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Weekly Rounds 4-19-20


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We ask for you to join DFA by contacting the White House and your congressional representatives to ensure that our patients have affordable access to all COVID-19 treatments.


CLICK HERE: and provide your information which will customize the letter drafted by Doctors for America to be sent to your Congressional representative and Senators. Your signature will also be applied to the letter being sent to the White House and Congressional leaders along with your colleagues’ signatures.

 

THANK YOU for all your hard work. 


DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:


DFA Doctor Nina Agrawal - The Coronavirus Could Cause a Child Abuse Epidemic - This pandemic has brought with it additional challenges in protecting young people from abuse and revealed gaps in our existing approach. We have an opportunity to use new tools to ensure that children are safe — tools that will serve them during this crisis and long after. (New York Times)


THE WEEK IN QUOTES:


PROFESSIONALISM: Why do millions of health care workers — doctors, nurses, emergency responders, aides, transport specialists, and more — risk their lives every day to care for those with Covid-19, a potentially deadly infection? Personal courage is part of the explanation. But there’s more to it than that. What we are seeing is the professionalism of people like Anthony Fauci and thousands of health care workers at work. The essence of their professionalism is that they put the interests of patients and the public before their own. We take it for granted at our peril.” - David Blumenthal, M.D., President of The Commonwealth Fund


INTUBATION: Intubated patients with Covid lung disease are doing very poorly, and while this may be the disease and not the mechanical ventilation, most of us believe that intubation is to be avoided until unequivocally required,” - Dr. Reuben Strayer, Emergency Medicine Physician at Maimonides Medical Center in Brooklyn NY


DIRECT VIRAL INVOLVEMENT OF THE KIDNEY?: “It does raise the very clear suspicion that at least a part of the acute kidney injury that we’re seeing is resulting from direct viral involvement of the kidney, which is distinct from what was seen in the SARS outbreak in 2002,” Paul M. Palevsky, a University of Pittsburgh School of Medicine Nephrologist and President-elect of the National Kidney Foundation.


BLOOD CLOTS: This is a real-time learning experience, I don’t think any of us can declare anything definitively, but we know from the best available data that about one-third of patients who have Covid-19 infections do in fact have evidence of thrombotic disease,” - Clyde Yancy, Chief of Cardiology at Northwestern University Feinberg School of Medicine


WE NEED THE ACA: We need to leverage the Affordable Care Act so it can serve as the strong safety net that our country needs, especially given the job disruption that is causing many Americans to lose their health insurance,” - Dr. Patrice Harris, President American Medical Association


60,000 GET COVERAGE IN CA: "We are living in unprecedented times, and California is doing everything it can to make sure people have access to care during this public health emergency, Having more people insured and protected is the right thing for California's families and helps keep everyone better off as those with insurance don't delay getting needed care." - Covered California Executive Director Peter Lee


CONTACT TRACING: "Failing to invest in and train more workers for contact tracing now could extend this crisis months," Chris Meekins, Former Trump Administration Health Official who is now an Analyst at Raymond James


TRUMP CUTS OFF $ TO THE WORLD HEALTH ORGANIZATION:We're in the middle of a goddamn pandemic. It is ill-considered, irresponsible, and wrong to remove our support for the firefighters who are on the front lines of the 6 alarm blaze while we're fighting it. It hurts everyone, everywhere. This is not who we are.”  - Beth Cameron, Former National Security Council Official Known for Authoring the Obama-Era Pandemic Playbook.


CDC ON THE SIDELINES: The “CDC is seen as an incredibly important institution, not just for America but for the world, There is a void, when you have an organization that people have looked to that is not providing the kind of global leadership that it once did.” - Helene Gayle, Philanthropy Executive and 20-year veteran of U.S. Centers for Disease Control and Prevention


MEDIA COVERAGE: 


DOCTORS - MEDICINE & RESEARCH:


What Doctors on the Front Lines Wish They’d Known a Month Ago - Doctors, if you could go back in time, what would you tell yourselves in early March? (Jim Dwyer, New York Times)


COVID-19 Distancing Drives a Halt in Measles Vaccinations - experts worry that the postponement of routine immunizations could lead to an outbreak of vaccine-preventable diseases after social distancing practices begin to relax. (Steven Ross Johnson, Modern Healthcare)


Coronavirus Destroys Lungs. but Doctors Are Finding Its Damage in Kidneys, Hearts and Elsewhere. - Clinicians around the world are seeing evidence that suggests the virus also may be causing heart inflammation, acute kidney disease, neurological malfunction, blood clots, intestinal damage and liver problems.  (Lenny Bernstein, Carolyn Y. Johnson, Sarah Kaplan and Laurie McGinley, Washington Post)


U.S. Races to Stock up on Dialysis Supplies as Kidney Failure Ravages Virus Patients - Approximately 20 percent of coronavirus patients in intensive care around the city need the kidney treatment, often for weeks, a development that many providers did not see coming. (Sarah Owermohle and Amanda Eisenberg, Politico


Blood Clots in Severe Covid-19 Patients Leave Clinicians With Clues About the Illness — but No Proven Treatments - Doctors treating the sickest Covid-19 patients have zeroed in on a new phenomenon: Some people have developed widespread blood clots, their lungs peppered with tiny blockages that prevent oxygen from pumping into the bloodstream and body. (Elizabeth Cooney, STAT)


Which Profession Has the Biggest Gender Pay Gap? - The biggest gender pay gap in the U.S. exists among physicians and surgeons. ...If you take men and women physicians who have the same length of training, the same kind of training, have the same kind of CV publications, even have the same grants from the National Institute of Health, work in the same field, with the same exact time parameters — and you do do a multivariate analysis with all things being equal, women are still being paid significantly less.” (Elizabeth Ralph, Politico)


COVID-19:


Thousands of Medical Workers Are Getting Sick from Coronavirus - Health-care workers may constitute between 1 and 2 of every 10 coronavirus cases in the United States (Paige Winfield Cunningham & Paulina Firozi, Washington Post)


Inside America’s 2-Decade Failure to Prepare for Coronavirus - When the pandemic finally came, the team that had prepared their careers for it were working for a president unwilling and unready to act. … Global health experts increasingly view the U.S. response as among the worst in the developed world. (Dan Diamond, Politico Magazine)


How Anthony Fauci Became America’s Doctor - At seventy-nine, Fauci has run the National Institute of Allergy and Infectious Diseases for thirty-six years, through six Administrations and a long procession of viral epidemics: H.I.V., sars, avian influenza, swine flu, Zika, and Ebola among them. (Michael Specter, The New Yorker)


W.H.O., Now Trump’s Scapegoat, Warned About Coronavirus Early and Often - The World Health Organization, always cautious, acted more forcefully and faster than many national governments. (Richard Pérez-Peña and Donald G. McNeil Jr., New York Times)


COVID-19 TESTING:


Testing Falls Woefully Short as Trump Seeks an End to Stay-at-Home Orders - Flawed tests, scarce supplies and limited access to screening have hurt the U.S.’s ability to monitor Covid-19, governors and health officials warn. (Abby Goodnough, Katie Thomas and Sheila Kaplan, New York Times)


Coronavirus Testing Hits Dramatic Slowdown In U.S. - The number of coronavirus tests analyzed each day by commercial labs in the U.S. plummeted by more than 30 percent over the past week, even though new infections are still surging in many states and officials are desperately trying to ramp up testing so the country can reopen. (David Lim, Politico)

The Next Coronavirus Testing Debacle - Blood tests that measure a person’s antibodies to the coronavirus could be a powerful tool to determine when it’s safe to reopen the country. But concerns about the accuracy and availability of the tests (David Lim, Politico)


TRUMP ADMINISTRATION RESPONSE:


He Could Have Seen What Was Coming: Behind Trump’s Failure on the Virus - An examination reveals the president was warned about the potential for a pandemic but that internal divisions, lack of planning and his faith in his own instincts led to a halting response. …  (Eric Lipton, David E. Sanger, Maggie Haberman, Michael D. Shear, Mark Mazzetti and Julian E. Barnes, New York Times)


Trump Leaves Trail of Unmet Promises in Coronavirus Response - For several months, President Donald Trump and his officials have cast a fog of promises meant to reassure a country in the throes of the coronavirus pandemic. Trump and his team haven’t delivered on critical ones. (Calvin Woodward, Associated Press)


COVID-19 & IMMIGRATION:


Fearing Deportation, Many Immigrants at Higher Risk of Covid-19 Are Afraid to Seek Testing or Care - Worsening matters is the federal government’s new “public charge” immigration rule that went into effect in late February, just as the virus was beginning to sweep through communities here. (Usha Lee Mcfarling, STAT)


AFFORDABLE CARE ACT AND COVERAGE ISSUES:


Trump’s Disdain for ‘ObamaCare’ Could Hamper Virus Response - The Trump administration’s unrelenting opposition to “ObamaCare” could become an obstacle for millions of uninsured people in the coronavirus outbreak, as well as many who are losing coverage in the economic shutdown. (Ricardo Alonso-Zaldivar, Associated Press)


As Coronavirus Rages, Republicans Still Don’t Have a Plan to Give Americans Health-Care Coverage - Republicans still did not have any sort of consensus plan for addressing such basic problems as the millions of Americans without health insurance or the insurance-company practice of denying coverage to those with preexisting health conditions.  …. And then came the coronavirus pandemic. Has that changed the Republican posture on health-care policy? Not in any significant way. (Ed Kilgore, New York Magazine)


WOMEN’S HEALTH:


Judge Rules Alabama Can't Prohibit Abortion During Coronavirus Crisis - A federal judge on Sunday ruled that Alabama cannot ban abortions as part of the state’s response to coronavirus. (Kim Chandler, Associated Press)


Calif. A.G. Becerra, Mass. A.G. Healey Lead Multistate Amicus Brief Defending Affordable Care Act Birth Control Coverage Mandate in Supreme Court - In the brief filed in Donald Trump et al. v. Pennsylvania, the attorneys general explain that states have an interest in safeguarding the ACA's birth control coverage requirement  (Newswires)


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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

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