Doctor, Heal Thyself: Physician Burnout In The Wake Of Covid-19 – Forbes

Physician burnout and suicide were epidemics before the current pandemic.

Nationwide, our doctors are jumping from rooftops, overdosing in call rooms and hanging themselves in hospital chapels. Its medicines dirty secret.

This unnerving account by Pamela Wible, MD during her 2015 TEDMED talk sent chills down my spine. Dr. Wible described the death of one physician by bullying, hazing and sleep deprivation a torture technique adding that each year, more than one million Americans lose their doctor due to suicide. Her cell phone has become an unofficial suicide hotline. The founder of Ideal Medical Care, Dr. Wible is also featured in the groundbreaking documentary, Do No Harm, which has been virtually screened every Sunday in May at 8pm EST. Suicide is an occupational hazard of our profession.

Physician burnout was an epidemic BEFORE the Covid-19 pandemic. According to a 2018 study, 400 physicians die by suicide each year double that of the general population. In addition, doctors have the highest suicide rate of any profession in the U.S including combat veterans. From an economic standpoint, studies estimate that physician burnout is costing the health care system approximately $4.6 billion per year. So, how do we stop this dreadful reality? Read on (HINT: its NOT through resilience and wellness trainings).

Many doctors view medicine as a calling, entering the field with immense altruism paired with a passion for science and healing the sick. The erosion of these intrinsic motivators leads to burnout which psychologist Christina Maslach defines as a syndrome of emotional and physical exhaustion, depersonalization and diminished personal accomplishment.

The stress of long hours, no sleep, poor eating, inadequate protection, the fear of contaminating loved ones, the fear of dying and seeing patients die no matter what you do, the disrespect by hospital administrators and the fear of being fired, all remain the reality for those who are in the thick of things, denounced Lynette Charity, MD, an anesthesiologist who speaks nationwide about physician burnout.

Studies also show that burnout is associated with negative clinical outcomes: decreased quality of patient care; increased number of medical errors; and higher rates of addiction, depression and suicide among physicians.

Dr. Lynette Charity, an anesthesiologist and physician advocate, speaks nationwide about burnout ... [+] among doctors.

Burnout has nothing to do with weakness, laziness or incompetence. The prevailing attitude, report Pamela Hartzband, MD and Jerome Groopman, MD in a recent NEJM article, was that burnout is a physician problem and those who cant adapt need to get with the program or leave. Turns out that structural and systemic issues are heavy culprits. Despite lip service to patient-centered care, many physicians believe the current healthcare system is propelled by money and metrics, according to Hartzband and Groopman. Doctors are well-meaning and willing to work long hours, and hospital executives know this and exploit it, as Danielle Ofri, MD aptly asserts in The Business of Health Care Depends on Exploiting Doctors and Nurses.

Medical workers in protective clothing move the body of a deceased patient to a refrigerated ... [+] overflow morgue outside the Wyckoff Heights Medical Center in the Brooklyn borough of New York City, the epicenter of the Covid-19 pandemic.

The medical field is at a crisis. This pandemic has exposed many cracks in the U.S. healthcare system. From inadequate testing and personal protective equipment (PPE) to overcrowded emergency departments, frontline health staff are putting their lives at risk to care for highly infectious patients debilitated by Covid-19. And yet medical professionals are responding to this crisis with unprecedented selflessness, resilience and compassion.

For many physicians, Covid-19 may be the proverbial straw that breaks the camels back as they isolate themselves physically from their family and friends while encountering a surge of sickness and death, said Nisha Mehta, MD, radiologist, physician advocate and keynote speaker.

Here are a few real-world examples. About a month into the pandemic, at the end of a difficult shift, an infectious disease physician with 20 years of experience, texted me the following: Just admitted a 28yo pregnant woman in 2nd trimester w COVID. About to get intubated. I hate these days. Two weeks later, this same physician texted: I just started sobbing. I mean, bawling. But in the bathroom so my 6yo wouldnt see.

A doctor checks on a Covid-19-infected patient connected to a ventilator.

Some hospitals have created the position, Chief Wellness Officer. Others have offered resilience and meditation workshops, social hours and tips for maximizing productivity. But, according to Hartzman and Groopman, none of these solutions address the underlying problem: a profound lack of alignment between caregivers values and the reconfigured health care system. Here are some strategies that may actually curtail the wave of physician burnout and suicide:

1. Reduce administrative burden This includes prior authorizations, disability paperwork and the electronic medical record (EMR) which has simply become a burdensome billing tool. Let the bean counters and the C-Suite collect the data and enter it into the EMRs, suggested Dr. Charity, adding: Provide scribes for the doctors.

2. Flexibility over schedules A 2017 study showed that physician input in scheduling was one of the few systems solutions that reduced burnout as it allowed for individual practice styles and patient interactions.

3. Mental health support Because burnout can lead to depression, anxiety, PTSD and secondary trauma, appropriate and timely mental health treatment is critical and can include counseling and medications. In NY state, text NYFRONTLINE to 741741 to access 24/7 emotional support services.

Access to timely mental health support is critical in reducing burnout.

4. Reduce gender bias The National Academy of Medicine reported that burnout may be 20-60% higher among female vs male physicians. Over 70% of women doctors experienced gender discrimination; they are consistently paid less than their male counterparts, less likely to be referred by their professional titles and less likely to be promoted. Female physicians also spend 8.5 additional hours per week on childcare and other domestic duties, while men reported spending an extra 40 minutes on domestic work.

6. Diversify Doctor Voices We need more women and women of color to be in decision-making positions. Minority voices are not being heard, and they are being disproportionately harmed.

7. Speak Out - If youre a physician whos going through a hard time, I promise you youre not alone. Please talk to somebody. And if you see a colleague suffering, please get her/him help. You may just be saving a life. Call National Suicide Prevention Lifeline 1-800-273-TALK (8255).

In addition to the above recommendations, a group of New York doctors (myself included) created a petition to advocate for physician protection and compensation which is being sent to legislators. It can be signed by non-healthcare workers.

Dr. Nisha Mehta, a physician advocate: "So many physicians contact me with fears, frustrations and ... [+] sadness as they experience unprecedented challenges emotionally, physically and financially."

*****

Medicine is a calling for many. But is it really worth dying for? I dont think so. Doctors are people, too. And thats not being trite. In order to stem the tide of physician burnout and suicide, we all have a role to play. If we want our doctors to be whole and full of joy, we must reaffirm their humanity and their value in society. Medical culture and health care systems must change but this will only happen when theyre forced to change. Physicians must first acknowledge and heal their own pain and suffering - for their sake and that of their patients and communities.

Read more:
Doctor, Heal Thyself: Physician Burnout In The Wake Of Covid-19 - Forbes

Outbreak on edge of Navajo Nation overwhelms rural hospital – Yahoo Lifestyle

GALLUP, N.M. (AP) On the eve of New Mexico's shutdown of bars and restaurants to stem the spread of the coronavirus, the city of Gallup came alive for one last night of revelry.

Before the night was out in the desert oasis on the fringes of the Navajo Nation, 98 people were detained for public intoxication and sent to sober up at a detox center. Several homeless people also sought refuge in the same cinder block building, which doubles as a shelter. Somewhere in the mix, lurked the virus.

The outbreak seeded at the NaNizhoozhi Center would combine with the small, local hospitals ill-fated staffing decisions and its well-intentioned but potentially overambitious treatment plans to create a perfect storm that has overwhelmed doctors and nurses and paralyzed this community in the states hard-hit northwest.

In all, 22 people infected with the coronavirus were transferred from the detox center to Rehoboth McKinley Christian Hospital, the only acute care medical center for the general public within 110 miles (180 kilometers) of Gallup.

They were putting multiple cots in one room to accommodate them, said pulmonologist Rajiv Patel, who helped lead the hospitals initial response.

To care for that influx, any available doctor was pressed into service, including those who normally don't handle critically ill patients, Patel said.

Thats right when we overloaded, said hospital CEO David Conejo. Now weve got too many patients, and too few (staff) to help.

Rehoboths eight intensive care beds are full, and now it has to transfer all coronavirus patients with severe breathing problems away from the facility and the adjacent Gallup Indian Medical Center, which attends exclusively to the Native American community.

Of about 500 medical and support staff, at least 32 hospital workers have become infected, and doctors and nurses say that they all live with the fear of spreading the virus to their colleagues and relatives.

Conejo blames Patel for the fact that the hospital became overwhelmed, saying the doctor took on more COVID-19 patients than the staff could handle because of his ambition but also good intentions.

Story continues

But Patel who arrived at Rehoboth in March from an Army reserve stint in Kuwait said the hospital simply didn't have enough staff with the experience to provide the right care and struggled to train more quickly. Patel has since left to work at Flagstaff Medical Center in Arizona.

Twice, the doctor said, alarms went off during the night on breathing machines only to be misinterpreted by overnight staff. Within two days of those missteps, he and colleagues decided that severely ill coronavirus patients would have to go elsewhere a heart-wrenching decision that meant sick people would be treated far from family and one that underscored the consequences of not having adequate care in the region.

It was an easy decision because it was the right thing to do for patients, said Patel, whose wife is Navajo. It was very saddening for me personally because my heart and soul are completely invested in the health situation on the reservation."

Many nurses and doctors, meanwhile, say staffing at the hospital was inadequate because of Conejo's move to cut back on nurses in the first week of March to offset declining hospital revenues after elective surgeries were suspended. They voiced their discontent at a recent protest calling for his resignation.

We knew it was coming to McKinley County, there wasnt any ifs, ands or buts. I was directed that I had to let go of 17 agency nurses, said Felicia Adams, chief nursing officer who has recovered from COVID-19. We want to take care of our patients, we dont want to have to send them away.

Conejo defended his oversight, noting that he deferred to the hospitals board of trustees and a team of nurses and physicians on final decisions. He also said the hospital couldnt afford not to cut staff in March and that the facility wanted to reduce overall employment to qualify for small-business assistance. But Adams and others believe Conejo put profits ahead of care.

Physician Caleb Lauber said that, as experienced contract nurses were let go in March, unfamiliar responsibilities were thrust upon other nurses given only on-the-fly training.

New Mexicos state auditor is seeking more information about the county-owned hospital's finances from its private operators. State health officials and philanthropists, meanwhile, are recruiting more than a dozen volunteer medical professionals and have hired a new critical care physician for the hospital.

While much of New Mexico is showing signs of emerging from the initial wave of the pandemic, stubbornly high rates of infection and death persist in the states northwest corner including in the Navajo Nation that extends into Arizona and Utah. More than half of New Mexicos roughly 6,100 confirmed infections are in Native Americans.

For most people, the coronavirus causes mild or moderate symptoms. For some, especially older adults and people with existing health problems, it can cause more severe illness and lead to death.

As the Navajo have suffered in this pandemic, so, too has Gallup, whose fate has long been tied to the neighboring Navajo Nation. In normal times, the citys population of 22,000 can quickly quadruple in size since it is a crucial source of supplies and water for faraway Navajo households, many of which lack full plumbing.

The city is also a destination for many of the most marginalized Navajo, those who have left home and ended up on Gallup's streets, often as they grapple with alcohol addiction. Officials suspect that the coronavirus whipped through the homeless population, and some passed through the NaNizhoozhi Center, putting the liquor-tax funded shelter and detox center at the heart of the city's outbreak.

The city and its rural outskirts account for about 30% of COVID-19 infections statewide, with 78 related deaths as of Monday.

To stem the spread, Gallup was subject to an extreme 10-day lockdown this month cutting the city off from many of those who depend on it for supplies. Authorities have now set up free water stations and deliveries to avoid the risk of transmission posed by coin-operated water stations, where hand after hand scooped out returned change.

Now, the NaNizhoozhi Center is also part of the response as it steers destitute people infected by the coronavirus toward isolation in rooms at four otherwise unoccupied motel buildings. Some 140 people are currently participating in the impromptu system, and officials hope it will interrupt a treadmill of infections among Gallups homeless population.

But the virus has also taken its toll on the center. In addition to the 22 residents who became infected, several staff have been sickened by the virus and some simply stopped showing up, said Kevin Foley, executive director of the center. Six jobs now are open at a rate of $10 and hour, with just one application, he said.

He yearns for a Hollywood ending.

I wish that all those people would come over in those space suits and just clean the place for good," he said, "but its not like that.

___

Associated Press writer Felicia Fonseca contributed to this report from Flagstaff, Arizona.

See original here:
Outbreak on edge of Navajo Nation overwhelms rural hospital - Yahoo Lifestyle

More than 290000 Covid-19 cases in Mena – MEED

COUNTRYLATEST UPDATES

Saudi Arabia

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Measures to minimise the economic crisis:

Covid-19 pandemic latest:

Actions to slow the spread of Covid-19:

Financial measures to minimise the economic crisis:

Link:
More than 290000 Covid-19 cases in Mena - MEED

Beware This COVID-19 Vaccine ‘Study’ From an 80s Teen Tech Titan and a Carnivorous Plant Smuggler – The Daily Beast

A 1980s teen tech tycoon has teamed up with a one-time international carnivorous plant smuggler and a veterinarian to promote what they claim is a possible vaccine for COVID-19but experts warn the budding research project could contribute to the flood of misinformation plaguing the coronavirus crisis.

The trio co-authored a study suggesting existing inoculations for measles, mumps, and rubella could help protect against the ravages of COVID-19. Their report, published through an obscure environmental charity called the World Organization, is also seeking coronavirus survivors to volunteer for blood work to test their theory.

They also want Dr. Anthony Fauci, the nations foremost infectious diseases specialist, or another team of epidemiologists to take on their research.

Jeff Gold, the computer scientist and chief investigator behind the report, told The Daily Beast that news reports of low fatality rates among those under 50 inspired him to search for a cause. Then he stumbled across the creation date of the combined vaccine for measles, mumps, and rubella: 1971.

The only thing that could be physically different about people in the younger demographic, people under 50 versus people over 50, was a vaccine, Gold argued.

But Dr. Jim Conway, a pediatric infectious disease specialist at the University of Wisconsin-Madison, said readers need to be cautious when people are trying to draw associations that dont have a lot of biological plausibility.

While data mining is fine, theres much more risk of uncovering associations that have no true correlation versus finding things that actually have causation, Conway said.

World Organization, not to be confused with the World Health Organization, has published the reporttitled MMR Vaccine Appears to Confer Strong Protection from COVID-19: Few Deaths from SARS-CoV-2 in Highly Vaccinated Populationson its website and promoted it in press releases and in local news and social media. The group based their findings off of published epidemiological data on COVID-19 death rates and MMR vaccination campaigns.

Right now, it is a national priority to develop a safe and effective vaccine for the COVID-19 virus, and the race is on to do this, with dozens of companies and millions of dollars spent in this effort, the report states. As part of this effort, there should be an immediate investigation of using the already available MMR vaccine in controlled studies to show a protective benefit.

Gold collected mortality data first from South Korea and Hong Kong, which have large-scale modern immunization programs and also low mortality ratesbut which also implemented early and aggressive testing regimens and mask-wearing policies after the COVID-19 outbreak. He then examined locations such as Madagascar and Pacific Island nations which reported few or no deaths and also have wide-scale MMR inoculation programs. He contrasted these findings with Belgium, which the study says didnt even offer MMR vaccinations until 1985, and it wasnt until 1995 that it began giving the recommended two doses of MMR vaccinations per person.

The findings were so compelling to the 53-year-old Gold, he said, that he ran to his local Walgreens to get the MMR vaccine himself.

You can make data say anything you want if you pick and choose the right stuff.

Scientists have floated existing vaccinationsparticularly the nearly century-old Bacillus Calmette-Guerin live, attenuated tuberculosis vaccine and the 60-year-old oral polio vaccineas a possible defense against coronavirus. Both vaccines have been shown to boost innate immunity against other viral infections.

The MMR vaccine also contains live weakened forms of measles, mumps and rubella.

Experts, however, warn not to draw quick conclusions from Golds hypothesis.

Everybody is trying to pitch in, and I dont blame these people for trying to do something helpful, Conway told The Daily Beast. But just because two things are happening doesnt mean one has to do with the other, he added.

For example, as a vaccination advocate who battles misinformation about vaccines and autism, Conway says he shows people a slide that indicates the disorder rises perfectly with an increase in the sale of organic foods. You can make data say anything you want if you pick and choose the right stuff, he said.

One factor missing from the study is pre-existing comorbidities. Its also lacking information on how many tests each country conducted, Conway said.

Weve been using MMR vaccines for decades and they have done nothing to prevent SARS and other coronaviruses, he added. Theres not a lot of reason biologically that other vaccines would protect against COVID.

Dr. Ajay K. Sethi, an infectious disease epidemiologist and associate professor of population health sciences at the University of Wisconsin-Madison, cautioned that there is no evidence Gold and his co-investigators used a scientific approach to test their hypothesis that different exposure to vaccines between younger and older people may account for this different morbidity rate [in COVID-19].

According to Sethi, some red flags in the report include that the study design is not provided and the authors do not cite relevant research that led to their hypothesis. Theres also no statistical tests to determine if the findings are due to chance.

Other explanations for the relationship between older age and COVID deaths are not explored even though much has been written about this subject, Sethi continued. The countries chosen and presentation of information appear to be cherry-picked to support their conclusion. Evidence of objectivity is lacking. Citations are not provided for many of the claims made.

He said conclusions should not be drawn until three questions are addressed: Are the findings instead due to statistical chance? Can bias explain the findings? And could the reason for the finding be explained by some other variable?

Meanwhile, Gold is pushing for wider recognition of his MMR vaccine theory. Its Golds first apparent foray into immunology; for most of the past decade, he and the World Organization have run a pet adoption networkRescue Me!and the Georgia Nature Center, an attraction in Watkinsville geared toward school children. But he spent the 1980s making startling discoveries of another kind.

U.S. News & World Report profiled Gold in 1983, when he was the then-16-year-old founder of Double-Gold Software, having developed an early anti-piracy program called Lock-It Up and an algorithm that could solve a Rubiks Cube. When the magazine paid Gold a visit, the teenage genius was angry hed need a cosigner for the furniture hed ordered for his suite of offices. Back then, he told the outlet he didnt believe in failure.

If you start a company and go bankrupt, it doesnt mean you have failed. You will have learned from the experience, said the Silicon Valley wunderkind, who had dropped out of high school to pursue his tech businesses.

According to a 1984 Washington Post feature on young computer capitalists, Gold was raking in more than $100,000 a year and driving a Datsun sports car with vanity plates: DBL GOLD. In his memoir The Accidental Millionaire, entrepreneur Gary Fong recalled meeting Gold at the University of California, Santa Barbara, around the same time, and described him as a generational genius.

By the early 1990s, Gold had cultivated an interest in carnivorous plantsone he shared with a friend, William Baumgartl, a doctor at the Allegiant Spine Institute in Nevada who is now involved in Golds MMR vaccine push.

Baumgartl, an anesthesiologist and stem cell specialist, said his friends findings impressed him when Gold shared them earlier this year. The data suggests a correlation between those who get the MMR and have protection, Baumgartl told The Daily Beast. It may be the basis of a very inexpensive, and very easy to initiate, vaccine therapy for this disease.

The files of the Nevada State Board of Medical Examiners indicate that Baumgartls history as a physician is unblemished. But his personal record is not so pristine: In 1995, he and two friends pleaded guilty to smuggling hundreds of carnivorous Nepenthes pitcher plants into the U.S. from Indonesia and Malaysia, in violation of the Endangered Species Act. Just a few years earlier, Gold had faced a similar accusation from the Venezuelan government, which alleged he had stolen carnivorous orchids from the slopes of the South American nations Tepui mesas. Gold disputed the accusationsand still doesbut subsequently dissolved a nonprofit he had founded to study the insect-swallowing flora.

Theres a need now to have someone, an epidemiologist, take this to the next level.

Baumgartl, for his part, blamed his imbroglio on bad legal advice from one of his accomplices, an Oakland deputy district attorney. I accounted for what I did, accepted responsibility, and it was a very minor charge, the doctor said, adding that he served no hard time for the crime.

Meanwhile, the ragtag team of researchers has linked a University of Cambridge study on MMR vaccines to their own, calling it a corroborating report.

In April, U.K. scientists uploaded a study to the server medRxiv which identified some chemical similarities between COVID-19 and the measles, mumps, and rubella viruses, and a correlation between rubella antibodies and a lower impact by the novel coronavirus. The report, which is not peer-reviewed, concludes that vaccination of at risk age groups with an MMR vaccination merits further consideration as a time-appropriate and safe intervention.

I suddenly felt like this is such an important connection that's been made, and they've made, most importantly, that really knocks this out of the park, Gold said of finding the Cambridge paper. They came up with the same thing we did coming at it with completely different angles.

Still, Rocio Hernandez, one of the researchers on the Cambridge study, objected to the World Organizations interpretation of their research in a statement to the Daily Beast. He pointed to disclaimers on medRxiv which warn that papers there should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information. He further underscored that the Cambridge teams work is still in its embryonic stages, and requires considerable further lab research.

In short, no, they are not using the work appropriately, it cannot be used to corroborate their own conclusions for obvious reasons, Hernandez told the Daily Beast. It is preliminary work, based on preliminary lab tests, and the hypothesis still requires further lab/clinical work to confirm or refute it. Our study leads are currently seeking funds for this.

Undeterred, Gold has been aggressively pushing his paper, sending it to Dr. Fauci, and to the National Institute of Health. And this week, on the advice of several friends, he began his campaign to get it noticed in the press.

They tell me you need to get this to the media before the people in the NIH are going to pay attention to it, Gold said. "What we're saying is if this is true, and what Cambridge more importantly has come across, if this is true, then there is a solution to this pandemic that could be put into action within weeks.

In an email, the NIHs National Institute of Allergy and Infectious Diseases confirmed that the World Organization reached out to its staff but that it is currently not studying a connection between the MMR vaccine and COVID-19.

Another associate of Golds, New Mexico-based veterinarian Dr. Larry Tilleythe author and editor of multiple volumes on animal ailmentstold The Daily Beast that he researched medical literature as part of the study, which was Golds brainchild. But he stressed theyre seeking government researchers or experienced epidemiologists to adopt the hypothesis. Theres a need now to have someone, an epidemiologist, take this to the next level, said Tilley, who also got a booster shot because of Golds findings. What we found is all preliminary.

We just simply saw something that didnt make sensewhy certain countries were having such a high death rate, Tilley added. I say it to people now: Im not an expert. But it seems like theres something there.

Tilley said the World Organization is trying to reach anyone who can run with their findings, whether its people in D.C., Dr. Faucis group, NIH, or CDC.

Readers of the study have already flocked to the groups Facebook page, asking if they should get a measles booster shot and if doctors administer them on request. One woman commented, I should be okay then. MMR is one of the vaccines I got in 2010, it was required for my citizenship process.

Another commenter said she was born in 1973 and asked if shed likely had the MMR vaccine. World.Org replied, You probably did, but at that time they only gave one rather than two in a row, which was less effective. Id recommend getting a series of two again now. Whether or not our study ends up proving this 100%, we already have a lot of evidence pointing that way, it cant hurt to get them again.

Hubby and I are going to CVS tomorrow, the woman replied. Thanks for the info!!!

Before The Daily Beast reached out, the World Organization had begun soliciting COVID-19 survivors through its website to participate in a new study in which volunteers would travel to the nearest Quest Diagnostics lab and get tested for MMR antibodies.

Sethi, the infectious disease epidemiologist, expressed concern that the studys authors are using their paper as the basis for recruiting COVID-19 survivors to participate in human subjects research.

In a time of crisis, fear and uncertainty can cause individuals to not exercise better judgment when evaluating the legitimacy of information found online, Sethi told The Daily Beast. COVID survivors may be eager to participate in research to get answers about the illness they had experienced and to contribute to the effort to address the pandemic.

Sethi, who also researches the spread of public health conspiracies, said that based on the studys appearance, a reader may mistake the paper as being scientifically rigorous.

Moreover, the name of the organization that carried out the study is called World Organization. Someone could easily confuse that with World Health Organization and be misled into thinking that the WHO carried out the study, Sethi added.

Indeed, at least one outlet, TechStartups.com, has confused Golds group with the World Health Organization and misattributed its research accordingly.

When encountering seemingly scientific papers, consumers should check to see if they were published in peer-reviewed journals, Sethi said. Those journals should have a reputation for publishing high-quality research in the field of study. Authors may instead choose to publish their research papers on preprint servers, like medRxiv, arXiv, and bioRxiv, which are well known by members of the scientific community, Sethi said.

Posting articles to these preprint servers is the norm in many fields, and by doing so, the research is immediately accessible to anyone and is inherently subject to continuous peer review once it is posted. By publishing their paper on their own website instead of a well known preprint servers, the authors have bypassed the peer-review process, Sethi added.

World Organizations report came with a caveat at the end: In the interest of providing early information to other researchers and the public, many COVID-19 researchers including ourselves are publishing early release articles like this one which are not considered final. The information contained herein, and certainty of any conclusions being reached, are subject to change as this study continues.

Sethi said, The disclaimer in the article is a good thing, but it's not a substitute for posting the research on a credible website where it can undergo peer-review.

But Gold defended himself and his work, claiming he hoped only to encourage further inquiry into a potential life-saving answer to the current crisis.

Were not trying to pretend to be the epidemiologists here, he said. If this is not a solution, I think it's equally important for someone to go through this data and analyze it.

Shortly after talking with The Daily Beast, Gold reconfigured the World Organizations website to redirect to ResearchGate, an academic networking and preprint site, where his study had gone up one day prior.

Conway, the pediatric infectious diseases expert, said that until such studies are peer-reviewed, theyre as good as social media.

Were in a historic era in one way, because science is so much more transparent than it used to be because of the internet, Conway said. This includes posting studies on websites before theyve been tested widely by other scientists.

And rushing to conclusions can have dangerous consequences. Conway noted how New York doctors prescribed the anti-malaria drug hydroxychloroquine in light of observational studies, which had not been peer-reviewed clinical trials. Then came a Food and Drug Administration warning that tests had indicated the medicine could cause potentially life-threatening heart rhythm problems, even though it hadnt proven safe or effective for treating COVID-19.

One glimmer of information and hope suddenly leads to a snowballing effect, Conway told The Daily Beast. Since we dont have anything clear, people want to act. They would prefer to not just stand there but do something.

Originally posted here:
Beware This COVID-19 Vaccine 'Study' From an 80s Teen Tech Titan and a Carnivorous Plant Smuggler - The Daily Beast

Higher risk of infection, changes to treatment makes COVID-19 a double threat for cancer patients – theday.com

The coronavirus pandemic has caused significant changes and delays to treatment plans for many people battling cancer, who are more susceptible to the virus due to weakened immune systems, nationwide statistics show.

A survey conducted by The American Cancer Society Cancer Action Network in late March and early April found that half of more than 1,000 patients and survivors surveyed had seen their treatment interrupted in some way. Many are working with health care providers to alter their treatment plans skipping treatments, delaying therapies and surgeries, changing dosages and switching to virtual visits to lower their risk of exposure to the virus.

Thesurvey asked respondents about their experience accessing health care as a result of the pandemic, including the availability of appointments and services, and concerns about being able to safely get their treatments in the future. It found that27% of patients in active treatment said they have had their treatment delayed. Of those, 13% saidthey haveno clear timeline for whentreatment will resume.

Additionally, many cancer patients also have had their support systems ripped away, as they practice social isolation and see annual support events such as Relay for Life in southeastern Connecticut canceled.

Balancing risks

Approximately 20,300 people in Connecticut will be diagnosed with cancer in 2020 and 6,390 will die from the disease, according to Bryte Johnson, Connecticut Government Relations Director for American Cancer.

Andy Salner, medical director for the Hartford HealthCare Cancer Institute at Hartford Hospital, said cancer patients often have weakened immune systems, so may more easily contract the virus than someone without cancer. They alsomay developa more severe case ofthe COVID-19, the disease caused by the virus,and have a harder time fighting it.

Some cancers themselves, like multiple melanomas and most types of Leukemia, impact the immune system directly by altering blood cells. People with cancer might also be poorly nourished because cancer itself can make it hard to digest food, cancer cells can use up nutrients and cancer treatments like radiation therapy and chemotherapy can cause nausea and lack of appetite, according to the Cancer Action Network.

Radiation therapy, immunotherapy and chemotherapy also can lead to short-term immune system damage, and bone marrow or stem cell transplants that use high-dose treatments to kill cancer also may harm immune system cells for weeks to months, according to the American Cancer Society. Chemotherapy is the most common cause of a weakened immune system, because it causes a decrease in white blood cells, meaning a person's body won't be able to fight off infections as effectively.

At the Hartford Healthcare Cancer Institute in Waterford, oncologists Michael Kane and Sapna Khubchandani complete thousands of patient visits each year, and are helping patients design new treatment plansto battle and monitor their cancer while reducing their risk of exposure to the coronavirus.

For one local woman, a COVID-19 diagnosis meant missing her final session of chemotherapy, Khubchandani said. She did not identify the patient for privacy reasons.

Khubchandani said she didnt think missing one session so late in the treatment plan would have too much of an impact on the patient, but it wasnt ideal. An elective surgery related to the woman's cancer treatment, meant to take place after she completed chemotherapy, was delayed due to the virus, Khubchandani said.

COVID-19 has caused doctors to delay many suchnonemergency surgeries related to cancer treatment, including breast biopsies, lumpectomies or colonoscopies. Khubchandani, Kane and Salner all said they have had to make changes to surgery plans, either for patient safety or due to a lack of beds in intensive care units that are overwhelmed with patients battling the virus.

Doctors have been exploring alternatives, such as putting patients on hormonal treatment as they await surgery, so that were still treating the cancer while we wait, which will buy them time, Khubchandani said.

From some of his patients, Kane has made adjustments to medication dosages or administration intervals, to limit visits. Its all about individualizing treatment for each patients scenario, he said.

Worrying about the unknown

For one of Kane's patients, Richard van Etten ofHadlyme, protecting the 89-year-old from COVID-19 meant forgoing the transfusion he normally receives every three weeks.

Van Etten has been battling cancer since 2018, first in his bladder, then a cancerous module in his left lung, then in his lymph nodes.

Hecompleted chemotherapy and recently started a new drug called Keytruda, administered via infusions through a port for the cancer in his bladder and lymph nodes.

He recently learned that the cancer in his lymph nodes is gone, but his care team decided to continue his transfusions in case there were any residual cancer cells left, he said. But whenthe coronavirusbecame a concern, they decided to stop.

The virus hit and I was very hesitant about continuing my infusions, which were taking place in Waterford, he said. I talked with Dr. Kane and we decided to forgo them for now.

Since the start of the pandemic, he has been to the treatment center only once, to have his port cleaned. He said he is being very careful and is barely leaving his home, where he lives with his wife and daughter.

Van Etten said that he is absolutely anxious about contracting COVID-19, mostly due to his age. He said he feels confident about his decision to delay his treatment to limit his exposure to the virus but is worried about what might be happening inside his body.

Knowing that I was either in remission or close to it when I stopped, that it was at least temporarily under control, makes me feel OK with missing my infusions, he said. But that doesnt mean that in the back of my mind I dont wonder if it might be coming back.

Heis anxiously awaiting his next in-person visit, a PET scan scheduled for June 1, thats going to tell me whether any of the cancer has come back or not, he said.

Margie Elkins is a breast cancer survivor and active volunteer for the American Cancer Society and several other cancer organizations in southeastern Connecticut. While she is missing regular checkups and experiencing some delays in her own follow-up care, she said, One of the things that really worries me is not only the people who are experiencing delays in treatment but the people who have yet to be diagnosed, because the longer you wait in some cases, the larger the cancer becomes."

For thosewhose treatment hasbeen delayed, Its like their life is on hold because they dont know if their cancer is getting worse or getting better, she said.

Salner said delaying treatments certainly poses a risk. I think the worry would be that the cancer cells could potentially grow during that time (that treatments are delayed), that the treatment might be less effective if its delayed too far, he said.

Among survey respondents whose care had been canceled, delayed or changed by the pandemic, the most commonly impacted services were imaging procedures to monitor growth of cancer, supportive services such as therapy and in-person provider visits.

Salner said that decisions to delay chemotherapies and radiation, or reversing the order of treatments to prevent weakening of the immune system during the pandemic, were being made regularly and in partnership with patients and their families.

We want to balance making sure that we deliver the best cancer therapy possible but also place the patient at the lowest risk for getting what could be a life-threatening infection, he said.

In Waterford, Kane and Khubchandani have started screening patients for COVID-19 before starting them on chemotherapy or immunotherapy to ensure they are strong and healthy enough for the treatment. If a patient does have the virus, the doctors are delaying chemotherapy or immunotherapy in almost all cases. The ultimate decision though, is primarily left up to the patient. If they want to receive treatment, they likely will be able to, doctors agree.

Kane and Khubchandani also are implementing general precautions for people entering their offices: taking patients temperature, calling patients the day before to screen for COVID-19 symptoms and opting for virtual visits when possible. At the Waterford treatment center, theyve reduced the number of chairs in the waiting room and are scheduling laboratory services further apart. All doctors and patients are wearing masks at all times.

The extra precautions seem to be helping, Salner said. The Hartford Healthcare group has not seen a large influx of cancer patients testing positive for COVID-19.

Finding support

Some survivors are concerned about the emotional impact of COVID-19 on people currently battling cancer, worrying that they may feel overwhelmed and alone, both in their diagnosis and by social distancing.

Elkins said that she felt isolated when she was first diagnosed with stage1 breast cancer years ago, and can only imagine how that feeling is being compounded by the isolation of quarantine.

Greg Schlough, event chairman for the American Cancer Society Relay for Life of Southeastern CT, said that in his experience, cancer is a disease that causes people to really rally around you. The survivor saidthose with cancer tend to rely on their family and friends for support, like he did after being diagnosed with stage 3 melanoma on his 40th birthday in September 2000.

At the beginning, you get that doom and gloom feeling but when people start to come around and you start to see other people who have survived, you are able to say Hey, Im going to beat this thing. You know that you have people backing up and cheering you on, he said.

Right now, folks fighting cancer, especially a new diagnosis, may be struggling to find that support as they practice social distancing from their family and friends.

Schlough, in remission for 20 years, said that if he was a cancer patient right now, he would be afraid to go outside, and cant imagine how new patients are feeling.

For patients who are struggling with feelings of isolation or fear, events like the annual relay provide an opportunity to connect with others who are fighting the same fight, or who are examples of strength and survival. This years relay, which was set to be held on July 14 in Norwich, has been postponed indefinitely.

The annual fundraiser normally raises an average of $80,000 to $120,000 a year for the American Cancer Society, helping the society fund resources and support services to help people with cancer.

Schlough said organizers are hoping to reschedule the event for the end of summer, but it wouldfunction in accordance with social distancing guidelines and everyone will be required to wear masks. People currently in treatment, he said, may have to miss out or participate virtually.

Wed rather see them there next year smiling than this year with the risk of getting sick, he said.

Schloughsuggests patients or survivors who are emotionally strugglingor needhelp understanding treatment options shouldreach out to friends and family for over-the-phone support or call the American Cancer Societys hotline, 1 (800) 227-2345.

t.hartz@theday.com

See the rest here:
Higher risk of infection, changes to treatment makes COVID-19 a double threat for cancer patients - theday.com

The Latest Technological Innovations in Orthopedic Surgery 2020 Technology – IMC Grupo

Technology across the world is improving and innovatingwith time. Over the years, man-managed labor has almost finished from themarket and more and more technological and scientific gadgets are taking placemaking human labor more effective, efficient, and precise.

Medical science has also taken a lot of advantage fromthis scientific advancement therefore, we can say that doctors are making fulluse of science and technology and the world of medicine has evolved quiterapidly.

Orthopedic hospitalshave also seena remarkable transformation over time and the days when a regular orthopedicclinic only comprised of a few tools and a bad. The launch of innovativetechnologies, biologics, and hybrid items into the orthopedic industry isincreasingly growing.

Any of these emerging inventions gain regulatory approvalby showing significant equivalence to the US System of the Food and DrugAdministration (FDA) 510(k).

Surgeons play a key role in the implementation ofemerging technology to patients and will play a leading role in supportinghealthy, efficient, adequate, and cost-effective treatment, particularly forsurgical procedures. Surgeons will track and record the health results andadverse effects of their patients utilizing modern technologies and ensure thatthe new technology works as expected.

Ortho-biologics utilizes the regenerative ability ofcells in the human body. Ortho-biologics are created from compounds naturallypresent in the body which are used to facilitate the recovery of fracturedbones which injured joints, ligaments, and tendons.

These involve bone graft, growth factors, stem cells,platelet-infused plasma, autologous blood, and autologous controlled serum. Themesenchymal stem cells (MSCs) contained in the bone marrow has been shown to besuccessful in the production of the appropriate tissues.

Result in Orthopedic Procedures

Recent advances in this area, including growth factor andstem cell therapies, may contribute to faster recovery. One breakthrough isdrug-free bone grafts, which may be used to cure conditions such as orthopedicsurgery. Clinical trials have demonstrated that growth factors can improve thehealing cycle.

Stem cells will continually self-regenerate and transforminto either form of cell, providing an unmatched source of regenerativemedicine technology. Definitions of musculoskeletal procedures utilizing stemcells are listed below.

Biotechnology firms began utilizing orthopedic stemcells. For starters, BioTime works on stem cell therapies for age-relateddegenerative diseases, IntelliCell BioSciences on adipose-derived stem cellsfor orthopedic conditions, and Bio-Tissues on Ortho-biological treatments forcartilage defects.

Orthopedic procedures using robots are less intrusive anddeliver reproducible accuracy, resulting in shorter hospital stays and quickerrecovery times. The Swiss clinic, La Source, recorded a decline in averagehospitalization from 10 to 6 days with the usage of surgical robots.Nevertheless, this technology is also costly to develop, so solid,evidence-based trials are required to prove that robotic technology contributesto improved outcomes.

The Da Vinci Surgical Method became the first U.S. Food andDrug Administration (FDA)-an authorized robotic surgery program in 2000. Morebusinesses are investing in this technology to enhance navigation duringservice or to receive 3-D scans that aid in the design of custom joints.

Organizations that are interested, in robotics areinclined towards the following technological masterpieces:

Several modern surgical techniques are enhancing theresults. These involve motion-preservation methods, minimally intrusive surgery,tissue-guided surgery, and cement-free joint repair.

Motion recovery strategies require partial or completedisk removal and the usage of active stability systems and interspinous spacersthat do not impair versatility.

Minimally intrusive procedures involve the use ofendoscopes, tubular retractors, and computer-aided guidance devices, allowingan incision of just 2 cm instead of 12 cm in conventional therapies. Minimallyinvasive treatments are gaining popularity in joint and hip replacement and spinalsurgery.

Smart devices provide built-in sensors to offer real-timetracking and post-operative evaluation details to surgeons for better patientsafety across the clinical process. Such implants have the ability to minimizeperiprosthetic infection, which is an increasing orthopedic issue.Sensor-enabled innovations also presented health care professionals with arange of innovative, cost-effective goods.

Companies working in this field include:

3-D orthopedic printing is gaining traction in themanufacture of personalized braces, surgical equipment, and orthotics from arange of materials. 3-D printing technology cuts operating times, saves energy,increases the long-term reliability of the implant, and enhances the healtheffects of surgical procedures. 3-D printing technologies of orthopedics areinclusive of:

Companies investing in 3-D Orthopedic Printing

Medical science has taken a huge turn with the introduction of technology. The orthopedic industry has also transformed to a huge extent making sure that the specialists and surgeons are able to treat and operate on their patients without any hassle. Almost all the orthopedic hospitals are equipped with high-end gadgets and tools to assist the doctor.

Even though the technology has evolved greatly since thefield of medicine was invented, it is important to understand that this is justa beginning and there are many more things to come in the future.

See the rest here:
The Latest Technological Innovations in Orthopedic Surgery 2020 Technology - IMC Grupo

Nancy Davidson describes plans for reopening the Seattle Cancer Care Alliance as COVID-19 wave recedes – The Cancer Letter

publication date: May. 15, 2020

Nancy E. Davidson, MD

President and executive director, Seattle Cancer Care Alliance

Senior vice president, director and member, Clinical Research Division, Fred Hutchinson Cancer Research Center

Raisbeck Endowed Chair for Collaborative Research, Fred Hutch

Professor and head of medical oncology, University of Washington

This story is part of The Cancer Letters ongoing coverage of COVID-19s impact on oncology. A full list of our coverage, as well as the latest meeting cancellations, is availablehere.

Nancy Davidson is now in the eleventh week of managing the COVID-19 pandemicthe longest stretch experienced by any health executive in the U.S.

And now, like her peers throughout the country, Davidson, president and executive director of the Seattle Cancer Care Alliance, is in the midst of ramping up plans for a comeback of cancer services.

The Cancer Letter asked Davidson to discuss these plans and share her thoughts on the way cancer care will evolve both at SCCA and nationwide.

This conversation is part of an informal series of stories, interviews, and commentaries that track cancer institutions as they seek to reopen, reorganize, and reinvent in the wake of the COVID-19 pandemic:

Health systems and academic cancer centers are cutting expenses to make up for operational shortfalls resulting from the pandemiclaying off employees, furloughing staff, and cutting salaries and benefits (The Cancer Letter, May 8, 2020).

Community oncology practices are experiencing a significant decrease in patient volume, as weekly visits dropped by nearly 40%, while cancellations and no-shows have nearly doubled (The Cancer Letter, May 1, 2020).

Washington was the first state to record what at the time was believed to be the first COVID-19 caseon Jan. 15, in a traveler from Wuhan, China.

Washington was also the first to register what appeared to be the first COVID-19 death, and SCCA as well as Fred Hutchinson Cancer Center, a component of the alliance, were the first major cancer institutions to take decisive action and shut down non-essential operations (The Cancer Letter, March 13, 2020).

At this writing, the state of Washington has 18,964 confirmed cases and 991 COVID-related deaths. The disease peaked weeks ago, and the spread has slowed. On May 15, for example, 101 new cases and 5 deaths were reported in the state. Washington ranks 18th in the number of cases.

Now, SCCA is among the first to make plans to reopen its operations.

We are bringing our stem cell transplant and our CAR T programs back online in a very thoughtful way, and theres a lot of pent-up demand for that. We had over a hundred transplant patients whove been waiting in the queue, for example. And so, were beginning to recall them and bring them in, Davidson said to The Cancer Letter.

We looked at things like imaging, close to a thousand mammograms that didnt take place because screening mammograms were paused during this time of maximum separation. And so, were also beginning to think about how we can thoughtfully recall those patients. Some patients who had more elective therapies also put it off for a while.

And so, we have a pretty good idea of what the numbers are. I mean, youre right. We are actively reaching out to patients and letting them know that the system was always safe. But were now at a position where we think that they can safely come for their in-person care.

And I think thatll be an important thing going forward, especially in cancer. You and I know that cancer didnt take a pause during the COVID pandemic, and it isnt taking a pause in the near future. We really need to be in a position where we can try to optimize our care going forward. We do know that some of our patients are worried. Theyre concerned about the possibility that they would somehow increase their exposure by coming in to their visits. And so, we have very, very robust testing in place in Washington. Thats also helped us.

Davidson spoke with Paul Goldberg, editor and publisher of The Cancer Letter.

Paul Goldberg:

You have more experience with more phases of COVID-19 than anyone else in the U.S. So, going back to the beginning, to what feels like a decade ago, you moved very, very fast and set up prioritization, and closed things down. What was it like to be on the inside of those decisions?

Nancy Davidson:

Paul, youre right that were in the 10th week of our pandemic response at the Seattle Cancer Care Alliance. As you point out, we are the first of the United States NCI-designated comprehensive cancer centers to experience this in a meaningful way. And at the time, I think that we knew that we were entering into uncharted territory, but territory that we were well equipped to deal with.

As you point out, were in a state that has had a very robust response.

We work at an institution that has a lot of people who are already involved in research in viruses. Fred Hutch houses one of the big coordinating centers for the HIV vaccine efforts, so that we felt that we were in a good position to do this, but we were kind of learning on the job.

Oncologists, though, are very good at dynamic situations, and tackling risk; right? Thats what we do for a living.

PG:

Well, you have also seen more impact on your institution and research, both clinical and basic. How would you summarize this impact?

ND:

We have seen much more impact than all of us would like on our cancer research.

Obviously, our COVID research is flourishing right now, but on the cancer side, we made the decision institutionally, across Fred Hutch and Seattle Cancer Care Alliance, to really slow down our basic laboratory research in accordance with the state guidelines and with our own modeling about what we should do to try to flatten the curve.

And we also made the decision to really limit access to some of our clinical trials, particularly the phase I clinical trials, where we felt that the real goal of a phase I trial is toxicity rather than improving patient wellbeing. And we also closed some of our phase III clinical trials, because we felt that a standard treatment option was available for those patients.

But Paul, weve continued our phase II clinical trials all during this time, for patients where we thought that clinical trial participation would be important for their wellbeing, and we certainly have continued care on trial for everybody who was already on trial. The new accrual was limited more to folks who were going on to the phase II trials.

And were now doing the reverse.

Were at a point where were able now to think about how to wind up after the wind-down. And so, right now, we are, in a very thoughtful and deliberate fashion, opening about 10% new trials and 10% of our closed trials over the next week or so.

Well look carefully at the impact of that, and then we hope to continue that ramp up in a stepwise fashion. And weve tried to prioritize those for trials that are in patients best interests, trials that really reflect some of our primary research interests as an institution, and those where we think that we can try to optimize the safety of the participants and our staff.

PG:

Do you think anything has been irrevocably lost, in terms of data?

ND:

I think that in some of our clinical trials, we werent able to collect every single piece of data that mightve been mandated by the clinical trial.

Certainly, we were able to collect all the data that would be vital for patient safety. And we may not be able to get all of those things, but I suspect that for the clinical trials that have remained in operation and those that will be restarting, that well be able to gather the information that we need to address the primary aims of the clinical trial.

PG:

Ive heard it said that with randomization, problems affect both sides of the trial. So, with randomized trials, you might actually be in okay shape.

ND:

I think so. Many of the randomized trials are very large trials; right? And one would hope that what were going to see is a short period of a pause, and then, youre right, the trial will resume in its full form, and that we will not have any compromise of the primary outcome of the trial.

PG:

What about clinical care? Has that been set back?

ND:

No, I dont think so. I do think that oncologists are pretty good at dealing with adversity, as are our patients. So, we have remained operational the entire time. Weve actually used this as an opportunity to accelerate some of the initiatives that we probably should have done before.

All of us have become very adept at telehealth now, and we are hoping that well be able to right-size how we would use that going forward. And, of course, were hoping that the reimbursement strategies nationally will make that a viable alternative for some patients where its appropriate.

We continued all of our infusion therapies, by and large. The one place where we made some pretty strategic decisions was to slow access to our cell-based therapy trials and treatments, our CAR T trials and our stem cell transplant trials.

As members of a healthcare ecosystem, we needed to be in line with the priorities of the state of Washington and the Puget Sound region at the time, to make sure that we freed up inpatient beds and critical care resources for what we thought would be the surge of COVID-19 patients.

And so, that meant that those transplant and CAR T patients were the patients who were the most likely to require those things, and we made the decision to slow their entry into our system. Were now restarting that, too, Paul. As of last week, were reentering some of the most needy patients who require those particular kinds of interventions, because we feel that we have the hospital capacity to care for them should they become ill.

PG:

Have you had to do triage on COVID? On, say, ventilators?

ND:

Thankfully, we have not. I think, again, the state of Washington has been very forward-thinking on this. In our state, early on there were a lot of workplaces that put people to work from home. The Fred Hutch and the SCCA did this early on; the governor has been very diligent in the state of Washington.

And so, I think we were in happy circumstances where, thankfully, our critical care capacity was higher than our needs. And so there was never a time that Im aware of where in the University of Washington system we had to triage the use of ventilators.

PG:

What role have disparities played in this crisis?

ND:

Well, gosh, I think thats an area where were all trying to sort it through; right?

Our region has a large homeless population. Thats certainly a major form of disparity. And so, I think that within the region, were trying to work collectively with our government facilities and with our partner organizations to make sure that our homeless population has access to the kind of care that they need across the boardthings that are related to prevention or treatment in COVID, as well as underlying social and health problems that they might have.

Ours is a state that has a large Native American population, and so, were trying to make sure that we work pretty actively with our tribes, where appropriate, to make sure that theyre getting the appropriate health care.

And you may know that also in our region the Yakima Valley, which is in the middle of the state, is the home of our larger Hispanic population. That region has been particularly hard hit, and I think that might have to do with the nature of the workforce and the kinds of jobs.

These are folks who often work in situations where its hard to distance in the workplace, and they work in vital industries, and so, this is a population thats also been especially hard hit. So, were trying very hard to make sure that we understand these individuals who are at particular risk, and we do everything we can to try to mitigate that risk within those individuals.

PG:

How soon do you think you might have some data?

ND:

I dont have a good answer for you on that one right now. I think that everybody is pedaling as fast as they can, Paul, to try to get data generally. And then, also, for specific populations.

For example, populations of patients with cancer.

AACR had a session where they tried to review what we know about cancer as a risk factor for COVID, and it looks to me like we dont have a clear understanding of that as a field, either. So, there are a lot of places where we have knowledge that we really have to gain over relatively short period of time.

PG:

What about financial impact? Have you had to have furloughs or any other forms of belt-tightening?

ND:

We think our workforce is incredibly important. Thats obviously one of our most important resources, and so, wed like very much to retain our workforce as best as we can going forward. Weve been fortunate that many people were in a situation where they could work from home.

And so, many of our workforce members who dont have to be physically in the office or who are not directly patient-facing are working from home and theyre working extremely hard.

I think it will be interesting to see how it goes over time. What the healthcare workforce looks like generally is something that were all going to need to be thinking about as we go into the months and the years aheadwhat weve learned from this, and what we can use to try to optimize the delivery of healthcare going forward generally, and also the delivery of cancer care specifically.

PG:

People talk about a rebound in demand for carepatients showing up saying, Take care of us. You should probably be starting to see it about now, I would think. Is it happening?

ND:

We are hoping that were going to see that shortly, and, actually, were trying to begin to promote that, if you will.

First, I told you about the fact that we are bringing our stem cell transplant and our CAR T programs back online in a very thoughtful way, and theres a lot of pent-up demand for that. We had over a hundred transplant patients whove been waiting in the queue, for example. And so, were beginning to recall them and bring them in.

We looked at things like imaging, close to a thousand mammograms that didnt take place because screening mammograms were paused during this time of maximum separation. And so, were also beginning to think about how we can thoughtfully recall those patients. Some patients who had more elective therapies also put it off for a while. And so, we have a pretty good idea of what the numbers are. I mean, youre right. We are actively reaching out to patients and letting them know that the system was always safe. But were now at a position where we think that they can safely come for their in-person care.

And I think thatll be an important thing going forward, especially in cancer. You and I know that cancer didnt take a pause during the COVID pandemic, and it isnt taking a pause in the near future. We really need to be in a position where we can try to optimize our care going forward. We do know that some of our patients are worried. Theyre concerned about the possibility that they would somehow increase their exposure by coming in to their visits. And so, we have very, very robust testing in place in Washington. Thats also helped us.

Go here to see the original:
Nancy Davidson describes plans for reopening the Seattle Cancer Care Alliance as COVID-19 wave recedes - The Cancer Letter

The first breakthrough coronavirus antibody drug might finally be here – BGR

The moment we find COVID-19 treatments that are truly effective, well see the novel coronavirus with different eyes. Yes, the virus is highly transmissible and can lead to severe illness and death. But effective drugs that can block its ability to infect cells and meds that can reduce respiratory distress and inflammation will turn the new disease into an infection that well learn to live with.

Several experts warned this week that the novel coronavirus is here to stay, and we may never get rid of it even when the vaccines arrive. But an increasing number of reports detail various therapies that can be used to improve the odds of recovery. Some of them rely on drugs that were developed to treat other conditions. Others use stem cells. And then there are plasma transfusions from patients who survived COVID-19.

Researchers are also working on a new type of drug thats related to plasma therapy, antibody-based meds that can offer the same kind of protection as a plasma transfusion. Now, we have learned that one of the antibodies capable of blocking the SARS-CoV-2 virus from binding to cells has proven to be 100% effective in labs.

The novel coronavirus binds to human cells via a spike protein that can link up to ACE2 receptors. Then the virus enters the cell where it wreaks havoc. The cell deciphers the viruss genetic information to create more and more copies of the virus. The cell dies in the process, and the new replicas are released into the body where they are free to infect other cells and continue to replicate.

The immune system detects pathogens and can fight them very efficiently. Many people will get COVID-19 and never know it because theyll never even present any symptoms. That means the immune system cleared the virus before it could cause complications, and the resulting antibodies will be able to deal with the illness in the future, providing immunity against COVID-19 for an unknown period of time. Thats why plasma treatments work. Doctors use the antibodies from donors to treat other patients with weaker immune systems. But demand for plasma far exceeds supply, and thats why monoclonal antibody drugs would work better.

Sorrento is one of several companies working on this breakthrough type of drug. The pharmaceutical company has found what it describes as a potent anti-SARS-CoV-2 antibody that can completely prevent the virus from linking to ACE2 cells in lab tests. The antibody is called STI-1499, and Sorrento says its been able to deliver 100% inhibition of the virus in healthy cells after four days of incubation.

Sorrento has screened billions of antibodies in its proprietary G-MAB fully human antibody library and identified hundreds of candidates that can bind to the S1 subunit of the SARS-CoV-2 spike protein. A dozen of them have been able to block the interaction between S1 and ACE2.

STI-1499 stood out for its ability to completely block SARS-CoV-2 infection of healthy cells in the experiments. The company says that the virus was neutralized even in low antibody doses. This antibody will likely be the first antibody to be used in the COVI-SHIELD antibody cocktail that will include a combination of antibodies meant to deal with potential mutations of the coronavirus. STI-1499 is also expected to be used as a standalone therapy in a COVI-GUARD drug, assuming it receives regulatory approval.

Sorrento will request priority evaluation and accelerated review. Clinical trials will have to prove the antibody works just as well in patients as it does in lab conditions.

Assuming STI-1499 is effective and safe, Sorrento says itll be able to produce up to 200,000 doses per month, and the company plans to make 1 million of them while its waiting for FDA approval. Manufacturing capacity could be increased through partnerships to meet demand. If all goes well, STI-1499 might be among the first brand new drugs developed specifically to treat COVID-19.

Doctors analyzing lung CT scan. Image Source: STEPHANIE LECOCQ/EPA-EFE/Shutterstock

Chris Smith started writing about gadgets as a hobby, and before he knew it he was sharing his views on tech stuff with readers around the world. Whenever he's not writing about gadgets he miserably fails to stay away from them, although he desperately tries. But that's not necessarily a bad thing.

Originally posted here:
The first breakthrough coronavirus antibody drug might finally be here - BGR

Coronavirus: The trials and triumphs of UAE residents – Gulf News

Trials and triumphs of the COVID-19 combat Image Credit: Gulf News

Dubai: The first case of coronavirus in the UAE was announced on January 29, 2020. Thats around three-and-a-half months ago. Time flies, you would ordinarily be inclined to think. But these are extraordinary times.

Ever since the beastly virus spread its ugly tentacles, everything weve been thinking, saying or doing has revolved around COVID-19. But beyond the general fatigue that were all beginning to feel, there is no denying that life as we know it why, even death has changed forever.

Gasping patients gone without a goodbye; family members watching funerals of loved ones on Facebook; infected couples having to leave young children in the care of others; tables turning on doctors and nurses COVIDs trying tales are heart-wrenching.

But the unimaginable trauma notwithstanding, there are those who are counting their blessings too, whether its a new mum beating the virus with her just-born; a patient coming off the ventilator after 20 days; or the UAEs health care community clocking record testing rates and its researchers achieving a treatment breakthrough.

A look at the trials, tribulations and triumphs of UAE residents since the COVID-19 combat began:

The ultimate trial

Its bad enough to lose a loved one, but not being able to bid goodbye takes away even the sense of closure.

THE WAY IT IS

Global protocols on heath safety, hygiene and social distancing stipulate that coronavirus patients must get treated in isolation, and even depart alone.

Global protocols on heath safety, hygiene and social distancing stipulate that coronavirus patients must get treated in isolation, and even depart alone, so one has no choice but to let go.

When Bangladeshi expat Tofail Alam, 51, passed away in Abu Dhabi last week, his wife Nausheen told Gulf News her husband went to see a doctor at a hospital in March because he had a bad cold.

Tofail Alam

But he was admitted the same day and transferred to a public hospital for treatment. We lost the pillar of our family to the coronavirus pandemic. It is so devastating that I simply have no words.

A friend who tried to contact Alam in hospital said, The calls never went through. So all I could do was ask the nurses about his condition. Somewhere along the line, he learnt that the father of two was no more.

Funeral on Facebook

Even in non-coronavirus cases, flight suspensions in recent times have meant that some residents havent been able to attend funerals of loved ones in other countries.

Among them: A Keralite family in the UAE who watched the funeral of their cancer-stricken son Jeuel G. Jomay, a Grade 10 student at a Sharjah school, on Facebook on April 16. They could not accompany his body when it was flown to native Kerala under lockdown.

Jeuels funeral ceremony back home began at 4am in the UAE. His cousin told Gulf News her family and Jeuels family watched the five-hour ceremony on Facebook while the St Marys Church in Sharjah provided a link to the YouTube livestreaming on its website for members here to watch the service.

None of the flights was getting sanctioned soon. Jeuels father wanted to fly with him. But that was not possible, the cousin told Gulf News at the time.

Similarly, on April 17, Dubai-based Pakistani expat Ghulam Mustafa Awan watched the funeral of his father Malik Nazir Ahmad on video. Ahmad had died of a heart and lung condition.

I tried everything, but I couldnt go and see the face of my father one last time, said Awan.

- Ghulam Mustafa Awan

In both cases, COVID-19-related restrictions prevented their travel.

Double whammy

Telling a young COVID-19 mother of three that her husband, also a coronavirus patient, has passed on can by no means be easy.

But that is precisely what Dr Samara Khatib, Consultant InternalMedicine and team lead at the COVID-19 ward at Mediclinic Parkview Hospital in Dubai, was tasked to do recently.

We had to take the help of mental health professionals to break the tragic news to the patient, who is in her 30s, said the American doctor of Syrian origin. It shook us as healthcare workers.

- Dr Samara Khatib

Coronavirus has struck other couples too in the UAE, which has meant they have had to leave their children in the care of others.

Dubai-based Suman Manning, who tested positive along with her triathlete husband Shane Manning, said her sister took care of her triplets during the ordeal. Although she showed no symptoms, she had to isolate herself and tell her kids and sister to keep away from her, while her husband was recovering in hospital.

It was a particularly trying time as the kids had just started the first week of remote learning and needed some kind of support, she told Gulf News earlier.

Were not invincible

Working on the frontlines in the face of an invisible and yet-to-be-conquered virus, doctors and nurses are probably at the highest risk of contracting COVID-19. Ask Reem Yousef, who works as an emergency nurse manager at the Emirates Specialty Hospital in Dubai.

- Reem Yousef

The Lebanese mum, who is still breastfeeding her nine-month-old baby, told Gulf News: It is really hard. I am literally wearing my heart on my sleeve for my little one, Relle. Yes, there is fear of contracting COVID-19 as we work 12-15 hours a day for five days. We try our best to manage. When I go back home, I take utmost care to completely sterilise myself before I hold my baby in my arms again.

Dr Khatib said she tests herself for the virus at least once a month. I am also very particular about hygiene. Its almost as if I suffer from obsessive compulsive disorder (OCD). There is no respite on the front line and when we see our own colleagues falling prey to the virus, we feel emotionally distraught. It makes us realise we are not invincible. But we have a responsibility to stay safe and healthy as we can pass on the virus to other patients or our families back home.

Despite the best efforts though, the tables do get turned sometimes. And when that happens, the resolve to combat coronavirus only gets stronger.

As a doctor duo at Zulekha Hospital Dubai, Dr Nishath Ahmed Liyakat and Dr Unni Nair, who have recovered from COVID-19 testify, there was no way the virus would have held them back from doing their duty once they had received the treatment and completed their quarantine.

Victor and the virus

Yes, the dismal health crisis surrounding us does have its share of good news. As the official tracker posts new cases every day, there are considerable recoveries too, with each corona warrior, irrespective of whether they are a mild or critical case, emerging as an emphatic victor against the virus.

Speak to patients who have turned the blind corner, and their words inspire you. While some will tell you coronavirus is not a death sentence, others will say they do not wish their hellish experience even on their worst enemies.

- Wilfredo

Either way, there is no bitterness and no taking away from the huge sense of relief and gratitude on the road to recovery.

I hardly had any symptoms and it never felt like a death sentence. But now that I have completed my quarantine, I thank God its over, said one young Indian woman who did not want to be named.

Wilfredo, a Filipino expat, who came out of the ventilator after 20 days at Al Zahra Hospital, Sharjah, said, I prayed hard to God and placed my trust in the medical team. Now, Im getting better every day and can only remember those weeks on the ventilator like it was yesterday.

In Abu Dhabi, Raneen Abu Zaher, a Palestinian homemaker, and her newborn son, Jad, who also beat coronavirus, inspire hope.

The duo were diagnosed with the infection when Jad was just a day old. But two weeks later, when they got the all-clear, the mother of three told Gulf News, I tried to hold on to my faith, and prayed for my entire family.

UAE will not let you down

If theres one thing any patient in the UAE will vouch for, its the fact that they could not have been in better hands. Whether it is Liu Yujia, a 73-year-old visitor from Wuhan, China, who was the first patient to have fully recovered in the UAE or Aubrey Escano, 27, a Filipina from Abu Dhabi who is currently under quarantine, there has been only praise and gratefulness for the UAE for the manner in which coronavirus cases are handled.

Escano in her message said, I would like to tell COVID-19 patients not to lose hope, not to worry and continue the fight because the UAE will not let them down.

The exemplary patient care apart, the UAE has also hit international headlines for carrying out a record number of laboratory tests for coronavirus. According to the Ministry of Health and Prevention, the UAE leads global coronavirus testing with 1.5 million tests conducted since the beginning of the outbreak. The UAE daily testing average equals a four-month average of COVID-19 testing in other countries.

- Aubrey Escano

Addressing a UAE Government remote meeting today, Minister of Health and Prevention Abdul Rahman Bin Mohammed Al Owais said, The UAEs response to the COVID-19 pandemic is unique and different from other countries. The UAE has shown exceptional management of the crisis, whilst leveraging other countries experiences. However, the level of response was different, given the demographic composition in the country, which is home to more than 200 nationalities, and its distinct resources, readiness and experiences in many sectors.

On May 1, doctors and researchers at the Abu Dhabi Stem Cell Centre also achieved a major breakthrough with a promising stem cell treatment for COVID-19 patients.

The Ministry of Economy even granted a patent for the development of the innovative method, which was administered to 73 COVID-19 patients, all of whom were cured of the virus using stem cells.

Researchers, who have completed the initial phase of clinical trials, are now working on demonstrating the efficacy of the treatment.

Now that is no mean achievement, by any measure.

See the original post here:
Coronavirus: The trials and triumphs of UAE residents - Gulf News

Daughter of former journalist who died of colon cancer battling cancer of the bones – Nairobi News

This Thursday will mark exactly 10 years since journalist Elly Abongo succumbed to colon cancer in Nairobi. He died just days after being featured in Daily Nations Living magazine, narrating his struggles with the disease.

His widow, Joyce Wambui, and daughter, Lakita Abongo, will be marking the anniversary in India. Since January, they have been at the Medanta Hospital in New Delhi where the 13-year-old Lakita is being treated for cancer of the bones.

CELL TRANSPLANT

Her right leg was amputated at the hip in March and she is now awaiting a stem cell transplant to as medics seek to ensure that the cancer, called osteosarcoma in technical terms, is banished from her body.

Hers is a hereditary condition. Tests by medics on Lakitas blood showed that she had inherited a syndrome that increases chances of a person contracting cancer.

She tested positive for Li-Fraumeni syndrome. That one makes someone be more susceptible to different types of cancer. So, that can run in the family, Ms Wambui told the Sunday Nation on Friday.

She explained that the death of Mr Abongos mother and two siblings might have been due to the predisposition to cancer, though it had not been established as such.

In Lakitas case, the cancer began with pain in the leg, which they tried managing but it just couldnt go away. Several scans later, it was discovered that she has osteosarcoma, which was manifesting itself as a tumour. The cancer forms in the cells that form bones.

LOSS OF LEG

One of the interventions done was to remove the affected part. In its place, a metallic blade was introduced to ensure the leg still supported the body.

But during the examination in January, it was discovered that the tumour was not responding to chemotherapy.

They did a scan and found out that the chemo wasnt working. When they analysed the site of the tumour, there was no other option but an amputation, said Ms Wambui.

To place further stops on the cancer, which doctors have deemed aggressive, medics have recommended a stem cell transplant. This weekend, doctors have been harvesting cells from her body to be reconditioned and later returned to her body.

If all goes according to plan, the transplant is scheduled for May 18. But that depends on whether they will have raised the Sh4.9 million required for the procedure, an amount that the family is asking well-wishers to contribute.

LOSS OF DADDY

If there is no money, they will continue with chemotherapy until we get money for a stem cell transplant, said Ms Wambui.

Lakita, Standard Eight pupil at Juja Preparatory, said it has not been easy dealing with the loss of a leg.

Sometimes I just feel like my leg is there, but its not. I reach out to touch it, but its not there, she said.

She hopes all financial hurdles will be cleared soon so that she can return to Kenya by June.

(I wish to) go back to my family and friends to resume school and sit my KCPE, she said.

Her father died at 32, when she was three years old. He had worked for Family TV, Citizen TV, Radio Ramogi, BBC Radio among other media outlets by the time of his demise.

Well-wishers can donate through M-PesaPaybill Number 8011987, with the senders name as the account name.

See the rest here:
Daughter of former journalist who died of colon cancer battling cancer of the bones - Nairobi News