Blog posts

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)

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