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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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