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Weekly Rounds 7-26-2020



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Upcoming Webinar: 

A Conversation with Don Berwick: Principled, Practical Approaches to Achieving Health for All.  Join us for a webinar featuring Dr. Don Berwick, longtime leader of the Institute for Healthcare Improvement, past administrator of CMS, and author of the recent JAMA piece, The Moral Determinants of Health.

A Conversation with Don Berwick: Principled, Practical Approaches to Achieving Health for All. 
Monday, July 27 at 8 pm Eastern
Registration. If zoom is at capacity watch Facebook Live


Recent DFA Webinar: Quarentine’s Disproportionate Impact on Womxn - July 21, 2020
Deval Zaveri, MD; Libby Benedict, MPA;  Krista Niemczyk, MPP
Click to view our Webinar (Passcode: Womxn##4)

DFA Doctor Max Jordan and Nguemeni Tiako At Last, the Medical Profession Speaks Out for Black Lives - In July 2016, a month before I started medical school, Alton Sterling and Philando Castile were killed by police officers. Soon after came Terence Crutcher and Keith Lamont Scott. These instances of police brutality prompted a group of my classmates to attend a Black Lives Matter rally, donning their white coats. I didn’t attend because of a prior obligation. (MedScape)


BACK TO SCHOOL? As a pediatrician and parent, I know how important it is to get students back in the classroom. We all want that. And with each day that passes, we know that communities of color — and students in those communities — likely will suffer disproportionately, just as we’ve seen with Blacks, Latinos and Native Americans across the nation in the first six months of this pandemic. In America, property taxes provide a large part of the funding for schools, so wealthy communities may be able to make the necessary changes while schools in lower income communities are left behind. We immediately need federal and state resources in place so that schools can reopen safely and equitably. Without adequate funding and better control of this pandemic, we’re setting ourselves up for failure. And tragically, we’ll be failing the students who can least afford this lost time to learn and thrive.”- Richard Besser, President and CEO Robert Wood Johnson Foundation

SOMETHING I DON’T LIKE TO SAY: It will probably, unfortunately, get worse before it gets better, Something I don’t like saying about things, but that’s the way it is.”....“Get a mask, Whether you like the mask or not, they have an impact. They will have an effect and we need everything we can get.”  - President Trump

THE TRUMP VIRUS: "Well, I think with the president's comments today, he recognized the mistakes he has made by now embracing mask-wearing and the recognition this is not a hoax. It is a pandemic that has gotten worse before it will get better because of his inaction, …”In fact, clearly, it is the Trump virus," -  Speaker Nancy Pelosi (D-Calif.)

ESSENTIAL WORKERS: "With most of the country reopening — whether it's safe or not — workers in so many occupations are put in the untenable position of having to choose between being able to sustain their families or putting their health at risk,"  Sharon Block, Executive Director of the Labor and Work-Life Program at Harvard Law School

THE SIDELINING OF SCIENCE: As current and former public health officials, researchers, and public health professionals, we call on our political leaders, members of the media and all Americans to reject the sidelining of science, to speak out against the silencing of scientists, and to champion open and public scientific discussions of the issues facing our country as we struggle to make progress against the SARS-CoV-2 pandemic. For that, we need the clear voices of government experts, including Dr. Fauci, to be available to the American public without limitation. That is the only path that can bring success in our efforts to control the virus.” - 3,500 Public Health Experts in a Letter in Support of Dr. Fauci

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.



U.S. Sees Spreading Infection, Spiking Deaths and Dwindling Supply of PPE - More deaths, more infections, and more restrictions. The spread of the coronavirus pandemic shows no sign of easing, and officials are scrambling to respond….All of this as testing delays, and shortages in personal protective equipment, are again growing acute. At a House hearing in Washington today, the head of the Federal Emergency Management Agency, Pete Gaynor, acknowledged shortcomings. (Stephanie Sy, PBS NewsHour)

Mistrust of a Coronavirus Vaccine Could Imperil Widespread Immunity - A growing number of polls find so many people saying they would not get a coronavirus vaccine that its potential to shut down the pandemic could be in jeopardy. Distrust of it is particularly pronounced in African-American communities, which have been disproportionately devastated by the virus. But even many staunch supporters of immunization say they are wary of this vaccine. (Jan Hoffman, New York Times)

True Number of U.S. Coronavirus Infections Likely 10 Times Larger Than Reported, CDC Data Shows - The true number of U.S. coronavirus cases so far could be six to 24 times larger than official figures show, according to CDC data. (David Lim, Politico)

Public Health Group Calls for Standardized Data Collection to More Clearly Track Covid-19- The assessment, released Tuesday by the nongovernmental organization Resolve to Save Lives, calls on states and communities to start recording and sharing standardized data on 15 key metrics, so that people — and health departments — can get a clearer picture of how the response to the pandemic is working in their area. (Helen Branswell, STAT)


US Labs Buckle Amid Testing Surge; World Virus Cases Top 15M - Laboratories across the U.S. are buckling under a surge of coronavirus tests, creating long processing delays that experts say are undercutting the pandemic response. (Matthew Perrone, Tammy Webber and Matt Sedensky, Associated Press)

US Lab Giant Warns of New Covid-19 Testing Crunch in Autumn - The largest laboratory company in the US has warned it will be impossible to increase coronavirus testing capacity to cope with a surge in demand during the autumn flu season, in a sign that crippling delays will continue to hamper the American response to the pandemic. (David Crow, Financial Times)


FEMA Head: 'We Have a Ways to Go' on Having Enough PPE - The head of the Federal Emergency Management Agency (FEMA) told Congress on Wednesday the country has “a ways to go” on getting enough protective equipment for health workers fighting coronavirus, though he said the situation has been improving. “I want to be clear: We have a ways to go on making sure we have enough PPE,” Administrator Pete Gaynor said at a congressional hearing, referring to personal protective equipment. “This is not as simple as just throwing a light switch and we just magically make more.” (Peter Sullivan, The Hill)

Nurses Place Shoes on Capitol Lawn for Every Colleague Who Died of Coronavirus - Members of a national nurses union laid pairs of shoes representing their colleagues who have died while treating coronavirus patients on the lawn of the U.S. Capitol on Tuesday. The demonstration, organized by National Nurses United (NNU), was designed to encourage Congress to invoke the Defense Production Act and mandate that U.S. manufacturing plants switch production to manufacture personal protective equipment (PPE), such as gloves and masks. (John Bowden, The Hill)


The Virus Found a Crowded Houston Neighborhood, Sparing One Nearby - The starkly divergent ways in which the coronavirus has affected neighboring communities in the Houston area — one rich and one poor — underscore how it is a magnifier of inequities. To see how the virus can largely spare one neighborhood but upend one next door, look at Bellaire, with its tidy yards and spacious homes, and Gulfton, where apartment blocks pack residents in tight. (J. David Goodman, New York Times)

 'Crashing Down’: How the Child Care Crisis Is Magnifying Racial Disparities - The collapse of the child care industry is hitting women of color the hardest, threatening to stoke racial and gender inequities and putting pressure on Congress to address the crisis in its new round of coronavirus aid. Black and Latina women are suffering a double-barreled blow as coronavirus-induced shutdowns batter the industry, since they dominate the ranks of child care providers and have long struggled to gain access to the services for their own kids. (Eleanor Mueller, Politico)


Trump’s End Run Around CDC Brings Threat of Fewer Drugs for Hospitals - A Trump administration change in the way hospitals report coronavirus data is bringing confusion and more work to medical centers and states as cases explode across the country. And hospitals that don’t get it right every day could end up receiving fewer critical drugs like remdesivir. (Darius Tahir and Rachel Roubein, Politico


How Laid-Off Americans May ‘Fall Through the Cracks’ Of the Health Care System During COVID-19 - In a country where many rely on their employer for health care coverage, the economic crisis has also left a significant number of Americans uninsured. According to a report released by the nonpartisan organization Families USA during the week of July 13, an estimated 5.4 million workers in the U.S. are uninsured because of job losses they experienced from February to May this year. Another recent study by the Commonwealth Fund found that among people who lost a job or were furloughed because of the pandemic, two out of five had health care through their job, and one out of five of those respondents said that they or a spouse or partner was now uninsured. (Courtney Vinopal, PBS NewsHour)

‘Surprise’ Billing Fix Likely Out of Next Covid-19 Package as Fight Over Tests Plays Out - Congress looks unable to protect patients from "surprise" medical bills before the election, despite a push from key health committee chairs and the Trump administration to include a fix in a new coronavirus relief package. ..."Surprise" billing protections — once thought to be a bipartisan rallying point, and an increasing concern of patient advocates during the pandemic — appear as stuck as ever, with powerful health industry interests gridlocked. (Susannah Luthi and Rachel Roubein, Politico)

Democratic AGs Sue Trump Administration Over LGBTQ Health Protections Rollback - A coalition of 23 Democratic state attorneys general are suing the Trump administration over a rule that scraps ObamaCare's nondiscrimination protections for LGBTQ patients. ...The administration's rule, released in June, will roll back implementation of the Affordable Care Act's Section 1557, which prohibits federally funded health programs and facilities from discriminating against patients based on race, color, national origin, sex, disability or age. (Nathaniel Weixel, The Hill)


Many Drug Companies Working on Covid-19 Vaccines and Treatments Are Lobbying Harder Than Usual - Pharmaceutical companies racing to develop coronavirus treatments and vaccines have upped their lobbying presence in the past three months, as drug companies work to combat the pandemic and fend off many lawmakers’ longstanding quest to lower drug prices via regulation. (Lev Facher, STAT)

US Signs Contract with Pfizer for COVID-19 Vaccine Doses - The Trump administration will pay Pfizer nearly $2 billion for a December delivery of 100 million doses of a COVID-19 vaccine the pharmaceutical company is developing, Health and Human Services Secretary Alex Azar announced Wednesday. The U.S. could buy another 500 million doses under the agreement, Azar said. … Americans will receive the vaccine for free, the companies said. … Pfizer is finishing an earlier stage of testing to determine which of four possible candidates to try in a larger, final study. (Darlene Superville, Associated Press)

Trump Likely to Sign Executive Orders on Drug Pricing Friday - President Trump is likely to sign executive orders on Friday aimed at lowering drug prices, elevating a key issue for voters in an election year. (Peter Sullivan, The Hill)


DHS Experts Issue Warning as ICE Attempts to Reinstitute Family Separation - Government Accountability Project Clients Urge Congress to Prevent Imminent Harm - Government Accountability Project clients Drs. Scott Allen, Pamela McPherson, and Josiah ‘Jody’ Rich, medical and mental health experts for the Department of Homeland Security’s Office of Civil Rights and Civil Liberties (DHS CRCL), sent a letter last week to Congress urging them to prevent Immigration and Customs Enforcement  (ICE) from separating immigrant children from their families under the guise of a federal court order. The doctors warned that separating children from their families will exacerbate the physical and mental trauma already experienced by children in detention, as well as that of detained families who know they are unable to protect themselves from the deadly, rapidly spreading pandemic. (Government Accountability Project)

ICE Detainees Remain in Facility During Coronavirus Outbreak Despite Judge's Order Mandating Their Release - Nearly 350 migrant parents and children remain detained in facilities with coronavirus outbreaks nearly a month after a federal court ruled all children must be released “with all deliberate speed” from Immigration and Customs Enforcement (ICE) detention facilities. A total of 346 children and parents remain detained in the facilities, despite District Judge Dolly Gee’s order in June, NBC News reported. In her ruling, Gee said the facilities were “on fire, and there is no more time for half measures.” (Zack Budryk, The Hill)


How the Pandemic is Complicating America’s Addiction Crisis - According to preliminary data, drug overdoses killed nearly 72,000 Americans in 2019, a record high. Now, it appears that 2020 is on track to be even worse, as the U.S. has witnessed a startling rise in overdoses during the pandemic. William Brangham reports on how increased isolation, economic uncertainty and reduced access to care have exacerbated American addiction -- with deadly consequences. (William Brangham & Mike Fritz PBS NewsHour)

FDA Tells Doctors to Discuss Overdose Antidote With Patients - Doctors who prescribe opioid painkillers should tell their patients about a potentially life-saving medication that can reverse drug overdoses, according to new federal guidelines issued Thursday. (Matthew Perrone, Associated Press)


CDC Now Recommends Coronavirus-Positive People Isolate For 10 Days, Not 14 Days - The CDC had previously recommended people who test positive isolate until they had two negative swabs for the coronavirus — but that turned out to be impractical given the shortage of tests. It now advises most people with active cases of COVID-19, the illness caused by the coronavirus, to isolate for 10 days after symptoms begin and 24 hours after their fever has broken. After that, they are free to leave isolation. (Ariana Eunjung Cha, Washington Post)

Plastics and Pesticides: Health Impacts of Synthetic Chemicals in Us Products Doubled in Last 5 Years, Study Finds - The proof is piling up: Many synthetic chemicals can harm your health and that of your children. Evidence has doubled in the last five years about the negative impact on our health of endocrine-disrupting chemicals in plastics, pesticides, flame retardants and other merchandise, according to a new review of recent literature. (Sandee LaMotte, CNN)

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