backed challenge to Obamacare before Election Day, likely avoiding a high-stakes showdown over a lawsuit that will factor prominently into this fall's campaigns. (Susannah Luthi, Politico)

Pandemic Upends Trump’s Plans to Shrink Health Care Safety Net - Voters in even the reddest parts of the country are approving or weighing Medicaid expansions as the coronavirus tears through communities and historic levels of unemployment leave workers without health coverage. And Republican governors aren't lining up for Trump’s two major moves to restrict Medicaid: work requirements for many adults and block grants to states instead of open-ended funding. (Rachel Roubein, Politico)

WOMEN’S HEALTH:

Federal Judge Voids Georgia ‘Heartbeat’ Abortion Restriction - A federal judge on Monday permanently blocked Georgia’s 2019 “heartbeat” abortion law, finding that it violates the U.S. Constitution. U.S. District Judge Steve Jones ruled against the state in a lawsuit filed by abortion providers and an advocacy group. Jones had temporarily blocked the law in October, and it never went into effect. The new ruling permanently enjoins the state from ever enforcing House Bill 481. .. Republican Gov. Brian Kemp, who has supported the restriction, immediately vowed an appeal. “We will appeal the court’s decision,” Kemp said in a statement. “Georgia values life and we will keep fighting for the rights of the unborn.” (Jeff Amy, Associated Press)

Judge: Women Can Get Abortion Pill Without Doctor Visits - A federal judge agreed Monday to suspend a rule that requires women during the COVID-19 pandemic to visit a hospital, clinic or medical office to obtain an abortion pill. U.S. District Judge Theodore Chuang in Maryland concluded that the “in-person requirements” for patients seeking medication abortion care impose a “substantial obstacle” to abortion patients and are likely unconstitutional under the circumstances of the pandemic. (Michael Kunzelman, Associated Press)

STRUCTURAL RACISM - THE PUBLIC HEALTH CRISIS:

Racism in Care Leads to Health Disparities, Doctors and Other Experts Say as They Push for Change - The protests over the deaths of black men and women at the hands of police have turned attention to other American institutions, including health care, where some members of the profession are calling for transformation of a system they say results in poorer health for black Americans because of deep-rooted racism. (Tonya Russell, Washington Post)

Latinos Hit Hard by Coronavirus, but Chicago Suggests It’s Even Worse Than it Looks - Official statistics show that Latinos are hospitalized and dying from the coronavirus at four times the rates of whites, but even those high numbers may be seriously underestimated, says Andres Ramirez, a health care expert with Protect Our Care, a coalition trying to fend off Republican attacks on the Affordable Care Act. (Kristian Ramos, Washington Post)

COVID-19 TESTING:

Virus Spread, Not Politics Should Guide Schools, Doctors Say - As the Trump administration pushes full steam ahead to force schools to resume in-person education, public health experts warn that a one-size-fits-all reopening could drive infection and death rates even higher. They’re urging a more cautious approach, which many local governments and school districts are already pursuing. But U.S. Education Secretary Betsy DeVos doubled down on President Donald Trump’s insistence that kids can safely return to the classroom. “There’s nothing in the data that suggests that kids being in school is in any way dangerous,” she told Chris Wallace on “Fox News Sunday.” (Lindsey Tanner, Associated Press)

PERSONAL PROTECTIVE EQUIPMENT: 

Trump Administration's Delayed Use of 1950s Law Leads to Critical Supplies Shortages - Nearly four months after invoking a 1950s-era law in order to compel businesses to manufacture equipment for the fight against the coronavirus, the Trump administration has made only sparing use of its authorities, leaving front-line workers in dire need of supplies like masks, gowns and gloves amid the recent surge in cases. (Priscilla Alvarez, Curt Devine, Drew Griffin and Kristen Holmes, CNN)

TRUMP ADMINISTRATION RESPONSE: 

As the Coronavirus Crisis Spins Out of Control, Trump Issues Directives — but Still No Clear Plan - There is no cohesive national strategy, apart from unenforced federal health guidelines. Instead, the administration is offering a patchwork of solutions, often in reaction to outbreaks after they occur. Although Trump and his team declare sweeping objectives, such as reopening schools, they have largely shirked responsibility for developing and executing plans to achieve them, putting the onus instead on state and local authorities. (Philip Rucker, Yasmeen Abutaleb and Ashley Parker, Washington Post)

Trump Administration Strips C.D.C. of Control of Coronavirus Data - Hospitals have been ordered to bypass the Centers for Disease Control and Prevention and send all patient information to a central database in Washington, raising questions about transparency. (Sheryl Gay Stolberg, New York Times)\

Hospital Officials, Experts Say New Federal Rules for Covid-19 Reporting Will Add Burdens During Pandemic - State health leaders, public health experts and hospital officials warn that an abrupt change in how the Trump administration requires them to report coronavirus data will increase the burden on facilities already strained by the pandemic and could impede the distribution of critical medicines. (Amy Goldstein and Lena H. Sun, Washington Post)

IMMIGRANT AND REFUGEE HEALTH JUSTICE:

Doctors Not Part of DHS Review of Migrant Children’s Deaths - A government auditor did not employ medical professionals when his office cleared U.S. border agents of wrongdoing in the deaths of two Guatemalan children, the auditor said Wednesday. (Nomaan Merchant, Associated Press)

Die in Detention or at Home? U.s. Pandemic Forces Cruel Choice on Asylum Seekers - Reuters spoke to more than 30 lawyers, immigration advocates, detainees and their family members who said the risks of contracting COVID-19 inside detention facilities have driven people to seek deportation. Fifteen immigration lawyers and advocates, who together say they have received hundreds of requests from detainees seeking to leave facilities in eight U.S. states for health reasons, told Reuters they are seeing increases in the number of people considering abandoning their cases. Reuters found 12 cases of detainees who stopped fighting their cases and instead agreed to deportation or voluntary departure due to the pandemic. (Laura Gottesdiener, Reuters)

GUN VIOLENCE EPIDEMIC:

Record Numbers of Americans Try to Buy Guns - Americans are buying guns in record numbers. The new coronavirus pandemic, civil unrest after the killing of George Floyd and the ensuing movement to defund police are bringing in new buyers worried about their personal safety, according to buyers, store owners and gun experts….  Background checks in June for civilians seeking a license to carry were the highest since the FBI began conducting checks 20 years ago. (Julie Wernau and Zusha Elinson, Wall Street Journal)

Three Million More Guns: the Spring 2020 Spike in Firearm Sales - When Americans are concerned about their personal security, they buy firearms. Such concerns have been rampant since March, initially due to the onset of the COVID-19 pandemic and then the social unrest in June that followed George Floyd’s killing. Our estimates indicate that almost three million more firearms have been sold since March than would have ordinarily been sold during these months. Half of that increase occurred in June alone. This pattern highlights an important potential consequence that may result from this tumultuous period: more firearms in the hands of private citizens. (Phillip Levine and Robin McKnight, Brookings Institute

SUBSTANCE USE DISORDER:

New Peak of 71k US Overdose Deaths in 2019 Dashes Hopes - Nearly 71,000 Americans died of drug overdoses last year, a new record that predates the COVID-19 crisis, which the White House and many experts believe will drive such deaths even higher. Preliminary numbers released Wednesday by the Centers for Disease Control and Prevention show the trend is driven by fentanyl and similar synthetic opioids, which accounted for 36,500 overdose deaths. Deaths involving cocaine and methamphetamine also are rising. With billions of dollars devoted to ending the opioid epidemic, policymakers had hoped overdose deaths would continue to decline, or at least plateau, after 2018 showed a dip for the first time in three decades. (Carla K. Johnson, Associated Press)

Opioid Overdoses Have Skyrocketed Amid the Coronavirus, but States Are Nevertheless Slashing Addiction Treatment Program Budgets - Drug overdoses have skyrocketed and demand for addiction treatment medicine has soared as the coronavirus pandemic continues. But many cash-strapped states are nevertheless slashing budgets for opioid crisis programs… The budget cuts — many spurred by state budget shortfalls wrought by the economic consequences of the coronavirus pandemic — will hit behavioral health services when they are needed most, addiction treatment advocates told STAT. (Amy Sokolow, STAT)

DOCTORS - MEDICINE & RESEARCH:

First Coronavirus Vaccine Tested in Humans Shows Early Promise - An experimental coronavirus vaccine made by the biotech company Moderna provoked a promising immune response against the virus and appeared safe in the first 45 people who received it, researchers reported on Tuesday in The New England Journal of Medicine. (Denise Grady, New York Times)

Coronavirus Associated With Heart Damage, Study Finds - More than half of COVID-19 patients showed some form of heart damage in scans after their illness, according to a recent study that adds to mounting evidence showing the virus may cause cardiac injury. An observational analysis of more than 1,200 confirmed and suspected COVID-19 patients across 69 countries between April 3 and April 20 found heart abnormalities in 55% after they underwent echocardiograms, with 1 in 7 experiencing severe cardiac disease. The results were recently published in the European Heart Journal–Cardiovascular Imaging. (Steven Ross Johnson, Modern Healthcare)

 

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Weekly Rounds 7-12-2020


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DFA ACTION ITEM:

Immigrant Health Justice: The administration has proposed new rules that would dismantle asylum as we know it, including - allowing judges to reject requests without an in-person court appearance, and eliminating protections for domestic violence survivors, and much more. This is part of a broader xenophobic campaign. Please help stop these inhumane proposals by making a public comment by July 15th. The notice to the proposed rule and link to submit comments may be submitted online here. View suggested language here.

Please Make a Tax-Deductible Donation to Doctors for America so it can amplify the trusted voices of physicians and medical students in debates about the impact of structural racism and a pandemic on the health of the marginalized and the vulnerable in our country. DFA is committed to healing America and building a new system that will make health truly accessible to everyone; Please Click Here to Contribute.

Register; If Zoom is at capacity,  Facebook Live

Fabiola Carrion, JD: Fabiola is a senior attorney at the National Health Law Program (NHeLP), an organization dedicated to protecting and promoting the health rights of low-income individuals. Fabiola is based in Los Angeles.

Bhavik Kumar, MD, MPH: Bhavik is a family medicine physician and Medical Director for Primary and Trans Care at Planned Parenthood Gulf Coast, in Houston, Texas. He has also been an abortion provider in his home state of Texas since 2015.

Pratima Gupta, MD: Pratima is an obstetrician/gynecologist at UCSD and Planned Parenthood. She is on the Board of Directors of Close the Gap California which works towards getting more women elected to State office. 

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

DFA Founders Vivek H. Murthy and Alice T. Chen :Here's the Best Way to Take Care of Your Mental Health During the Pandemic - Better policies are essential to improving our mental health and well-being. But policy ultimately flows from the culture and values that shape our decisions. This is our moment to re-center our lives and our country around a simple but powerful credo: put people first. Covid-19 is our opportunity to recommit to one another, to recognize that human connection is the foundation for greater health, resilience and fulfillment. (CNN)

DFA Member Leana S. Wen: If Trump Wants to Reopen Schools, Here’s What His Administration Needs to Do  - We have already seen what happens when reopening occurs too soon and without the proper safeguards. If getting schools back is the top priority that the Trump administration says it is, it needs to do the hard work and provide the necessary funding to get there. Arbitrary timelines and empty rhetoric will only harm students, parents and teachers. (Washington Post)

DFA Webinar Last Week:
Telehealth Prenatal Care: Patient Impact During COVID and After - July 8, 2020
Elissa Edmunds, MA: Meghana Rao, MD  Ariste Sallas-Brookwell, LICSW
View Recording (Passcode: Passcode: Womxn##2)

REACH OUT: If you get an opinion piece, letter to the editor, or media appearance distributed PLEASE alert Pete Van Vranken - pete@drsforamerica.org for publication in the next edition of the Physician Rounds. Your feedback is welcome.

THE WEEK IN QUOTES:

SIDELINING SCIENCE:Sidelining science has already cost lives, imperiled the safety of our loved ones, compromised our ability to safely reopen our businesses, schools, and places of worship, and endangered the health of our democracy itself,” - Officials from the Trump, Obama and George W. Bush Administrations

NO HAND ON THE TILLER: At a time when our country needs an orchestrated, all-hands-on-deck response, there is simply no hand on the tiller,” - Beth Cameron, Former Senior Director for Global Health Security and Biodefense on the White House National Security Council

WE ARE NOT POWERLESS: We are urging the American public to take the simple steps we know will help stop the spread of the virus: wearing a face mask, maintaining physical distancing, and washing hands. We are not powerless in this public health crisis, and we can defeat it in the same way we defeated previous threats to public health—by allowing science and evidence to shape our decisions and inform our actions” - An Open Letter to the American Public from The American Hospital Association, the American Medical Association and the American Nurses Association

TOO TOUGH: The president said today we just don’t want the guidance to be too tough, And that’s the reason next week the CDC is going to be issuing a new set of tools.” - Vice President Mike Pence 

OPEN UP THE SCHOOLS: Even before the pandemic, our nation’s public schools were chronically underfunded. Reopening schools now, without more investment, presents serious risks to the health and safety of our students and educators. What's worse, the administration is now threatening to ignore health experts and issue their own ‘less restrictive’ guidelines, prioritizing politics over the health and safety of students, parents, and educators. This move is not only irresponsible, it is dangerous," Representative Bobby Scott, House Education and Labor Committee Chairman (D-VA.) 

NO CHILDCARE: It’s amazing to me how many people are worried that Americans won’t go back to work because unemployment pays too darn much, I’m way more worried about people not going back to work because they have no child care.” - Betsey Stevenson, University of Michigan Economics Professor

BIRTH CONTROL COVERAGE WEAKENED: Today, for the first time, the Court casts totally aside countervailing rights and interests in its zeal to secure religious rights to the nth degree,"  - Supreme Court Justice Ruth Bader Ginsburg 

MEDIA COVERAGE

COVID-19:

239 Experts With One Big Claim: The Coronavirus Is Airborne - If airborne transmission is a significant factor in the pandemic, especially in crowded spaces with poor ventilation, the consequences for containment will be significant. Masks may be needed indoors, even in socially-distant settings. Health care workers may need N95 masks that filter out even the smallest respiratory droplets as they care for coronavirus patients. Ventilation systems in schools, nursing homes, residences and businesses may need to minimize recirculating air and add powerful new filters. Ultraviolet lights may be needed to kill viral particles floating in tiny droplets indoors. (Apoorva Mandavilli, New York Times)

The Coronavirus Can Be Airborne Indoors, W.H.O. Says - The coronavirus may linger in the air in crowded indoor spaces, spreading from one person to the next, the World Health Organization acknowledged on Thursday. …. growing scientific and anecdotal evidence suggest this route may be important in spreading the virus, and this week more than 200 scientists urged the agency to revisit the research and revise its position.  (Apoorva Mandavilli, New York Times)

The U.S.' New Default Coronavirus Strategy: Herd Immunity - By letting the coronavirus surge through the population with only minimal social distancing measures in place, the U.S. has accidentally become the world’s largest experiment in herd immunity. (Caitlin Owens, Axios)

Grim Projection: 200,000 Dead by Election Day - As the United States surpasses 3 million coronavirus infections, forecasters are updating their models to account for the recent resurgence and reaching a grim consensus: the next few months are going to be bad. The national death toll is now expected to eclipse 200,000 by Election Day, according to the latest models. (Dan Goldberg and Adam Cancryn, Politico)

Bipartisan Group of Former Government Officials Demand Science-Based Approach to Pandemic - Fifty-seven former government scientists and public health officials of both parties called on Monday for a science-based approach to the coronavirus pandemic and criticized the Trump administration for marginalizing science and expertise in its response. (Yasmeen Abutaleb, Washington Post)

Hospitals Struggle to Contain Covid-19 Spread Inside Their Walls - U.S. medical centers have reported 5,000-plus cases of patients likely catching the coronavirus once admitted for other conditions, adding to the strain of the pandemic itself - In the fight against the coronavirus, the nation’s hospitals are a refuge for the sickest. Yet despite their intensive efforts, hospitals also are a place where the virus sometimes spreads. (Russell Gold and Melanie Evans, Wall Street Journal)

STRUCTURAL RACISM - THE PUBLIC HEALTH CRISIS:

Racism in Health Care Isn't Always Obvious - As physicians, we believe that recognizing it begins with understanding our own privilege and biases.  Health care workers are constantly thinking about how to improve the quality of care being delivered to our patients. However, we rarely talk about our own biases toward our patients—let alone racial bias. We usually aren’t even aware of them. But they exist, and in fact, when it comes to our patients, evidence suggests that us doctors have the same level of bias as the wider population. Hence, it’s time we address them head on. (Joseph V. Sakran, Ebony Jade Hilton, Chethan Sathya, Scientific American)

Stark Racial Disparities Emerge as Families Struggle to Get Enough Food - Nearly four in 10 Black and Hispanic households with children are struggling to feed their families during the coronavirus pandemic — a dramatic spike that is exacerbating racial inequities and potentially threatening the health of millions of young Americans. (Helena Bottemiller Evich, Politico)

Virus, Floyd Death Merge in Brutal Blow to Black Well-Being - Doctors have known it for a long time, well before the resounding cries of “Black Lives Matter”: Black people suffer disproportionately. They face countless challenges to good health, among them food, transportation and income. The stress of living with racism has very real, physical effects. And they are especially prone to diabetes, hypertension and other chronic diseases that can be tricky to manage even in normal times. Then came COVID-19 and George Floyd — one killing Black people in alarming numbers, the other shining a harsh light on systemic racism. In a matter of months and nearly 8 minutes, it became clear that institutions designed to ensure the two most important things in life — health and safety — had converged to turn against one segment of the population in stark, horrific ways. (Lindsey Tanner, Associated Press)

The Fullest Look Yet at the Racial Inequity of Coronavirus - Early numbers had shown that Black and Latino people were being harmed by the virus at higher rates. But the new federal data — made available after The New York Times sued the Centers for Disease Control and Prevention — reveals a clearer and more complete picture: Black and Latino people have been disproportionately affected by the coronavirus in a widespread manner that spans the country, throughout hundreds of counties in urban, suburban and rural areas, and across all age groups. (Richard A. Oppel Jr., Robert Gebeloff, K.K. Rebecca Lai, Will Wright and Mitch Smith, New York Times)

REPRODUCTIVE HEALTH:

Supreme Court Undercuts Access to Birth Control Under ObamaCare - The U.S. Supreme Court has made it more difficult for women to get access to birth control as part of their health plans if their employer has religious or moral objections to contraceptives. The opinion upheld a Trump administration rule that significantly cut back on the Affordable Care Act requirement that insurers provide free birth control coverage as part of almost all health care plans (Nina Totenberg, National Public Radio)

IMMIGRANT AND REFUGEE HEALTH JUSTICE:

‘It Was Like a Time Bomb’: How ICE Helped Spread the Coronavirus - An investigation by The New York Times in collaboration with The Marshall Project reveals how unsafe conditions and scattershot testing helped turn ICE into a domestic and global spreader of the virus — and how pressure from the Trump administration led countries to take in sick deportees. (Emily Kassie and Barbara Marcolini, New York Times)

US Rule Targets Disease-Stricken Countries to Deny Asylum - The Trump administration on Wednesday proposed empowering border authorities to deny asylum to people from countries with widespread communicable disease, its latest in a string of regulations before the November elections to dramatically raise the bar on who qualifies for humanitarian protections. (Elliot Spagat, Associated Press)

COVID-19 TESTING:

Covid-19 Testing in the US Is Abysmal. Again. - The US never fixed the core causes of its testing problem. So it’s now seeing the same kinds of issues pop up again. - “Basically, two things are happening,” Ashish Jha, faculty director of the Harvard Global Health Institute (HGHI), told me. “One is the outbreaks are getting much bigger, so the amount of testing we need to get our arms around the outbreak is going up. And second, what we did [before] was some tweaking on capacity issues to get ourselves up to 500,000 to 600,000 tests a day, but didn’t fundamentally address the supply chain problems.” (German Lopez, VOX)

PERSONAL PROTECTIVE EQUIPMENT:

Protective Gear for Medical Workers Begins to Run Low Again - The personal protective gear that was in dangerously short supply during the early weeks of the coronavirus crisis in the U.S. is running low again as the virus resumes its rapid spread and the number of hospitalized patients climbs. (Geoff Mulvihill and Camille Fassett, Associated Press)

Grave Shortages of Protective Gear Flare Again as Covid Cases Surge - As coronavirus cases surge across the country, hospitals, nursing homes and private medical practices are facing a problem many had hoped would be resolved by now: a dire shortage of respirator masks, isolation gowns and disposable gloves that protect front-line medical workers from infection. (Andrew Jacobs, New York Times)

TRUMP ADMINISTRATION RESPONSE: 

Trump Moves to Pull U.S. Out of World Health Organization in Midst of Covid-19 Pandemic - The U.S. has formally notified the World Health Organization it will withdraw from the United Nations agency over President Trump’s criticism of its ties to China, a move critics say will hamper the international fight against the Covid-19 pandemic and sap the U.S. of global influence. (Drew Hinshaw and Stephanie Armour, Wall Street Journal)

CDC Feels Pressure from Trump as Rift Grows Over Coronavirus Response - The CDC, the nation’s top public health agency, is coming under intense pressure from President Trump and his allies, who are downplaying the dangers in a bid to revive the economy ahead of the Nov. 3 presidential election. In a White House guided by the president’s instincts, rather than by evidence-based policy, the CDC finds itself forced constantly to backtrack or sidelined from pivotal decisions. (Lena H. Sun & Josh Dawsey, Washington Post)

Trump’s Health Officials Find Ways to Contradict His Message Downplaying Virus Risks - What the American public ends up seeing is a jarring split screen, public health experts said, with fragmented but dire assessments about the pandemic response and what should be done shrouding the White House’s sunny, hands-off approach. (Adam Cancryn and Brianna Ehley, Politico)

DRUG AFFORDABILITY:

Drug Prices Steadily Rise Amid Pandemic, Data Shows - Drugmakers raised the price of hundreds of medicines during the coronavirus pandemic, even in the face of Trump administration vows to crack down on surging drug costs and efforts to tack price controls on Covid-19 relief packages. (Sarah Owermohle, Politico)

GUN VIOLENCE EPIDEMIC:

After Photos of Armed Customers in Raleigh NC Go Viral, Subway Changes Open Carry Policy - Two months after photos of gun-toting customers visiting their downtown Raleigh location drew nationwide attention, Subway has altered its policy regarding firearms in its stores nationwide. (Steve Wiseman, Raleigh News & Observer)

Dangerous Gaps in Gun Laws Exposed by the Coronavirus Gun Sale Surge - The coronavirus crisis has not created new problems in the laws and systems guiding the sale and ownership of firearms. But the recent surge in gun sales has put new stress on an already weak system and highlighted some of the most dangerous gaps in the law that allow people who are prohibited from buying guns to continue to have easy access to them. It has also put a spotlight on the negligence of the United States’ current approach to ensuring that first-time gun owners have the tools and resources necessary to bring these guns home safely. (Chelsea Parsons and Rukmani Bhatia, Center for American Progress)

SUBSTANCE USE DISORDER:

Coronavirus Crisis Disrupts Treatment for Another Epidemic: Addiction - Drug rehabs around the country — including in Pennsylvania, Illinois, Indiana, Minnesota and Florida — have experienced flare-ups of the coronavirus or COVID-related financial difficulties that have forced them to close or limit operations. Centers that serve the poor have been hit particularly hard. And that has left people who have another potentially deadly disease — addiction — with fewer opportunities for treatment, while threatening to reverse their recovery gains. (Giles Bruce, Kaiser Health News)

Safe Injection Sites May Curb Opioid Deaths, Report Suggests - Every year in the United States, nearly 70,000 people die of a drug overdose. Quick treatment with the medicine naloxone can prevent death in many cases. Besides offering trained staff to administer it, these injection sites offer safe disposal of used needles and a chance to get users into counseling and help with other health problems. (Marilynn Marchione, Associated Press)

 

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Weekly Rounds 7-5-2020


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DFA ACTION ITEM: 

Doctors for America has joined an effort calling on the U.S. to immediately restore full funding to both the World Health Organization (WHO) and the Pan American Health Organization (PAHO).

During a pandemic, the Trump administration has terminated WHO and PAHO funding, undermining the global response to COVID and the Global Health Security agenda. 

IF NOT US, WHO?: Physicians and medical students must speak up against ideological attacks on public health and science. Congress needs to ensure that we support and strengthen WHO and PAHO. Sign on today. 

Please Make a Tax-Deductible Donation to Doctors for America so it can amplify the trusted voices of physicians and medical students in debates about the impact of structural racism and a pandemic on the health of the marginalized and the vulnerable in our country. DFA is committed to healing America and building a new system that will make health truly accessible to everyone; Please Click Here to Contribute.


Telehealth Prenatal Care: Patient Impact During COVID and After
Wednesday, July 8 at 8:30 pm Eastern
To attend: Register via Zoom 
If Zoom is at capacity, watch via Facebook Live

The second in the Womxn's Health webinar series launched last week will address changes in the obstetrics world during COVID and illuminate the patient perspective on prenatal care. In addition, there will be a discussion of anticipated prenatal care changes in a post-COVID world and steps to prevent exacerbating current disparities in obstetrics and maternal care. 

Elissa Edmunds, MA: Elissa has centered her career, volunteer, and personal endeavors around improving black maternal health, addressing minority health disparities, and creating messaging that promotes black voices and solutions driven by the community. She currently serves as the Mother’s Rising Program Coordinator at Mamatoto Village, a perinatal health organization based in Washington, DC. 

Meghana Rao, MD: Meghana is an OBGYN working for an underserved clinic that serves Maryland and Washington, DC. She completed medical school and residency at Johns Hopkins University. She has been involved with health policy advocacy for over 10 years serving Doctors for America as the Maryland State Director and as a former Board Member of DFA. She has also served in ACOG as the Maryland Section Junior Fellow Legislative Chair, the District IV Junior Fellow Legislative Chair. 

Ariste Sallas-Brookwell, LICSW: Ariste is a clinical social worker at Mary’s Center, a Federally Qualified Health Center in Washington, DC. She coordinates the Maternal Mental Health Program. In her role, she provides psychotherapy and care coordination to individuals at risk of or diagnosed with Perinatal Mood and Anxiety Disorders (PMADs).

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

DFA BOARD CHAIR, DR. EVAN SAULINO & DFA DOC CHARLES MAYER: Kaiser interest group called the Health Equity and Access Team (HEAT) collaborated with the Economic Opportunity Institute on “The Impact of COVID-19 on the Economy, Healthcare, Racism, and Equity”. DFA Board Chair, Dr. Evan Saulino had an opportunity to introduce Doctors for America to attendees and to call out DFA’s COVID response work, anti-racism training webinars, and our upcoming virtual National Leadership Conference.  View Recording

DFA MED STUDENT DANIEL PHAM: ‘We Really Needed Medicaid Expansion a Long Time Ago’ -Daniel Pham, medical student at the University of Oklahoma Health Sciences Center supports Medicaid expansion, which would help meet the health needs of more than 200,000 uninsured Oklahomans. (Miguel Rios, OK Policy Blog)

DFA Webinars Last Week:

Structural Racism Leading to Health Disparities Exacerbated by COVID - July 1, 2020
Brian Williams, MD; Lisako McKyer, PhD, MPH; Rachel Lorenzo, MPA
View Recording (Passcode: DFA#AntiRacism4)

How Womxn Have Been Disproportionately Affected by COVID - June 30, 2020
Maria Phillis, JD, MD; Courtney Thomas, BA; Jessica Stender, JD
View Recording (Passcode: Womxn-06-30)

DFA Partnered Webinars:

Extreme Risk Laws and Safe Storage: DFA partnered webinar with Brady United Against Gun Violence - July 1, 2020
Angela Janis, MD; Melvin H. Wilson, MBA, LCSW; U.S. Rep. Madeleine Dean, JD; Kris Brown, JD
View Recording

Talking to Doctors about Gun Safety: DFA partnered webinar with CeaseFire PA - July 1, 2020
Sofia Chaudhary, MD.
View Recording 

THE WEEK IN QUOTES:

A SINGLE DAY: “It took a little more than two months for the US to record its first 50,000 coronavirus cases. Now it has seen that many cases reported in a single day. On Wednesday, 50,203 new coronavirus cases were reported -- a record for one day. - CNN

OUT OF CONTROL: “We’re not in the situation of New Zealand or Singapore or Korea where a new case is rapidly identified and all the contacts are traced and people are isolated who are sick and people who are exposed are quarantined and they can keep things under control, We have way too much virus across the country for that right now, so it’s very discouraging.” - Anne Schuchat, Director of Centers for Disease Control (CDC)

EMBERS?: “We’re aware that there are embers that need to be put out,” - White House Press Secretary Kayleigh McEnany (June 29th Press Briefing)

SERIOUSLY?!: “I think we are going to be very good with the coronavirus, I think that, at some point, that’s going to sort of just disappear, I hope.” - The President of the United States of America - July 1, 2020

ADRIFT IN A VIRAL SEA: “President Trump’s negligent approach, leaving it to the states while declaring that everything is fine, has put the nation adrift in a viral sea.” - Washington Post Editorial Board

DR FAUCI: "You should avoid whenever possible gathering in crowds where people cannot maintain physical distance. Avoid crowds, wear a mask, keep physical distance, It doesn't matter what the reason for the congregation, whether it's a celebration here, the demonstration there. It doesn't make any difference — wear a mask." - Dr. Anthony S. Fauci - Director of the National Institute of Allergy and Infectious Diseases

EUROPEAN UNION HAS BANNED AMERICAN TRAVELERS: “Today, America is first in infections, first in deaths, and the EU has decided to bar Americans from traveling there as Europe reopens.  A President who started his term by writing hateful travel bans is responsible for getting the American people banned from traveling. His presidency is an outrage from start to finish.” - Former Vice President Joe Biden

IT’S OUR JOB: “I have no idea. I don’t have an education. I’m not smart.” This is what a patient told me when I asked if he truly understood why he needed surgery. I almost teared up. It’s our job to double-check that patients understand their situation. Google pictures, draw, etc. it’s crucial.” James W. Stewart II, MD

THE GODS OF DATA: “Mask-wearing has become a totem, a secular religious symbol, Christians wear crosses, Muslims wear a hijab, and members of the Church of Secular Science bow to the Gods of Data by wearing a mask as their symbol, demonstrating that they are the elite; smarter, more rational, and morally superior to everyone else.”  - Alex Castellanos, a veteran Republican Strategist 

AN INSTRUMENT OF FREEDOM: “Wear a face covering when you go out in public. It is not an inconvenience. It is not a suppression of your freedom. It actually is a vehicle to achieve our goals, It adds to your convenience and your freedom because it allows us to open up more places, and it allows those places to stay open, This mask, this face covering, actually is an instrument of freedom for Americans if we all use it." - U.S. Surgeon General, Jerome Adams

LOWER DRUG PRICES: “Trying times have never been an excuse for Congress to dawdle. For years, Republicans and Democrats across the ideological spectrum have promised to lower prescription drug prices. The time to act is now. The American people have waited long enough.” - U.S. Senator Chuck Grassley, (IA-R)

ZIP CODE INEQUALITY: We have a level of inequality that is so endemic that your ZIP code is now a better predictor of life expectancy than your genetic code. - Thomas L. Friedman, New York Times Opinion Columnist

A HOLLOWED OUT PUBLIC HEALTH SYSTEM:We don’t say to the fire department, ‘Oh, I’m sorry. There were no fires last year, so we’re going to take 30% of your budget away.’ That would be crazy, right?” ...“But we do that with public health, day in and day out. - Dr. Gianfranco Pezzino, the Health Officer in Shawnee County, Kansas

OKLAHOMA EXPANDS MEDICAID: “What we saw last night was Medicaid expansion triumph over party and ideology, Oklahoma voted for Medicaid expansion even as Trump is doubling down on repeal.” - Jonathan Schleifer, executive director of the Fairness Project 

REACH OUT: If you get an opinion piece or letter to the editor published PLEASE email with a link to Pete Van Vranken - pete@drsforamerica.org for publication in the next edition of the Physician Rounds. Your feedback is welcome.

MEDIA COVERAGE: 

COVID-19:

WORTH READING: Hollowed Out Public Health System Faces More Cuts Amid Virus - The U.S. public health system has been starved for decades and lacks the resources to confront the worst health crisis in a century. (Lauren Weber, Laura Ungar, Michelle R. Smith, Hannah Recht and Anna Maria Barry-Jester, Associated Press)

Requiring Face Masks Nationwide Could Save Us Economy from 5% Hit, Goldman Sachs Predicts - A team of analysts at investment bank Goldman Sachs argued that mandatory face masks nationwide could not only improve health outcomes amid the novel coronavirus pandemic, but could also save the U.S. gross domestic product from a potential 5% hit. (Catherine Thorbecke, ABC News)

Texas Governor Reverses Course and Orders Face Mask - Gov. Greg Abbott on Thursday ordered all Texans to wear face coverings in public, with a limited number of exceptions, a sharp reversal that underscored the severity of the coronavirus outbreak that has surged out of control in Texas. (David Montgomery and J. David Goodman, New York Times)

Republican Leaders Now Say Everyone Should Wear a Mask — Even as Trump Refuses and  Has Mocked Some Who Do - The president has refused to trumpet his own administration’s recommendation that people cover their faces, nor has he set an example by wearing a mask at public events. In fact, he has used his bully pulpit to mock others who do and to cast doubt on the efficacy of masks. But with coronavirus cases soaring across the nation — and most precipitously across Florida, Texas and other parts of so-called Trump country — many prominent Republicans are now echoing the pleas of infectious-disease expert Anthony S. Fauci and other health experts that people wear masks to slow the spread of the virus and help the economy reopen safely. (Philip Rucker and Seung Min Kim, Washington Post)

Coronavirus Cases Rose by Nearly 50 Percent Last Month, Led by States That Reopened First - Coronavirus infections in the United States surged nearly 50 percent in June as states relaxed quarantine rules and tried to reopen their economies, data compiled Wednesday showed, and several states moved to reimpose restrictions on bars and recreation. (Anne Gearan, Derek Hawkins and Siobhán O'Grady, Washington Post)

The 3 Weeks That Changed Everything - Consider a thought experiment: What if the NTSB were brought in to look at the Trump administration’s handling of the pandemic? ...“There was a flight plan. There was accurate information about what lay ahead. The controllers were ready. The checklists were complete. The aircraft was sound. But the person at the controls was tweeting. Even if the person at the controls had been able to give effective orders, he had laid off people that would carry them out. This was a preventable catastrophe.” The summation by a former senior official was less dry and less clinical. He said to me, “Here we stand, on a mountain of dead.” (James Fallows, The Atlantic)

STRUCTURAL RACISM - THE PUBLIC HEALTH CRISIS:

Mississippi Governor Signs Law to Remove Flag With Confederate Emblem - The legislation mandates the “prompt, dignified and respectful” removal of the flag, which features the blue bars and white stars of the Confederate battle flag, within 15 days. . When the state flag was last on the ballot, in 2001, Mississippi voters overwhelmingly decided to keep it. But over the weekend, the House voted, 91-23, in favor of removing the flag, and the Senate affirmed that decision in a 37-14 vote. (Rick Rojas, New York Times)

COVID-19 TESTING:

Testing Czar Says Coronavirus Surge Is Straining Testing Capacity - Brett Giroir, the coronavirus testing czar, said Wednesday that the United States' coronavirus testing capacity is at risk of being overwhelmed in some states by a surge in new infections and increased surveillance efforts in nursing homes and jails. “It is absolutely correct that some labs across the country are reaching or near capacity,” Giroir said. “Recent data from several states indicate rising infections and now an uptick in hospitalizations and death, even as other states and the great majority of counties are maintaining a low infection burden." (David Lim, Politico)

PERSONAL PROTECTIVE EQUIPMENT:

(Massachusetts) Providers Urge State To Stock Up On PPE For Second Wave - Physician groups, hospitals and nurses told senators Monday that as policy leaders prepare for a possible second wave of the coronavirus in the fall the state should be thinking about how it can play a role in ensuring personal protective equipment isn't in short supply. The health care leaders told legislators that in addition to the state developing a stockpile that could be bought into by providers if supplies run low, the state should also be thinking about securing a supply chain now to avoid the bidding wars that providers and states fought early in the pandemic. (Matt Murphy, State House News Service)

Workers Filed More Than 4,100 Complaints About Protective Gear. Some Still Died - Since March, more than 4,100 COVID-related complaints regarding health care facilities have poured into the nation’s network of federal and state OSHA offices, which are tasked with protecting workers from harm on the job. A KHN investigation found that at least 35 health care workers died after OSHA received safety complaints about their workplaces. Yet by June 21, the agency had quietly closed almost all of those complaints, and none of them led to a citation or a fine. (Christina Jewett and Shefali Luthra and Melissa Bailey, Kaiser Health News)

AFFORDABLE CARE ACT AND COVERAGE ISSUES:

House Democrats Push Through First Bill in a Decade Expanding Affordable Care Act - The House Monday passed the first significant expansion of the Affordable Care Act since its birth a decade ago, … Monday’s vote symbolized that House Democrats have a path to make health insurance and treatment more accessible at a moment when the novel coronavirus — and the jobs the pandemic has cost — has strained the U.S. health system, robbed millions of Americans of health benefits and caused nearly 125,000 deaths nationwide. (Amy Goldstein, Washington Post)

Oklahoma Voters Narrowly Approve Medicaid Expansion - Oklahoma voters narrowly decided on Tuesday to expand Medicaid health insurance to tens of thousands low-income residents, becoming the first state to amend its Constitution to do so…. Amending the Oklahoma Constitution will prevent the Republican-controlled Legislature, which has resisted Medicaid expansion for a decade, from tinkering with the program or rolling back coverage. Missouri voters also will decide on a constitutional amendment on Aug. 4. (Sean Murphy, Associated Press)

Republican Leaders Want to End Obamacare. Their Voters Are Expanding It - Deeply conservative Oklahoma narrowly approved a ballot initiative Tuesday to expand Medicaid to nearly 200,000 low-income adults, the first state to do so in the midst of the coronavirus pandemic. The vote to expand the Affordable Care Act’s reach once again put voters, many of them conservative, at odds with Republican leaders, who have worked to block it or invalidate it. Five states — Maine, Utah, Idaho, Nebraska, and now Oklahoma — have used ballot initiatives to expand Medicaid after their Republican governors refused to do so. (Sarah Kliff, New York Times)

Health Care Experts Call for Nationwide Special Enrollment Period - Health care experts are pushing for the government to create a nationwide special enrollment period (SEP) amid the ongoing coronavirus pandemic. An SEP would allow uninsured Americans — of which there were roughly 28.5 million as of 2018 — to immediately sign up for health care coverage through the Affordable Care Act (ACA) marketplace. … In an open letter to Congress on June 17, several CEOs and health care experts such as Andy Slavitt, the former acting administrator of the Centers for Medicare and Medicaid Services (CMS), and Dr. Ezekiel Emanuel, a former health care adviser under the Obama administration, called on Congress to open a one-time nationwide SEP.  (Adriana Belmonte, Yahoo Finance)

DRUG AFFORDABILITY:

Another Drug Pricing Effort Breaks Down -  Momentum for Senate Finance Chair Chuck Grassley’s drug pricing measure stalled long ago amid GOP concerns — and got even more stuck as attention turned fully to the coronavirus pandemic. Now it may have fallen apart entirely amid partisan finger-pointing, leaving few options for meaningful reform before the November elections. (Sarah Owermohle, Politico)

Pharmaceutical Giant Charged With Price-Fixing in Generic Drug Probe - The Justice Department on Tuesday charged generic drug giant Glenmark Pharmaceuticals with manipulating the prices of drugs sold in the U.S., as part of a broad federal probe of price-fixing in the generics industry. (Betsy Woodruff Swan, Politico)

Canadian Court Upholds Most of a Controversial New Rule for Controlling Excessive Drug Prices - In a setback to the pharmaceutical industry, a Federal Court judge in Canada has dismissed a challenge by drug makers that contended controversial new government rules designed to regulate excessive pricing would inhibit innovation and hurt the Canadian economy. (Ed Silverman, STAT)

WOMEN’S HEALTH:

Supreme Court Sidesteps Abortion Cases, Shortly After Striking Louisiana Restrictions - The Supreme Court on Thursday declined to take up several abortion cases, just days after striking down a Louisiana law in the first major abortion decision since President Donald Trump’s two appointees joined the bench. (Alice Miranda Ollstein, Politico)

GUN VIOLENCE EPIDEMIC: 

Virginia’s New Gun Control Bills in Effect Beginning July 1 - Many of the bills passed by Virginia’s General Assembly and signed into law by the governor are set to take effect on July 1. Several gun control laws were passed after Democrats took control of the House of Delegates, Senate, and the governor’s mansion for the first time in decades. “Any of the laws that they have [passed] aren’t going to change anything for the better,” Dubby Carr, the owner of Dubby’s Fishing and Hunting, said. “It’s not going to make anything different than it already is, except make it harder.” (WHSV)

DOCTORS - MEDICINE & RESEARCH:

Fever Checks Are a Flawed Way to Flag COVID-19 Cases. Experts Say Smell Tests Might Help - Unfortunately, temperature checks could well join the long list of fumbled responses to the pandemic, from the testing debacle to federal officials’ about-face on masks. (Sharon Begley, STAT)

Three Months In, These Patients Are Still Ravaged by COVID’s Fallout - Doctors are studying coronavirus patients who are still experiencing symptoms or aftereffects of the disease, months after infection. (Sumathi Reddy, Wall Street Journal)

Among Those Disrupted By COVID-19: The Nation’s Newest Doctors - July 1 is a big day in medical education. It’s traditionally the day newly minted doctors start their first year of residency. But this year is different. Getting from here to there — from medical school to residency training sites — has been complicated by the coronavirus. (Julie Rovner, Kaiser Health News)

U.S. FDA Comes Out With Guidance for COVID-19 Vaccine Approval - The U.S. Food and Drug Administration on Tuesday released guidance for approving a coronavirus vaccine, saying the vaccine has to prevent or decrease disease severity in at least 50% of people who are inoculated. (Manojna Maddipatla, Dania Nadeem, Reuters)

 

Back to the Top


Weekly Rounds 6-28-2020


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DFA ACTION ITEM:

The Immigrant Health Justice (IHJ) Work Group is collaborating in solidarity with immigrant and Black, Indigenous, people of color-led organizations to identify key ways that physicians and other health workers can  support migrant justice efforts and to fight racism and xenophobia. Please fill out the form to indicate your interest in receiving IHJ communications going forward, action areas of interest and attending the IHJ meeting TODAY - Sunday, June 28th at 4:30 PM (Eastern) 

Please Make a Tax-Deductible Donation to Doctors for America. Donations are needed to amplify the trusted voices of physicians and medical students in debates about the impact of structural racism and a pandemic on the health of the marginalized and the vulnerable in our country. DFA is committed to healing America and building a new system that will make health truly accessible to everyone; Please Click Here to Contribute.

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

UPCOMING DOCTORS FOR AMERICA WEBINARS:

A Changing Landscape: How Womxn Have Been Disproportionately Affected by COVID-19
Tuesday, June 30 at 8:30 PM Eastern Time
To Attend: Register with Zoom by Clicking Here.
If Zoom is at capacity, watch on Facebook Live


Structural Racism Leading to Health Disparities Exacerbated by COVID-19
Wednesday, July 1 at 8:00 PM Eastern Time
To Attend: Register with Zoom by Clicking Here.
If Zoom is at capacity, watch on Facebook Live


Extreme Risk Laws and Safe Gun Storage
A DFA partnered webinarco-branded event with Brady United Against Gun Violence
Date: Wednesday, July 1
Time: 2:30 Eastern Time
To attend: register with Zoom
If Zoom is at capacity, please watch on Facebook Live 


Recent DFA Webinar: Health Professionals Facing Racism; What Can You Do?
Held: Thursday, June 25th.
Click HERE to View the recording of “Health Professionals Facing Racism”


DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

DFA Doc Leana S. Wen: Eight Ways to Reduce the Pandemic’s Outsize Impact on People of Color - In recent weeks, there has been increased recognition of the profound health disparities unmasked by covid-19. …The perfect cannot be the enemy of the good when there are specific actions that policymakers can take that will reduce disparities in covid-19 outcomes and, in so doing, improve health for all.   (Leana S. Wen, Washington Post

DFA Doc Cedric Dark: Coronavirus Update: NY, NJ, CT Slap Restrictions on Travelers as Outlook Darkens in Key States - Dr. Cedric Dark, an assistant professor at Baylor College of Medicine & Doctors for America board member, told Yahoo Finance Governor Abbot’s  masking policies may have made Texas’ outbreak worse. (Yahoo Finance). AND, Dr. Dark discussed the skyrocketing COVID-19 cases in Houston on NPR Friday.

DFA Doc Dipesh Navsaria:On Experts, Soils and Toilet Plumes - For a more current example, take toilet plumes — if you’re not familiar, this is the concept that a flushing toilet causes aerosolized particles to enter the air and, in theory, spread viruses and bacteria. Recently, a scientist developed computer models showing that COVID-19 could, theoretically, be spread this way. No real world data, no actual cases, just computer models. It was picked up by a number of newspapers and, yes, you guessed it, people started fixating on toilet plumes. (Dr. Dipesh Navsaria, The Cap Times)

DFA Doc. Arkaprava Deb: Focus on the ‘Hot Zones’ to Truly Control COVID-19 - The resolve of all city government officials should reflect the central understanding that New York City will continue to be at risk of COVID-19 case surges until our most vulnerable neighborhoods have the tools needed to reduce transmission. The entire city needs to heal together or not at all. (Arkaprava Deb, City Limits)

THE WEEK IN QUOTES:

I CAN DO SOMETHING: I’ve had a firm view [that] what hurts people or kills people is mine, I may not have the authority to change it all by myself, but by being proactive, I can do something about that.”  Dr. Georges Benjamin, Executive Director of the American Public Health Association

RACISM IS THE ROOT CAUSE: "Racism is the root cause of the disproportionate impact of COVID-19 on communities of color in the United States, "Camara Phyllis Jones, Emory University

KINDA SIMPLE: Plan A, don’t go in a crowd. Plan B, if you do, make sure you wear a mask,”  Dr. Anthony Fauci

STRIKE DOWN THE AFFORDABLE CARE ACT: President Trump and the Republicans’ campaign to rip away the protections and benefits of the Affordable Care Act in the middle of the coronavirus crisis is an act of unfathomable cruelty, If President Trump gets his way, 130 million Americans with pre-existing conditions will lose the A.C.A.’s lifesaving protections and 23 million Americans will lose their health coverage entirely.” - Nancy Pelosi, Speaker of the United States House of Representatives

OVERTURN THE ENTIRE AFFORDABLE CARE ACT?: "I think it's cruel, it's heartless, it's callous ..."I cannot comprehend the cruelty that's driving him to inflict this pain on the very people he's supposed to serve," Former Vice President Joe Biden

PUBLIC OPTION: “We need a public option, now more than ever, especially when more than 20 million people are unemployed,” - Former Vice President Joe Biden

THE PRESIDENT:Coronavirus deaths are way down. Mortality rate is one of the lowest in the World. Our Economy is roaring back and will NOT be shut down. “Embers” or flare ups will be put out, as necessary!”  The President of the United States of America - 11:54 PM · Jun 25, 2020

10X: Our best estimate right now is for every case reported there were actually 10 other infections,”  - CDC Director Robert Redfield

FAR-RIGHT MEDIA CONSUMPTION: We are receiving an incredible number of studies and solid data showing that consuming far-right media and social media content was strongly associated with low concern about the virus at the onset of the pandemic,” - Irene Pasquetto, Chief Editor of the Harvard Kennedy School Misinformation Review

MALFEASANCE: When the history books are written about this crisis, is anyone actually going to believe that America’s abysmal performance and its high death rate was because of some bureaucratic impediment at the CDC?  The core of America's problem is a White House that clearly was not pressed into action in January. And every flaw — from CDC and testing to FEMA and the stockpiles to the supply chain and the states — every systemic problem is rooted in White House malfeasance." - Juliette Kayyem, Former Obama-Era Homeland Security Official

ANTI-SCIENCE BIAS: "One of the problems we face in the United States is that unfortunately, there is a combination of an anti-science bias that people are -- for reasons that sometimes are, you know, inconceivable and not understandable -- they just don't believe science and they don't believe authority," - Anthony S. Fauci, M.D., NIAID Director

THE BOTTOM: “We may end up being the worst of any country in the world in terms of our response,” - Ashish Jha, Harvard’s Global Health Institute

A DEFINING FEATURE: The racial inequities baked into the U.S. healthcare system are a defining feature of this pandemic.” - Caitlin Owens, Axios

KUNG FLU: 121,000 Americans are dead.  Thousands died alone. Isolated.  Families could not grieve. Donald Trump’s response is to make racist jokes.” - United States Senator Tammy Duckworth (D., Ill.) 

REACH OUT: If you get an opinion piece or letter to the editor published PLEASE email with a link to Pete Van Vranken - pete@drsforamerica.org for publication in the next edition of the Physician Rounds. Your feedback is welcome.

MEDIA COVERAGE: 

COVID-19:

Tracking The Pandemic: Are Coronavirus Cases Rising Or Falling In Your State? - In the graphics below, explore the trend in new cases in your state to see whether cases are rising, falling or staying level. To jump to a map of total cases and deaths by state, click here. (National Public Radio)

Coronavirus Cases Rise in States With Relaxed Face Mask Policies - Coronavirus cases seem to be rising in states with relaxed policies on wearing masks, leading experts to reemphasize the importance of face coverings to preventing spread of the disease. Sixteen states currently recommend, but do not require, that residents wear masks in public. In those states — including Texas and Arizona — new coronavirus cases have risen by 84% over the last two weeks, according to an Inquirer analysis. (Kasra Zarei and John Duchneskie, Philadelphia Inquirer

Daily Coronavirus Cases Hit New High as States Mandate Masks and New Restrictions - There were 38,459 new cases of the virus reported nationwide on Thursday, a number that surpassed a record set the prior day of 38,115. The upticks are the largest in two months, when 36,739 cases were reported April 24. (Jaweed Kaleem, LA Times)

As States Reopen, Workers, Executives Want Government to Make Masks Mandatory - Business executives and front-line workers are pushing government officials to require customers to wear masks, a step that could allow companies to avoid alienating a portion of the public.   … Rules vary by state and even by municipality, and some executives have said the issue would be simpler if governments ordered them to require masks, so they could tell reluctant customers that they are simply abiding by regulations. (Katherine Sayre and Alison Sider, Wall Street Journal)

New Research Explores How Conservative Media Misinformation May Have Intensified the Severity of the Pandemic - Three studies have focused on conservative media’s role in fostering confusion about the seriousness of the coronavirus. Taken together, they paint a picture of a media ecosystem that amplifies misinformation, entertains conspiracy theories and discourages audiences from taking concrete steps to protect themselves and others. (Christopher Ingraham, Washington Post)

STRUCTURAL RACISM - THE PUBLIC HEALTH CRISIS:

Black Americans Hospitalized for COVID-19 at Four Times the Rate of Whites, Medicare Data Shows - Black Americans enrolled in Medicare were around four times as likely as their white counterparts to be hospitalized for COVID-19, U.S. government data released on Monday showed, highlighting significant racial disparities in health outcomes during the pandemic. (Carl O'Donnell, Trisha Roy, Reuters)

Income Emerges as a Major Predictor of Coronavirus Infections, Along With Race - Income is a potent force along with race in determining who among the nation’s vulnerable, older population has been infected with the novel coronavirus, according to a federal analysis that lays bare stark disparities in the pandemic’s toll. (Amy Goldstein, Washington Post

As Covid-19 Devastates Communities of Color, the Government’s Minority Health Experts Are Conspicuously Quiet - Four months into a pandemic that has disproportionately devastated Black, Latino, and Native American communities, leading minority health experts within the Trump administration remain conspicuously quiet and have conducted minimal outreach to communities of color. (Lev Facher, STAT)

House Passes Sweeping Policing Bill Targeting Racial Bias and Use of Force - The bipartisan vote was 236-181 to approve the measure, the most sweeping federal intervention into law enforcement in years. It would eliminate legal protections that shield police officers from lawsuits, make it easier to prosecute them for wrongdoing, impose a new set of restrictions on the use of deadly force, and effectively ban the use of chokeholds. But passage of the legislation, introduced as a response to the killings of black Americans across the country and a wave of protests that have followed, only underscored the depth of the stalemate in Congress over how to bring about law enforcement changes that both parties say are needed. (Catie Edmondson, New York Times)

AFFORDABLE CARE ACT AND COVERAGE ISSUES:

Trump Administration Urges End to ACA as Pandemic Surge - As coronavirus cases rise in more than half of the states, the Trump administration is urging the Supreme Court to overturn the Affordable Care Act. The administration’s high court filing Thursday came the same day the government reported that close to half a million people who lost their health insurance amid the economic shutdown to slow the spread of COVID-19 have gotten coverage through HealthCare.gov. (Ricardo Alonso-Zaldivar and Mark Sherman, Associated Press)

Trump Administration Asks Supreme Court to Strike Down Affordable Care Act - The administration’s argument, coming in the thick of an election season — as well as a pandemic that has devastated the economy and left millions of unemployed Americans without health coverage — is sure to reignite Washington’s bitter political debate over health care… The Texas case is by far the most serious challenge to date for the 10-year-old health care law, President Barack Obama’s signature domestic achievement. (Sheryl Gay Stolberg, New York Times)

ACA Enrollment Up 46% - The number of people who lost jobs and related health coverage and then signed up for Affordable Care Act health plans on the federal website was up 46% this year compared with 2019, representing an increase of 154,000 people, the federal government said in a new report. The bottom line: The government said the rush of people going to HealthCare.gov was tied to "job losses due to COVID-19," Yes, but: Medicaid enrollment due to coronavirus-related job losses appears to be growing even faster than enrollment in ACA plans, according to the Georgetown University Health Policy Institute.  (Caitlin Owens, Axios

G.O.P. Faces Risk From Push to Repeal Health Law During Pandemic - Republicans are increasingly worried that their decade-long push to repeal the Affordable Care Act will hurt them in the November elections, as coronavirus cases spike around the country and millions of Americans who have lost jobs during the pandemic lose their health coverage as well. The issue will come into sharp focus this week, when the White House is expected to file legal briefs asking the Supreme Court to put an end to the program, popularly known as Obamacare. Speaker Nancy Pelosi, seizing on the moment, will unveil a Democratic bill to lower the cost of health care, with a vote scheduled for next week in the House. (Sheryl Gay Stolberg, New York Times)

PERSONAL PROTECTIVE EQUIPMENT:

Virginia Becomes First State to Enact Workplace Coronavirus Safety Rules - Virginia’s health and safety board voted Wednesday to create workplace coronavirus safety rules, becoming the first state in the country to take steps toward creating such rules amid the pandemic that has infected more than 2 million people in the U.S.  The state’s 14-member board voted 9-3 to create the safety rules that the board will continue to work on and finalize in coming days (Rebecca Klar, The Hill)

TRUMP ADMINISTRATION RESPONSE:

States Plead for Help While White House Touts Success in Curbing Virus - When state leaders got on a conference call with President Donald Trump’s coronavirus task force on Monday, a sense of alarm over the spike in cases sweeping the South and West was palpable. Yet as daily new infections climbed above 30,000 for the first time since May 1, Vice President Mike Pence repeated the same assurance offered by Trump at his rally in Oklahoma two days earlier: The spike is largely due to increased testing. (Adam Cancryn and Darius Tahir, Politico)

Trump Team Weighs a CDC Scrubbing to Deflect Mounting Criticism - White House officials are putting a target on the Centers for Disease Control and Prevention, positioning the agency as a coronavirus scapegoat as cases surge in many states and the U.S. falls behind other nations that are taming the pandemic. … Aides have also discussed narrowing the mission of the agency or trying to embed more political appointees within it. (Nancy Cook and Adam Cancryn, Politico)

Trump Administration Moving to Close Federally Funded COVID Testing Sites - The Trump administration is defending plans to close 13 federally run coronavirus testing sites in five states at the end of the month. The testing sites are located in Colorado, Pennsylvania, Illinois, New Jersey and Texas. They are the last of 41 federally operated testing sites. … The move comes as President Trump has repeatedly blamed the rise in coronavirus cases on the expansion of testing, despite evidence that the virus is spreading rapidly in many parts of the country and leading to increased hospitalizations. (Vanessa Romo, National Public Radio)

COVID-19 & IMMIGRATION:

H-1B visa Freeze Might Hurt Rural Areas in Need of Doctors - In America, around 28% of doctors, 35% of home aides and 20% of nursing assistants are foreign born, according to the National Foundation for American Policy. … For many international medical students, the way to stay in the United States after graduation is by serving at-risk communities with an H-1B visa. ... It’s an arrangement that might be in jeopardy. On Monday, President Donald Trump temporarily suspended new work visas, barring hundreds of thousands of foreign nationals from seeking employment in the United States. (Jasmine Garsd, NPR’s Marketplace)

 SUBSTANCE USE DISORDER:

Swamped Mental Health and Addiction Services Appeal for COVID Bailout - Mental health and addiction treatment centers and counselors have been overwhelmed with work during the coronavirus pandemic and economic crash. But many are struggling to stay afloat amid confusion and delays over the federal bailout for the health care industry. (Rachel Roubein and Brianna Ehley, Politico)

DOCTORS - MEDICINE & RESEARCH:

Harvard Medical School: $15 Billion Revenue Loss Projected for US Primary Care Due to COVID-19 Shutdowns - Primary care practices are projected to lose more than $65,000 in revenue per full-time physician in 2020, following drastic declines in office visits and fees for services from March to May during the COVID-19 pandemic, according to a study led by researchers in the Blavatnik Institute at Harvard Medical School. The lost revenue adds up to a shortfall of $15 billion to primary care practices across the United States, according to the analysis to be published June 25 in Health Affairs. (DOI: 10.1377/hlthaff.2020.00794). The researchers also caution that losses would balloon substantially if there is a second viral peak later in the year or if the reimbursement rates for telehealth visits revert to pre-COVID levels (Harvard Medical School, SciTechDaily)

Inside the Coronavirus - What Scientists Know About the Inner Workings of the Pathogen That Has Infected the World - For all the mysteries that remain about the novel coronavirus and the COVID-19 disease it causes, scientists have generated an incredible amount of fine-grained knowledge in a surprisingly short time. In the graphics that follow, Scientific American presents detailed explanations, current as of mid-June, into how SARS-CoV-2 sneaks inside human cells, makes copies of itself and bursts out to infiltrate many more cells, widening infection. (Mark Fischetti, Scientific American)

Physicians Urge Cancer Screening to Avoid Second Health Crisis - Healthcare leaders are concerned that delaying cancer screening and care during the pandemic could contribute to another health crisis. Many patients are putting off preventive services and screenings, such as mammographies and colonoscopies, for fear of potential exposure to COVID-19. A recent survey by the American Cancer Society found that 50% of cancer patients and survivors reported some impact to their care as a result of the pandemic. (Jennifer Henderson, Modern Healthcare)

Taxing Sugar Levels in Soda Could Prevent 2 Million US Cases of Diabetes and Cardiovascular Disease, Study Says - Taxes on sugary drinks, a new study has revealed, can lead to major health gains and reductions in health care costs — but just how much of a benefit they provide can vary by the design of the tax. Many sugar-sweetened beverage taxes are volume-based, meaning the tax may be 2 cents per ounce of the beverage's overall volume, for instance, or 3 cents per teaspoon of sugar, which aims to reduce the consumption of a product by increasing its cost. The city of San Francisco and the nations of Mexico, Norway and the Philippines have implemented such tax designs, according to the study. (Jacqueline Howard, CNN)

A Year In, 1st Patient To Get Gene Editing For Sickle Cell Disease Is Thriving - The billions of genetically modified cells doctors infused into her body clearly appear to be alleviating virtually all the complications of her disorder, sickle cell disease. … The researchers conducting the study Gray started caution that it's too soon to reach any firm conclusions about the long-term safety and effectiveness of the approach. Gray is just one patient who has been followed for what is still a relatively short period of time, they noted. (Rob Stein, National Public Radio)

 

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Weekly Rounds 6-21-2020


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DFA’S WEEKLY ACTION ITEM: 

Women’s Health Workgroup:  We would like to formally introduce and invite you to become involved in our newest DFA Workgroup: Women’s Health! Our guiding principles are: Equity: Every woman in America has a fundamental right to equitable, high-quality, and affordable health care regardless of race/ethnicity, socioeconomic status, and geography. Justice: All womxn should have the opportunity and autonomy to lead a healthy life. Every part of society should value and promote healthy families and safe communities. Partnership: Doctors of all specialties should take a leadership role in improving health care of womxn and ending health disparities.

To Get Involved With the Women’s Health Workgroup and Be the First to Hear About Our Current and Upcoming Projects. Click HERE

Please Make a Tax-Deductible Donation to Doctors for America.Donations are necessary for DFA, during the world pandemic, to illuminate through its physician and medical student network the many shortcomings and as well as necessary solutions to heal America during COVID-19 and after. Together we must work toward a better normal where health truly is for all; Please Click Here to Contribute.

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

Upcoming DFA Webinar: Health Professionals Facing Racism
Date: Thursday, June 25th
Time: 6 PM Eastern Time
To Attend: Register with Zoom. Click here.
If Zoom webinar is at capacity, please watch via Facebook Live 

Recent DFA Webinar: Addressing Police Brutality 
Tuesday, June 16, 2020
Addressing Structural Racism, Police Brutality, Advocacy, and Racism Health Professionals Face - What Can You Do?
Hosted by Armen Henderson, MD, MBA; Isabelle Rostain, MD; Jace Valcore, PhD
Click HERE to view a recording of our Webinar  (Passcode: 0l#59Vv9)

DFA Member & Med Student - Daniel Pham - SQ 802 (Medicaid Expansion) Would Be a Step Forward for Oklahoma - ...However, the economic arguments mean little to me because as a future health care professional, I do not want to practice in a system that fails to meet the health needs of our most vulnerable. The COVID-19 pandemic magnified the fact that individual health is connected to the health of an entire community. We are only as strong as our weakest link. For those with adequate and comprehensive health coverage, it is imperative that we collectively ensure everyone around us has access to the care they need. In medical school, I learn to examine the social determinants of health and believe that one of the biggest developments the state could make would be to give every Oklahoman access to high-quality health care and guarantee it as a human right. There is work to be done toward providing everyone the care they deserve, and voting for State Question 802, Medicaid expansion, is the first step in that direction.

THE WEEK IN QUOTES:

HEALTH DISPARITIES’: “What we politely call a ‘health disparity’ is killing people of color daily. It is causing people of color to live sicker and die quicker, because of the color of their skin.” The data on COVID-19 provides the latest proof of this enduring fact. - Dayna Bowen Matthew, Tiffany Ford, Sarah Reber, and Richard V. Reeves, The Brookings Institution

TRIPLE THREAT: For both the African American and Latino populations there's a triple threat, The first is that there's more exposure, the second is that there's more underlying health problems sometimes, and the third is there's less access to health care.” - Former CDC Director Dr. Tom Frieden

PEOPLE WILL LISTEN: The fact that we have those two letters after our name means that, for good or for bad, we go to certain tables and people will listen to us more than people who aren’t physicians.” Dr. Nathan Chomilo, Pediatrician and Minnesota Doctors for Health Equity

PERSONAL PROTECTIVE EQUIPMENT: I hoped that the federal government would have stepped in to demand an increase in production and accountability so that we could deal with this, But five months in, it’s really immoral that they haven’t stepped up to the plate.” - Deborah Burger, Co-President National Nurses United / President of the California Nurses Association 

NOT FADE AWAY: it’s fading away, it’s going to fade away, but having a vaccine would be really nice and that’s going to happen.” The President of the United States of America

THE BOSS: “With all respect, sir, show some consideration and care for your countrymen and your country. Put on a f---ing mask.” - Bruce Springsteen 

THE GREATER GOOD: During World War II, the government called upon every American to make personal sacrifices for the good of the nation. Americans need to chip in for the greater good once again. But instead of being asked to sacrifice food, gasoline or their very lives, they are being asked to endure some slight inconveniences for just a little while longer. Wear a mask. Don’t gather in crowds. Maintain social distancing. Is that so hard?” The LA Times Editorial Board

HEARTLESS AND DANGEROUS: This pandemic has underscored the need for every American to have health coverage when they need it -- and they need it now. As lawyers and stakeholders continue to file amicus briefs in the latest case to overturn the ACA, we must continue to expose this repeal attempt for what it really is: heartless and dangerous. The American people must once again raise their voices once and tell Donald Trump: stop playing politics with our health care.U.S. Senator Kamala D. Harris (D-CA)

ALABAMA SURGE: “It’s bad, The hospitals are darn near at capacity. We’ve got a lot of patients. It’s just steadily gone up the last week. The number of cases. People on ventilators. It’s bad. Unfortunately, it’s going to continue to get worse, I’m afraid.” Dr. David Thrasher, Head of Pulmonology at Jackson Hospital (Alabama)

COLORADO: We’re only a few steps ahead of this virus, We can’t let good news give us a false sense of security. We see some of our neighboring states, Arizona and Utah, moving the wrong way…. The minute human behavior lapses, this will surge back.” - Colorado Governor Jared Polis

DEFYING SCIENCE: “I find it literally incomprehensible that the president, who is an extraordinary narcissist, is willing to sacrifice the health not only of the people who attend his indoor rally, but those people who come into contact with the people who attend the indoor rally, You have public officials in Oklahoma begging him not to do this rally. It is in defiance of what science is telling us is appropriate. And the leader of the United States government is defying science in order to hear cheers from his supporters, It is incredibly irresponsible.” - U.S. Senator Bernie Sander (I-VT)

Please click for the remainder of the stories you are used to reading on DFA’s Weekly Rounds. 

REACH OUT: If you get an opinion piece or letter to the editor published PLEASE email with a link to Pete Van Vranken - pete@drsforamerica.org for publication in the next edition of the Physician Rounds. Your feedback is welcome.

MEDIA COVERAGE: 

STRUCTURAL RACISM - THE PUBLIC HEALTH CRISIS:

An Obligation’: Doctors and Other Health Workers Increasingly See Protesting Racial Injustice as Part of the Job - Amid the dual crises of a global pandemic and a reckoning with systemic racial injustice, health workers and health educators are grappling with a momentous question that hovers between personal and professional: how much of an activist should a health care worker be? Doctors, epidemiologists, and nurses are increasingly abandoning their characteristic reticence in favor of direct advocacy. (Ruth Hailujune, STAT)

Rising Coronavirus Cases Among Latinos Alarm Public Health Experts - Latinos Age 25 to 54 Have a Coronavirus Mortality Rate at Least Five Times Greater Than White People. (Laura Barrón-López, Politico)

Racism, Hazing And Other Abuse Taints Medical Training, Students Say - As doctors and nurses across the United States continue to gather outside hospitals and clinics to protest police brutality and racism as part of the White Coats for Black Lives movement, LaShyra Nolen, a first-year student at Harvard Medical School, says it's time to take medical schools to task over racism, too. (Mara Gordon, National Public Radio)

Many Medical Decision Tools Disadvantage Black Patients - Doctors look to these digital calculators to make treatment decisions, but they can end up denying black patients access to certain specialists, drugs and transplants … The unintended result, the paper concludes, has been to direct medical resources away from black patients and to deny some black patients treatment options available to white patients. (Gina Kolata, New York Times)

Medical Bias: From Pain Pills to COVID-19, Racial Discrimination in Health Care Festers - Whether it's unconscious, explicit, institutional or research bias, discrimination in the health care system contributes to the stark disparities seen in how COVID-19 sickens and kills patients of color, health care experts agree. (Jayne O'Donnell & Ken Alltucker, USA Today)

Missing Data Veils Coronavirus Damage to Minority Communities - The coronavirus’ brutal impact on African Americans and other minorities may never be fully known because of consistent gaps in gathering data on race and ethnicity that persist more than four months into the pandemic. (Laura Barrón-López, Adam Cancryn, Maya King and Darius Tahir, Politico)

COVID-19:

How Exactly Do You Catch Covid-19? There Is a Growing Consensus - Surface contamination and fleeting encounters are less of a worry than close-up, person-to-person interactions for extended periods - Six months into the coronavirus crisis, there’s a growing consensus about a central question: How do people become infected?....  the major culprit is close-up, person-to-person interactions for extended periods. Crowded events, poorly ventilated areas and places where people are talking loudly—or singing, in one famous case—maximize the risk. (Daniela Hernandez, Sarah Toy and Betsy McKay, Wall Street Journal)

California Orders People to Wear Masks in Most Indoor Spaces - “Science shows that face coverings and masks work,” Gov. Gavin Newsom said in a statement about the new order. “They are critical to keeping those who are around you safe, keeping businesses open and restarting our economy.” States including Michigan, New York, Maine, Delaware and Maryland already have statewide mask orders in place. (Kathleen Ronayne and Amy Taxin, Associated Press)

Nebraska Governor Ricketts Tells Local Governments They Won't Get Federal COVID-19 Money If They Require Masks - He doesn’t want local officials to require masks. In fact, he’s told counties that they won’t receive any of the $100 million in federal COVID-19 money if their “customers” are required to wear masks….The no-mask mandate has been poorly received in some corners of the state, with officials criticizing the loss of local control. It also runs counter to the advice of public health officials, who have stressed the importance of wearing masks. (Paul Hammel, Omaha World-Herald)

Montgomery, Alabama City Council Votes Down Mask Ordinance, Sends Doctors Out in Disgust  - More doctors followed him to the microphone, describing the dead being carried out within 30 minutes of each other, and doctors being disturbed when people on the street ask them if the media is lying about the pandemic as part of a political ploy. … the council killed the ordinance after it failed to pass in a 4-4 tie, mostly along racial lines.  (Brad Harper, Montgomery Advertiser)

What Colorado Is Getting Right About Reopening - Colorado Gov. Jared Polis stood out because he embarked on a slow and methodical economic recovery in late April — even before the White House’s stay-at-home guidelines expired. … Colorado’s methodical approach is working. (Dan Goldberg, Politico)

Vermont Borders States With Major COVID-19 Outbreaks, but You Won’t Find That Here - “We took a lot of steps early, and we didn’t waste a lot of time, and Vermonters accepted that,” Governor Scott said at a recent news conference. “And they also complied with all the measures. So, I think that resulted in us having very low rates and put us in the position we’re in today.”.. Jennifer Nuzzo, an epidemiologist and senior scholar at the Johns Hopkins Center for Health Security, said the coronavirus’s trajectory through Vermont stands out because the number of cases spiked in early April and then fell sharply, a sign that “they did something right.” “Most states don’t look like that,” she said. (Maria Sacchetti, Washington Post)

PERSONAL PROTECTIVE EQUIPMENT:

Few N95 Masks, Reused Gowns: Dire PPE Shortages Reveal COVID-19's Racial Divide - Nearly 100 days after the World Health Organization declared the coronavirus outbreak a pandemic, health care workers across the country are still facing major shortages of personal protective equipment, or PPE, including crucial equipment such as masks, gowns, gloves and N95 respirators. Amid an alarming rise in coronavirus cases across the United States, the situation is especially dire at hospitals serving communities of color or patients on Medicaid, NBC News has found. (Lauren Dunn and Sarah Fitzpatrick, NBC News)

TRUMP ADMINISTRATION RESPONSE:

With the Federal Health Megaphone Silent, States Struggle With a Shifting Pandemic - As state and local governments confront a new wave of coronavirus infections, President Trump is sending mixed messages and Washington’s public health bully pulpit has gone silent (Sheryl Gay Stolberg, Noah Weiland, Sarah Mervosh and David E. Sanger, New York Times)

Vice President, Mike Pence Opinion Piece - There Isn’t a Coronavirus ‘Second Wave’ - In recent days, the media has taken to sounding the alarm bells over a “second wave” of coronavirus infections. Such panic is overblown. Thanks to the leadership of President Trump and the courage and compassion of the American people, our public health system is far stronger than it was four months ago, and we are winning the fight against the invisible enemy. (Vice President, Mike Pence, Wall Street Journal)

WOMEN’S HEALTH: 

Medicaid Expansions May Have Affected Contraceptive Choices, Says Study - A recent study has shown that Medicaid expansions may have affected contraceptive choices. In states where the Affordable Care Act–sponsored Medicaid expansions have taken place, there’s been a small but important increase in access to the most effective methods of contraception. A study published on JAMA Open Network in June 2020 has found that in states that expanded Medicaid under the Affordable Care Act, more people are using long-term birth control methods. The research found that of the 310,000 women they studied in expansion states, 6% were using long-acting reversible contraceptives in 2016. This compares to 2.4% of women in non-expansion states. (Alice Broster, Forbes)

DRUG AFFORDABILITY:

A Majority of Americans Fear Pharma Will Use COVID-19 as an Excuse to Raise Prices - Amid a race to find therapies and vaccines to combat Covid-19, a new poll finds that nearly 9 in 10 Americans are concerned that drug makers will take advantage of the pandemic to raise prices. (Ed Silverman, STAT)

SUPREME COURT:

'We Won': DACA Recipients Overwhelmed by Surprise Supreme Court Victory Over Trump - In a deeply divided 5-4 opinion written by Chief Justice John Roberts, the court ruled that the Department of Homeland Security's "arbitrary and capricious" process to end DACA was unlawful. That means that the Deferred Action for Childhood Protection (DACA) program created by President Barack Obama in 2012 will endure, allowing more than 650,000 DACA recipients to continue legally living and working in the U.S. (Alan Gomez, USA Today)

Aligning With Liberals On DACA and LGBTQ Rights, Chief Justice John Roberts Asserts His Independence - The winners at the Supreme Court this week were the nation's LGBTQ community and undocumented immigrants. The losers were conservatives, led by President Donald Trump. And the man most responsible for the unexpected turn of events was the leader of the supposedly conservative court – a label that is coming under a little re-examination. John Roberts, the chief justice of the United States, was in the majority in both cases, along with all four of the court's liberal justices. In delivering the one-two punch to the president and his base, Roberts served notice that he can be either side's punching bag. (Richard Wolf, USA Today)

Supreme Court's LGBTQ Ruling May Sideline Trump's Health Care Rules - The Supreme Court’s historic ruling on LGBTQ nondiscrimination could sideline the Trump administration's new policies on health care and adoption. Why it matters: The ruling's ripple effects will be felt immediately, and could ultimately derail regulations the administration had finalized just days ago. … The bottom line: It may take a while for some of these issues to work their way through the courts, but the Supreme Court's ruling Monday will make many forms of LGBTQ discrimination harder to defend, and in the scheme of things, that will likely happen pretty quickly. (Sam Baker, Alayna Treene, Axios)

SUBSTANCE USE DISORDER:

A New Addiction Crisis: Treatment Centers Face Financial Collapse - Costs have gone up for addiction treatment centers in recent months, as they have had to invest in teletherapy and personal protective gear. "We are at risk for not having the funding that we need to keep our doors open," says one medical director. - Fewer patients in recent months have been showing up for drug and alcohol treatment at REACH Health Services in Baltimore. But Dr. Yngvild Olsen, the medical director there, suspects it's not for good reasons: Some have likely relapsed or delayed drug and alcohol addiction treatment, while others likely fear infection and have stayed home.  (Yuki Noguchi, National Public Radio)

DOCTORS - MEDICINE & RESEARCH:

WHO to Update COVID-19 Clinical Guidance, Stresses That Steroids Should Not Be Used as Prevention - The World Health Organization will update its clinical guidance for COVID-19 following the University of Oxford's announcement of results from a trial on the steroid dexamethasone. WHO Director-General Tedros Adhanom Ghebreyesus called the findings "very welcome news" during a media briefing Wednesday, but stressed that the drug should only be used in severe cases under close clinical supervision. "We will update our clinical guidance to reflect how and when dexamethasone should be used," Tedros said. Oxford researchers said in a press release Tuesday that dexamethasone was found to reduce deaths in patients with severe COVID-19, such as those on ventilators or oxygen. (Sara G. Miller, NBC News)

CDC Report Offers Detailed Demographic Breakdown of Who Is Getting Coronavirus -New numbers released by the US Centers for Disease Control and Prevention offer a comprehensive picture of who in the United States has been diagnosed with Covid-19 and how they fared. The latest figures confirm that older people, minorities and those with preexisting health conditions are at the highest risk of death. (Andrea Kane and Paul LeBlanc, CNN)

Why Virtual Care Will Outlast the Pandemic - With millions of people suddenly video chatting their doctors, there's pressure on Washington to make telehealth a permanent option. An explosion of virtual care during the pandemic is raising expectations that Washington will make sure Americans can continue video chatting with their doctors after the health crisis subsides. (Mohana Ravindranath, Politico)

Study Ties Blood Type to COVID-19 risk; O May Help, A Hurt - A genetic analysis of COVID-19 patients suggests that blood type might influence whether someone develops severe disease. (Marilynn Marchione, Associated Press)

 

Back to the Top


Weekly Rounds 6-14-2020


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DFA’S WEEKLY ACTION ITEM: 

At Doctors for America we share the deep concern of many Americans across the country who have decided to take action to protest, and to demand change. Issues of structural racism, inequality, unequal justice and economic disparities must be of concern to us all, and as physicians we recognize how these impact social determinants of health and have serious detrimental effects on the welfare of the disadvantaged and vulnerable in our society.

DFA would like to better represent our concerns and add our respected voice to those who are demonstrating and urging for change. You can help us tell the story of these times by sharing with us any photos of healthcare providers and advocates who are engaging in these important efforts. Our mission is to place patients before politics, and images tell a powerful story.

Please share your photos with us through your social media accounts, or by sending directly as an email attachment. We will credit images with your name unless you request otherwise. Click on this link to easily share your images. 

Thank you for your continuing advocacy and your support of DFA and the work we must continue.

Please Make a Tax-Deductible Donation to Doctors for America.Donations are necessary for DFA, during the world pandemic, to illuminate through its physician and medical student network the many shortcomings and as well as necessary solutions to heal America during COVID-19 and after. Together we must work toward a better normal where health truly is for all; Please Click Here to Contribute.

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

Copello Fellowship Call: “Racial Inequities Experienced or Witnessed – What Can You Do?” with Armen Henderson, MD; Jennifer Edgoose, MD
Recording of the Call can be found HERE (Passcode: 4d?6#80!) 

Upcoming Event:  Doctors For America: “Addressing Police Brutality” webinar.
Date: Tuesday, June 16th
Time: 4 PM Eastern Time
To Attend: Register with Zoom by Clicking Here.
If Zoom webinar is at capacity, please watch via Facebook Live, by clicking on this link.  

DFA Dr. Margo D. Simon: We Are Protesting During a Pandemic: Local Authorities Should Act Like It - Passionate protesters, fueled by centuries of racism, are taking to the streets and trying to do so responsibly: wearing masks and physically distancing. Still, the COVID-19 pandemic rages on, and local governments should start acting like it: health authorities should bring free, voluntary, curbside COVID testing and mask distribution to protesters; crowds should be given space and time to assemble, and crowding peaceful protesters into wagons and jails should cease. ..Beyond the obvious direct public health benefits, a public health presence at protests could also be symbolic of local government supporting civil rights (and against state-sponsored brutality) while still raising awareness of ongoing and severe health risks during the pandemic and doing something about it. Health workers' presence might even deescalate tensions between protesters and police, discouraging tear gas, rubber bullets, assaults, arrests, and other abuses of power. (Dr. Margo D. Simon, The Hill)

DFA Dr. Shetal Shah: As the Economy Shrank, Families Have Slipped Backward Into Poverty, Jeopardizing Health Care … As a pediatrician, I’ve had a front-row seat to the impact of the coronavirus pandemic and our shelter-in-place policies on children. ...As the economy shrank 4.8% in the first quarter of 2020, children have slipped backward into poverty, creating a social environment adverse to both their short and long-term health. Children are already the poorest members of our communities. ...Children can no longer be an afterthought as policymakers continue to debate all aspects of our shared medical and economic recovery.  (Dr. Shetal Shah, Columbus Dispatch)

THE WEEK IN QUOTES:

THE DIRECT RESULT OF RACISM: “People of color right now are more likely to be infected, and we’re more likely to die. What we’re seeing here is the direct result of racism, That’s the thing that is slapping us in the face. Actually, it’s lashing us like whips.” - Camara Phyllis Jones, an epidemiologist who recently served as president of the American Public Health Association

BLACK COMMUNITY BRACES FOR NEXT THREAT: MASS EVICTIONS: “One knee to the neck just explode[d] a tinderbox of other injustices that we must address, and one of them is housing, Housing security is a matter of justice, as structural racism puts communities of color unfairly at risk of being rent-burdened or homeless.” House Speaker Nancy Pelosi

PUBLIC OPINION ON RACE RELATIONS: “In my 35 years of polling, I’ve never seen opinion shift this fast or deeply, We are a different country today than just 30 days ago. The consequences politically, economically, and socially are too great to fit into a tweet. This is big.”  - Frank Luntz, Republican Pollster

U.S. SURGEON GENERAL, JEROME ADAMS: “I look at him, (George Floyd) and I really do think that could have been me,” 

WEAR A MASK IN PUBLIC: “Our analyses support the immediate and universal adoption of face masks by the public,” Richard Stutt, Cambridge University

THE FORGOTTEN PLAGUE: “I have some good news and bad news. The good news: At last, there is some bipartisan agreement in America. The bad news: It’s a tacit agreement to pretend that the threat from the novel coronavirus has somehow gone away. Covid-19 has become the forgotten plague — and it’s nowhere near ending. - Max Boot - Washington Post Columnist 

STILL AT THE BEGINNING:  In a period of four months, it has devastated the whole world. And it isn’t over yet.”....“Where is it going to end? We’re still at the beginning of it,Dr. Anthony Fauci

NOT GOING AWAY: “This virus is not going to go away. Period, We don’t have a vaccine and we don’t know we’re going to develop one … so we’ve all got to learn to live with this virus.” - David Nabarro, World Health Organization

YA THINK? With rapid escalation of transmission rates in several states this week, investors are beginning to recognize that their enthusiasm for a rapid return to normal is premature,” Wayne Wicker, Chief Investment Officer at Vantagepoint Investment Advisers 

CORONAVIRUS LIABILITY DISCLAIMER: By attending the Rally, you and any guests voluntarily assume all risks related to exposure to COVID-19 and agree not to hold Donald J. Trump for President, Inc.; BOK Center; ASM Global; or any of their affiliates, directors, officers, employees, agents, contractors, or volunteers liable for any illness or injury,”  - President Trump’s Campaign Invite

REACH OUT: If you get an opinion piece or letter to the editor published PLEASE email with a link to Pete Van Vranken - pete@drsforamerica.org for publication in the next edition of the Physician Rounds. Your feedback is welcome.

MEDIA COVERAGE: 

STRUCTURAL RACISM - THE PUBLIC HEALTH CRISIS:

White Coats and Black Lives: Health Care Workers Say 'Racism Is a Pandemic Too' - In the midst of staggering statistics, health care workers across the country are hitting the streets in solidarity to protest--some right after their shifts, still donned in their scrubs and personal protective equipment. (Terrance Smith, ABC News)

To Battle Racism, Experts Say Make Health Equity a Central Principle - “In the healthcare profession, we’re not making widgets; we’re saving lives. Prejudice and inequities and racism can kill people—and it does kill people.” … But experts say many health organizations have yet to really address the role structural racism and racial bias play as health determinants within their own institutions, as well as throughout their communities. (Steven Ross Johnson, Modern Healthcare)

‘The Direct Result of Racism’: COVID-19 Lays Bare How Discrimination Drives Health Disparities Among Black People - The demonstrations sparked by the killing of George Floyd in Minneapolis have prompted a reckoning over racism and police brutality. But, among those in the medical communities, there have also been calls for urgent action to address the role that systemic racism plays in health disparities among Black people. … The Covid-19 pandemic has only made those disparities — and the structural discrimination they are rooted in — all the more apparent. (Meghana Keshavan, STAT)

Black Community Braces for Next Threat: Mass Evictions - A Federal Moratorium on Evictions — Which Only Applies to the 1 in 4 Rental Units That Are Backed by the Government — Expires in a Matter of Weeks. - A new tremor is threatening to shake minority communities as protests over racial injustice sweep the country: A wave of evictions as a federal moratorium on kicking people out of their rental units expires. The ban on evictions — which applies to rentals that are backed by the government — expires in a matter of weeks. On top of that, the federal boost to unemployment benefits that many laid-off workers have used to pay their rent is set to end July 31. (Katy O'Donnell, Politico)

American Indian Tribes Thwarted in Efforts to Get Coronavirus Data - The CDC has turned down tribal epidemiologists’ requests for data that it’s making freely available to states.

Federal and state health agencies are refusing to give Native American tribes and organizations representing them access to data showing how the coronavirus is spreading around their lands, potentially widening health disparities and frustrating tribal leaders already ill-equipped to contain the pandemic. (Darius Tahir and Adam Cancryn, Politico)

Where Protesters Go, Street Medics Follow - Through Tear Gas and Rubber Bullets, Professional and Amateur Medical Volunteers Have Stepped Forward to Aid the Injured (Emma Grillo, New York Times)

Over 5,000 Scientists Stop Work in Protest Against Systemic Racism in STEM - Thousands of scientists pledged to halt research on Wednesday as part of a protest over systemic racism against black academics and STEM (science, technology, engineering and math) professionals.  More than 5,000 academics from institutions across the globe signed an online pledge to strike posted by Particles for Justice. (Rebecca Klar, The Hill)

COVID-19:

Widespread Mask-Wearing Could Prevent COVID-19 Second Waves: Study - Population-wide face mask use could push COVID-19 transmission down to controllable levels for national epidemics, and could prevent further waves of the pandemic disease when combined with lockdowns, according to a British study on Wednesday. (Kate Kelland, Reuters)

Alarming Rise in Virus Cases as States Roll Back Lockdowns - States are rolling back lockdowns, but the coronavirus isn’t done with the U.S. ... The analysis found that in 21 states as of Monday, the rolling seven-day average of new cases per capita was higher than the average seven days earlier. (Mike Stobbe, Associated Press)

Michigan Coronavirus Cases, Deaths Continue Downward Trajectory, Hit New Lows Since Outbreak's Peak - A seven-day rolling average of new cases has fallen by a third over the past week, to an average of 210 new cases per day. That figure stood at 378 new cases per day a week earlier, according to figures from the Michigan Department of Health and Human Services. Deaths have also fallen. (Crain's Detroit Business)

Public Health Workers Fighting Virus Face Growing Threats - In the battle against COVID-19, public health workers spread across states, cities and small towns make up an invisible army on the front lines. But that army, which has suffered neglect for decades, is under assault when it’s needed most. ...Elected officials and members of the public who are frustrated with the lockdowns and safety restrictions have at times turned public health workers into politicized punching bags, battering them with countless angry calls and even physical threats. (Michelle R. Smith, Lauren Weber and Anna Maria Barry-Jester, Associated Press)

PERSONAL PROTECTIVE EQUIPMENT: 

Health Workers Resort To Etsy, Learning Chinese, Shady Deals To Find Safety Gear - The global pandemic has ordinary health care workers going to extremes in a desperate hunt for medical supplies. Community clinics, nursing homes and independent doctors, in particular, find themselves on the fringe of the supply chain for masks, gowns, gloves and ventilators. (Eli Cahan and Sarah Varney, Kaiser Health News)

Internal Document Reveals Federal Plan to Ask Nurses to Reuse Masks - The slides show FEMA’s plan to ramp up supply into June and July hinges on the reusing of N95 masks and surgical gowns, increasing the risk of contamination. Those are supposed to be disposed of after one use.  (Emily Kopp, Roll Call)

TRUMP ADMINISTRATION RESPONSE: 

A Detailed Timeline of All the Ways Trump Failed to Respond to the Coronavirus - Here’s what Trump and the federal government have — and have not — done to respond to the virus: (Cameron Peter, VOX)

Trump’s Decision to Leave W.H.O Came With Bluster, but No Action So Far - Nearly two weeks have passed since President Trump announced he was withdrawing the United States from the World Health Organization. To date, none of the levers that would need to be pulled to follow through on that decision has been pulled. (Helen Branswell, STAT)

DOCTORS - MEDICINE & RESEARCH:

Immunity to the Coronavirus Remains a Mystery. Scientists Are Trying to Crack the Case - Scientists stress that just because someone has recovered from Covid-19 and produced antibodies to the coronavirus does not mean they are protected from contracting it a second time. No one’s yet proven that. That, then, leaves open the question: What does immunity look like? (Andrew Joseph, STAT)

U.S. Blood Reserves Are Critically Low - The U.S. blood supply is at critically low levels after Covid-19 shutdowns have emptied community centers, universities, places of worship and other venues where blood drives typically occur. The American Red Cross, which supplies about 40% of the nation’s blood, said more than 30,000 planned blood drives have been canceled since mid-March. (Amy Dockser Marcus, Wall Street Journal)

A New Embryo-like Model Could Help Scientists Study the ‘Black Box’ of Early Human Development - Researchers have developed the first-ever embryo-like model from human embryonic stem cells, a workaround that will let them examine birth defects and diseases they couldn’t otherwise, given ethical and technical issues with studying a human embryo in the lab. The model resembles a human embryo around 18 to 21 days old — complete with the layers of the cells that will eventually form the nervous system, muscles, the gut, and other cells and structures in the human body. (Natalya Ortolano, STAT)

AFFORDABLE CARE ACT AND COVERAGE ISSUES:

House Majority Leader Steny Hoyer: House Will Vote Soon on Bill to Improve ObamaCare - The House will vote the week of June 29 on a bill aimed at improving the Affordable Care Act (ACA), House Majority Leader Steny Hoyer (D-Md.) said Thursday.  (Peter Sullivan, The Hill)

Kentucky Governor Pledges Health Coverage to All Black Residents - Offering few specifics, Kentucky Gov. Andy Beshear said his administration is committed to ensuring that 100% of the state’s black residents have health insurance. (Alex Ebert, Bloomberg News)

Millions at High Risk of Severe COVID-19 Outcomes Lack Coverage to Cover Costs - More than 18 million people who were most at risk of experiencing severe outcomes from COVID-19 at the start of the outbreak had the least access to healthcare because they were either uninsured or underinsured, according to a new study. (Steven Ross Johnson, Modern Healthcare

DRUG AFFORDABILITY:

U.S. States Accuse 26 Drugmakers of Generic Drug Price Fixing in Sweeping Lawsuit - Twenty-six drug manufacturers were sued on Wednesday by the attorneys general of most U.S. states and several territories, which accused them of conspiring to reduce competition and drive up generic drug prices. (Diane Bartz, Jonathan Stempel, Reuters)

Wholesale Drug Prices — and Net Prices — Keep Falling for Most Drugs - Amid continued political pressure on the pharmaceutical industry, a new analysis finds that brand-name drug makers increased their wholesale prices by 2.3% in the first quarter of this year, a much smaller boost than 3.2% hike that occurred during the same time a year ago. (Ed Silverman, STAT)

IMMIGRANT AND REFUGEE HEALTH JUSTICE:

Trump Administration Moves to Solidify Restrictive Immigration Policies - Under the cloak of a pandemic and the convulsions of anti-racist protests, the Trump administration continues to advance its policies to restrict legal immigration, halting the flow of foreign workers and raising the bar for asylum seekers hoping for sanctuary. (Zolan Kanno-Youngs and Maggie Haberman, New York Times)

Advocates Sue Trump Administration Over Mass Border Expulsions - It’s the first challenge to the Trump administration’s policy of mass expulsions of border-crossers, under which nearly 45,000 migrants — including 2,000 children — have been pushed out of the U.S. (Dara Lind, ProPublica)

DeVos Issues Rule Barring Colleges from Granting Coronavirus Relief Funds to DACA Recipients - Education Secretary Betsy DeVos issued a rule Thursday that would ban colleges from granting coronavirus relief funds to noncitizens, including those protected under the Deferred Action for Childhood Arrival (DACA) program. (J. Edward Moreno, The Hill)

GUN VIOLENCE EPIDEMIC:

Coronavirus Could Make America’s Gun Problem Even Deadlier - Stress and isolation combined with another feature of American life — easy access to firearms — could form a deadly brew. …On the other hand, evidence that guns may be misused and do serious harm — to owners and their family members, including children — is substantial and growing. It’s a lopsided balance sheet that should give pause to people who own guns or are considering buying their first gun. (David Studdert, Matthew Miller and Garen Wintemute, New York Times)

SUBSTANCE USE DISORDER:

How Americans’ Drinking Habits Have Changed During the Pandemic - Stay-at-home orders posed a special challenge to Americans who struggle with addiction and rely on the support of in-person recovery meetings. Many others found their alcohol consumption patterns changed significantly during the pandemic. William Brangham reports on the impact COVID-19 has had on Americans’ substance use -- including consequences that could long outlast the virus. (William Brangham, Leah Nagy, PBS NewsHour).

 

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Weekly Rounds 6-7-2020


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DFA’S WEEKLY ACTION ITEM: 

Structural racism and race-based violence are among our nation’s enduring sins and serve as the root cause of many health-related problems such as gun violence, maternal mortality, substance use disorder, and inequities in health insurance coverage, and access to care. This is reflected in the dysfunction of our justice system, our educational systems, our neighborhoods, and most recently thehealth outcomes around COVID-19.  

Our hearts are filled with passion; thus we will not wallow in our despair. There is freedom in action – in trying to make big ideas happen, working together to make the foundational changes necessary to promote equality and equity. If we’re really going to heal our nation – we cannot just feel angry or simply put on Band-Aids - we must collaborate and take meaningful action on these fundamental, structural issues. Each of us as individuals can take action right now, by engaging with policymakers and your local chief of police on your concerns about the impact of structural racism. Phone your chief of police and tell them you want to have a conversation about what they can do to help. Personalize this suggested message and send it to your federal legislators now. - Thank you for your work, and for your willingness to stand up and make your voices heard. - Take Action Right Now.

Please Make a Tax-Deductible Donation to Doctors for America.Donations are necessary for DFA, during the world pandemic, to illuminate through its physician and medical student network the many shortcomings and as well as necessary solutions to heal America during COVID-19 and after. Together we must work toward a better normal where health truly is for all; Please Click Here to Contribute.

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:

DFA Taking Action:As Coronavirus Cases Increase at Detention Centers, Doctors’ Group Demands Release of Immigrants - As confirmed COVID-19 cases increase inside Immigration and Customs Enforcement’s detention centers, Doctors for America protested Friday at facilities in Conroe and near San Antonio, demanding the release of non-violent immigrants. The demonstrations at Joe Corley Detention Facility in Conroe and Karnes County Residential Center southeast of San Antonio were part of a series of actions across the country organized by the advocacy group. (Olivia P. Tallet, Houston Chronicle)

DFA's Dr. Howard Forman - COVID-19 Highlights Racial Disparities in Our Health Care System - "The global pandemic is a dark moment in US history, exposing our lack of attention to health equity in the nation. However, it can be a moment when we begin to address long-standing failures of our health care system, promote equitable access to health services and help communities of color to achieve the care that all Americans should have." (Aneta Gasiewska, Dr. Howard P. Forman and Dr. Darin Latimor, USA Today)

DFA Webinar - End High Drug Prices - END HIGH DRUG PRICES: Webinar talking with Rep. Lloyd Doggett, Rep. Jan Schakowsky, Abdul El-Sayed, about real life health care stories and why Congress must act to #EndHighDrugPrices. DFA leader, Dr. Reshma Ramachandran, shared a patient story about the devastations of high prescription drug prices.

DFA Webinar - Mental Health and Safe Gun Storage - a webinar on mental health, gun safety, and safe storage during the #COVID19 pandemic. Co-hosted with  @bradybuzz, moderated by @RambaKy, featuring  @EmmyBetz, @PsychBrownBag & our very own Dr. Arka Deb! 

THE WEEK IN QUOTES:

#ThisIsOurLaneToo: We are physicians when we are at work in the hospital, but we are always Black men. We don’t live in our white coats — we live in our Black skin. For those like us who experience these tragedies as terrifying, the silence of the medical community is deafening. Where loss of life due to police brutality is concerned, #ThisIsOurLaneToo.” - Chijioke Nze, Elorm F. Avakame, Olusola J. Ayankola, and Jamaji C. Nwanaji-Enwerem, STAT

A REALITY THAT NONE OF US SHOULD TOLERATE: And we must keep in mind that institutional racism and injustice are at the root of disparate outcomes in health. Uprisings affect people’s health in the short term, but the reason they are occurring is because of the long-standing reality that people’s lives are valued differently in our society. This is a reality that none of us should tolerate.”  - Dr. Leana S. Wen - Former  Baltimore Health Commissioner

A PUBLIC HEALTH CRISIS:At the end of the day, racism is the original sin here, Racism attacks people’s physical and mental health,” It’s “an ongoing public health crisis that needs our attention now.” - Dr. Georges Benjamin, executive director of the American Public Health Assn.

MY GREATEST RISK: I’ve spent the last several months of my life imploring and exhorting people to protect themselves, to reduce the spread of this virus and save lives,” But after Floyd’s death under the knee of Minneapolis police officer Derek Chauvin, “it dawned on me that my greatest risk is not COVID-19. It’s the color of my skin.” - Dr. Clyde W. Yancy, Cardiologist at Northwestern University’s Feinberg School of Medicine

DANGEROUS: The police tactics — the kettling, the mass arrests, the use of chemical irritants — those are completely opposed to public health recommendations, They're causing protesters to violate the six-feet recommendation. The chemicals may make them have to remove their masks. This is all very dangerous.” - Malika Fair, Director of Public Health Initiatives at the Association of American Medical Colleges

THE CHARACTER OF OUR POPULACE:How does a civil society — if indeed we are civil — respond not only to disproportionate suffering but also to a legacy of injustice? We will soon know the character of our populace.” Dr. Clyde W. Yancy, Cardiologist at Northwestern University’s Feinberg School of Medicine

NOT A FAIRY TALE: American history isn’t a fairy tale with a guaranteed happy ending. The battle for the soul of this nation has been a constant push and pull for more than 240 years, a tug of war between the American ideal that we’re all created equal, and the harsh reality that racism has long torn us apart. The honest truth is that both elements are part of the American character, both elements. At our best, the American ideal wins out. But it’s never a route, it’s always a fight and the battle is never fully won. But we can’t ignore the truth that we’re at our best when we open our hearts rather than to clench our fist.” - Vice President, Joe Biden - June 2, 2020 Philadelphia, PA

EVERY 3 DAYS: “2,977 people were killed in the terrorist attacks on Sept. 11, 2001. As of now, the daily average of COVID-19 deaths equal that total every three days.” - (Jiachuan Wu, Nigel Chiwaya and Robin Muccari, NBC News)

THE CDC: Here is an agency (The C.D.C) that has been waiting its entire existence for this moment, And then they flub it. It is very sad. That is what they were set up to do.” - Dr. Peter Lurie, Former Associate Commissioner at the Food and Drug Administration 

VERY EARLY: “We are really early in this disease, If this were a baseball game, it would be the second inning.” - Dr. Ashish Jha, Director, Harvard Global Health Institute 

AN UNTENABLE SITUATION:The pandemic amplified an already untenable situation, where women are burning the candle at both ends as they drown in work and hack together child care,” - Alexis Barad-Cutler, Not Safe For Mom Group

IRRESPONSIBLE AND DAMAGING: “The pandemic has also dealt a huge setback to vaccination campaigns against measles, diptheria and polio. In a statement, the World Health Organization and others estimated that routine immunization services are being substantially hindered in at least 68 countries and about 80 million children under the age of 1 year old are likely to be affected. Public health experts worry that as nations throw limited resources into fighting the pandemic, there will be less for fighting HIV/AIDs, malaria and tuberculosis. All of this will put extra demands on the WHO, which has been at the front lines of fighting disease in the developing world — and it’s more evidence that President Trump’s decision to abandon the WHO is irresponsible and damaging.” - Editorial Board - Washington Post

REACH OUT: If you get an opinion piece or letter to the editor published PLEASE send me (Pete Van Vranken - pete@drsforamerica.org ) an email with a link to your piece and I will include it in the next edition of the Physician Rounds. Also please send me any feedback you may have on the “Rounds” - Much Appreciated - Pete

MEDIA COVERAGE: 

Cause of Death: COVID-19, Police Violence or Racism? - Doctors and public health experts will tell you that, compared to white Americans, African American people die prematurely and disproportionately of many ills: heart disease, stroke, COVID-19, police violence. The proximate causes of these early deaths vary. But there is a sameness to the pattern, experts say, and a common source of the skewed statistics. Racism — not in its overt, name-calling form, but the kind woven deeply into the nation’s institutions — harms the 44 million Americans who identify as black and potentially shortens their lives, according to those who study racial inequities in health. Melissa Healy, LA Times)

‘This Is What Happens to Us.’ How U.S. Cities Lost Precious Time to Protect Black Residents from the Coronavirus - The coronavirus crisis in black America follows a familiar pattern, from the AIDS epidemic to maternal mortality to breast cancer to even natural disasters such as Hurricane Katrina, where community concerns were overlooked until gross disparities were revealed. (Robert Samuels, Aaron Williams, Tracy Jan and Jose A. Del Real, Washington Post)

Protests Will Likely Spread The Coronavirus. These Doctors And Nurses Are Protesting Anyway - Doctors, nurses, residents, medical students, and others in the medical field are just some of the thousands of protesters flooding town squares and downtowns. To some, their participation may seem controversial or hypocritical. (Stephanie M. Lee, BuzzFeed News)

Police Using Rubber Bullets On Protesters That Can Kill, Blind Or Maim For Life - … when fired at close range, rubber bullets can penetrate the skin, break bones, fracture the skull and explode the eyeball, he said. Rubber bullets can cause traumatic brain injuries and “serious abdominal injury, including injuries to the spleen and bowel along with major blood vessels,” said Dr. Robert Glatter, an emergency physician in New York City and a spokesperson for the American College of Emergency Physicians.” (Liz Szabo, Kaiser Health News)

Mass Arrests Jeopardizing the Health of Protesters, Police - Mass arrests of protesters across the country — many held for hours in vans, cells and other enclosed spaces — are heightening the risk of coronavirus spread, according to public health experts and lawsuits filed by civil rights groups. As tens of thousands of people take to the streets to protest police brutality after the killing of George Floyd in Minneapolis, the arrest and detention of thousands further jeopardizes the health of demonstrators — and that of police officers and the broader community.  (Alice Miranda Ollstein and Dan Goldberg, Politico)

A Minneapolis School Asked People to Donate Food for Students After Looting Closed Stores. ‘Miles of Cars’ Lined Up - “There were miles of cars holding food, wrapped around our city blocks,” said Mara Bernick, family liaison for Sanford Middle School. Hundreds of people showed up to give what they could. Some arrived in U-Haul trucks and trailers, and some came carrying groceries in their hands. Soon, the school property was covered with thousands of bags of groceries. By the end of the day, an estimated 30,000 food kits were delivered, and more than 500 families and individuals were able to stock their pantries and fridges. (Sydney Page, Washington Post)

DOCTORS - MEDICINE & RESEARCH:

Red Cross Warns of a ‘Staggering’ Drop in Blood Supplies - Hospitals have resumed elective surgeries and many Americans are venturing out of their homes again, but the rate of donations has yet to bounce back - As protests and violence erupt in cities, the United States faces a new threat: The country is running out of blood. (Christopher Flavelle, New York Times)

Proteins in COVID-19 Patients' Blood Could Predict Severity of Illness, Study Finds - Scientists have found 27 key proteins in the blood of people infected with COVID-19 which they say could act as predictive biomarkers for how ill a patient could become with the disease. (Kate Kelland, Reuters)

Convalescent Plasma Not Helpful in China Study; Hydroxychloroquine Doesn't Prevent Infection - Convalescent plasma disappoints in Chinese trial - Infusions of antibody-rich blood plasma from people who have recovered from the coronavirus, so-called convalescent plasma, failed to make a difference in a study of hospitalized patients in China. (Nancy Lapid, Reuters)

ICUs Become A ‘Delirium Factory’ For COVID Patients - Although COVID-19 is best known for damaging the lungs, it also increases the risk of life-threatening brain injuries — from mental confusion to hallucinations, seizures, coma, stroke and paralysis. The virus may invade the brain, as well as starve the organ of oxygen by damaging the lungs. To fight the infection, the immune system sometimes overreacts, battering the brain and other organs it normally protects. (Liz Szabo, Kaiser Health News)

Doctors Are Tweeting About Coronavirus to Make Facts Go Viral - Dr. Wachter, 62 years old, is part of a growing group of scientists and public-health officials who are increasingly active and drawing large audiences on social media. They say they feel a moral obligation to provide credible information online and steer the conversation away from dubious claims, such as those in “Plandemic,” a video espousing Covid-19 conspiracy theories that drew millions of views last week. (Georgia Wells, Wall Street Journal)

COVID-19 TESTING:

Race, Ethnicity Data to Be Required With Coronavirus Tests Starting Aug. 1 - Federal health officials announced Thursday they will require laboratories to report race, ethnic and other information about each person tested for the novel coronavirus, following months of criticism that the Trump administration has been insensitive to the pandemic’s profound demographic disparities. (Amy Goldstein, Washington Post)

Coronavirus Antibody Tests: Facts, Myths and Everything You Need To Know - Are the tests reliable? What do they tell you? Your antibody test questions answered…. For a closer look at all of these issues, we asked experts what we know—and don’t know—about the tests. (Sumathi Reddy, Wall Street Journal)

TRUMP ADMINISTRATION RESPONSE: 

The C.D.C. Waited ‘Its Entire Existence for This Moment.’ What Went Wrong? - The technology was old, the data poor, the bureaucracy slow, the guidance confusing, the administration not in agreement. The coronavirus shook the world’s premier health agency, creating a loss of confidence and hampering the U.S. response to the crisis.  (Eric Lipton, Abby Goodnough, Michael D. Shear, Megan Twohey, Apoorva Mandavilli, New York Times)

Experts Warn of Dire Global Health Consequences If U.S. Withdraws from the World Health Organization - An American withdrawal from the World Health Organization could wreak profound damage on the global effort to eradicate polio and could undermine the world’s ability to detect and respond to disease threats, health experts warned. (Helen Branswell, STAT)

The Trump Administration Has Yet to Pay Out Billions in Emergency Health Aid - Months after Congress approved $175 billion in emergency aid to health providers, the Trump administration has yet to pay out the majority of the funds — nearly $100 billion — amid a series of setbacks and internal uncertainty over how best to distribute the money.  (Adam Cancryn, Politico)

COVID-19 & IMMIGRATION:

Doctor Who Advised Homeland Security Testifies Against COVID-19 Protocols in Immigration Detention - A doctor contracted by the Department of Homeland Security to advise on detention health conditions appeared before Congress on Tuesday to personally criticize the Trump administration as COVID-19 continues to spread through civil immigration detention centers. (Quinn Owen, ABC News)

Fear, Illness and Death in ICE Detention: How a Protest Grew on the Inside

For months in ICE’s detention centers, nobody really knew how many immigrant detainees had Covid-19, because the agency was scarcely testing, even as public-health experts warned of a pending crisis… In response to the pandemic, immigrants in at least a dozen ICE facilities have announced protests and strikes. (Seth Freed Wessler, New York Times)

Illinois to Become 1st State to Provide Medicaid Regardless of Immigration Status - Illinois will become the first state to provide Medicaid for undocumented seniors ...Tucked in near the end of the 465-page budget implementation bill that passed the Illinois General Assembly late Saturday night was a provision giving Medicaid access to noncitizens over 65 years old and whose income is $12,670 or less (Kade Heather, The State Journal-Register)

DRUG AFFORDABILITY:

Long-Delayed Drug-Price Legislation Not Dead Yet, Grassley Says - Senate Finance Committee Chairman Chuck Grassley said that he intends to push for a vote this year on a bill that would limit drug-price increases, even as pharmaceutical companies race to find treatments and vaccines for Covid-19. (Riley Griffin & Emma Court, Bloomberg News)

Medical Societies Have ‘Extensive’ Financial Ties With Drug and Device Makers

Many leaders of influential U.S. medical societies have extensive financial relationships with drug and device makers, raising concerns about the extent to which industry may influence research, physician education, and treatment guidelines, a new study finds. (Ed Silverman, STAT)

GUN VIOLENCE EPIDEMIC: 

Handgun Ownership Vastly Increases Suicide Risk, Large Study Confirms - A large new study confirms what mental health experts and those who research firearms have known for some time: Owning a handgun vastly increases one’s risk of suicide. The research, published Wednesday in the New England Journal of Medicine, goes beyond what smaller past studies have shown, however, by capturing suicide risk down to the individual level. (Shraddha Chakradhar, STAT)

SUBSTANCE USE DISORDER:

Overdose Deaths Have Skyrocketed in Chicago, and the Coronavirus Pandemic May Be Making It Worse - Opioid-related deaths in Cook County have doubled since this time last year, and similar increases are happening across the country. “If you’re alone, there’s nobody to give you the Narcan,” said one coroner. ...“This is going to make it so much worse,” said Kathleen Kane-Willis, a researcher with the Chicago Urban League who has studied the opioid epidemic for more than a decade, adding that the true impact of the pandemic on drug overdoses likely won’t be known for some time. (Melissa Sanchez and Duaa Eldeib, ProPublica)

 

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