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Weekly Rounds 6-21-2020



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.


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.


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 - for publication in the next edition of the Physician Rounds. Your feedback is welcome.



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)


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)


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)


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)


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)


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)


'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)


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)


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)

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