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Weekly Rounds 5-10-20


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As doctors, nurses and health experts from around the world, we are here to sound the alarm. Our job is to keep people safe. But right now we face not only a COVID-19 pandemic but a global infodemic, with viral misinformation on social media threatening lives around the world. Stories claiming cocaine is a cure, or that COVID-19 was developed as a biological weapon by China or the US, have spread faster than the virus itself. Tech companies have tried to act, taking down certain content when it is flagged, and allowing the World Health Organization to run free ads. But their efforts are far from enough. That’s why today we are calling on the tech giants to take immediate systemic action to stem the flow of health misinformation, and the public health crisis it has triggered.  Sign the Petition Now!

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DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED:


DFA Board Member, Dr. Dona Kim Murphey: Texas COVID-19 Cases In Immigrant Detention Quadruple In Two Weeks, As ICE Transfers Continue - “You really shouldn’t be transferring people between facilities if you have any positives,” said Dr. Dona Kim Murphey, a neurologist and immigrant health advocate with Doctors for America. Murphey has been demanding the release of people from detention since the outbreak started. ….Murphey said. “With people who are constantly transferred between facilities, new people who are entering facilities, the staff who are actually traveling between facilities,” she said, “it’s very likely that you will have at some point the introduction of the infection into these populations, which then are kind of like tinderboxes.” (Elizabeth Trovall,  Houston Public Radio)


DFA Doctor Dr. Juliana E. Morris - San Francisco’s Homeless Need More Than Hotel Rooms to Survive During Coronavirus, and After - I knock on the hotel room door to greet my first patient of the day. I hear a rustling inside the room and a loud cough. My heart accelerates. Does he need to be tested? I adjust my mask and take a step back as I wait for the door to open... (Dr. Juliana E. Morris, San Francisco Chronicle)


DFA Doctors Ali Khan, Shikha Jain & Vineet Arora - All Americans Should Care About When States Reopen - But reopening the country prematurely, without effective test, trace, and treat measures in place, will most certainly result in a second surge. Failing to control the virus effectively now will likely lead to the inevitable consequence of worsening devastation and damage to the economy.  (US News & World Report)


THE WEEK IN QUOTES:


TOO HARD: Like many countries we picked a strategy to beat COVID-19. We just decided not to stick to it.Andy Slavitt


LESSONS FROM AROUND THE WORLD: Some lessons from around the world: the most successful global leaders in fighting coronavirus have communicated clearly, displayed empathy, and always favored science over politics.” Christiane Amanpour, CNN Chief International Anchor


MORE WORRIED, NOT LESS: If we were worried about it being overwhelmed a month ago or a month and half ago when the restrictions started, and there are more cases per day now, then we should be more worried, not less.” Marc Lipsitch, Epidemiologist - Harvard’s T.H. Chan School of Public Health


PICNIC IN YOSEMITE?: it’s great time to explore America, A lot of people haven’t seen many parts of America.” - Treasury Secretary Steve Mnuchin 


NOT WHO WE ARE: "The Confederate flags and nooses, the swastikas, the, you know, behavior that you've seen in all of the clips, is not representative of who we are in Michigan. And the fact of the matter is, I mean, we're in a global pandemic, we need to listen to the expertise and our institutions of higher learning and our health system and make decisions that are going to protect the lives of everyone." - Michigan Governor Gretchen Whitmer


KNOWINGLY GOING BACK TO MID-MARCH: “It will be tempting to see reopening as a return to our way of life before the coronavirus, but it will be anything but. As a society, we have made the decision to reopen before the science says we are ready. We are knowingly going back to where we were in mid-March, before the first exponential surge in infections and deaths. That surge will come again, but this time no one can say they didn’t see it coming.” - Dr. Leana S. Wen - Emergency Physician and Visiting Professor at George Washington University Milken Institute School of Public Health. Previously, She Served as Baltimore’s Health Commissioner.


ONTO A BATTLEFIELD WITHOUT ARMOR: "You talk about how essential, how needed, how grateful you are, and yet you throw us to the wolves, You throw us out onto a battlefield without armor and the more we complain we don't see anything being done.”Jean Ross, President of National Nurses United


PRICING OF REMDESIVIR: Drug prices have taken a backseat to the pandemic, but remdesivir is about to make the issue very relevant again.” - Caitlin Owens - Axios Vitals


STATEMENT BY VICE PRESIDENT JOE BIDEN - “By siding with the Republican Attorneys-General who are seeking to invalidate the ACA in the U.S. Supreme Court, Trump has made clear where his priorities lie. Not with protecting the millions of people who depend on the exchanges for their health coverage. Not with ensuring that more than 100 million people with pre-existing conditions won’t be denied coverage or charged more by their insurers. Not with the thousands of Americans who may develop new “pre-existing conditions” due to their battle with COVID-19. Not with the young people who can now stay on their parents insurance until 26. Not with women, who will no longer be protected against being charged more for their insurance. No — Trump has decided he’d rather destroy President Obama’s legacy than protect the health care of millions upon millions of Americans. He’d rather look after the profits of the insurance industry than make sure people can access healthcare in their hour of need. It’s despicable." - Former Vice President Joe Biden


REACH OUT: If you have 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: 


DOCTORS - MEDICINE & RESEARCH:


Coronavirus Hijacks the Body From Head to Toe, Perplexing Doctors - More than a respiratory infection, Covid-19 wreaks havoc on many organs; inflammation and abnormal blood clotting are likely culprits (Betsy McKay and Daniela Hernandez, Wall Street Journal)


Doctors Rush to Understand COVID-19's Second-Week Crash - Doctors have now described alarming situations in which patients with COVID-19 suddenly and inexplicably become critically ill around the eighth day after being infected with the virus. .. While doctors may be uncertain why the crash appears in the second week, they do have several theories as to what may be causing the crashes. (Dr. Angela N. Baldwin, ABC News)


New COVID-19 Study Raises Immunity Hopes for Recovered Patients - Researchers in China tested the blood of 285 patients hospitalized with severe COVID-19 illness and found that all had developed antibodies within two to three weeks of their first symptoms. (Jessie Hellmann, The Hill)


Eerie Emptiness Of ERs Worries Doctors As Heart Attack And Stroke Patients Delay Care - Across the U.S., doctors call the drop-off staggering, unlike anything they’ve seen. And they worry a new wave of patients is headed their way — people who have delayed care and will be sicker and whose injuries will be exacerbated by the time they finally arrive in emergency rooms. (Will Stone and Elly Yu, KPCC)


New Bill Would Forgive Medical School Debt for COVID-19 Health Workers - The idea is catching on. Last month, more than 500,000 people signed a MoveOn petition asking Congress to include student loan debt forgiveness for doctors in the next stimulus bill. (Erin Schumaker, ABC News)


Malaria Drug Shows No Benefit in Another Coronavirus Study - Hydroxychloroquine did not lower the risk of dying or needing a breathing tube in a comparison that involved nearly 1,400 patients treated at Columbia University in New York, researchers reported Thursday in the New England Journal of Medicine. (Marilynn Marchione, Associated Press)


Johns Hopkins' Ideas for Better Preparedness After COVID-19 - An action plan published Tuesday by researchers at Johns Hopkins University offers wide-ranging solutions for both the private healthcare sector and the federal government in response to the shortcomings that have come to light in the wake of the COVID-19 pandemic. The Report (Maria Castellucci, Modern Healthcare)


Facebook and Other Companies Are Removing Viral ‘Plandemic’ Conspiracy Video - Social media companies including YouTube, Vimeo and Facebook are removing a viral conspiracy theory video because of its claims regarding the coronavirus pandemic. The approximately 26-minute video was presented as an extremely long “trailer” for a full-length film titled “Plandemic” and features an extended interview with Judy Mikovits, a well-known figure in the anti-vaccination movement who has made various discredited claims about the effects of vaccines. (Travis M. Andrews, Washington Post)


AFFORDABLE CARE ACT AND COVERAGE ISSUES:


Trump Vows Complete End of ObamaCare Law Despite Pandemic - President Trump said Wednesday he will continue trying to toss out all of the Affordable Care Act, even as some in his administration, including Attorney General William P. Barr, have privately argued parts of the law should be preserved amid a pandemic. (Devlin Barrett, Washington Post)


In a Time of COVID-19, 'ObamaCare' Still Part of The Action - From nearly 12 million people to 35 million could lose their workplace coverage due to layoffs in the coronavirus shutdown, according to an estimate by the consulting firm Health Management Associates. They have more options because of the Obama-era law. (Ricardo Alonso-Zaldivar, Associated Press)


Thousands Will Go Uninsured in the Covid-19 Outbreak Because Republicans Rejected Medicaid Expansion - Republican-led states have for years refused to expand Medicaid eligibility to many of their poorest residents, and now, in the midst of the coronavirus pandemic and an unprecedented economic crisis, thousands upon thousands of Americans will fall through that hole in the safety net and end up uninsured. This was completely avoidable. (Dylan Scott, Vox)


COVID-19:


Coronavirus in the U.S.: An Unrelenting Crush of Cases and Deaths - Any notion that the coronavirus threat is fading away appears to be magical thinking, at odds with what the latest numbers show. (Julie Bosman, Mitch Smith and Amy Harmon, New York Times)


The Coronavirus Pandemic Is Pushing America Into a Mental Health Crisis - Anxiety and depression are rising. The U.S. is ill-prepared, with some clinics already on the brink of collapse. (William Wan, Washington Post)


Jobless Rate Spikes to 14.7%, Highest Since Great Depression - The U.S. unemployment rate hit 14.7% in April, the highest rate since the Great Depression, as 20.5 million jobs vanished in the worst monthly loss on record. (Christopher Rugaber, Associated Press)


PERSONAL PROTECTIVE EQUIPMENT:


How Profit and Incompetence Delayed N95 Masks While People Died at the VA - Federal agencies have hired contractors with no experience to find respirators and masks, fueling a black market filled with price gouging and multiple layers of profiteering brokers. One contractor called them “buccaneers and pirates.” (J. David McSwane, ProPublica)


After ‘Cutthroat’ Global Competition For PPE, U.S. Seeks to Make More at Home - Today's increased manufacturing in the U.S. should lead to less U.S. dependence on foreign imports. But, even today, front-line workers are paying the price for the shortage. (Nick Schifrin, PBS NewsHour)


COVID-19 TESTING:


'Not Nearly Enough' Coronavirus Testing to Safely Reopen, Senate Health Chair Says - The Harvard Global Health Institute released new data Thursday that suggest more than 900,000 coronavirus tests need to be completed daily to consider safely relax distancing measures, as a growing number of states are doing. That number is significantly higher than the approximately 250,000 tests per day the country is currently running, according to data from The COVID Tracking Project.  (David Lim, Politico)


TRUMP ADMINISTRATION RESPONSE:


White House Rejects C.D.C.’s Coronavirus Reopening Plan - White House and other administration officials rejected the recommendations over concerns that they were overly prescriptive, infringed on religious rights and risked further damaging an economy that Mr. Trump was banking on to recover quickly. (Abby Goodnough and Maggie Haberman, New York Times)


Trump Cheers on Governors Even as They Ignore White House Coronavirus Guidelines in Race to Reopen - States across the country are moving swiftly to reopen their economies despite failing to achieve benchmarks laid out by the White House for when social distancing restrictions could be eased to ensure the public’s safety during the coronavirus pandemic. These governors’ biggest cheerleader is President Trump. (Toluse Olorunnipa, Griff Witte and Lenny Bernstein, New York Times)


Trump Officials' Dysfunction Harms Delivery of Coronavirus Drug - A complete breakdown in communication and coordination within the Trump administration has undermined the distribution of a promising treatment, according to senior officials with direct knowledge of the discussions. .. "Some went to the wrong places, some went to the right places," said one senior official. "We don't know who gave the order. And no one is claiming responsibility." (Jonathan Swan, Axios)


COVID-19 & IMMIGRATION:


Before Covid-19, Trump Aide Sought to Use Disease to Close Borders - The president’s chief adviser on immigration, Stephen Miller, had long tried to halt migration based on public health, without success. Then came the coronavirus. - … The idea that immigrants carry infections into the country echoes a racist notion with a long history in the United States that associates minorities with disease. (Caitlin Dickerson and Michael D. Shear, New York Times)


GUN VIOLENCE EPIDEMIC: 


Open States, Lots of Guns. America Is Paying a Heavy Price for Freedom. - As a country, we seem resigned to preventable firearm deaths. Each year, 36,000 Americans are killed by guns — roughly 100 per day, most from suicide, according to data from the Giffords Law Center. Similarly, the Everytown for Gun Safety Support Fund calculates that there have been 583 “incidents of gunfire” on school grounds since 2013. In the first eight months of 2019, there were at least 38 mass shootings, The Times reported. Last August, 53 Americans died in mass shootings — at work, at bars, while shopping with their children. (Charlie Warzel, New York Times)


WOMEN’S HEALTH:


Justices Wary of ‘ObamaCare’ Birth Control Coverage Changes - The Supreme Court seemed concerned Wednesday about the sweep of Trump administration rules that would allow more employers who cite a religious or moral objection to opt out of providing no-cost birth control to women as required by the Affordable Care Act. … Even though the Trump rules remain blocked, a ruling by a federal judge in Texas in June already allows most people who object to covering contraception to avoid doing so. (Jessica Gresko and Mark Sherman, Associated Press)

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