Data collected from the Association of American Medical Colleges shows that from 2018 TO 2020 UNDs medical school ranked in the 100th percentile higher than any other school in the database for the fraction of its graduating medical student class to identify as American Indian. In recent years prior to 2018, the school ranked in the 99th percentile.

In its nearly 50-year history, the INMED program has produced almost 1,000 American Indian health professionals, including more than 250 physicians.

I like to say that an organization like the UND SMHS (School of Medicine and Health Sciences) is characterized by not just what it says, but also by what it does, Joshua Wynne, vice president for Health Affairs at UND and dean of the medical school, said in a statement. The INMED program is a testament to our commitment to deliver on the imperative to move toward more health equity implicit in former President Nixons Special Message on Indian Affairs.

Nixon gave that policy speech 50 years ago this month on July 8, 1970.

Donald Warne, director of the INMED and master of public health programs at the UND medical school, said the policy speech not only paved the way for reversing the federal governments termination policy, which had rescinded the sovereignty of American Indian tribes, but strove to improve American Indian health in several ways.

Warne said people, including his students, are sometimes surprised to hear that Nixon was instrumental in promoting tribal sovereignty. The 1970s was an important decade for indigenous rights, including taking over management of schools from the Bureau of Indian Affairs and improved access to and control over tribes' health care needs. The 1970s also brought the American Indian Religious Freedom Act, which reversed a law that had made indigenous religious practices illegal in the 1880s.

In the 1970s, it was kind of a renaissance of American Indian policy and law, Warne said.

Nixon's policy reversal also played a direct role in creating UNDs Indians Into Medicine program, which was founded in 1973. The program was originally established through federal appropriations. The programs mission is to improve American Indian health and produce more American Indian health care providers, from physicians and physical therapists to occupational therapists and public health researchers.

I think without federal support, this would not be as successful as it is, Warne said, noting there is a long way to go to address disparities in education and health. But at least at UND, we're doing our part.

The medical school is also launching a new doctoral program in indigenous health, the first of its kind.

I think in many ways, the University of North Dakota is well positioned to be the national leader in medical education, and public health education and doctorate level, health professions education really for many years to come, Warne said. Our starting point is really a national leader, but I envision a lot more growth from here as well.

Read this article:

UND continues to lead the nation in American Indian physicians - The Dickinson Press

TCU and UNTHSC School of Medicine associate professor Amber Heck, Ph.D., has been chosen as the 2020 recipient of the International Association of Medical Science Educators (IAMSE) Early Career Award for Excellence in Teaching and Innovation.

I am honored and humbled to receive this award and to be chosen by my colleagues and mentors within IAMSE, Heck said in a news release from HSC.The award honors an IAMSE member who has made significant innovations, particularly with respect to teaching, in the short time they have focused their careers toward enhancing teaching, learning and learner assessment, according to their website.

Heck teaches physiology at the Fort Worth medical school and her responsibilities include curriculum design and development and active learning facilitation in cell biology and physiology. Heck joined the IAMSE in 2016 as a fellow and is currently an active member of the organizations scholarship committee.

I have watched the careers of past winners as well as their innovations and contributions to medical education, Heck said. I am thrilled to be now be mentioned in the same group as them. The IAMSE has pushed awardees to continue to pursue innovative projects in the field of academic medicine and I plan to continue to do that.The TCU and UNTHSC School of Medicine, Fort Worths M.D. school, opened with a class of 60 students in July 2019. FWBP Staff

Read the original:

Fort Worth M.D. School faculty member wins award for excellence in teaching and innovation - fortworthbusiness.com

(Credit: Unsplash)

This article was exclusively written forThe European Sting by Mr. Abdul-Rahman Toufik, originally from Ghana and currently a third year medical student at Sumy State University, Ukraine. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSAs view on the topic, nor The European Stings one.

The study and practice of medicine has always been an integral part of the life of man. Records of practices from as late as 500AD 1500AD have been discovered and coined down by archaeologists and researchers alike. As mankind reached into the stages of industrial revolution in the early 1200s, so did the improvement in other fields follow suit medicine included. The first ever medical school in the USA established in 1765 in the University of Pennsylvania went on to admit students wishing to pursue a course in the field.

Admission at that time was quite unique as most of the admitted were the majority from more prominent backgrounds. Their minority counterpart rarely had such opportunities as studies then was more practical based and the resources used in practical work and research was quite expensive. People started to have the opportunity to delve into medicine both men and women, old and young. The earliest records of admission into medical schools has shown that the majority of the admitted were men with women making up only a few. As the years progressed this has not been the case anymore. There has however been always been discrimination against some of the applicants. The earliest of such recorded were women back in the late 90s. As this practice almost became the norm, a law was passed in the 1970 in the US which addressed discrimination against women thereby paving the road for them to pursue their dream of being a medical practitioner.

In contrast to the situation back then in the USA and most parts of the world, white women in the UK have more chances of being admitted to medical schools than their ethnic counterparts as stated by McManuss analysis conducted in 1998 concerning admission to medical schools in the UK. Caribbeans remain more disadvantaged than African and Indians less than their Pakistani and Bangladesh counterparts. Even if their grades were brought into account, that gave no assurance of some of them getting a chance to be admitted. In addition, according to McManus analysis, student who in their motivation letters did not give or show earnest interest in the field were not considered for admission. The same goes for older applicants. There has been cases of this in the US and other parts of the world.

Moreover, a study conducted by Yale university researchers in the US found that some students of different genders, race and sexual orientation were discriminated against not only by their fellow students but by the medical faculty as well. Most of the affected were female, multiracial, lesbian, gay and bisexual students.

The world is now a globalized place with people from almost all ethnic backgrounds, gender, age and sexual orientation found in every part it. Knowledge and expertise in a particular field is something everyone is capable of if given the proper guidance and resources. One of such fields is the medical field and it is a very crucial field for the continued survival of mankind.

References

1)Cole, S. (1986). Sex discrimination and admission to medical school, 1929-1984. American Journal of Sociology, 92(3), 549-567.

2)McManus, I. C., Richards, P., Winder, B. C., & Sproston, K. A. (1998). Clinical experience, performance in final examinations, and learning style in medical students: prospective study. Bmj, 316(7128), 345-350.

3)Hill, K. A., Samuels, E. A., Gross, C. P., Desai, M. M., Zelin, N. S., Latimore, D., & Boatright, D. (2020). Assessment of the prevalence of medical student mistreatment by sex, race/ethnicity, and sexual orientation. JAMA Internal Medicine, 180(5), 653-665.

About the author

Abdul-Rahman Toufik comes from Ghana and is currently a third year medical student at Sumy State University, Ukraine and the academic committee chairman for the national Union for Ghanaian Students in Sumy.

Read more:

Are medical students with equal access to the medical profession? - The European Sting

When Shelter-In-Place was ordered in March, and Campbell University moved all instruction to online, Meredith Culbertson was an MS-III enjoying rotations at Cape Fear Valley Health providing care and learning in the hands-on, dynamic atmosphere that is the rich reward after two years in lecture and lab. Meredith shares the challenges COVID-19 brought to the second half of her third year and the anxieties she and her classmateshave as they prepare to apply for residency

What is the difference between MS-I/II years and MS-III/IV years of medical school?MS-I/II years are primarily lecture and lab instruction. When we apply to med school and throughout our first two years, all many of us do is dream about getting into the hospital finally getting to clinical rotations. The reason we stress and study ridiculous hours those first two years (and then those excruciating months at the end of 2nd year when we are preparing for boards) is to make it to clinical rotations its like a mini graduation! Its a huge victory, and you feel proud of what we are doing.

For me, I believe the amount we learn in clinical years is enormously different and more helpful. Now when I see a question, I can actually picture that patient because Ive had that patient. I feel very confident about how to treat that patient in real life or in a board style question because now I have had that experience. COVID-19 ripped that away from us and put us back into first and second year.

As MS-IVs, typically we would spend months on away rotations in preparation for applying for residency in the spring. Medical schools nationally are struggling to figure out what the process is going to be and most of us are very stressed about our schedules and requirements. We just dont know if we are even going to be able to do away rotations. I am pursuing Emergency Medicine, and we need a specialized Standardized Letter of Evaluation (SLOE) without it you struggle to get into certain programs. Emergency Medicine Resident Association (EMRA) is working with all the program directors to be more lenient like other residencies (family medicine, pediatrics, etc.) to accept letters from non-residency emergency departments to help us through the application process. Theyare limiting everyone to one ED rotation tomake sure everyone across United States has at least one rotation through an emergency department with a residency before the Match. So, for my class when it comes to The Match, there are just a lot of unknowns and that heightens the stress and frustration.

How did COVID-19 change your MS-III year?

I feel like COVID-19 has stolen our education from us because what weve been doing the past few months is not real rotations. It was very frustrating for us because we felt like we went backwards back to the classroom and lectures in front of a computer versus being in the hospital learning from life experiences. Many of us struggle to learn from books and lecture, but excel in clinical. For me personally, I really excelled for 8-9 months on rotations, and I struggled to not loose motivation and inspiration when that was suddenly taken away.

So, a lot of us were very frustrated and were complaining especially in the beginning when everything was constantly changing. But, we had to remind ourselves that we are the lucky ones because we still have opportunities to help people in other ways some people signed up to babysit, to deliver groceries, we did a pediatric supply drive and we will soon have jobs that will make a huge difference.

How would you say you have been affected personally?

I am a very sociable person and being kinda isolated doing everything remotely has been hard. It definitely messes with your psyche sometimes. I knew going into this career theres a chance that we might get sick and even really ill I feel like I know that better than most because Im immunocompromised. This is not your normal sickness. We all need to be careful and abide by the guidelines, but sometimes its really hard and frustrating when all you want to do is to get back into the hospital and help.

Also, my sister is a physician in Colorado. She has MS and had COVID-19 for a month. Shes had to live separately from her husband since that time because he is an anesthesiologist and early on had to provide his own PPE. It was very stressful for them living a part and making sure she didnt get reinfected. So, as students, we have to remember people like them and consider ourselves lucky and not complain because it could be so much worse.

What do you think we can learn from COVID-19?

I think its been a learning experience for everyone on how to grow and learn with the new normal. We cant be mad with what has happened. There are still so many opportunities for us to help in other capacities and thats all we can do right now. Sit down and get through the grunt work knowing that at some point we will get back what we had. We just have to look at the here and now and hope the best for the future knowing were all in this together.

Your MS-III year officially ended on June 30th. What was that last month like?I just tried to focus on studying for boards fingers crossed my boards dont get cancelled. I will have to travel to Louisville, KY to take them. I continued taking my dog to the park and survived another month on alternative schedule.

I was supposed to be on surgery my last month as an MS-III. This is what I shared on Facebook the last day of rotations:Today is bittersweet. We are doing the right thing by sheltering in place due to COVID-19, but today was supposed to be the start of my last rotation in the hospital as. 3rd year medical student. Instead of doing surgeries in the hospital, I am making the most of it by hunkering down in the books, practicing my skills, and watching surgeries. We must stay positive and find new ways to challenged ourselves and continue our education to advance our medical careers. So, this month, I will not complain, but make the best of itvirtual surgery.

Now, I am back in the hospital and its been great, but also very weird. Its like riding a bike. You learned how, but youve lost some of the skill, so youre stumbling through how to do it again and now there are lots of new guidelines especially in the emergency department.

N 95 masks do give you bruises, but I dont care that I get bruises or feel tired because this is what I want to do. I love learning something new every day and working hard. I get to be in a place that I feel I belong, and I fit in with a great group of people that are just like me. There are amazing people here at Cape Fear Valley Health who go above beyond.

Im still very nervous about this residency application season and how it will unfold with all four of my audition rotations being canceled. I have a lower board score, so I wanted to make sure I can show them in person how I excel in hopes they will look past my board score. Again, its just very much an unknown, but we have some really good attendings who are understanding and working with us, so Im hopeful.

See the original post:

Reflections on COVID-19: The Impact on MS-III's | Blogs | Campbell University - Campbell University News

Arizona has expanded its coronavirus testing capacity thanks to several partnerships with universities and labs. But test results are taking up to two weeks for some individuals meaning a lot of people who dont have COVID-19 are quarantining while awaiting results.

Doctor Shad Marvasti with the University of Arizona College of Medicine Phoenix says that until labs are able to return test results faster, anybody who gets a test should isolate themselves until they no longer have any symptoms.

"(If) you have no fevers or any other symptoms, or youre feeling better, you could tentatively begin resuming activities," Marvasti said. "Being more cautious in terms of your contact with the elderly, those with chronic conditions, and as all of us should be doing, wearing a mask in public and keeping our distance."

COVID-19 statistics from across the country are showing that states with mandatory mask orders are faring better than states without including Arizona.

Marvasti says Arizona is a global hotspot of the disease and not having a statewide mask mandate makes the state look foolish.

"(Other states) have the statewide mask mandate, and yet we have this crisis and are a hotspot and we dont, doesnt seem to make common sense to me," he said. "I think we also need to add with the ordinances, and I this varies from city to city, some kind of fine or fee to help ensure enforcement."

Short of another shutdown, Marvasti says mandatory face masks would be the most effective way of reducing infection rates across the state.

Read The Latest News On The Coronavirus Disease

Continued here:

Expert: Mandate Masks, Speed Up Test Results In AZ - KJZZ

Note: This is part of a series of stories about former Michigan State players who have gone on to interesting or unique post-basketball careers. Previously: Adam Ballinger, artist; Delvon Roe, actor; Anthony Ianni, public speaker

Four decades later, the memory of his first practice against Earvin Magic Johnson is a vivid one for Michael Longaker.

As a sophomore guard for Michigan State in 1977-78, Longaker was among those tasked with defending the Spartans star newcomer. He spent that day exhausting himself while chasing the bigger and more athletic Johnson around Jenison Fieldhouse.

But the challenges didnt stop even when practice did. After leaving the court, Longaker balled up the tape on his ankles and threw it in a wastebasket. Johnson promptly grabbed the ball of tape and boasted he could sink the wastebasket shot from further away.

I was like Oh my gosh, what a nightmare, Longaker said. That was a window into how competitive Earvin was at everything.

While they competed in practice, the two teamed up to help Michigan State win the schools first national title in 1979. Johnson was the face of the team, while Longaker was a role player helping keep Johnson and others sharp in practice every day.

After Michigan State, the two teammates went to California and found plenty of professional success.

Johnson, of course, won five NBA titles and three MVP awards in his Hall of Fame career for the Lakers.

Longaker, meanwhile, settled in Northern California and became a leader in a different field: medicine.

I do something very different from my teammates, I imagine, Longaker said this week from his office.

Longaker has spent the last two decades at Stanford University, where hes a professor at the School of Medicine and the co-director of the Institute for Stem Cell Biology and Regenerative Medicine. His work focuses on scarring and how to regenerate skin and improve wound healing.

Its a field of study far different than the matchup zone he worked to master under Jud Heathcote. But playing and studying at Michigan State, he said, set him up for a successful career in medicine.

I cant overstate the role that Michigan State has played in my career, Longaker said.

Longaker spent four years at Michigan State working hard in practices like that first one and fighting for playing time on some immensely talented Spartans teams.

His contributions were often not seen on box scores. Later in his career, Heathcote started asking Longer for his thoughts before and during games. He saw Longaker as a potential future coach.

Longaker, though, had other career plans. He initially planned on going into dentistry, but a summer spent doing research with James Potchen, then the chair of Michigan States Department of Radiology, sold him on a career in medicine.

Heathcote ended up writing a letter of recommendation that helped Longaker get into Harvard Medical School. But even then, he still held out hope to see his former player on the sideline one day.

I said Coach, Im kind of committed to being a physician, Longaker said.

Longaker finished medical school with the intent of becoming a pediatric heart surgeon. But during a year of research during his residency at the University of California, San Francisco, he was assigned to work under a doctor who operated on children before they were born and asked to investigate how embryos heal wounds.

His findings, that embryos heal without scars in their first two trimesters, set his career on a different course. One year of research turned into four, then was followed by more training in New York and Los Angeles before he landed at Stanford in 2000.

Now, most of his work is in directing a lab that focuses on skin and the skeleton, developing techniques to use stem cells to improve wound healing and prevent scarring. His work has earned him numerous awards and hes been an inventor on over 40 patents and patent applications.

Its been great, Longaker said. I couldnt have predicted it.

That world is far removed from that of Michigan State basketball, but Longaker finds ways to bridge his past and his present. He has two sons who follow the program closely he was elated this week in the afterglow of commitments from Emoni Bates and Max Christie and typically attends multiple games per year. Tom Izzo didnt join Heathcotes staff until after Longaker left, but the two have developed a friendship over the years.

Longaker has also become involved with the sports program at his employer (he attended the 2013 Rose Bowl wearing a split T-shirt featuring both Stanford and Michigan State) Former Stanford running back Bryce Love, the 2017 Heisman Trophy runner-up, worked in Longakers lab while completing his degree in human biology, and Oscar da Silva, an All-Pac 12 forward for the Cardinal, counts Longaker as his academic mentor.

One of Longakers recent trips back to East Lansing was last year, for the 40th anniversary of the 1979 national title. And when that team meets again in another decade, Longaker hopes his smarts can help reverse the outcome of that first practice way back when.

I always joked with my teammates, at our 50-year reunion, Im going to dominate, Longaker said.

View original post here:

Michael Longaker won a national title at Michigan State, then dove into the world of medicine - MLive.com

More residents are pursuing fellowship each year, according to data from the National Resident Matching Program. The decision to opt for additional trainingin lieu of going straight into practiceis a personal one. It is also one that residents must make early on in their training as they plot their career course.

A recent resident who opted to skip fellowship and become an attending physician offers his insight on the answers to five questions that informed his decision and could be helpful to other medical and surgical residents.

After three years as an emergency medicine resident at McGovern Medical School at the University of Texas Health Science Center in Houston, July 1 marked the first day in the emergency department as an attending physician for Jason Lesnick, MD. He opted to go directly to practiceaccepting a position in the emergency medicine department at nearby Memorial Hermann Northeast Hospitalinstead of pursuing a fellowship position.

The decision to pursue a fellowship is all about what you plan to do eventually, Dr. Lesnick said. For emergency medicine, you dont need to a fellowship. A lot of my friends who do orthopedic surgery, almost all of them subspecialized, whether they want to do hip or ankle or upper extremity [surgery], there are multiple chances for them to get additional training beyond residency and thats sort of the standard for their specialty.

Learn the top five factors fellowship program directors look for in applicants.

Training longer will mean you have less time to maximize your income. When pondering fellowship, you should consider your potential income losses by extending training and the potential gains your additional training could yield. Dr. Lesnick noted that physicians are significantly behind the curve when it comes to savings relative to their peers who are typically working and saving some of their take-home pay during the time that doctors spend accruing more debt in medical school.

Dr. Lesnick has interest in potentially working in C-suite positions down the road, which could be something a physician trains for with a one- or two-year administrative fellowship. Still, he felt much of that experience could be gained outside of a fellowship, and by going into practice his salary is a multiple of what it would have been during fellowship.

If you do a two-year [administrative] fellowship, theyll pay for your MBA as well, he said. The problem is the cost of an MBA plus the salary you would make as a fellow is still significantly less than what you can make as a community physician. My plan is to get my MBA on my own and that still keeps every option open for me while keeping me from losing a large sum of money potentially available to me.

Learn how much youll spend looking for a fellowship.

In choosing to eschew fellowship, Dr. Lesnick considered geography. He wanted to stay in the Houston area and begin building a life with his fiance. As a recent chief resident at one of the larger emergency medicine programs in the city, he was confident he could secure an attending position in the area.

The experience [of pursuing fellowship] is obviously an incredibly valuable opportunity, Dr. Lesnick said. The learning that could come from it, the mentorship and connections are very valuable. But, by having done residency in a big city and having worked with people in a large program already, I was looking at it in the sense that I already had those connections. So that aspect was less of a factor for me.

I was really not interested in moving from Houston right now. Im very happy here with my fiance. We didnt see much of a point in moving for one maybe two years and having to move again after that, eventually.

Learn how the choice to subspecialize differs by gender.

Deferring income to pursue fellowship means that you are also likely to wait on paying down your loans in any significant fashion. Dr. Lesnick saw that as a con of going for a fellowship position.

By continuing to live like a resident while collecting an attendings salary he believes he can pay down his loans entirely in around two years.

Loans feel like hundreds of thousands of little weights you carry around with you, Dr. Lesnick said. Theres pressure I feel to want to get that done with as soon as possible and by going straight into practice without a fellowship I will be able to do it much faster.

Learn the three items you should have on your loan-repayment checklist during residency.

Seek out physicians and mentors whose opinions you value and get their input on what additional value a fellowship could offer.

The most important thing is to talk to multiple people who have been there and done what you want to do and ask them do you think its worth it for you to do, Dr. Lesnick said. For those who have already done it you can ask would you go back and do it again?

Ultimately, Dr. Lesnick said, you shouldnt skip a fellowship if its what you have your heart set on.

You have to take a good long hard look in the mirror and ask yourself what are your future goals? Dr. Lesnick said. If a fellowship is necessary to reach those goals, you wont be happy unless you do it. If you are pursuing a career that doesnt require a fellowship, I would posit that it might not be worth your time.

With summer application deadlines for several subspecialties looming, make use ofFREIDAa recently revamped comprehensive AMA tool that captures data on more than 12,000 residency and fellowship programs accredited by the Accreditation Council for Graduate Medical Education.

Continue reading here:

Thinking about fellowship? Ask yourself these 5 questions - American Medical Association

Were aiming for the week of July 27 to have all that available. The week prior would be essential communication that needs to go out, for example, if were under Plan B, there is some communication wed like to push out a little bit earlier in regards to how the students will be grouped because that is high-priority info for parents to know, and then follow up that next week, the week of the 27th, with more detailed plans for each area.

KCS is operating as is much of the state on three plans for the potential re-opening of schools. Plan A is 100 percent attendance on campus. Plan B is 50 percent and Plan C is completely online learning.

Gov. Cooper is expected to make an announcement this week on what the official plan will be. Schools can place more harsh restrictions than Cooper allows, but they cannot lighten them.

KCS Superintendent Chip Buckwell said he has heard Coopers announcement could come as soon as Tuesday, but it could also come Wednesday or Thursday.

The general consensus is the announcement will be Wednesday, and if that is the case, or if it happens Tuesday, KCS is planning a meeting Thursday morning with Cabarrus Health Alliance to consult on the plan and then there will be another Board of Education Meeting on Monday at 2 p.m. for the Board to approve or disapprove of the plan officially moving forward.

Here is the original post:

KCS says they're well prepared for Gov. Cooper's announcement on school re-openings, now they just need official guidance - Independent Tribune

Three years ago, Michael Osterholm laid out in a book the scenario of a global influenza pandemic originating in China that portended the current COVID-19 situation with eerie accuracy. Though Osterholm did not know when such a pandemic would occur, he was certain it would.

When [a pandemic] happens, Osterholm wrote, it will spread before we realize what is happening. ... And unless we are prepared, it would be like trying to contain the wind. Infectious disease is the deadliest enemy faced by all of humankind.

Now that COVID-19 has emerged as that enemy, Osterholm has been in constant demand. Regional, national, and international mediaincluding CNN, MSNBC, CBS, and even irreverent comedian and podcast host Joe Roganhave sought him out repeatedly. The Washington Post and New York Times have published his op-eds. The Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services, and the World Health Organization all seek his counsel.

Osterholm has deep knowledge of infectious diseases, a long track record of being ahead of the curve in understanding their impact, and a decided knack for distilling complex situations into comprehensible terms. Along the way, he has raised visibility for the University of Minnesota and the School of Public Health (SPH) as a source of credible, reliable information at the heart of a global pandemic.

A teacher and a mentor

After completing his bachelors degree at Luther College, Osterholm did his graduate work at the University. He began working at the Minnesota Department of Health (MDH) as a graduate student in 1975 and rose to the level of state epidemiologist in 1984, a position he held for 15 years.

He founded the U of Ms Center for Infectious Disease Research and Policy (CIDRAP) in 2001. He wanted to ground policy in solid science, with the mission to prevent illness and death from targeted infectious disease threats through research and the translation of scientific information into real-world, practical applications, policies, and solutions.

I wish I had 10 Michaels to raise the profile of the importance of prevention around the planet.

Throughout his long tenure, Osterholm has taught. Hes a Distinguished Teaching Professor in the Division of Environmental Health Sciences in the School of Public Health and an adjunct professor in the medical school. The single most important thing I do is teaching, which Ive been doing for 44 years, he says.

Mikes been able to train many people in a variety of roles to work in different capacities, says Kristen Ehresmann, director of the Infectious Disease Epidemiology, Prevention and Control Division at MDH.

Back in 1979, as an SPH graduate student, Ehresmann became a research assistant under Osterholm at the MDH. Three decades later, shes leading what she calls the guts of the response to COVID-19. Shes quoted nearly daily in the media, offering both cautions and explanations.

In addition to Osterholm and Ehresmann, media have sought out at least a dozen more SPH alumni and faculty to interpret and analyze various aspects of the coronavirus pandemic. A group of faculty and students have also worked with the MDH on models employing the most recent data to map and predict the spread of the pandemic to help hospitals prepare for potential spikes.

SPH dean John Finnegan says its not surprising that health authorities and the public are looking to the University for this expertise or that U of M alumni are fortifying the ranks of those responding to the pandemic.

Finnegan has been especially proud of Osterholms role lately. He says, I wish I had 10 Michaels to raise the profile of the importance of prevention around the planet.

Explore the CIDRAP COVID-19 podcasts.

Read the original:

And then it happened - UMN News

Medical experts weigh in on whether or not to send kids back to school in the fall

While many politicians have been weighing in, FOX 4 Asked the medical experts for their opinion.

DALLAS - Now that Texas is leaving it up to parents to decide whether to return to school or continue with a virtual education, many parents are struggling to decide which decision is best for their child.

While many politicians have been weighing in, FOX 4 Asked the medical experts for their opinion.

The doctors agree that unlike other respiratory illnesses, it is rare for children to become seriously ill from COVID-19. However, that is not necessarily the case for their teachers or their grandparents they may see outside of school.

Dr. Albert Karam, a Dallas pediatrician, says with only six months of data on COVID-19, there is no right, wrong or easy answer. He recommends parents weigh the risk versus benefit for their families.

Medication risks versus benefit. Most of the time, the benefit outweighs the risk, he said. In this case with school, we know kids need not only cognitive learning, behaviorally, socially, these kids physically, emotionally need each other the way our country has run for 100 years now.

Dr. Mark Casanova, president of the Dallas County Medical Society, says other countries have been able to successfully reopen schools. But that is likely due to widespread compliance with mask-wearing and physical distancing in their societies as a whole.

Their mask-wearing and physical distancing have been different than here in U.S. Can it be done? Yes. We are seeing evidence of that, Dr. Casanova said. But it needs to be done as part of a package deal.

Dr. Julie Linderman, a pediatrician at Inwood Village Pediatrics in Dallas, says the CDC data on death rates paints an interesting picture. At the height of the death rate, the line for 0 to 24-year-olds stayed flat, while it increased with each older age bracket.

Kids are by far the least affected population, which is really counter-intuitive because typically with respiratory illness kids in the past have been the most affected group, she said.

Dr. Linderman says when schools reopen, teachers should still social distance from other teachers. Families should be cautious if their households include grandparents or those at high risk. She believes reopening schools to in-person attendance is important for children's overall wellbeing.

There are a lot of parents who can do some virtual school. Maybe one parent stays home or has a flex schedule, she said. But there is a huge percentage of the population that does not have that ability. The kids really suffer.

Dr. Linderman recommends that once children return to school, it would be wise for them to physically distance themselves from their grandparents while wearing masks.

Read more:

Medical experts weigh in on whether or not to send kids back to school in the fall - FOX 4 Dallas

Visit the News Hub

This episode of 'Show Me the Science' focuses on monitoring and identifying pathogens that might jump from animals into humans

Scientists prepare to take a skin biopsy from the wing of a bat as part of a health check in Peru. Wildlife biologists, infectious disease experts and others, including scientists at Washington University School of Medicine in St. Louis, are proposing a decentralized, global wildlife biosurveillance system to identify before the next pandemic emerges animal viruses that have the potential to cause human disease.

A new episode of our podcast, Show Me the Science, has been posted. At present, these episodes are highlighting research and patient care on the Washington University Medical Campus as our scientists and clinicians confront the COVID-19 pandemic.

The virus that causes COVID-19 is thought to have originated in wild bats that live in caves around Wuhan, China. Many devastating epidemics in recent years including SARS, Ebola and HIV/AIDS were caused by animal viruses that spilled over into people. Before another pandemic begins, a diverse group of infectious disease experts, ecologists, wildlife biologists and other experts say that a new, decentralized, global system of wildlife surveillance must be established to identify animal viruses in wild animals that have the potential to infect and sicken people.

In this episode, Jennifer A. Philips, MD, PhD, an associate professor of medicine and co-director of the Division of Infectious Diseases at Washington University School of Medicine in St. Louis, and Gideon Erkenswick, PhD, a postdoctoral research associate in Philips lab and director of Field Projects International, discuss why we need an early-detection system for viruses that have the potential to trigger the next pandemic and how it would work.

The podcast Show Me the Science is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Experts propose decentralized system to monitor wildlife markets, other hot spots

Full Transcript

[music plays]

Jim Dryden (host): Hello, and welcome to Show Me the Science, a podcast about the research, teaching and patient care as well as the students, staff and faculty at Washington University School of Medicine in St. Louis, Missouri, the Show Me state. My name is Jim Dryden, and Im your host this week. Weve been focusing these podcasts on the COVID-19 pandemic and Washington Universitys response. This week, were discussing where COVID-19 might have come from and how to detect the next virus with pandemic potential before it spreads. Its thought that the virus that causes COVID-19 may have originated in wild bats that live in caves around Wuhan, China. Like many devastating epidemics in recent decades from Ebola to HIV/AIDS, its thought this pandemic was triggered by an animal virus that spilled over into the human population. Now, a diverse group of infectious diseases experts, wildlife biologists, ecologists and others, including researchers at Washington University School of Medicine in St. Louis, is proposing that a global system of wildlife surveillance could and should be established to identify viruses from animals that have the potential to infect people.

Jennifer Philips, MD, PhD: Its hard to say how often it happens, but its happened enough in our history, and when the wrong pathogen enters the human population where we dont have adequate immunity, then the cost to human life can be enormous. And as weve seen the social disruption that is caused can also be really tremendous.

Dryden: Thats Washington University infectious diseases specialist Jennifer Philips, one of the authors of a new article on biosurveillance published in the journal Science. Shes part of the international team proposing that we pay closer attention to emerging infectious diseases by monitoring wild animals around the world. It would have been very difficult to do this sort of work even 10 years ago, but Gideon Erkenswick, a postdoctoral researcher in Philips laboratory, who also is a director of Field Projects International, a research organization focused on studying wildlife, says it is possible now to do complicated surveillance even in very remote places.

Gideon Erkenswick, PhD: There is and have been few groups that have been doing this work. Theres been a lot of hand-waving from individuals that have recognized for a long time how important biosurveillance is, but theres not been a lot of commitment to it internationally. For example, we still dont have any standardized international regulation on the movement of wildlife that reflects disease risks.

Dryden: Currently, there are scientists studying animals stationed in many places around the world. Erkenswick says with the technology now available, it would be possible to put resources together to learn more about potentially emerging viruses before they can cross from some of those animals into humans. He says a decentralized, global wildlife biosurveillance system would have the potential to identify viruses that could cause human disease before the next pandemic emerges.

Erkenswick: You would have diverse groups of people who are trained and cognizant of the risks we are now all very aware of, especially with SARS-CoV-2. You would be collecting samples from bats. You would visit caves, you would go into natural habitat, collect samples in wildlife markets. You probably would collect samples from rural communities where theres a lot of overlap between wildlife habitats, and then you would bring them to a nearby location where, again, using safe technique you extract RNA and DNA and directly on-site sequence for conserved regions within viral genomes. You can prescreen things fairly rapidly for the presence of an infectious agent.

Dryden: So without getting too terribly technical, what kind of tools would those be?

Erkenswick: So the kind of things were talking about in terms of new technology are portable sequencers. Theres a new sequencer thats literally the size of a USB stick and can fit in your pocket, and you can carry that to a rainforest, and then you sequence it right on the spot. If you do encounter something like SARS-CoV-2, if you chance upon it, do you really want to be collecting it, storing it, bringing it all over the place before you figure out if theres something potentially worrisome in it? The ideal situation is, on the spot, you can safely assess whether there is something there.

Dryden: And its not as simple as looking for sick animals in this cave or in the wet market because the viruses that would affect us like SARS-CoV-2 may or may not make the animals sick, correct?

Philips: Right. Thats absolutely true. So especially bats are able to tolerate a lot of viruses without necessarily being sick. And so just sampling sick animals is not really an adequate way to do biosurveillance. There have been a small number of government-funded biosurveillance efforts. And these programs are really sort of groundbreaking in beginning to do this kind of work, and they have done amazing work, but theyre very focused and localized so the sampling is quite intermittent in just certain locations. And theres just few regional labs that do the analysis. And so there hasnt thats, I guess, the start of whats needed, but it hasnt really provided the kind of global sampling that is probably needed. Or touched upon the variety of environments in wildlife markets and in the wildlife trade, where humans and wildlife do come into contact with one another. And I think the other point thats worth making is that these biosurveillance systems that we do have right now, because theres sort of no global consensus, no global effort, theyre subject to political whims of a few countries.

Dryden: Now, how common is it that animal viruses can cross over into humans? Its not uncommon, correct?

Philips: When it happens, we only know about it if there is really transmission between humans or ongoing transmission, or if we happen to identify an individual whos sick and comes to medical attention and actually gets a rare diagnosis. So we dont know how many times it necessarily happens, but we know its happened many times in our lifetime. So even in the last 20 years, this has happened at least three times in the case of coronaviruses, starting with the SARS epidemic and then MERS and now, of course, SARS-CoV-2, the virus that is causing the COVID-19 pandemic. And its not restricted to coronaviruses either, so other viruses in our lifetime have transmitted infection and those include HIV and Ebola among others. Its hard to say how often it happens, but its happened enough in our history. And when the wrong pathogen enters the human population where we dont have adequate immunity, then the cost to human life can be enormous. And as weve seen, the social disruption that is caused can also be really tremendous.

Dryden: So where does the idea for a decentralized, global surveillance system come from?

Erkenswick: There is and have been few groups that have been doing this work. And theres been a lot of hand-waving from individuals that have recognized for a long time how important biosurveillance is, but theres not been a lot of commitment to it internationally. For example, we still dont have any standardized international regulation on the movement of wildlife that reflects disease risks.

Philips: Well, I think this came together because we really brought together a group of individuals who have really diverse expertise and interests, people with human, animal and environmental expertise, with the understanding that all of these things are really inextricably linked together. We thought that bringing this group of people together was important to try to come up with ideas of how we could prevent this kind of thing from happening again in the future. And, as a group, we brainstormed what could be critical next steps to create more effective biosurveillance infrastructure, I would say. Thats something that would have to be practical, affordable. It has to be safe for people who are doing the biosurveillance or the sampling. It has to be feasible. But one thing thats really happened in the last five years is that theres more affordable and portable technology that could really be implemented more widely around the world and could take advantage of the local expertise at, really, sites of wildlife-human interface.

Erkenswick: Thats why we did it. We felt there was a need for this diverse group of peoples voices to be heard in a collective way. You want to go to places where theres no theres very little overlap between human communities and wildlife populations. So you know whats natural because it is totally normal for a species to have their own viruses and bacterial infections, and they cope with them, and they survive just fine, and theyre not necessarily infectious to us. So you want to know whats in the natural system, then you want to know whats different when these animals, wildlife and humans are in contact.

Dryden: Now a system like this would do surveillance of wild animals like bats, certainly, but what about domestic animals, even pets?

Erkenswick: Domestic animals and pets are very much part of that human-wildlife interface. If you live in the rainforest in Southeast Asia and you have a dog or a cat, and its roaming around and goes into the forests and attacks a primate or a bat, so yeah, absolutely. And you want to know if that exchange is being mediated by domestic animals, absolutely.

Dryden: What sorts of global biosurveillance systems do we have in place now, if any?

Erkenswick: In the lead up to this article, some of the things we did was contact a lot of colleagues we know throughout the world that do wildlife research in Madagascar, in Indonesia, in Peru, in Ecuador and we just literally surveyed friends and associates, Where do you take animals when theyre sick? And in almost every situation, it was, Nowhere. We dispose of things. We collect things. We store them, but really theres nobody offering to do this work, and its expensive. Here in the U.S., we have just vaulted forward on our capacity to do pathogen screening. I mean, in high school, you have kids running PCR machines and extracting DNA and in some cases sequencing DNA. In places where zoonotic risks are greatest, you just have light microscopes. Its not that the capacity to do genetic or genomic-based pathogen detection couldnt be there. There are smart people with a lot of experience that just dont have the tools. And the idea behind this paper is that it can be done affordably. We can utilize all of those people on the ground to do much better biosurveillance.

Dryden: If they have the equipment in place, is it easy to know that this is something that can cross over from one species to another, or do you know that it can make people sick when people start getting sick?

Philips: Theres not one answer to that question. Part of risk assessment builds upon all the knowledge that our virologists have built up over the years. So for some microbes or some viruses that we know are related to viruses that infect humans like coronaviruses, then we start to learn something about that. And we can make some predictions. We know whether a population of viruses now that are circulating in bats have the sequence that would allow them to attach to the receptors that would enable them to infect human cells. Or we may know something about whether theyre dissimilar enough from circulating viruses that humans might lack immunity to those viruses. So sometimes it builds upon the knowledge that we have. And then sometimes we can take new viruses and see whether they do infect human cells in the lab, or even just whether if we replace the sequence of a virus that we work within the lab with a sequence thats circulating in the wild, how would that impact its ability to infect human cells or to infect an animal model. And then I think theres a lot of unknown about just what is circulating and what is the potential. And so part of it is starting to gain more information about that interface.

Dryden: So this is a way to identify viruses, but can knowing about these viruses keep us safer, maybe even prevent this type of outbreak next time?

Philips: Yeah. I think especially and this is very much what happens with influenza. I think thats the case where its most developed. And one can certainly see with coronaviruses that having this information allows you to stay ahead in terms of therapeutics and interventions. So hopefully, we will have effective therapeutics. Well have monoclonal antibodies, maybe, and vaccines that work for SARS-CoV-2. And we would like to have more broadly neutralizing antibodies or broadly effective therapeutics. And we can ensure that we stay ahead of whats in the wildlife population, right, that interface. Weve had three epidemics in 20 years. Its not that rare an event. So we should be trying to make sure that we can stay ahead in terms of our therapies and our interventions.

[music plays]

Dryden: Erkenswick, Philips and their colleagues around the world have proposed better biosurveillance, but governments and funders still need to cooperate to make the idea a reality. But considering the thousands who have died and been hospitalized and the millions of jobs lost due to the pandemic, perhaps setting up such programs to screen for viruses would be a money saver in the long run. They say that as humans and animals continue to interact in new ways and in new locations, its virtually certain other animal pathogens also will cross over to humans in the future. But without a decentralized, global system of biosurveillance, it wont be possible to predict how and when that will happen.

Show Me the Science is a production of the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis. The goal of this project is to keep you informed and maybe teach you some things that will give you hope. Thanks for tuning in. Im Jim Dryden. Stay safe.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

Related press release here

See more here:

Podcast: Wildlife surveillance may help identify the next pandemic - Washington University School of Medicine in St. Louis

Even as COVID-19 cases surge across the nation, hospitals and physician practices are working to figure out how to bring back some non-emergency services and procedures that had been put off for months. Questions remain about what this new normal will look like. For one thing, virtual care is here to stay, says Dr. Richard Isaacs, CEO and executive director of the Permanente Medical Group, and president and CEO of the Mid-Atlantic Permanente Medical Group, Kaiser Permanentes two largest medical group practices. He expects roughly 60% of Kaiser members visits will be virtual in the future. He recently spoke with Modern Healthcare Managing Editor Matthew Weinstock. The following is an edited transcript.

MH: How are your medical groups handling the recent spike in cases?

Isaacs: Ive been very impressed with the physician groups on both coasts, and in (Northern) California, we were one of the first areas that received patients from Japan via plane, and also via ship. This was around the middle of February, and we learned (a lot) about coronavirus, and it was unprecedented. There was a fair amount of uncertainty, and there continues to be uncertainty, but we helped lead the states effort in dealing with these patients, who were scheduled to be disembarked from the ship and be repatriated to Travis Air Force Base. However, the Department of Defense felt that, at that point, it was a national security issue, so we were involved in repatriating COVID-positive patients to various hospitals across Northern California, and about 50% of our hospitals received the first COVID patients here in Northern California. We were very much involved in the suppression strategies, and we were excited because early on we flattened the curve like nowhere else on the globe. California was the front-runner in preventing (the spread of) this disease.

However, over the last three to four weeks, weve been seeing another surge of the disease across the entire state of California, and (more than) half of the states are currently surging.

MH: What does that mean for practices that are trying to balance the surge, but also bringing back non-emergency procedures?

Isaacs: Early on, we continued to take care of all of the patients who had essential needs. We took care of all emergencies, all cancer surgeries were managed, which was about 50% of our normal volume in Northern California, which we did in February, March and April. About three weeks ago, as the shelter-in-place orders were lifted, we started opening back up. We take care of 4.5 million members in Northern California and another 800,000 in the mid-Atlantic region. We have patients who have been waiting for their elective care. The biggest challenge for me right now is the delay in screening. When people were sheltering in place, they werent getting their typical mammography, colorectal cancer screening, so theres some queuing of patients who really need to get this essential screening care.

MH: How do you start building that back into the routine?

Isaacs: The priority has been patient safety and also staff safety. Were working very hard to ensure that we maintain social distancing in the medical office buildings and in the hospital, and that we encourage people to come in when theyre healthy. We do screening at the entry of every medical office. If someone has symptoms of COVID-19 or they have fever, we take care of them in a different setting. So the goal is to keep COVID-free medical offices and manage patients for their essential needs.

MH: Youve talked about battling the pandemic on two endsCOVID-19, but also the pandemic of fear. How are you talking to patients about coming back when they may be fearful of exposing themselves in a medical setting?

Isaacs: The medical office is the most trusted place where you can be, because we have regular processes that sterilize and sanitize the hallways and the medical examination rooms. People are doing essential grocery shopping. Its much safer to be in a Kaiser Permanente facility than in any place in the community today.

MH: Kaiser was at the forefront of using telehealth even before the COVID crisis. How has that grown during the pandemic?

Isaacs: We started our video-first strategy in March. We knew that patients were sheltering in place, and there was that pandemic of fear. We encourage patients to pursue the video-first strategy and see their primary-care physician on video. Were currently doing close to 80% of all examinations and medical care on a video-first platform, and the patients who need to be seen are then triaged into the appropriate venue for care.

Were seeing tremendous satisfaction with the care from home. We deliver supplies and medications right to their front door, and its hugely satisfying for our membership.

MH: Are there specialties where you started offering telehealth because of the pandemic that you hadnt done before?

Isaacs: The Permanente medical groups have been leaders in telemedicine. The first foray was dermatology, and in a pre-COVID world, 90% of all initial dermatology consults were being done via video or secure message with a photograph. Were very experienced with telemedicine, but in the COVID world, with sheltering in place, it pretty much spanned every specialtypediatrics, OB-GYN, primary care, family medicine, mental health, internal medicine are all doing large percentages of video visits, and my job now is to harvest all of these learnings from the COVID experience, because this is an incredible way to deliver care. Im very pleased, and the doctors are excited, because its very user-friendly for the physician, their care team, and also the patients.

MH: Does this become the new norm post-COVID? How does that permanently transform what youre doing?

Isaacs: I believe its going to completely transform. Its the integration of technology with care delivery, and we will have the ability to do video 24/7, 365, and ideally, youre having a video with a patient and a physician who knows you very well. With our electronic medical record system, were able to connect all 12.5 million members that we take care of across the United States. We have all of their information at our fingertips. If a patient needs a physician or advice at 2 in the morning on a Saturday, they can reach us and get a video visit with a provider who will have all of their information.

MH: How do you address it from a physician-training standpoint? How do you make everybody on your team feel comfortable doing it on an ongoing basis?

Isaacs: We developed protocols for how to do video care effectively, and we train our physicians in the appropriate technique. Obviously, this is a secure environment. We want the patients to understand that its a one-on-one evaluation, and we just provide the environment for the physicians to do their job.

As we learn in medical school, the majority of all diagnoses are achieved (when) taking the (patients) history. The physical helps clarify some things, but the majority of diagnoses are made during the initial contact and conversation.

MH: Do you expect your physicians will return to an office setting, or will they be doing most of their work remotely now?

Isaacs: Were trying to determine whats the appropriate mix. I think that there will always be a need for face-to-face and office examinations. Right now, its looking like 60% of all visits in the future could be done via video, with an exam for the other 40%, when needed.

MH: Getting back to the surge in cases, how are you managing burnout and morale among your physicians?

Isaacs: I talk a lot about the trifecta of uncertainty, which does contribute to some burnout, because we dont know how long this is going to last. The trifecta is: When will there be a vaccine? When will we have enough herd immunity that we can go back to some semblance of normalcy? Thats No. 1.

No. 2 is the uncertainty of the economic recovery, and it looked like we were heading back toward job recovery about three, four weeks ago in several states, and now the governors are talking about sheltering in place again.

The third uncertainty, and unfortunately this whole COVID-19 with the economic sequelae, (helped reveal) the racial unrest, social injustice, and (expose) years of systemic racism in this country.

As far as the burnout goes, its really about collaborating as a team. Were all in this together, and the Permanente medical groups are integrated multispecialty groups that actually care about each other, and more importantly, care about the care delivery to the population. Its amazing to see how our subspecialists have really risen to the occasion and are supporting everyone in primary care, as theres been a shift in burden from some specialty care to primary care.

My job is to make it easy for people to do the right thing. Having the resources, the tools, the technology helps eliminate some of that burnout, and just knowing that youre in this together has been very helpful.

More here:

Dr. Richard Isaacs: Video-first doctor visits are here to stay - ModernHealthcare.com