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Weekly Rounds 7-12-2020



Immigrant Health Justice: The administration has proposed new rules that would dismantle asylum as we know it, including - allowing judges to reject requests without an in-person court appearance, and eliminating protections for domestic violence survivors, and much more. This is part of a broader xenophobic campaign. Please help stop these inhumane proposals by making a public comment by July 15th. The notice to the proposed rule and link to submit comments may be submitted online here. View suggested language here.

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.

Register; If Zoom is at capacity,  Facebook Live

Fabiola Carrion, JD: Fabiola is a senior attorney at the National Health Law Program (NHeLP), an organization dedicated to protecting and promoting the health rights of low-income individuals. Fabiola is based in Los Angeles.

Bhavik Kumar, MD, MPH: Bhavik is a family medicine physician and Medical Director for Primary and Trans Care at Planned Parenthood Gulf Coast, in Houston, Texas. He has also been an abortion provider in his home state of Texas since 2015.

Pratima Gupta, MD: Pratima is an obstetrician/gynecologist at UCSD and Planned Parenthood. She is on the Board of Directors of Close the Gap California which works towards getting more women elected to State office. 


DFA Founders Vivek H. Murthy and Alice T. Chen :Here's the Best Way to Take Care of Your Mental Health During the Pandemic - Better policies are essential to improving our mental health and well-being. But policy ultimately flows from the culture and values that shape our decisions. This is our moment to re-center our lives and our country around a simple but powerful credo: put people first. Covid-19 is our opportunity to recommit to one another, to recognize that human connection is the foundation for greater health, resilience and fulfillment. (CNN)

DFA Member Leana S. Wen: If Trump Wants to Reopen Schools, Here’s What His Administration Needs to Do  - We have already seen what happens when reopening occurs too soon and without the proper safeguards. If getting schools back is the top priority that the Trump administration says it is, it needs to do the hard work and provide the necessary funding to get there. Arbitrary timelines and empty rhetoric will only harm students, parents and teachers. (Washington Post)

DFA Webinar Last Week:
Telehealth Prenatal Care: Patient Impact During COVID and After - July 8, 2020
Elissa Edmunds, MA: Meghana Rao, MD  Ariste Sallas-Brookwell, LICSW
View Recording (Passcode: Passcode: Womxn##2)

REACH OUT: If you get an opinion piece, letter to the editor, or media appearance distributed PLEASE alert Pete Van Vranken - for publication in the next edition of the Physician Rounds. Your feedback is welcome.


SIDELINING SCIENCE:Sidelining science has already cost lives, imperiled the safety of our loved ones, compromised our ability to safely reopen our businesses, schools, and places of worship, and endangered the health of our democracy itself,” - Officials from the Trump, Obama and George W. Bush Administrations

NO HAND ON THE TILLER: At a time when our country needs an orchestrated, all-hands-on-deck response, there is simply no hand on the tiller,” - Beth Cameron, Former Senior Director for Global Health Security and Biodefense on the White House National Security Council

WE ARE NOT POWERLESS: We are urging the American public to take the simple steps we know will help stop the spread of the virus: wearing a face mask, maintaining physical distancing, and washing hands. We are not powerless in this public health crisis, and we can defeat it in the same way we defeated previous threats to public health—by allowing science and evidence to shape our decisions and inform our actions” - An Open Letter to the American Public from The American Hospital Association, the American Medical Association and the American Nurses Association

TOO TOUGH: The president said today we just don’t want the guidance to be too tough, And that’s the reason next week the CDC is going to be issuing a new set of tools.” - Vice President Mike Pence 

OPEN UP THE SCHOOLS: Even before the pandemic, our nation’s public schools were chronically underfunded. Reopening schools now, without more investment, presents serious risks to the health and safety of our students and educators. What's worse, the administration is now threatening to ignore health experts and issue their own ‘less restrictive’ guidelines, prioritizing politics over the health and safety of students, parents, and educators. This move is not only irresponsible, it is dangerous," Representative Bobby Scott, House Education and Labor Committee Chairman (D-VA.) 

NO CHILDCARE: It’s amazing to me how many people are worried that Americans won’t go back to work because unemployment pays too darn much, I’m way more worried about people not going back to work because they have no child care.” - Betsey Stevenson, University of Michigan Economics Professor

BIRTH CONTROL COVERAGE WEAKENED: Today, for the first time, the Court casts totally aside countervailing rights and interests in its zeal to secure religious rights to the nth degree,"  - Supreme Court Justice Ruth Bader Ginsburg 



239 Experts With One Big Claim: The Coronavirus Is Airborne - If airborne transmission is a significant factor in the pandemic, especially in crowded spaces with poor ventilation, the consequences for containment will be significant. Masks may be needed indoors, even in socially-distant settings. Health care workers may need N95 masks that filter out even the smallest respiratory droplets as they care for coronavirus patients. Ventilation systems in schools, nursing homes, residences and businesses may need to minimize recirculating air and add powerful new filters. Ultraviolet lights may be needed to kill viral particles floating in tiny droplets indoors. (Apoorva Mandavilli, New York Times)

The Coronavirus Can Be Airborne Indoors, W.H.O. Says - The coronavirus may linger in the air in crowded indoor spaces, spreading from one person to the next, the World Health Organization acknowledged on Thursday. …. growing scientific and anecdotal evidence suggest this route may be important in spreading the virus, and this week more than 200 scientists urged the agency to revisit the research and revise its position.  (Apoorva Mandavilli, New York Times)

The U.S.' New Default Coronavirus Strategy: Herd Immunity - By letting the coronavirus surge through the population with only minimal social distancing measures in place, the U.S. has accidentally become the world’s largest experiment in herd immunity. (Caitlin Owens, Axios)

Grim Projection: 200,000 Dead by Election Day - As the United States surpasses 3 million coronavirus infections, forecasters are updating their models to account for the recent resurgence and reaching a grim consensus: the next few months are going to be bad. The national death toll is now expected to eclipse 200,000 by Election Day, according to the latest models. (Dan Goldberg and Adam Cancryn, Politico)

Bipartisan Group of Former Government Officials Demand Science-Based Approach to Pandemic - Fifty-seven former government scientists and public health officials of both parties called on Monday for a science-based approach to the coronavirus pandemic and criticized the Trump administration for marginalizing science and expertise in its response. (Yasmeen Abutaleb, Washington Post)

Hospitals Struggle to Contain Covid-19 Spread Inside Their Walls - U.S. medical centers have reported 5,000-plus cases of patients likely catching the coronavirus once admitted for other conditions, adding to the strain of the pandemic itself - In the fight against the coronavirus, the nation’s hospitals are a refuge for the sickest. Yet despite their intensive efforts, hospitals also are a place where the virus sometimes spreads. (Russell Gold and Melanie Evans, Wall Street Journal)


Racism in Health Care Isn't Always Obvious - As physicians, we believe that recognizing it begins with understanding our own privilege and biases.  Health care workers are constantly thinking about how to improve the quality of care being delivered to our patients. However, we rarely talk about our own biases toward our patients—let alone racial bias. We usually aren’t even aware of them. But they exist, and in fact, when it comes to our patients, evidence suggests that us doctors have the same level of bias as the wider population. Hence, it’s time we address them head on. (Joseph V. Sakran, Ebony Jade Hilton, Chethan Sathya, Scientific American)

Stark Racial Disparities Emerge as Families Struggle to Get Enough Food - Nearly four in 10 Black and Hispanic households with children are struggling to feed their families during the coronavirus pandemic — a dramatic spike that is exacerbating racial inequities and potentially threatening the health of millions of young Americans. (Helena Bottemiller Evich, Politico)

Virus, Floyd Death Merge in Brutal Blow to Black Well-Being - Doctors have known it for a long time, well before the resounding cries of “Black Lives Matter”: Black people suffer disproportionately. They face countless challenges to good health, among them food, transportation and income. The stress of living with racism has very real, physical effects. And they are especially prone to diabetes, hypertension and other chronic diseases that can be tricky to manage even in normal times. Then came COVID-19 and George Floyd — one killing Black people in alarming numbers, the other shining a harsh light on systemic racism. In a matter of months and nearly 8 minutes, it became clear that institutions designed to ensure the two most important things in life — health and safety — had converged to turn against one segment of the population in stark, horrific ways. (Lindsey Tanner, Associated Press)

The Fullest Look Yet at the Racial Inequity of Coronavirus - Early numbers had shown that Black and Latino people were being harmed by the virus at higher rates. But the new federal data — made available after The New York Times sued the Centers for Disease Control and Prevention — reveals a clearer and more complete picture: Black and Latino people have been disproportionately affected by the coronavirus in a widespread manner that spans the country, throughout hundreds of counties in urban, suburban and rural areas, and across all age groups. (Richard A. Oppel Jr., Robert Gebeloff, K.K. Rebecca Lai, Will Wright and Mitch Smith, New York Times)


Supreme Court Undercuts Access to Birth Control Under ObamaCare - The U.S. Supreme Court has made it more difficult for women to get access to birth control as part of their health plans if their employer has religious or moral objections to contraceptives. The opinion upheld a Trump administration rule that significantly cut back on the Affordable Care Act requirement that insurers provide free birth control coverage as part of almost all health care plans (Nina Totenberg, National Public Radio)


‘It Was Like a Time Bomb’: How ICE Helped Spread the Coronavirus - An investigation by The New York Times in collaboration with The Marshall Project reveals how unsafe conditions and scattershot testing helped turn ICE into a domestic and global spreader of the virus — and how pressure from the Trump administration led countries to take in sick deportees. (Emily Kassie and Barbara Marcolini, New York Times)

US Rule Targets Disease-Stricken Countries to Deny Asylum - The Trump administration on Wednesday proposed empowering border authorities to deny asylum to people from countries with widespread communicable disease, its latest in a string of regulations before the November elections to dramatically raise the bar on who qualifies for humanitarian protections. (Elliot Spagat, Associated Press)


Covid-19 Testing in the US Is Abysmal. Again. - The US never fixed the core causes of its testing problem. So it’s now seeing the same kinds of issues pop up again. - “Basically, two things are happening,” Ashish Jha, faculty director of the Harvard Global Health Institute (HGHI), told me. “One is the outbreaks are getting much bigger, so the amount of testing we need to get our arms around the outbreak is going up. And second, what we did [before] was some tweaking on capacity issues to get ourselves up to 500,000 to 600,000 tests a day, but didn’t fundamentally address the supply chain problems.” (German Lopez, VOX)


Protective Gear for Medical Workers Begins to Run Low Again - The personal protective gear that was in dangerously short supply during the early weeks of the coronavirus crisis in the U.S. is running low again as the virus resumes its rapid spread and the number of hospitalized patients climbs. (Geoff Mulvihill and Camille Fassett, Associated Press)

Grave Shortages of Protective Gear Flare Again as Covid Cases Surge - As coronavirus cases surge across the country, hospitals, nursing homes and private medical practices are facing a problem many had hoped would be resolved by now: a dire shortage of respirator masks, isolation gowns and disposable gloves that protect front-line medical workers from infection. (Andrew Jacobs, New York Times)


Trump Moves to Pull U.S. Out of World Health Organization in Midst of Covid-19 Pandemic - The U.S. has formally notified the World Health Organization it will withdraw from the United Nations agency over President Trump’s criticism of its ties to China, a move critics say will hamper the international fight against the Covid-19 pandemic and sap the U.S. of global influence. (Drew Hinshaw and Stephanie Armour, Wall Street Journal)

CDC Feels Pressure from Trump as Rift Grows Over Coronavirus Response - The CDC, the nation’s top public health agency, is coming under intense pressure from President Trump and his allies, who are downplaying the dangers in a bid to revive the economy ahead of the Nov. 3 presidential election. In a White House guided by the president’s instincts, rather than by evidence-based policy, the CDC finds itself forced constantly to backtrack or sidelined from pivotal decisions. (Lena H. Sun & Josh Dawsey, Washington Post)

Trump’s Health Officials Find Ways to Contradict His Message Downplaying Virus Risks - What the American public ends up seeing is a jarring split screen, public health experts said, with fragmented but dire assessments about the pandemic response and what should be done shrouding the White House’s sunny, hands-off approach. (Adam Cancryn and Brianna Ehley, Politico)


Drug Prices Steadily Rise Amid Pandemic, Data Shows - Drugmakers raised the price of hundreds of medicines during the coronavirus pandemic, even in the face of Trump administration vows to crack down on surging drug costs and efforts to tack price controls on Covid-19 relief packages. (Sarah Owermohle, Politico)


After Photos of Armed Customers in Raleigh NC Go Viral, Subway Changes Open Carry Policy - Two months after photos of gun-toting customers visiting their downtown Raleigh location drew nationwide attention, Subway has altered its policy regarding firearms in its stores nationwide. (Steve Wiseman, Raleigh News & Observer)

Dangerous Gaps in Gun Laws Exposed by the Coronavirus Gun Sale Surge - The coronavirus crisis has not created new problems in the laws and systems guiding the sale and ownership of firearms. But the recent surge in gun sales has put new stress on an already weak system and highlighted some of the most dangerous gaps in the law that allow people who are prohibited from buying guns to continue to have easy access to them. It has also put a spotlight on the negligence of the United States’ current approach to ensuring that first-time gun owners have the tools and resources necessary to bring these guns home safely. (Chelsea Parsons and Rukmani Bhatia, Center for American Progress)


Coronavirus Crisis Disrupts Treatment for Another Epidemic: Addiction - Drug rehabs around the country — including in Pennsylvania, Illinois, Indiana, Minnesota and Florida — have experienced flare-ups of the coronavirus or COVID-related financial difficulties that have forced them to close or limit operations. Centers that serve the poor have been hit particularly hard. And that has left people who have another potentially deadly disease — addiction — with fewer opportunities for treatment, while threatening to reverse their recovery gains. (Giles Bruce, Kaiser Health News)

Safe Injection Sites May Curb Opioid Deaths, Report Suggests - Every year in the United States, nearly 70,000 people die of a drug overdose. Quick treatment with the medicine naloxone can prevent death in many cases. Besides offering trained staff to administer it, these injection sites offer safe disposal of used needles and a chance to get users into counseling and help with other health problems. (Marilynn Marchione, Associated Press)

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