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A surgical nurse with the functional specialty team in the 322nd Civil Affairs Brigade, 9th Mission Support Command, began her voyage on the U.S. Coast Guard Cutter Joseph Gerczak, in order to provide advanced medical support and ensure the health and safety of all crew members while the Coast Guard conducts Hawaiian Island patrol.

1st Lt. Kayla Kight, a 12-year veteran from Palm Bay, Florida, comes with an extensive background to include medical telemetry, oncology, acute care, family medicine, internal and preventative medicine. Shes also the first nurse to graduate from the 25th Infantry Division Jungle Operations Course.

My courses, experiences and knowledge have set me up for success to provide adequate support for this mission, said Kight. I have been preparing individually for this mission by recently recertifying my licensures in Basic Life Savers, Advanced Cardio Life Saver, Pediatric Life Saver, and the use of the AED.

Kight will be the only medical support officer on board from the Army Reserve in support of the U.S. Coast Guard.

Its kind of a test run for, hopefully, future operations where we push out a little further south, toward American Samoa and other Pacific regions, said 1st Lt. Casey Rude, Executive Officer on board the Joseph Gerczak, part of the Sand Island Coast Guard Station in Honolulu, Hawaii. She will provide that extra advanced medical support on our platform 154-foot vessel. There are no health service technicians from the Coast Guard so this will allow us to have that advanced medical care for those longer trips.

In addition to providing important medical care, 1st Lt. Kight will also have additional tasks on board.

Shes going to provide some advanced training to the crew with AEDs and other life saving techniques while seeing the day in the life of the Coast Guard as well, said Rude. Well run her through some of our drills and do some of the things we do.

This is the first time the 322nd Civil Affairs Brigade is sending personnel for medical support with the Coast Guard.

This is the first mission of its kind for us and in this region, said Rude. The connection was done through our district office. We want to strengthen the partnership with the Army and allow for potential future operations.

Kight is grateful for this experience, saying, I am thankful to my leadership for giving me this great opportunity, this is my first time participating in a mission like this. Ultimately, I am happy to give reassurance and trust to the team that I am competent and an expert in my skills.

Continue reading here:
Partnership in the Pacific: Army Reserve nurse provides medical care for Coast Guard unit - kacc.nrmc.amedd.army.mil

With many schools preparing for a return to the classroom this fall, mask and social distancing restrictions have many parents, teachers and experts questioning how reasonable the requirements actually are.

The state of Illinois' guidelines for the return to school in the fall require all students age 5 or older to wear facial coverings.

The guideline has been included in several plans already announced for certain districts in the state.

Township High School District 211, one of the largest school districts in Illinois, announced its preparations Friday, which includes wearing face coverings and the potential for alternating between remote learning and in-classroom instruction to limit students in the school at one time.

Also on Friday, the Archdiocese of Chicago announced its plan to reopen schools in the fall, mandating face masks for students over the age of 2, student "cohorts," temperature checks and the option to continue online learning.

The CDCs existing guidance recommends that students and teachers wear masks whenever feasible, spread out desks, stagger schedules, eat meals in classrooms instead of the cafeteria and add physical barriers between bathroom sinks.

But with the restrictions comes concern from parents, teachers and experts.

According to Terri Sabol, an assistant professor of human development and social policy at Northwestern's School of Education and Social Policy, schools are faced "with a nearly impossible task."

"Prioritize the health and safety of teachers, students, and their families while ensuring that education meets the needs of young children and families," she said in a statement.

Sabol said it's possible to strike a balance, "but it will not be easy."

"Safety precautions for schools that serve young children will have to look different compared to schools that serve older children," Sabol said. "For instance, it is not reasonable or developmentally appropriate to expect young children to practice social distancing in a classroom. If you have ever been in a high-quality preschool classroom, you know that they are loud, interactive, and buzzing with excitement. On any given day, you may find teachers and children huddling over a sunflower plant, carefully picking out seeds with a tweezer while guessing and predicting how it grew. At the same time, a separate group of children may play doctor and patient in dress-up area while two children paint a picture together at the easel. It is through these interactions that children learn, grow and create. These active, dynamic interactions cannot simply be replaced with individual desks 6-feet apart (nor could young children even sit in a desk all day if we tried)."

Similar concerns over how young children will be able to wear a mask for a day were noted by Dr. Sadiya Khan, an assistant professor of preventative medicine in epidemiology at the Northwestern University Feinberg School of Medicine.

"Recommendations by the American Academy of Pediatrics are that children age 2 years and up should wear a mask and/or cloth covering if not able to socially/physically distance," Khan said in a statement. "The most important thing is to ensure that it is comfortable and fits well, covering the nose and mouth. It is also important to remember to wash hands before and after putting it on and taking it off."

But will kids keep them on?

"Based on personal experience with two small children (age 2 and 3 years), eliminate the fear factor and normalize wearing masks by showing yourself wearing them as well as having their stuffed animals wear them," Khan said. "It has quickly become part of my children's 'normal' and they remind me to wear one before we leave the house."

There are also concerns for bilingual families as some research suggests children speaking multiple languages tend to rely on the mouth of the person speaking and other visual cues that could be hindered by a mask.

"There are potential implications of mask-use for dual language learners that we will want to keep an eye on," Adriana Weisleder, Director of the Child Language Lab, said in a statement. "On the other hand, children are also remarkably adaptable and may learn to rely on other kinds of cues in this environment."

Excerpt from:
It Will Not Be Easy': Experts Weigh in on Masks, Social Distancing in Schools - NBC Chicago

More than 130,000 Americans have died from COVID-19, a novel strain of coronavirus, and cases continue to surge in communities across the country. But for frontline medical workers, particularly those working in emergency rooms and treating COVID-19 patients, the fight has only just begun.

While the Centers for Disease Control and Prevention (CDC) estimates that at least 515 healthcare workers have died so far after contracting COVID-19 with 34 percent of cases still unreported a larger, potentially even more deadly crisis is looming. For doctors, nurses, hospital cleaners, and other staff members on the front lines nearly 80 percent of whom are women, according to the US Bureau of Labor and Statistics it's their mental health that has been devastated, and this country is beyond ill-equipped to help them repair it.

"Trauma does not have a timeline, so we will be seeing the ramifications from this for a while and need to be prepared to step up and help in the long run," Jessi Gold, MD, an assistant professor in the department of psychiatry at Washington University in St. Louis, told POPSUGAR. Dr. Gold explained that physicians and other healthcare workers already faced unique challenges, but she expects that "we will see more burnout, depression, anxiety, substance use, and PTSD. I think we will see people leave medicine or have trouble returning to work because of it."

Prior to COVID-19, physicians were already at a higher risk of suicide. A 2019 analysis published in PLos One found that female physicians and those making life and death decisions may be particularly vulnerable, and all medical workers would benefit from preventative strategies implemented in the workplace. It's estimated that anywhere from 10 to 15 percent of physicians suffer from substance abuse, according to a 2007 study published in Critical Care Medicine.

But COVID-19 has exacerbated these risks. One emergency room doctor in New York City, Lorna Breen, died by suicide after treating COVID-19 patients and recovering from COVID-19 herself. "She went down in the trenches and was killed by the enemy on the front line," Philip Breen, Lorna's father, told CNN. "She loved New York and wouldn't hear about living anywhere else. She loved her coworkers and did what she could for them."

LJ Punch, MD, a trauma surgeon in St. Louis, MO, has also been fighting in the trenches. "The first wave of COVID-19 was like a flood. I felt like I was both underwater and at the same time well prepared to swim," Dr. Punch told POPSUGAR. But eventually, the work began to take a toll. "Taking care of room after room of ICU patients behind isolation walls and separated from their families was emotionally taxing. Having complex conversations over the phone about life and death decisions that would typically occur in person where families could feel and touch their loved one was difficult, frustrating, and sometimes really sad," Dr. Punch said. "It felt like we were all floating, unable to ascend to the surface to breathe."

Dr. Punch first realized they wanted to pursue a career in medicine after surviving a suicide attempt their freshman year of college. That near-tragedy, coupled with the evolution of their gender identity, made Dr. Punch feel more equipped than most to handle the heartbreak and stress that comes with caring for COVID-19 patients, though they added that as a Black person, the unrest that has emerged during the pandemic is both a relief and "a source of constant tension in my body." To that end, "I am grateful that I was already connected to a large network of community resources to be able to do that kind of engagement even in the midst of such suffering," Dr. Punch explained. "I don't think I would have been as resilient if I was not spending as much time in the community outside of the hospital as I have been."

Of course, not everyone has community resources available to them, and being a woman, a member of the LGBTQ+ community, or a person of color seeking mental health care presents an entirely new set of challenges.

It's especially troubling that, for years, women who now make up such a large portion of the workforce in hospitals were dismissed as "hysterical" or "emotional" when they were clearly struggling. Dr. Gold told POPSUGAR that she has had patients who didn't seek help because they thought they were simply too emotional or their mood swings were related to their period. "We very much internalize the messages we hear from others, and it can lead to women not seeking or recognizing the need for help themselves," Dr. Gold said.

These internalized messages aren't the only things working against the women fighting COVID-19 on the front lines. There's also the staggering lack of mental health resources and the prevailing stigma surrounding mental illness. In many cases, women have also been conditioned to prioritize others over themselves. One study published in BMJ found that being a woman and having children increases your psychological risk.

The medical community as a whole doesn't encourage workers to seek mental health care, either. A 2016 survey of women physicians found that half believed they had a mental illness but did not seek treatment. Fears that they'll be perceived as weak, lose their medical license, or be judged by their coworkers keep those who need support from seeking it, putting them at greater risk of burnout, substance abuse, and suicide.

"Medicine as a culture is stoic," Dr. Gold said. "It is modeled by the people who train you, and you learn to 'suck it up' and do your work and work the shifts you're asked to work. You're asked to sleep less, eat less, keep going (some specialities more than others), and to learn what you need to do and do what you have to do. As such, emotions are not given space or prioritized and, often, not modeled."

While the system medical and social is not set up to support these frontline workers, there are things we, as a culture and in our own communities, can do to help those who are continuing to treat COVID-19 patients, clean the hospital rooms they're being treated in, and provide an essential service at a time of so much duress and uncertainty.

"Give them space to feel and validate and support their feelings," Dr Gold said. "Know the warning signs and actually look for them in your friends who are healthcare workers. Ask them if they're OK, and point them towards resources." Some of those resources include forthefrontlines.org, which provides counseling for frontline medical workers, and Project Parachute, a support network for frontline healthcare workers and therapists.

"Also, consider advocating for them to get basic needs, like child care, sick and parental leave, hazard pay, and personal protective equipment," Dr. Gold continued. "This will make doing their lives and navigating the stressors of their jobs simultaneously easier. This will also protect them and their families, and in turn protect their mental health." Zero to Three offers an online child care advocacy toolkit, PL+US offers resources and campaigns on advocating for paid sick and family leave, and you can search for your congressional representation online to tell them to pass legislation that will provide hazard pay for frontline medical workers.

In many ways, as a country, we have failed healthcare workers. In New York state alone, it's estimated that COVID-19 deaths could have been reduced by 80 percent if politicians had acted sooner. We have left these medical professionals with very little to no necessary resources as their emergency rooms have been overwhelmed, and all we've done to show our appreciation is label them heroes and shell out money to have the Blue Angels fly over their cities.

What these healthcare workers really need is support unwavering, tangible support so they can continue to live healthy lives, both mentally and physically.

Read the rest here:
We're Facing a Mental Health Crisis in Healthcare Workers, the Majority of Whom Are Women - POPSUGAR

Studies in thousands of people on multiple continents now show the malaria drug hydroxychloroquine does not help patients hospitalized with Covid-19 live longer. But on Tuesday the White House, based on a new study that outsiders greeted with deep skepticism, disagreed.

Now the Food and Drug Administration again risks being pulled into an ugly political fracas over whether to permit more patients to be treated with the drug. It is a debate that threatens to undermine the agencys credibility when it needs it perhaps more than ever.

The FDA cannot afford another misstep if it wants to maintain credibility with American people, which is going to be so essential when doing a broad vaccine program, should we identify a safe and effective vaccine for Covid, said Luciana Borio, who served as the FDAs acting chief scientist from 2017 to 2019.

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At the root of the conflict is the fundamental principle that the FDA uses to evaluate drugs. Decisions are based almost entirely on what is known as a randomized controlled trial, in which patients are randomly assigned to receive a treatment or not. Other types of studies have, again and again, failed to deliver accurate information about medicines benefits and risks, and are used sparingly in making medical decisions. Three randomized studies have now shown no benefit for hydroxychloroquine in hospitalized patients.

The study that sparked the latest controversy was anything but randomized. Not only was it not randomized, outside experts noted, but patients who received hydroxychloroquine were also more likely to get steroids, which appear to help very sick patients with Covid-19. That is likely to have influenced the central finding of the Henry Ford study: that death rates were 50% lower among patients in hospitals treated with hydroxychloroquine.

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On Monday, President Trump, who has long been enthusiastic about hydroxychloroquine and even took the drug himself, tweeted about the results, saying that Democrats had politicized the drug and that the FDA should should Act Now. The presidents trade adviser, Peter Navarro, told reporters that Henry Ford had asked the FDA to issue a new emergency use authorization for the drug. The agency had previously revoked hydroxychloroquines authorization on June 15, based on evidence it was not effective.

Experts were taken aback by the developments.

The medical community has come to the inescapable conclusion that hydroxychloroquine is not effective at treating Covid-19 infections, said Steven Nissen, a cardiologist at the Cleveland Clinic and a longtime clinical trialist. Peter Navarro is not a scientist, he is the presidents trade representative. He should not be advising the public on matters of health.

Nissen and Borio say observational studies simply cannot be used to determine whether a medicine is effective. Again and again they have been wrong. In one famous example, estrogen replacement therapy after menopause was thought to have benefits in preventing heart and other problems; large studies showed this was not the case. In another, a knee surgery for arthritis was shown to have no benefits over medical care.

A paper that showed that hydroxychloroquine was potentially harmful, which was published in The Lancet in May, was met with similar criticism. It was eventually withdrawn over questions about the validity of its data.

Observational studies are often used to decide what ideas to test in randomized studies, to make sure that results from randomized studies translate to the real world, and to detect side effects.

But, puzzlingly, Henry Ford has applied for authorization to use hydroxychloroquine for a clearly defined list of clinical uses, including use in clinical trials, the system said in a statement.

We owe it to our patients and our communities to do everything we can to provide safe, effective, affordable treatments, and we will continue to collaborate toward meaningful solutions that address this deadly disease.

Evidence that hydroxychloroquine does not help hospitalized patients the use in its original emergency use authorization, which was designed to allow doctors to access a national stockpile of the drug is mounting.

One study, the RECOVERY study conducted in the U.K., compared 1,542 patients on a particularly high dose of the drug to 3,132 control patients and found no difference in how long patients lived. A second, conducted by the National Institutes of Health, also found no benefit from hydroxychloroquine at higher doses.

Yet, in his interview with the White House press pool, Navarro argued that the studies so far were based on bad science and that the Henry Ford data were evidence enough. He argued that the drug appears to work when given earlier in the disease course than it was in the large randomized studies. He said that rescinding the FDA authorization had a tremendously negative effect on two things.

One is the ability for American people to use this medicine to protect themselves, Navarro said, and, two, the ability for hospitals, like the Detroit hospital system, to recruit patients for the kind of randomized blind clinical trials that everybody wants to settle once and for all the questions of efficacy and safety.

It is not clear how the FDAs decision to rescind the emergency authorization for hydroxychloroquine affected either. Doctors can prescribe any drug for any use, and conducting a clinical trial requires a different type of approval from the FDA. It is clear that granting a new emergency use authorization based on an observational study would go against decades of experience by medical researchers and regulators around the globe.

A huge amount of scientific attention has been focused on hydroxychloroquine. An analysis Monday by STAT and AppliedXL, a computational journalism company, found that 1 in 6 clinical trials started for Covid-19 involved hydroxychloroquine or a similar drug, chloroquine.

Said Nissen: The sooner we stop talking about hydroxychloroquine, the sooner we can focus attention on more promising therapies.

View post:
A flawed Covid study gets Trump's attention and FDA may pay the price - STAT

What do your teeth, brain, mood and gut all have in common? Unsurprisingly, it turns out one answer is almost everything. They are, after all, interconnected and essential aspects of your body and life. The other, often overlooked answer, however, is food. The COVID pandemic put into perspective how little control we have over certain parts of our health, but quarantine was sobering, proving we dont have to be an inert chunk of randomly assembled molecules drifting wherever the universe blows us. In fact, the decisions we make about our food give us resounding leverage over our health. While the extent to which health outcomes are influenced by our food choices is still an area of active research and investigation, physicians can give us insight into how to make the best choices for our health.

It seems like a new diet or fad food appears every day Atkins, Alkaline Water and Keto to name a few. Dr. Carolyn Newberry, a gastroenterologist at Weill Cornell Medicine, advises against jumping on fad diets and foods, warning they may not be sustainable nor provide health benefits. Take the ketogenic diet, or Keto for short, which requires replacing most carbohydrates with fat. Such a diet may lead to unbalanced eating and cutting out entire food groups. Worse, its difficult to adhere to for a prolonged period of time, causing yo-yo dieting, characterized by rapid fluctuations in weight. Dr. Newberry advises her patients to opt for food choices your ancestors would recognize, and to think about making choices you can continue to make for the long term. Her message is this: Eat simple. Stay away from processed foods, eat plenty of plants, vegetables and seafood and moderate the junk.

Dr. Steven Acker, of Elite Dental of Staten Island, lent us some insight into a holistic picture of food and health. According to Dr. Acker, the villain of college students diets is acidity, typically found in fast and carb-dense foods. When it comes to dentistry, acidity is responsible for dental disease, gum disease, cavities and even contributes to sleep apnea. The impact of poor food choices doesnt end there, as it can also adversely influence the composition and quantity of the essential bacteria living in your gut. At this age, however, there is good news: Damage caused by acidity is reversible. A kombucha and jamba juice overdose isnt going to be the panacea we are looking for, but fermented foods, unprocessed diets and eating well in the long term are the powerful preventative measures we should all be taking to decrease the chances of poor health.

For the majority of us, its perfectly OK to eat chips. Its OK to have a slice of cake at a birthday party. Its OK to have some fast food because sometimes there are no other options. The relationship between dietary choices and health is a long one. The decisions you make over months and years are closely related to what happens down the road, so its important to make these choices consciously and learn about the pros and cons of whats going into your body. If you are interested in learning more about the cutting edge in the link between food and health, here are some resources:

Peter Kaplinsky is a rising junior in College of Arts and Sciences. He can be reached at pk445@cornell.edu.

Excerpt from:
A Foodie's Trip to the Doctor - Cornell University The Cornell Daily Sun

Since December 31, 2019, COVID-19 has been raging throughout the world. Many causes have been attributed to its success in infecting millions of people, such as how it is an airborne-illness or how the disease can last long periods of time in cold weather. However, according toThe National Academies of Science, Engineering and Medicine,one nations leadership can be a huge contributor to the prevention of global pandemics, such as the one that is currently happening.

Undoubtedly, as the United States is the current most powerful country in the world, our nation should have stepped up to the task, but unfortunately, we didnt.

Thus, because the United States did not sufficiently grasp just how devastating this new disease would be, the USs reaction to it was subpar. There needed to be a more coordinated approach on the national level. On the global level, there should have been more allocation of resources amongst different countries, with the US and other wealthy and powerful countries leading the path towards the response to COVID-19.

As the world superpower, the US should not have been greatly impacted by the COVID-19 and the reason it has suffered the worst outbreak in the world is due to the lack of effective responses.

After the terrible spreading of COVID-19 amongst the population in Wuhan, China, there has been a lot of commotion in that country to try to stop this novel infection from spreading rapidly. They erected hospitals in a matter of days and, according to the Deccan Herald and South China Morning Post, had many doctors from all over China rush to aid the coronavirus victims.

After winter break, while the virus was spreading rapidly across Wuhan, I was in school, coming off a nice vacation snowboarding in Canada. Like many of my classmates and teachers, I was not as worried about the coronavirus as I should have been, as the disease was thousands of miles away from me overseas.

With this thought process, many Americans, including the US president, have disregarded the coronavirus disease until the last possible minute, when the US started reporting that there were outbreaks in many major cities.

Back in February, as reported byFactCheck.org, President Trump had said in a speech that there was no need to worry about the coronavirus as the United States has the best doctors in the world and that he has the coronavirus very much under control.

Although this reassurance may have helped boost the morale of US citizens in the short term, the long term effects were that the US was very dismissive about just how severe the coronavirus was. Even with travel bans in place, many US citizens started being diagnosed with coronavirus, eventually leading to lockdowns in many school districts and companies, possibly costing the US more than 2 trillion dollars, according to theNew York Times.

Thus, due to the incorrect mindset and late actions of the US government, the United States reaction to the coronavirus was very unsatisfactory, to say the least.

Speaking of unsatisfactory, on the national level, the US could have dealt with the spread of the coronavirus in a much more efficient way by implementing more extreme measures.

According to Vox, after learning from their mistakes during the MERS outbreak in 2015, South Korea passed an urgent law, effective only in pandemics, to start tracking individuals with the coronavirus, providing updates to their latest locations in order to prevent other civilians from crossing paths with the infected individuals. Although, to us Americans, this seems like a blatant intrusion of privacy, they only allow it in the case of a public health emergency. South Korea has been able to successfully contain the coronavirus to only a small percent of its population and has leveled off the curve and rate of infection.

On the other hand, America is struggling to prevent the coronavirus from spreading, with over three million cases, as of July 10, according to the CDC. With the current technology and the money available at our disposal, the US should have implemented the measures that South Korea utilized: tracking the individuals who were infected.

Although many would argue against this severe approach, this would be the best method in preventing people from contacting others with the coronavirus as proven by the fact that South Korea is able to manage and control their outbreaks much better than the U.S., even after, as reported in The Diplomat, several outbreaks.

In addition, in Century of Outbreaks, the authors quote Amanda McClelland, senior vice president of Prevent Epidemics at Resolve to Save Lives, that countries tend to fall into a cycle of panic and neglect of pandemics, noting that once a horrible global pandemic has passed, many countries stop worrying and funding for the future pandemic preventative measures.

With the 2009 influenza pandemic as the latest epidemic to hit the US, the US should have started preparing since then, but unfortunately, as the effects of the coronavirus display, we have not. I point this out, even though we cannot go back in time to fix this mistake, because the US should have focused more on planning for future pandemics and not thinking that in time, everything will sort itself out.

Although sometimes pandemics seem too far into the future, time is of the essence and there needs to be adequate planning, which the US did not have in fighting the coronavirus, but other countries, like South Korea, did. Therefore, there need to be more rigorous approaches in stopping COVID-19 today, as well as planning for the future.

On the global scale, coronavirus can be better treated with the US being the leader and working with other countries to prevent later outbreaks of the coronavirus or any future pandemic.

According to Century of Outbreaks, a huge factor in pandemic prevention is the collaboration of many countries, whether that be pooling resources such as funding or vaccine development or helping surveillance of the coronavirus. As of now, many countries are dealing with outbreaks independently and not as a global effort, especially with the US struggling to contain the coronavirus from spreading within its own borders.

If the world wants to quell this COVID-19 pandemic, the US needs to step up alongside other developed countries to share resources and serve as role models to the world.

Adding on, Century of Outbreaks also mentions that developing countries, due to how severely pandemics impact their populations, can gather more data on outbreaks, and in doing so, contribute this vital information to the development of treatments and vaccines for the world community.

However, many developing countries usually get cheated despite their contributions due to other developed countries that have already bought most of the vaccines or health products needed to treat pandemics, leaving none for the developing countries.

In the case of COVID-19, the US should enlist the help of these developing countries for their intel or research on this disease to better fight this pandemic. In turn, the US should sign contracts to ensure that these developing countries will be provided with assistance against future pandemics. Not only will we better contain the outbreaks that will affect us, but we will also build stronger international friendships and alliances.

Although the US may be the most powerful country in the world, it is still beset with flaws, especially in the face of disastrous pandemics, as COVID-19 has revealed. The USs response towards the coronavirus was disastrous.

Finally, on a global scale, the US should have been the leader in addressing the coronavirus and a role model to other countries as well.As it is our responsibility as a global leader, we can do better and we should do better, not just for ourselves, but for everyone.

See original here:
Opinion: Is there hope for USA's international leadership after COVID-19? - Los Angeles Times

Cyndi Williams, CEO and founder at Quin, discusses why the digital and healthcare industries need to combine forcesto harness the full potential health apps have to offer.

There are more than 300,000 health-related apps available from leading app stores worldwide a number which has more than doubled in the past five years. In line with this astonishing growth, the number of digital health apps has also doubled since 2015, and is expected to be worth over $100 billion by 2023.

Whereas the traditional medical R&D process is incredibly expensive and time-consuming, app development offers an exciting alternative. Although the smartphone may never supersede medical devices, it is nonetheless an invaluable repository of lifestyle and behavioural data with immense promise for improving insights, outcomes and patient quality of life.

However, the exponential rise of mobile health apps (mHealth apps) now faces several significant obstacles from the rising cost of development to institutional reluctance and limitations to integration and interoperability.

Its time for a paradigm shift

As the populations of developed countries continue to skew older, chronic conditions become increasingly common and the shortage of healthcare workers continues, the requirement for further innovation in the industry also increases. The medical industry is built upon innovations that improve life expectancy, quality of life, and offer diagnostic and treatment options. mHealth apps offer the potential to not only assist with these, but also aid in improving healthcare costs and efficiency.

Medical health apps augment existing systems to enable earlier interventions, greater patient autonomy and significant improvements to quality of life. In the long term, this represents a paradigm shift from crisis intervention to patient-led preventative medicine.

Consumer interest is already here

While there is some resistance to this movement in the medical industry, healthcare consumers overwhelmingly support the increased use of digital technology. In a recent survey in the US, 75% of consumers reported that technology already played an important role in managing their health, while the number of healthcare consumers using mHealth apps jumped by 32% between 2014 and 2018, according to Accenture.

Accentures research also found that the 88% were comfortable sharing data gathered by wearable health devices with a medical professional, offering an early example of the beneficial interplay between digital monitoring and conventional medicine.

Changing life for people with diabetes

Diabetes is one such condition where mHealth apps can be hugely beneficial to an individuals lifestyle management. People with diabetes constantly make decisions that directly affect their physical health and attempt to balance dozens of interconnected factors that determine the appropriate insulin dose. For this reason, the mHealth App Economics 2017 study listed diabetes among the top three areas with the greatest market potential for digital health solutions, but market penetration has been limited. There is still a lot of potential for innovators who are willing to dig deep and understand more about how mHealth apps can positively influence the lives of people with diabetes.

For instance, many people with diabetes use continuous glucose monitors (CGMs) which already sync data to their phone. Combining this data with the other data that smartphones often collect sleep, steps, exercise, and even diet, weight and menstruation, if the person uses other apps to track these could produce significantly smarter and more personal dosage diagnosis for insulin.

The upcoming app Quin is an example of the next generation of intelligent, smartphone-based medical health apps. The app synthesises the users data to help them make informed, independent decisions on insulin dosing and lifestyle management based on previous experiences and day-to-day habits.

An exciting road ahead if we choose to take it

The proliferation of medical health apps represents truly personalised medicine, as patients phones passively log data in real-time and use their computational power to turn that raw information into actionable insights. From diagnosis to prevention and treatment, these affordable, scalable and ever-improving mobile health apps represent a revolution in medicine that will improve the quality of all our lives.

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The collision of fast-paced digital industry with healthcare - Med-Tech Innovation

Englands most notorious dynasty owes much to the trials of a 13-year-old girl: Margaret Beaufort, Countess of Richmond. On January 28, 1457, the young widowher first husband, Edmund Tudor, had died at age 26 several months priorbarely survived the birth of her only child, the future Henry VII. Twenty-eight years later, in large part due to Margarets tenacious, single-minded campaign for the crown, she saw her son take the throne as the first Tudor king.

Margaret never officially held the title of queen. But as Nicola Tallis argues in Uncrowned Queen: The Life of Margaret Beaufort, Mother of the Tudors, she fulfilled the role in all but name, orchestrating her familys rise to power and overseeing the machinations of government upon her sons ascension.

The latest installment in our series highlighting new book releases, which launched in late March to support authors whose works have been overshadowed amid the COVID-19 pandemic, centers on the matriarch of the Tudor dynasty, the oft-conflicting science of skin, a Pulitzer Prize-winning poets tragic past, the twilight years of Japanese isolationism and a Supreme Court decision with lasting implications for the criminal justice system.

Representing the fields of history, science, arts and culture, innovation, and travel, selections represent texts that piqued our curiosity with their new approaches to oft-discussed topics, elevation of overlooked stories and artful prose. Weve linked to Amazon for your convenience, but be sure to check with your local bookstore to see if it supports social distancing-appropriate delivery or pickup measures, too.

Margaret Beaufort had little reason to dream of the throne. The Wars of the Rosesa dynastic clash between two branches of the royal Plantagenet familyraged on for much of her early life, and more often than not, her Lancastrian relatives were on the losing side. Still, she managed to find favor under Yorkist king Edward IV and his wife, Elizabeth Woodville, embedding herself in the royal household with such success that she was named godmother to one of the couples children. All the while, Margaret worked to restore her son, Henry, then in exile as one of the last remaining Lancastrian heirs, to power.

Edward IVs untimely death in 1483, compounded by his brother Richard IIIs subsequent usurpation of the throne, complicated matters. But Margaret, working behind the scenes with the dowager queen Elizabeth and others who opposed Richards reign, ultimately proved victorious: On August 22, 1485, Henry defeated Richard at the Battle of Bosworth Field, winning the crown and, through his impending union with Elizabeth of York, daughter of Edward IV, uniting the warring royal houses after decades of civil war.

Nicola Tallis Uncrowned Queen details the complex web of operations that resulted in this unlikely victory, crediting Margaret for her sons success without lending credence to the commonly held perception of her as a religious fanatic who was obsessively ambitious on her sons behalf and who dominated his court. Instead, the historian presents a portrait of a singular woman who defied all expectations of the era, pressing against the constraints imposed by her sex and society, [and] slowly demanding more and more control over her life, until the crown on her sons head allowed her to make the unprecedented move for almost total independence: financially, physically and sexually.

A shower a day does not keep the dermatologist awayor so James Hamblin, a preventative medicine physician and staff writer at the Atlantic, argues in his latest book. Part history, part science, Clean addresses the many misconceptions surrounding skincare, outlining a compelling case for showering less and embracing (figuratively speaking) the many naturally occurring microbes found on the skin. To demonstrate his point, Hamblin swore off showering for the duration of the books writing; as Kirkus notes in its review of Clean, He did not become a public nuisance, and his skin improved.

The modern personal hygiene and beauty industry owes much to post-Industrial Revolution developments in germ theory, which identifies microbes as vectors of disease that must be destroyed or avoided. But certain bacteria and fungi are beneficial to the body, notes Hamblin in an excerpt for the Atlantic: Demodex mites, for instance, act as a natural exfoliant, while Roseomonas mucosa blocks the growth of another bacterium linked to eczema flares. And though parabens ensure the longevity of commercial products including deodorant, shampoo, toothpaste and lotion, these preservatives also eliminate helpful microbes, upsetting the balance essential to healthy skin.

Ultimately, writes Kirkus, Hamblin argues for more skin microbiome research and greater biodiversity in all aspects of our lives, underscoring the value of pets and plants and parks to enhance our livesand those that live in and on us.

When Natasha Trethewey was 19 years old, her abusive former stepfather murdered her mother. This tragedy echoes throughout the former United States poet laureates work: In Imperatives for Carrying On in the Aftermath, she describes how abusers wait, are patient, that they / dont beat you on the first date, sometimes / not even the first few years of a marriage, and reminds herself not to hang your head or clench your fists / when even your friend, after hearing the story, / says, My mother would never put up with that.

Gwendolyn Turnboughs killing was a pivotal moment in the young poets artistic development, but as Trethewey writes in her new memoir, she avoided confronting painful memories of the murder for decades. With the publication of Memorial Drivea searing examination of the authors upbringing in the Jim Crow South and the disastrous second marriage that followed her white father and African American mothers divorceshe hopes to make sense of our history, to understand the tragic course upon which my mothers life was set and the way my own life has been shaped by that legacy.

As Publishers Weekly concludes in its review, Memorial Drive is a beautifully composed, achingly sad reflection on the horrors of domestic abuse and a daughters eternal love for her mother.

Tsuneno, the central figure in historian Amy Stanleys debut book, was the loudest, the most passionate child of a 19th-century Buddhist priest named Emon. Restless and plagued by bad luck, according to Lidija Haas of Harpers magazine, she endured three failed marriages before abandoning her tiny Japanese village in favor of the bustling city of Edo, soon to be renamed Tokyo. Here, she worked a variety of odd jobs before meeting her fourth and final husband, a mercurial samurai named Hirosuke.

In addition to presenting a portrait of a city on the brink of a major cultural shiftCommodore Matthew Perry sailed into Japan and demanded the isolationist country reopen to the West in 1853, the year of Tsunenos deaththe work conveys a strong sense of its subjects personality, from her stubborn independent streak to her perseverance and self-described terrible temper. Drawing on letters, diary entries and family papers, Stanley revives both the world Tsuneno inhabited and the wise, brilliant, skillful woman herself.

To read Stranger in the Shoguns City, writes David Chaffetz for the Asian Review of Books, is to hear the sounds of the samurai trampling through the city, smell the eels grilling in tiny food stands, [and] see the color of posters for Kabuki performances.

Journalist Matthew Van Meters exploration of Duncan v. Louisiana, a 1968 Supreme Court case that affirmed defendants right to trial by jury, is decidedly timely reading, notes Kirkus in its review. Arriving amid a global reckoning on police brutality and criminal justice, Deep Delta Justice demonstrates how a seemingly minor incident brought massive, systemic change, according to the books description.

The legal battle in question began in 1966, when Gary Duncan, a 19-year-old black teenager, was arrested for placing his hand on a white peers arm while attempting to de-escalate a brewing fight. Duncan requested a trial by jury but was denied on the grounds that he was facing a misdemeanor, not felony, charge of simple battery; a judge sentenced him to 60 days in prison and a $150 fine.

Duncan appealed the verdict with the help of Richard Sobol, a white attorney at New Orleans most radical law firm. As Van Meter writes in the books prologue, the two-year legal odysseyreconstructed through first-person interviews and archival documentseventually affirmed the function of civil rights lawyers in the South and the fundamental right to a trial by jury in all cases carrying potential sentences of at least two years.

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An Uncrowned Tudor Queen, the Science of Skin and Other New Books to Read - Smithsonian Magazine

SAN DIEGO (KGTV) -- It's a question some are grappling with as COVID-19 cases surge across the country.

In June, a woman posted a picture of a San Diego barista on Facebook with the caption "Meet Lenen from Starbucks who refused to serve me cause I'm not wearing a mask. Next time I will wait for cops and bring a medical exemption."

Someone started a GoFundMe for the Starbucks barista who went viral and has raised $100,000 in donations.

Also last month, a woman went on a tirade after being asked to wear a face covering in a Trader Joe's store in North Hollywood.

There's no shortage of stories about public debates over face masks.

RELATED: New UCSD finding: Wearing masks significantly curbs spread of COVID-19

In California, people are required to wear face coverings in most indoor settings and outdoors when physical distancing isn't possible.

According to a Pew Research Center study conducted in early June, "Overall, 65% of U.S. adults say that they have personally worn a mask in stores or other businesses all or most of the time in the past month, while 15% say they did this some of the time. Relatively small shares of adults say they hardly ever (9%) or never (7%) wore a mask in the past month, and 4% say they have not gone to these types of places."

Reporter Adam Racusin spoke with two doctors in different parts of California to get their take on masks.

"The primary purpose of wearing a face covering is to protect other people in case you're one of the probably significant number of people who are shedding the virus and not have symptoms," said Dr. Dean Winslow, a professor of medicine at the Stanford University Medical Center.

Winslow said the risk of coming into contact with the virus is higher when in indoor settings.

RELATED: Some San Diegans push for end of San Diego County face mask requirement

"Historically, the major outbreaks we've seen we know where the point source is, and have almost always been indoors," he said.

"Eventually, the people around us, how healthy they are, is going to come back to haunt us," said Dr. Jyotu Sandhu, Family Medicine, Sharp Rees-Stealy Medical Group. "So we need to look at mitigating the risk for everybody, and masks regardless of the type can reduce the risk of spread.

Sandhu said the goal is to lessen or reduce the spread of COVID-19.

"They (people) want to hear a black or white answer, are masks good, or are they not good, are they protecting me? Are they not protecting me? And it's really a gray area," he said. "They are protecting you, but they are not 100 percent preventative."

So, what's behind the decision not to wear a mask, and what are people thinking?

RELATED: 8 mask hacks to follow rules while staying comfortable

"What we're talking about is the curtailing of folks freedom," said Dr. Saurabh Gupta with Southern Californian Psychology Centers.

Gupta said some of the factors influencing decisions are world experience, how people see their political leaders, and social responsibility.

"It's worth looking at people on kind of a spectrum," he said. "So there's some people who really appreciate the mask and recognize that their social responsibility dictates, they really care about other people, they want to make sure that if inadvertently they are infected they don't want to pass it on to anyone, gosh they would feel terrible about that. Then you have folks on the other end who just don't want their freedom curtailed in any way. They don't want to be told what to do, and to cover their face feels very personal. And then you have folks everywhere in between in that spectrum. They will say, alright, I'll put up with this if I have to, but as soon as I don't have to or I'm not being told to it's coming off because I don't like it on my face.

In a UCSD campus-released article titled "To wear a mask or not, is not the question; Research indicates it's the answer," Chemistry Nobel Laureate and UCSD Professor Mario Molina shows the data does not lie.

A pivotal point of the study was when they looked at the numbers in Italy and New York after their respective mask mandates went into effect on April 6, 2020, and April 17, 2020. It was only then that the spread of viral air particles slowed drastically.

See the article here:
Mask or no mask? Breaking down the debate on masks - 10News

According to the CDC, people on medication who are virally suppressed and have adequate immune responses are not at a higher risk of severe illness and death from COVID-19. However, factors common in some people living with HIV, in particular co-morbidities, do greatly increase the risk of poorer outcomes.

Despite COVID-19 creating unparalleled changes in how we live, theres been little discussion on how the Ryan White CARE Act, PEPFAR, and the Global Fund for AIDS, TB and Malaria will address safe practices, particularly at AIDS service organizations, and how these measures will be evaluated and where the funding for these provisions will come from. As restrictions continue to be lifted, how will people living with HIV at higher risk of illness safely receive services and medical care until there is a preventative vaccine?

Estimations suggest that it will be the spring of 2021 before a vaccine could be available to the general public. Although vaccine studies are moving forward at an unprecedented rate, clinical trials take time and it may take numerous attempts to discover a vaccine candidate that is safe and effective. After an effective vaccine is found, it will then take additional time to produce and distribute the vaccine globally. In the meantime, a significant risk will exist for some people living with HIV in accessing essential services.

Of the 1.1 million people in the U.S. currently living with HIV, only 53 percent are virally suppressed. In 2018, 17,032 individuals in the U.S. received an AIDS diagnosis. Initial observations indicate those with CD4 counts below 50 are at a higher risk for severe COVID-19. Viral suppression is most often needed to prevent further deterioration of the immune system and for the immune system to once again become effective at fighting off pathogens such as viruses and bacteria. However, not all virally suppressed individuals see a complete rebound of their immune system. Some people, particularly those who began antiretroviral therapy (ARVs) when their CD4 count was below 200, experience a decreased improvement in CD4s which may not return to normal levels.

Many people living with HIV experience co-morbidities which also significantly increase their risk of severe illness with COVID-19. Heart disease, diabetes, liver and kidney disease, and certain cancers are commonly seen in people living with HIV, particularly as they age. A recent South African study found the death rate of people co-infected with HIV and COVID-19 was 2.75-fold higher than those without HIV of equal age. Investigators determined that most of the individuals in this study had additional conditions including diabetes, and viral suppression or non-suppression was not a determining factor. In total, there is a large number of people living with HIV for who safeguards should be put in place to reduce the likelihood of COVID-19 infection where possible.

Many people living with HIV receive vital services such as case management, food pantry, benefits counseling, housing assistance, treatment, and substance abuse referrals from AIDS service organizations and community-based organizations. Currently many organizations are temporarily closed or conducting onsite screening for symptoms of COVID-19 as well as offering teleconference services to their clients for certain programs. However, some services can only be accessed in person. As states reopen, AIDS service organizations, harm reduction centers, mental health and substance abuse facilities will need to make long-term adjustments in the way they provide basic services in order to protect their clients and staff.

Social distancing and symptom screening have become normalized practices with the restructuring of offices, waiting rooms, conference rooms, and other closed environments that people frequent simultaneously. Teleconferencing and phone appointments are now common in clinical practice. Hours are also extended or decreased to limit the number of individuals who occupy a given space at the same time. Another vital preventative method against COVID infection is environmental sterilization (remediation).

How will AIDS service organizations, already running on shoestring budgets, absorb the cost of the remediation needed to prevent COVID-19 and why are these sterilization procedures not being discussed as an overall strategy? Studies show that COVID-19 can remain infectious on different surfaces in different environmental conditions. The New England Journal of Medicine reported that studies showed the virus was detectable on copper for up to four hours, on cardboard for up to 24 hours, and on plastic and steel for up to 72 hours. Over these periods, the viruss genetic code begins to deteriorate, but were unsure how quickly this occurs and at what point it becomes non-infectious.

Well thought-out plans for protecting vulnerable populations need to be proposed and carried out through state and federal recommendations and mandates, stated Dr. Roscoe Moore, former Assistant Surgeon General and Board Member of the Global Virus Network of The Institute of Human Virology.

Federal, state, and municipal governments are implementing strategies, albeit slower than expected, to protect the elderly, immune-compromised, and people with underlining conditions such as those we see in a growing percentage of people living with HIV and AIDS from COVID-19 acquisition. Proven social distancing measures in combination with additional support for those at risk and effective remediation of support service centers including AIDS service organizations, will help keep new infections down and protect those at highest risk.

Regular cleaning of places people living with HIV frequent will no longer be sufficient in protecting those most vulnerable to COVID-19. These service providers will need to adapt new procedures that, through remediation procedures, will lessen the possibility of people becoming infected. Employing effective remediation of surfaces exposed to COVID-19 should be a priority along with other prevention methods.

One currently available method uses hypochlorous acid, which has been proven to be effective when dispersed in a electrostatic spray that completely covers any area being remediated for COVID-19. A second application of an antimicrobial being studied by independent labs, known commercially as SHIELD, is then disbursed, providing a molecular barrier to all surfaces from new containments for 90 days. The ionized microbicide clings to surfaces, which destroy viruses on contact. This method, performed by Germinator Mobile Sanitizing and Disinfection, should be evaluated for use at AIDS service organizations and other public spaces frequented by at higher risk individuals.

Another method was shown in recent studies by TheGlobal Virus Network, a coalition comprised of the worlds preeminent human and animal virologists in 32 countries. GVN announced in early June that two of its partners, the Peter Doherty Institute for Infection and Immunity in Australia, and the Rega Medical Research Institute of KU Leuven in Belgium, demonstrated that a quaternary ammonium sulfide biocide compound called BIOPROTECT inactivates SARS-CoV-2 (the coronavirus that causes COVID-19) on surfaces, providing continuous residual viricidal activity for at least 46 days. The tests conducted were designed to conform with the U.S. Environmental Protection Agency and equivalent standards of regulatory agencies in Europe and Australia.

The results of the tests conducted by the Doherty and the Rega Institutes demonstrate that BIOPROTECT eradicates SARS-CoV-2 on surfaces and provides continuous residual antimicrobial protection for an extended period of time, said Dr. Christain Brchot, president of GVN. Effective antimicrobials will be extremely important in containing the COVID-19 pandemic, given the time it will take to implement mass vaccination and fully develop novel therapies.This represents a significant breakthrough in inhibiting the spread of COVID-19 by preventing surfaces from being contaminated by the virus.

Remediation is in its initial stages of development for reducing new COVID-19 infections. Yet, theres still no guidance on evaluating and employing remediation methods at AIDS service organizations by HIV planning councils around the country or by leading AIDS advocacy organizations like the International AIDS Society, AIDS United, or the National Minority AIDS Council, and no current funding mechanism exists for remediating the predictable risk of COVID-19 exposure at these places through Ryan White CARE Act funding. Evaluating this important method of protecting those at greater risk should be a priority.

As we prepare for COVID- 19 sticking around for a while, its critical to ensure people living with HIV are not lost to another epidemic.

Jeannie Wraight is a health writer and frequent contributor to Plus. Follow her on Twitter @JeaWra.

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People Living With HIV Need a Safe Way to Access Services During COVID - HivPlusMag.com

Three key government blunders are to blame for the intensity of Israels new COVID-19 wave, a former Health Ministry chief has claimed.

We could have [had] a smaller second wave if we would have treated the situation better, Gabi Barbash, a former director-general of the Health Ministry, told The Times of Israel.

And he cautioned against pointing fingers at citizens for their conduct, suggesting that the buck should stop with leaders. The public is not clear of responsibility, but I was raised in the army, with the saying there are no bad soldiers, there are bad commanders, said Barbash.

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His comments come as the number of new daily virus cases, which had dropped to low double digits through most of May, is soaring to some 1,000 per day, and the number of active cases is at an all-time high of more than 11,600. New restrictions reducing gathering sizes at synagogues and event halls to 50 went into effect Monday morning, and the cabinet is to consider further restrictions on Monday evening.

Magen David Adom medical workers perform COVID-19 tests at a mobile testing station, in Jerusalem, July 5, 2020 (Yonatan Sindel/Flash90)

But Barbash, professor of epidemiology and preventative medicine at Tel Aviv University and former CEO of the Tel Aviv Sourasky Medical Center, says the government could have prevented things getting this bad. He said that while the current government brought together Likud and its former foe Blue and White ostensibly so they could deal with the emergency, it didnt help in any way, it didnt do anything good.

Barbash added: Its a corona government that is really not about the corona.

In his view, the government both failed to take preventative measures and went too far in easing restrictions in late April and early May, because it didnt stand firm in the face of pressure from the public. As a result they have taken steps they shouldnt have taken, he said.

The intensity of the second wave has largely been caused by management issues, according to Barbash, who added that Israel should have responded more and earlier.

Gabi Barbash, Director General at Tel Aviv Sourasky Medical Center, April 7, 2020. (Channel 12)

In his view, these are the three main mistakes that account for Israels current situation:

1. Dangerous gatherings

Barbash says the government unnecessarily rushed to allow a resumption of gatherings in synagogues, at event halls and elsewhere. Im talking about gatherings of high density people in closed environments, he said. Wherever this happens, this is dangerous.

He added: They should have not opened these things.

He said there is no need for protracted discussions over which places should be open and which shouldnt, as one simple rule should govern all decisions. The issue is not the place; its gatherings of more than 10 or 15 people, he argued.

2. Testing neglected

Israel has neglected the development of efficient testing, according to Barbash.

He said: Were still waiting two to four days to get answers for tests and not enough of the people [who test positive] are being subjected to an investigation by an epidemiologist to trace their contacts.

If people they have encountered arent tracked down and quarantined, part of the potential benefit of testing is lost, he noted.

Barbash acknowledged that thousands of tests are performed per day, but said that the long turnaround time means that valuable time is lost in putting people who encountered carriers into quarantine. He also believes that it makes some people hesitant to get tested, given than the wait for results can be long, and they are expected to self-isolate as a precautionary measure while their sample is in the lab.

3. Schools mismanaged

Israeli students and teachers wear protective face masks as they return to school, at Hashalom School in Mevaseret Zion, near Jerusalem, May 17, 2020. (Yonatan Sindel/Flash90)

When schools reopened in early May, children studied in small groups, smaller than regular classes, as a measure to stop the spread of the virus. But this so-called capsule arrangement was quickly stopped, and regular class sizes were restored.

According to Barbash this was a major mistake. Schools should have either stayed closed or allowed only 15 kids in classes, he said. Kids who are above nine should be treated like adults, and shouldnt gather in groups of more than 10 to 15.

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Where we went wrong: Expert says these 3 blunders caused new Israeli COVID chaos - The Times of Israel

By Lalit K Jha

Washington, Jul 8 (PTI) The use of hydroxychloroquine to treat coronavirus patients has become highly politicized in the US but it is used widely in India, a top White House official has said, asserting latest research showed the malaria drug is highly effective in early stages of COVID-19.

It''s the politicization of this medicine by the mainstream media and portions of the medical community that somehow made this a battle between President Trump and them and created this undue fear and hysteria over a drug, a medicine that has been used for over 60 years relatively safely and is regularly prescribed to pregnant women if they are going to a malaria zone, White House Office of Trade and Manufacturing Policy Director Peter Navarro told reporters.

The idea that this is a dangerous drug is just silly, but if you ask the American people based on the media''s coverage of it, that is kind of the state of play right now, he said.

Navarro said a day earlier four doctors at the Detroit Hospital System filed a request for emergency use authorization for hydroxychloroquine. The request was for three things.

One, for early treatment use in a hospital setting. Number two, treatment between a doctor and his patient in an outpatient setting. Three, not just as a therapeutic but also as a possible prophylaxis for preventative use, he said.

This request to the FDA comes on the heels of the publication of their study in the Journal of Infectious Diseases last week that showed an astonishing 50 percent reduction in the mortality rate for patients taking hydroxychloroquine, Navarro said.

Give hydroxy a chance, and please don''t contribute to hydroxy hysteria because if it''s prescribed under the supervision of a doctor, the odds that it can harm you are way, way smaller than the odds that it can help you, Navarro said.

This has become a highly politicized, but India uses this widely for prophylaxis. There is a number of studies which point to this actually working, White House Office of Trade and Manufacturing Policy Director Peter Navarro told reporters.

The official said if he were to show any kind of symptoms, he would first ask his doctor whether hydroxychloroquine is appropriate. And then I wouldn''t hesitate to take it, he said.

He said if one looks at the 14-day arc of the virus from the beginning of symptoms, the first seven days are critical: when a person may have fever, dry cough, possibly a profound sense of fatigue.

At that point, your lungs are still intact, and the virus is not appreciably spread to the rest of your organs. Hydroxychloroquine, based on the science in articles like the one that originally appeared in 2005 in the Journal of Virology, works in a therapeutic way by raising the alkalinity of your cells which slows the replication of the virus and also can kill the virus, he said.

It also has an anti-inflammatory effect, which is why it is used for rheumatoid arthritis, and the drug can therefore also help manage what is called the cytokine storm, he said.

The latest request to the FDA also comes on the heels of two decisions by the FDA over the last several months to shut down hydroxychloroquine.

The first was what is called a black box warning, the second was a withdrawal of an EUA and what I can tell you as someone who works with the Health and Human Services Department and FEMA to manage the stockpiles of hydroxychloroquine the FDA decisions that they made which I think were precipitous and based on bad science had a tremendously negative effect on two things, he noted.

One is the ability for American people to use this medicine to protect themselves and two, the ability for hospitals like the Detroit Hospital System to recruit patients for the kind of randomized blind clinical trials that everybody wants to settle once and for all the questions of efficacy and safety, he added.

FDA''s previous decision to reject the emergency use authorization, he said, was based on two types of studies. One set of studies that were poorly designed and basically doomed to failure, another set of studies where if you look carefully at the data it is very clear that these were late treatment studies where the medicine would not work, he added.

Navarro said the Detroit doctors are bringing back to the FDA a clear case for early treatment.

If the results of the Detroit study are confirmed in later studies, President Trump was absolutely right that hydroxychloroquine can save lives and if in fact early treatment use can lead to a 50 percent reduction in mortality that is tens of thousands of American lives that are at stake by a phenomenon which I call hydroxy hysteria, Navarro said. PTI LKJ ABHABH

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Hydroxychloroquine has become highly politicised in US but India uses it widely: White House official - Outlook India

As a result of these efforts and sustained public activism, HIV-related deaths in the United States have plummeted by more than 80 percent since 1995.

But even as we celebrate these achievements, inequities stand out in black and white.

While Black Americans make up just 13 percent of the population, they represented 42 percent of new HIV diagnoses in 2018. If youre a gay or bisexual Black man in the United States, you have a 50 percent lifetime chance of being diagnosed with HIV, compared with just 9 percent for gay or bisexual white men. In the American Southhome to the fastest-growing rates of HIV infection in the U.S. gay and bisexual Black men account for 60 percent of new diagnoses. Black trans women are more vulnerable still: As of last year, an estimated 44 percent of all Black trans women were living with HIV. Worst of all, Black people living with HIV/AIDS are seven times more likely than white people to die from the virus.

Read: The gay men who have lived for years with someone waiting on their death

These disparities are not random. Rather, they reflect centuries of discrimination. Persistent structural inequities in economic opportunity, education, and housing disproportionately expose Black families to serious health risks, including HIV/AIDS. And a lack of representation, combined with a painful history of racism in medicine, has undermined the Black communitys trust in health-care systems and made people less likely to seek care. The same disparities have become glaringly apparent as the world battles the coronavirus pandemic; Black Americans are dying at more than two times the rate of white Americans, and the death rate rises to sixfold in pandemic hot spots.

I started the Elton John AIDS Foundation in 1992 because I believe that everyone deserves the right to a healthy life, no matter who you love, who you are, or where youre from. Today, Im proud that it supports organizations that serve and uplift marginalized communities.

Some of our most inspiring partners are in my adopted hometown of Atlanta, home to 37,000 people living with HIVmore than 70 percent of whom are Black. These partners include Thrive SS, a self-help support network for gay Black men living with HIV/AIDS, and Positive Impact Health Centers, which offer HIV preventive care and treatment, as well as services for those struggling with mental health and substance abuse. To ensure continued HIV care and treatment during the pandemic, my foundation has helped organizations transition from face-to-face to virtual appointments and provided personal protective equipment for staff members and the people they serve, as well as at-home delivery of lifesaving treatments and HIV self-testing kits. This tackles the immediate needs, but not the long-lasting stigma.

Read: The LGBTQ health clinic that faced a dark truth about the AIDS crisis

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We Cant End AIDS Without Fighting Racism - The Atlantic

Editor: We have the medicine we need to slow the coronavirus. As we wait for COVID-19 vaccine and drug therapies, we have powerful tools to reduce the transmission of coronavirus. Washing hands, social distancing and mask wearing all slow the spread of the virus.

While we normally do not think of physical barriers and actions as preventative medicine, these are the tools we have available today. These are simple, effective, affordable and accessible tools in slowing the spread of coronavirus. They do not have side effects and have limited environmental impacts. They are being employed at a global level to slow the virus.

Economic research has shown that a national mask mandate would save 5% of the GDP. To support our economy, keep our schools open and maintain quality health care, wash hands, wear a mask and social distance. The pandemic has had a significant, long term economic and social impact on all Americans. The pandemic has left millions of Americans unemployed and reduced state and local budgets which will cause cuts in social, medical and infrastructure programs. The pandemic has closed schools, increasing the burden on working parents and compromising the education of American children.

Let's not amplify these economic and social costs. Use the tools available today to save money, jobs and lives tomorrow.

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Letters to the Editor: July 9, 2020 | Opinion - Sonoma West

Congress should make primary care a top priority for the Medicaid program, the nonpartisan Bipartisan Policy Center said in a report Monday.

The group called on Congress to support a comprehensive framework to improve primary care by directing HHS to help states share best practices and innovations and measure and report "spending on primary care as a percentage of total healthcare spending." In addition, Congress should fully fund the Primary Care Extension Program.

Lawmakers should also boost access to insurance coverage by allowing states to expand Medicaid. States could follow traditional expansion to adults making up to 138% of the federal poverty level and receive 100% matching federal funds, eventually phasing down to 90%. Or they could expand Medicaid coverage to people making 100% of the federal poverty level and receive 88% matching federal funds if they do it within two years.

Likewise, Congress should allow states to automatically enroll eligible people in Medicaid, Children's Health Insurance Program or marketplace subsidies. States would only be permitted to enroll people in marketplace subsidies if the subsidies fully covered an individual's premium costs. BPC also recommended creating a new option for states to sign up eligible adults in 12 months of continuous Medicaid coverage, preventing coverage lapses and reducing reporting for enrollees.

Congress should also mandate fee-for-service Medicaid to cover preventative care services with no cost-sharing to make sure beneficiaries aren't discouraged from seeking high-value care.

"Access to primary care can help individuals live longer and help avoid or delay the onset of costly chronic conditions such as diabetes, heart disease and cancer," according to the report. "Access to primary care can also help reduce more expensive care, including hospitalizations and emergency department visits."

Hemi Tewarson, director of the National Governors Association's health division, said during a panel discussion that she's concerned states won't have enough resources to invest in primary care because of the downward pressure on state budgets caused by the COVID-19 pandemic, which could have long-term ramifications on the U.S. healthcare system.

The Bipartisan Policy Center also recommended boosting Medicaid's matching federal funds to 100% for primary care services for five years if states pay for them at the Medicare rate. According to the report, higher reimbursements for primary care services would ensure enough primary care providers to deliver care to Medicaid enrollees.

Likewise, HHS should delay any changes to network adequacy requirements for Medicaid managed care organizations until the Medicaid and CHIP Payment and Access Commission develops data-driven access standards. According to the report, Congress should order HHS to regulate network adequacy for Medicaid MCOs "based on the new data-driven standard."

The Bipartisan Policy Center recommended several other actions to increase the primary care workforce, including increased federal coordination of workforce development efforts and more visa waivers for foreign medical graduates.

The report also includes a wide range of recommendations to address racial, ethnic and economic disparities in Medicaid. They include blocking implementation of the June rule eliminating nondiscrimination regulations, requiring HHS to issue guidance to states about how to pay community health workers to address chronic conditions and empowering HHS to approve Medicaid coverage of non-medical services to address the social determinants of health.

Congress created the Primary Care Extension Program under the Affordable Care Act to improve primary care quality, but it never funded the program. According to the legislation, it was supposed to transform primary care by educating "providers about preventive medicine, health promotion, chronic disease management, mental and behavioral health services, and evidence-based and evidence-informed therapies and techniques."

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Primary care should be a top Medicaid priority, think tank says - ModernHealthcare.com

IN March this year we reported Dr Jennifer Brown Tomlinson, medical director at Jamaica AIDS Support for Life (JASL), urging people living with HIV to ensure that they take their medication daily.

A compromised immune system, Dr Tomlinson cautioned, may not be able to function at its optimum to fight against the coronavirus.

Said Dr Tomlinson: People living with HIV who are on their antiretroviral medication have the same risk [of contracting the novel coronavirus] as the normal population. All of the precautions that are being advised for the general population also apply to people living with HIV who are adherent to their antiretovirals.

That very sound advice takes on more relevance now as we are being told by health experts that Covid-19 could cause an additional half a million AIDS deaths if treatment is disrupted long term.

That chilling projection was made Monday at the start of the virtual International AIDS Conference at which it was noted that the Covid-19 pandemic was jeopardising years of progress against HIV.

The United Nations (UN), in its annual report, pointed out that the world was already way off course in its plan to end the HIV/AIDS threat before the Covid-19 outbreak.

According to the UN, despite the fact that AIDS-related deaths have fallen by 60 per cent since the peak of the HIV epidemic in 2004, approximately 690,000 people still died from the virus and 1.7 million people were infected last year.

The emergence and spread of the novel coronavirus now means that the UNs target of reducing AIDS-related deaths and new HIV infections to fewer than 500,000 this year will now be missed.

A key contributor to that danger is that the pandemic is impacting access to preventative medicine among communities at risk because of lockdowns and distribution difficulties.

A report from the UN conference tells us that one model run in conjunction with the World Health Organisation (WHO) showed that if Covid-19 measures disrupted HIV treatment programmes for six months it could leave an additional 500,000 people dead.

Indeed, WHO Director General Dr Tedros Adhanom Ghebreyesus is reported as saying: We cannot let the Covid-19 pandemic undo the hard-won gains in the global response to this disease.

The information coming out of the UN conferences should not be lost on the just over 32,000 people living with HIV in Jamaica. Those who are not compliant with their medication need to heed Dr Tomlinsons advice. In fact, anyone living with HIV should not, in the first place, be in a position of non-compliance.

As it now stands, our health authorities, and indeed the government, need to ensure that the Covid-19 pandemic does not result in a shortage of antiretroviral medicines here.

For, while, as we have already stated, we are disappointed that Jamaica will not meet the Joint United Nations Programme on HIV/AIDS 90-90-90 target, which was set to be attained this year, we are encouraged that JASL has already achieved one of the targets and is close to the 2020 goal of having 90 per cent of its more than 730 HIV-positive clients virally suppressed.

Courtesy Jamaica Observer

Originally posted here:
Frightening projection of Covid-19s effect on HIV treatment - Trinidad & Tobago Express Newspapers

For decades, the premise of diets have revolved around what you eat.

Atkins dieters believe that carbs are the devil, keto dieters are all about that high-fat lifestyle, while Paleo dieters wont eat grains that didnt exist pre-agricultural revolution. Today, that focus has shifted to not what we eat, but when we eat.

Everything that happens in our daily life revolves around the time of the day, and as much as wed like to think that we have total control over our meals, a lot of what we eat and when we eat has been scheduled around work, appointments, and everything in between.

This pattern of eating means that people often find themselves eating at odd hours and often too close to bedtime, leaving their brains confused and their bodies struggling to keep up.

Like sleeping, how we process food is also deeply reliant on the bodys circadian rhythm. Essentially an internal daily timetable, the cycle responds primarily to light and darkness, with sleeping at night and being awake during the day being the most common example.

Chronically disrupted circadian rhythms not only affect sleep, but also prevent the body systems from working efficiently,leading to insulin resistance, fat storage, and increased risk of disease over time, which explains why the most widely touted preventative medicine today is at least eight hours of good sleep every night.

Chances are your eating pattern now lasts over 15 hours a day and well past dark, which clashes with the bodys release of melatonin and lowered insulin resistance as it prepares for sleep.

Like intermittent fasting, the circadian rhythm diet advocates time-restricted eating of your daily calories within an eight to 10 hour block when the sun is up, leaving a 14-hour fast between your last meal of the day and the first meal of the next day.

For this diet, experts have suggested swapping your dinner for breakfast. Instead of bagels or processed cereal, eggs and avocado with toast or a portion of salmon with pasta will help keep you more satisfied and less hangry thoughout the day, especially after the long overnight fast.

Lunch should be less heavy but with a good proportion of protein, fat, and healthy carbohydrates, while dinner should be the smallest meal of the day, especially as your bodys insulin sensitivity decreases before bed. Ideally, you should consume bout 75 percent of your nutrition before 3pm.

No one likes being hungry and thats why diets like these are hard to stick with. The team kindly suggested I gave this diet a go earlier this week and so quite begrudgingly, I sacrificed my happiness for the sake of an honest report and lasted all but two days. If youre someone whos used to small meals and lives for snacking in between, this diet will be a difficult one to get used to.

The reported benefits, however, make it worth it. When the body is depleted of sugar, it taps into the bodys reserves, such as the carbohydrates that get stored in the liver. Fasting overnight allows the body to convert fat to ketone bodies, which fuel the brain and heart. Besides, your body isnt struggling to digest your leftover pizza binge while also trying to repair itself. Youll also be more inclined to skip dessert after dinner, which is truly a habit we could all get behind.

Interestingly, the circadian rhythm works for exercising too; working out outside in the early morning can be a big mood booster, especially since thats when your cortisol levels begin to rise before peaking. To fight the midday slum, a quick visit to the gym brings oxygen back into the body after hours spent hunched over the desk while rushing deadlines. An evening sweat session, on the hand, is associated with lower stress levels,better endurance and improved anaerobic performance, like sprinting and resistance training.

Unlike many diets, the circadian rhythm diet isnt about skipping meals or cutting calories. Its about listening to what your body needs and not what your mind wants, and not eating during the time when you dont need fuel can make a whole lot of difference to how your body takes on the day, whether the sun is up or not.

Read the rest here:
Everything you need to know about the circadian rhythm diet - Lifestyle Asia

You might not be able to run to the local MMJ outlet to buy a cure-all for COVID-19, but cannabis is still on the menu, with at least two clinical studies underway evaluating CBDs for prevention and treatment of the novel coronavirus.

Even if it is not the panacea the world is looking for, use of MMJ is probably a lot safer than injecting disinfectant into your veins.

While studies for coronavirus therapies are in the infancy stages, some have shown promise blocking the virus, and as an anti-inflammatory agent for those afflicted with the disease. Two such studies, originating in Canada and Israel, have recently caught the attention of medicinal cannabis advocates hoping to further legitimize the herb as mainstream medicine.

The studies are not for an anti-virus vaccine, but as therapies that could enhance primary treatment and "prevention strategies" to deny the virus entry into the body or as an anti-inflammatory treatment that may help prevent acute respiratory distress for those afflicted with the disease.

The Canadian study is a collaboration between the University of Lethbridge, Pathway Rx, a Canadian pharmaceutical research company that develops cannabis therapies and Swysh, Inc., a cannabinoid-based oral health company.

In April, the group released a preclinical study for peer review titled, "In Search of Preventative Strategies: Novel Anti-Inflammatory High-CBD Cannabis Sativa Extracts Modulate ACE2 Expression in COVID-19 Gateway Tissues."

The study looked at hundreds of strains of cannabis and their effect on artificial lung, oral/nasal and intestinal tissue and their ability to modulate angiotensin-converting enzyme 2 (ACE2). According to researchers involved in the study, ACE2 is a receptor required for COVID to enter the cells.

"ACE2 may be the way COVID enters the cell," Heather Moroso, NMD said. "If you make more of it, it's basically like opening more doors for the virus to enter. If you make less or block ACE2, then potentially that's fewer doors for the virus to enter."

If the research proves successful, the resulting medications could be administered in the form of mouthwash, gargle, inhalants or gel caps, according to those involved with the study. Smoking cannabis, on the other hand, might exacerbate lung problems brought on by the virus.

"There is some evidence that smoking in general may make one more vulnerable to COVID," Moroso said.

Researchers say a fraction of the strains that have been tested have shown success in reducing virus receptors by as much as 73 percent.

Studies may have hit roadblocks though, as a lack of clinical trials and insufficient funding has kept the work in its infancy phase.

The Israeli study, a collaboration between InnoCan Pharma of Israel and Tel Aviv University, focuses on products using CBD-loaded exosomes to treat lung inflammation.

The exosomes could be safely administered without adverse reactions, creating a potentially safe delivery system via inhalation for a variety of lung infections in COVID patients. The study focused on CBDs in order to reduce patient impairment that may be caused by higher levels of THC in other forms of the drug.

While the studies represent something of a boon for cannabis advocates, locally, response to the reports is that it's "not ready for prime time."

To begin with, the Canadian study utilized artificial tissue models, so it is not clear if the results would be the same if conducted on living humans.

"The [Lethbridge] paper utilizes tissue models which are very far removed from human, or animal, organs in-situ and hence any conclusions must be taken with great caution," said a retired Tucson neuroscientist who declined to be identified for this report. "In my opinion, the results are extremely preliminary and may not have any relevance to the question at hand: adjunct therapies to combat COVID-19 infection."

There is also a problem of "confirmation bias," which means there may be a subconscious desire for a cannabis "miracle cure" that may lead to a loss of objectivity in processing the results of studies on the drug.

"Everybody wants cannabis to be a cure-all miracle drug," Moroso said, adding that while the state of Arizona does not recognize sleep issues as qualifying conditions, sleep can be an important aspect to stress reduction.

Additionally, during the current state of the pandemic, MMJ can have positive effects on patients experiencing anxiety over their lives and futures, as the economic and health impacts of a global pandemic make the future murky, at best.

"Cannabis can help people suffering from anxiety, depression and post-traumatic stress disorder," Moroso said. "The stress and anxiety of being in isolation; unknown job and family situations; domestic abuse and isolation? I'm not a rocket scientist, but sensible use of the drug can help reduce the anxiety."

Go here to read the rest:
Cannabis and Coronavirus - Tucson Weekly

BASKING RIDGE, N.J., July 09, 2020 (GLOBE NEWSWIRE) -- electroCore Inc.(Nasdaq: ECOR), a commercial-stage bioelectronic medicine company, announced today that Dan Goldberger, Chief Executive Officer, will participate in three upcoming investor conferences:

Maxim Group/M-Vest COVID-19 Virtual Conference Series: Re-Engaging Medical Practices in an Era of COVID-19Format: panel discussionDate: Thursday, July 16Panel 2, Cant Touch This! Time for These Devices to Shine!Time: 12:30pm 1:45pm ET

To access the panel discussion, please RSVP HERE

Zooming with LD MicroFormat: corporate presentation followed by 1x1 virtual investor meetingsDate: Tuesday, July 21Time: 8:00am 8:40am PT

Investors can register for the presentation HERE.

Canaccord Genuity 40th Annual Growth ConferenceFormat: 1x1 virtual investor meetingsDate: Tuesday, August 11

About electroCore, Inc.

electroCore, Inc. is a commercial-stage bioelectronic medicine company dedicated to improving patient outcomes through its platform non-invasive vagus nerve stimulation therapy initially focused on the treatment of multiple conditions in neurology. The companys initial targets are the preventative treatment of cluster headache and migraine and acute treatment of migraine and episodic cluster headache.

For more information, visit http://www.electrocore.com.

About gammaCoreTM

gammaCoreTM (nVNS) is the first non-invasive, hand-held medical therapy applied at the neck to treat migraine and cluster headache through the utilization of a mild electrical stimulation to the vagus nerve that passes through the skin. Designed as a portable, easy-to-use technology, gammaCore can be self-administered by patients, as needed, without the potential side effects associated with commonly prescribed drugs. When placed on a patients neck over the vagus nerve, gammaCore stimulates the nerves afferent fibers, which may lead to a reduction of pain in patients.

gammaCore is FDA cleared in the United States for adjunctive use for the preventive treatment of cluster headache in adult patients, the acute treatment of pain associated with episodic cluster headache in adult patients, the acute treatment of pain associated with migraine headache in adult patients, and the prevention of migraine in adult patients. gammaCore is CE-marked in the European Union for the acute and/or prophylactic treatment of primary headache (Migraine, Cluster Headache, Trigeminal Autonomic Cephalalgias and Hemicrania Continua), Bronchoconstriction and Medication Overuse Headache in adults.

In the US, the FDA has not cleared gammaCore for the treatment of pneumonia and/or respiratory disorders such as acute respiratory stress disorder associated with COVID-19.

Please refer to the gammaCore Instructions for Use for all of the important warnings and precautions before using or prescribing this product.

Investors:

Hans VitzthumLifeSci Advisors617-430-7578hans@lifesciadvisors.com

or

Media Contact:

Jackie DorskyelectroCore973-290-0097jackie.dorsky@electrocore.com

Continued here:
electroCore to Participate in Three Upcoming Virtual Investor Conferences - BioSpace

Louisiana is now one of the leading states in the nation for most new coronavirus cases.

It ranks third in the U.S. this week for most new cases per capita on a rolling seven-day average, according to new data from Harvards T.H. Chan School of Public Health. Its a trajectory that could spark another shutdown. But you wouldnt know it by listening to state Rep. Danny McCormick.

The Constitution is being shredded before our very eyes, McCormick claimed in a video he released this week railing against the new mandate to wear a mask in public in Shreveport. Kenner and Jefferson Parish have also announced mask mandates, which are already in place in New Orleans and Baton Rouge.

McCormick represents parts of Caddo Parish, including Shreveport, where 243 people have died since the pandemics outbreak and where Black people have died at twice the rate of white people. Its also one of the parishes with the highest rates of new daily COVID-19 cases per capita in the state.

In the video, McCormick says mask mandates one of the key preventative measures to prevent the spread of the coronavirus, especially in urban hotspots such as Shreveport are an attack on liberty. Then he attempts to destroy a mask with a chainsaw.

McCormick also makes the goading claim that people who dont wear masks will be treated like Jews in Nazi Germany.

While other Republican leaders Texas Gov. Greg Abbott among them have shifted to embracing mask mandates, McCormick isnt the only Louisiana politician to attack mask-wearing. Thats despite the swelling pandemic and medical consensus that theyre not just helpful, but imperative.

Congressman Clay Higgins represents Lake Charles and Calcasieu Parish, one of the most worrying regions in the state, and has repeated conspiracy theories about the coronavirus, made false claims about the efficacy of masks, and called wearing a mask part of the dehumanization of the children of God.

In Lafayette, another alarming hot-spot, Mayor-President Josh Guillory rejected a mask mandate this week. He claimed he made the move based on the information Im getting on the medical task force, but The Advocate reported the task force wasnt asked for its opinion and would actually support such a mandate.

Republicans in Baton Rouge spent most of the legislative session resisting requests to wear masks. And it appears that many people across the state have been doing the same.

Louisianas startling trajectory

Louisianas jump to the top of the list for most new coronavirus cases cannot be explained by increased testing. Hospitalizations grew by more than 50 percent over the last two weeks, and the percentage of positive tests in the state has also been rising. On Thursday the latter rate hit 12 percent positive over the 10 percent threshold set by the state for safe opening in Phase 2. The 7-day rolling average is 8.7 percent, according to AH Datalyitcs.

But that could already be too high. The World Health Organizations recommended goal is 5 percent. A high positivity rate indicates that the viruss spread is too great for contact tracing to work and thats assuming contact tracing is actually being broadly embraced by the public, which hasnt been the case in Louisiana.

Dr. Vin Gupta, an assistant professor of pulmonary and critical care medicine at the University of Washington, is among the medical experts warning that contact tracing is now useless across much of the U.S. because the virus has already spread too widely.

On Wednesday, Gov. John Bel Edwards said the state has lost all the gains made in June and is now seeing some numbers that rival our peak back in April.

And while Texas, Florida and Arizona are seeing higher increases in hospitalizations, Dr. Thomas Tsai, a surgeon and assistant professor at Harvards School of Public Health, said it could be a matter of time.

My worry is that Louisiana may just be a few weeks behind Texas and Arizona and Florida, unless more concerted efforts are taken, he said.

Its unclear whether theres public appetite for that or even to abide by the guidelines already in place. Health officials say that as the state reopened too many people have ignored public health guidelines, particularly around wearing masks and keeping distance. Bars in particular have become a key source of outbreaks.

Frankly, it's been really, really frustrating. Because just a few weeks ago, we were in a really, pretty good place, said Suan Hassig, an infectious disease epidemiologist at Tulane University.

The curve is going to bounce back up if we don't keep jumping on it and stomping it down.

The plea of local public health leaders

If Louisianas hospitals are overwhelmed, if deaths once again spike, and if more people contract a virus that were learning could have long-term impacts on major organs including the brain and the heart, it wont be because public health leaders across the state havent been sounding the alarm.

Amanda Logue, the chief medical officer for Lafayette General Health, released a video on Facebook last week talking with another hospital leader about the alarming rise of COVID-19 cases in Acadiana. She said her hospital had seen about a 200 percent increase in hospitalizations over the last three weeks, which really correlated with the timing of Phase 2.

For Lake Charles mayor Nic Hunter, the time has come to plead with the public to take the advice of local health leaders.

God help us if we've come to a point in our society where during the middle of a pandemic, he said, if we want to know medical or scientific information, we are trusting a meme on Facebook, or what my brother-in-law overheard at the supermarket, more than guys like Dr. Tim Haman and Dr. Mac Jordan.

Hunter was introducing Haman and Jordan the head physicians of two Lake Charles hospitals in a video on Monday. The Lake Charles area has the highest rate of new cases in the state. Hospitalizations for COVID-19 have doubled from their previous peak in April. And the rate of positive tests has hit 25 percent.

All three denounced the polarization of mask-wearing, and Haman said he hates that masks have become a political football.

We wear them in the hospital all day. We wear them 10 to 12 hours at a time here. So I don't think it's asking too much of someone to wear a mask for 20 minutes while you're in a grocery store, he said. I think it puts people at risk. We don't think anything of following traffic laws, wearing seatbelts, holding the door for somebody.

Haman fears the consequences if people dont change their behaviors.

We are approaching the situation we're seeing in other cities like San Antonio and Houston where the healthcare system is on the verge of being overwhelmed, he said.

How New Orleans became a relative bright spot in the state

Whats happened in Louisiana is the same story across the country: Areas that werent initially hit hard by the pandemic in the spring are now seeing an exponential growth in cases.

According to Harvards data, 26 parishes in Louisiana and the entire state are past a tipping point where stay-at-home measures should be implemented.

Amid that, New Orleans is now one of the bright spots in the state, with some of lowest rates of new cases. But even here, the trajectory is in the wrong direction.

On Wednesday, Mayor Latoya Cantrell announced new restrictions based on trends in new cases and hospitalizations. Now, bar seating is prohibited in restaurants and bars only table seating is allowed. Private indoor events are being limited to 25 people.

And theres now the added worry of another shortage of test supplies.

New Orleans has had to nearly cut in half the number of daily tests it performs for free at its mobile testing site, amid rising demand. The citys mobile testing sites have run out of spots even before they opened twice this week.

Dr. Jennifer Avegno, director of the citys health department, said shortages in materials needed for the machines that analyze the tests are to blame, along with surging cases across the country.

My great concern is that if there's a shortage, there's a shortage. And I don't know how they're prioritizing where they're sending the materials, she said.

Testing is also being cut back by some hospital groups in the state Ochsner Health is now only testing people with symptoms. And while Louisiana has been testing far above its goal of 200,000 tests per month, the Harvard analysis suggested that in order to suppress the virus, that could need to be quadrupled.

For Steven Procopio, the Policy Director at the Public Affairs Research Council of Louisiana, the one bright spot in the exponential growth of cases is that deaths so far have not followed the same trajectory.

It may be because of the younger ages of people who are getting it, or we have better treatments, or it just could be there's a lag and we havent been hit, he said.

Hassig, the epidemiologist, said she wants to see mask mandates in every urban area. It could be that local leaders will be forced to make that call, because the governor has so far said he wont implement such a requirement statewide.

Link:
Louisiana's COVID-19 Surge Is Among The Worst In The U.S. And Some Leaders Are Still Fighting Mask - WRKF