12345...102030...


I’m the head of a medical school. But doctors like me are going back to the frontline – The Guardian

There has been a lot of public debate over the last few weeks over the role scientists are playing during the coronavirus crisis. In the space of just a few weeks, the likes of Chris Whitty, chief medical officer for England, and Patrick Vallance, the governments chief scientific adviser, have become household names.

As Covid-19 spreads around the world, scientists are taking a prominent role in advancing public knowledge about the virus by advising world leaders, providing expert comment in the media and urgently researching new ways of tackling the pandemic. We are lucky here in the UK: the scientists we have at the moment are as good as it gets. Whitty is a professor of epidemiology this is what he does.

But as this crisis deepens the role of researchers will become even more fundamental as many are now being called upon to join the NHS frontline. Thankfully, we understand within the community that research can go on hold. Whats more, much of it has to because of social distancing.

We have taken the decision to release all our clinical staff from academic and research responsibilities at UCL, where I am head of the medical school, as part of a national effort to staff hospitals. These are medically trained staff, who work across the faculties of population health, medical, life, brain and engineering sciences. I expect we will see the same measures enacted soon nationwide. The medical community needs to do everything possible in response to this epidemic.

In nearly 35 years as a doctor, the coronavirus pandemic is like nothing I have witnessed a global crisis, which will likely overload the health service in every country if it hasnt already done so. By this, I mean, health services will be overwhelmed by the demand put on them by the number of patients requiring treatment. I fear we have to see doctors and nurses working double, or even triple shifts. Many, themselves, will of course get sick, and will have to self-isolate, further compounding the problem.

My work at UCL requires me to look after the largest group of biomedical scientists in Europe. Two weeks ago, I started a regular, albeit occasional, clinical service as a consultant respiratory physician at Londons University College hospital alongside this. I always enjoy leaving the desk work behind and returning to my roots as a clinician. As things progress, I am in no doubt that I will spend more and more time on the frontline.

My first week working in the wards was unremarkable. But by week two last week everything had changed. The ward became eerily quiet. Very few patients were referred to the respiratory team as we prepared for the expected influx of patients infected with the Covid-19 virus. Patients were moved to different wards or different hospitals, personal protective equipment arrived and the infectious diseases team grew overnight.

Then, the patients with Covid-19 started to arrive. As expected some were well, some poorly and new unexpected challenges emerged. Can a patient who is a contact of a patient with Covid-19 have an MRI scan? How can we get a patient home if their carer(s) are unwilling to look after them?

We live in unprecedented times, at least for my generation of 50-something doctors. We are three-four weeks behind Italy and the full force of the pandemic is about to break in the UK which it is thought will not peak until mid-June. The horrific images that we see from Italy are likely to play out here. Of course I might get ill myself, but this is a challenge faced by everybody. Ideally, I hope I will be fine, but if I get it, I get it. I will self-isolate and hope I am fine.

The demand for beds and intensive care facilities, the difficult decisions with limited resources and the pressure on staff, will all build over the coming weeks and months. I have heard that many colleagues have offered to volunteer and have received numerous positive messages from our hospital colleagues. The government has said it will provide training for anyone who feels it is necessary.

Our senior students will also be given the opportunity to help and dozens of other highly skilled scientists working in our labs with relevant transferable skills will also be freed up. But UCL is not mandating this, it will be down to individual choice.

Whatever may happen over the coming weeks and months, I have never been so pleased that we have a joined-up public health structure, a top down NHS, dedicated and loyal staff from across the clinical field and the brightest and best-informed people advising the government on the way forward. Everyone is now stepping up in this new healthcare environment: health professionals doing what they do best. We are professionals, this is what we do. This is our moment. We have to step up and deliver.

Prof David Lomas is vice provost (health), UCL and head of UCL medical school

More:

I'm the head of a medical school. But doctors like me are going back to the frontline - The Guardian

Thousands of medical students are being fast-tracked into doctors to help fight the coronavirus – CNN

');$vidEndSlate.removeClass('video__end-slate--inactive').addClass('video__end-slate--active');}};CNN.autoPlayVideoExist = (CNN.autoPlayVideoExist === true) ? true : false;var configObj = {thumb: 'none',video: 'health/2020/02/20/coronavirus-how-it-unfolded-lon-orig-ja-tp.cnn',width: '100%',height: '100%',section: 'domestic',profile: 'expansion',network: 'cnn',markupId: 'large-media_0',adsection: 'const-article-carousel-pagetop',frameWidth: '100%',frameHeight: '100%',posterImageOverride: {"mini":{"width":220,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-small-169.jpg","height":124},"xsmall":{"width":307,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-medium-plus-169.jpg","height":173},"small":{"width":460,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-large-169.jpg","height":259},"medium":{"width":780,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-exlarge-169.jpg","height":438},"large":{"width":1100,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-super-169.jpg","height":619},"full16x9":{"width":1600,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-full-169.jpg","height":900},"mini1x1":{"width":120,"type":"jpg","uri":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-small-11.jpg","height":120}}},autoStartVideo = false,isVideoReplayClicked = false,callbackObj,containerEl,currentVideoCollection = [{"title":"Here's how the novel coronavirus outbreak unfolded","duration":"02:32","sourceName":"CNN","sourceLink":"","videoCMSUrl":"/video/data/3.0/video/health/2020/02/20/coronavirus-how-it-unfolded-lon-orig-ja-tp.cnn/index.xml","videoId":"health/2020/02/20/coronavirus-how-it-unfolded-lon-orig-ja-tp.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-large-169.jpg","videoUrl":"/videos/health/2020/02/20/coronavirus-how-it-unfolded-lon-orig-ja-tp.cnn/video/playlists/coronavirus/","description":"With tens of thousands of infections and more than 4,000 deaths across dozens of countries, the virus' rapid spread has caused quarantines, production issues for global brands and travel restrictions.","descriptionText":"With tens of thousands of infections and more than 4,000 deaths across dozens of countries, the virus' rapid spread has caused quarantines, production issues for global brands and travel restrictions."},{"title":"Is delivery dangerous? Can I go outside? Your Qs answered","duration":"03:42","sourceName":"CNN","sourceLink":"","videoCMSUrl":"/video/data/3.0/video/health/2020/03/20/coronavirus-town-hall-questions-answered-mh-orig.cnn/index.xml","videoId":"health/2020/03/20/coronavirus-town-hall-questions-answered-mh-orig.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319201203-03-coronavirus-town-hall-0319-large-169.jpg","videoUrl":"/videos/health/2020/03/20/coronavirus-town-hall-questions-answered-mh-orig.cnn/video/playlists/coronavirus/","description":"At CNN's coronavirus town hall, doctors answered your questions about testing, a possible antidote and social distancing.","descriptionText":"At CNN's coronavirus town hall, doctors answered your questions about testing, a possible antidote and social distancing."},{"title":"Dr. Fauci: There is no 'magic drug' for coronavirus","duration":"01:52","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/health/2020/03/20/anthony-fauci-coronavirus-no-magic-drug-sot-vpx.cnn/index.xml","videoId":"health/2020/03/20/anthony-fauci-coronavirus-no-magic-drug-sot-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319204643-dr-anthony-fauci-coronavirus-town-hall-03192020-large-169.jpg","videoUrl":"/videos/health/2020/03/20/anthony-fauci-coronavirus-no-magic-drug-sot-vpx.cnn/video/playlists/coronavirus/","description":"In a press conference, President Donald Trump said a drug called chloroquine could be a "game-changer" in treating coronavirus. Dr. Anthony Fauci, National Institute of Allergy and Infectious Diseases Director, says u003ca href="http://www.cnn.com/2020/03/19/health/us-coronavirus-case-updates-thursday/index.html" target="_blank">he doesn't think it was described that way.u003c/a>","descriptionText":"In a press conference, President Donald Trump said a drug called chloroquine could be a "game-changer" in treating coronavirus. Dr. Anthony Fauci, National Institute of Allergy and Infectious Diseases Director, says u003ca href="http://www.cnn.com/2020/03/19/health/us-coronavirus-case-updates-thursday/index.html" target="_blank">he doesn't think it was described that way.u003c/a>"},{"title":"Dr. Fauci: Testing asymptomatic patients is not the highest priority ","duration":"02:29","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/health/2020/03/20/coronavirus-testing-accessibility-anthony-fauci-cooper-vpx.cnn/index.xml","videoId":"health/2020/03/20/coronavirus-testing-accessibility-anthony-fauci-cooper-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200315102410-01-fauci-presser-0314-large-169.jpg","videoUrl":"/videos/health/2020/03/20/coronavirus-testing-accessibility-anthony-fauci-cooper-vpx.cnn/video/playlists/coronavirus/","description":"Dr. Anthony Fauci answers common questions concerning coronavirus testing availability in a CNN Town Hall hosted by u003ca href="/profiles/anderson-cooper-profile" target="_blank">Anderson Cooperu003c/a> and u003ca href="/profiles/sanjay-gupta-profile" target="_blank">Dr. Sanjay Guptau003c/a>.","descriptionText":"Dr. Anthony Fauci answers common questions concerning coronavirus testing availability in a CNN Town Hall hosted by u003ca href="/profiles/anderson-cooper-profile" target="_blank">Anderson Cooperu003c/a> and u003ca href="/profiles/sanjay-gupta-profile" target="_blank">Dr. Sanjay Guptau003c/a>."},{"title":"Here's how the novel coronavirus outbreak unfolded","duration":"02:38","sourceName":"CNN","sourceLink":"","videoCMSUrl":"/video/data/3.0/video/world/2020/03/19/how-the-coronavirus-pandemic-unfolded-lon-orig-ja-tp.cnn/index.xml","videoId":"world/2020/03/19/how-the-coronavirus-pandemic-unfolded-lon-orig-ja-tp.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-large-169.jpg","videoUrl":"/videos/world/2020/03/19/how-the-coronavirus-pandemic-unfolded-lon-orig-ja-tp.cnn/video/playlists/coronavirus/","description":"With more than 200,000 infections and 8,000 deaths across dozens of countries, the virus' rapid spread has caused quarantines, production issues for global brands and travel restrictions.","descriptionText":"With more than 200,000 infections and 8,000 deaths across dozens of countries, the virus' rapid spread has caused quarantines, production issues for global brands and travel restrictions."},{"title":"Former Obama official: We knew we were due for a pandemic","duration":"03:30","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/politics/2020/03/19/susan-rice-trump-administration-coronavirus-warning-sot-tsr-vpx.cnn/index.xml","videoId":"politics/2020/03/19/susan-rice-trump-administration-coronavirus-warning-sot-tsr-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200318021832-coronavirus-testing-united-states-0316-large-169.jpg","videoUrl":"/videos/politics/2020/03/19/susan-rice-trump-administration-coronavirus-warning-sot-tsr-vpx.cnn/video/playlists/coronavirus/","description":"Ambassador Susan Rice, National Security Adviser to President Obama, said that the US government has been aware of the threat of a global health crisis for decades, and she personally briefed President Trump's then-incoming National Security Adviser Gen. Michael Flynn on the matter during the transition. ","descriptionText":"Ambassador Susan Rice, National Security Adviser to President Obama, said that the US government has been aware of the threat of a global health crisis for decades, and she personally briefed President Trump's then-incoming National Security Adviser Gen. Michael Flynn on the matter during the transition. "},{"title":"Don't blame bats for coronavirus pandemic, blame humans","duration":"03:07","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/03/19/coronavirus-human-cost-nick-paton-walsh-pkg-vpx.cnn/index.xml","videoId":"world/2020/03/19/coronavirus-human-cost-nick-paton-walsh-pkg-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319110921-01-bats-coronavirus-study-large-169.jpg","videoUrl":"/videos/world/2020/03/19/coronavirus-human-cost-nick-paton-walsh-pkg-vpx.cnn/video/playlists/coronavirus/","description":"Reclusive, nocturnal, numerous - bats are a possible source of the coronavirus. Yet some scientists concur they are not to blame for the transfer of the disease that's changing daily life - humans are.","descriptionText":"Reclusive, nocturnal, numerous - bats are a possible source of the coronavirus. Yet some scientists concur they are not to blame for the transfer of the disease that's changing daily life - humans are."},{"title":"Doctor says hospitals don't have supplies Trump talks about","duration":"01:05","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/health/2020/03/19/ranney-intv-trump-pence-need-medical-supplies-hospital-masks-gowns-sot-crn-vpx.cnn/index.xml","videoId":"health/2020/03/19/ranney-intv-trump-pence-need-medical-supplies-hospital-masks-gowns-sot-crn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319134317-dr-ranney-large-169.jpg","videoUrl":"/videos/health/2020/03/19/ranney-intv-trump-pence-need-medical-supplies-hospital-masks-gowns-sot-crn-vpx.cnn/video/playlists/coronavirus/","description":"Emergency physician Dr. Megan Ranney said that despite President Trump saying supplies like hospital masks and gowns are available, they aren't showing up to hospitals. ","descriptionText":"Emergency physician Dr. Megan Ranney said that despite President Trump saying supplies like hospital masks and gowns are available, they aren't showing up to hospitals. "},{"title":"Gov. Andrew Cuomo announces 90-day mortgage relief plan","duration":"01:37","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/politics/2020/03/19/andrew-cuomo-new-york-governor-90day-mortgage-relief-vpx.cnn/index.xml","videoId":"politics/2020/03/19/andrew-cuomo-new-york-governor-90day-mortgage-relief-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200316213026-andrew-cuomo-coronavirus-military-large-169.jpg","videoUrl":"/videos/politics/2020/03/19/andrew-cuomo-new-york-governor-90day-mortgage-relief-vpx.cnn/video/playlists/coronavirus/","description":"Governor Andrew Cuomo (D-NY) has announced a 90-day mortgage relief plan that will waive payments for families experiencing economic hardships due to the coronavirus.","descriptionText":"Governor Andrew Cuomo (D-NY) has announced a 90-day mortgage relief plan that will waive payments for families experiencing economic hardships due to the coronavirus."},{"title":"Doctor: We're seeing people in their 40s on ventilators","duration":"01:26","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/health/2020/03/19/sanjay-gupta-darria-long-coronavirus-ventilators-newday-vpx.cnn/index.xml","videoId":"health/2020/03/19/sanjay-gupta-darria-long-coronavirus-ventilators-newday-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319090027-darria-long-new-day-large-169.jpg","videoUrl":"/videos/health/2020/03/19/sanjay-gupta-darria-long-coronavirus-ventilators-newday-vpx.cnn/video/playlists/coronavirus/","description":"CNN's Dr. Sanjay Gupta says data out of China claims that 4 out of 5 people who contracted the novel coronavirus there did so from someone who didn't know they had it. Dr. Darria Long, an emergency room physician, says she is seeing people in their 40s on ventilators.","descriptionText":"CNN's Dr. Sanjay Gupta says data out of China claims that 4 out of 5 people who contracted the novel coronavirus there did so from someone who didn't know they had it. Dr. Darria Long, an emergency room physician, says she is seeing people in their 40s on ventilators."},{"title":"Former FDNY fire marshal among victims of coronavirus","duration":"02:40","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/us/2020/03/19/fdny-fire-marshal-coronavirus-john-knox-intv-cooper-ac360-vpx.cnn/index.xml","videoId":"us/2020/03/19/fdny-fire-marshal-coronavirus-john-knox-intv-cooper-ac360-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319012530-john-knox-large-169.jpg","videoUrl":"/videos/us/2020/03/19/fdny-fire-marshal-coronavirus-john-knox-intv-cooper-ac360-vpx.cnn/video/playlists/coronavirus/","description":"CNN's Anderson Cooper pays tribute to a former FDNY fire marshal John Knox who passed away after contracting the novel coronavirus. His son, Zachary Knox, tells CNN that his father came out of retirement to help after the 9/11 terror attacks.","descriptionText":"CNN's Anderson Cooper pays tribute to a former FDNY fire marshal John Knox who passed away after contracting the novel coronavirus. His son, Zachary Knox, tells CNN that his father came out of retirement to help after the 9/11 terror attacks."},{"title":"Brad Paisley says free grocery store will deliver to seniors","duration":"00:57","sourceName":"HLN","sourceLink":"https://www.cnn.com/specials/videos/hln","videoCMSUrl":"/video/data/3.0/video/us/2020/03/19/brad-paisley-free-grocery-store-delivery-to-seniors-mxp-vpx.hln/index.xml","videoId":"us/2020/03/19/brad-paisley-free-grocery-store-delivery-to-seniors-mxp-vpx.hln","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/171109012040-cma-awards-paisley-large-169.jpg","videoUrl":"/videos/us/2020/03/19/brad-paisley-free-grocery-store-delivery-to-seniors-mxp-vpx.hln/video/playlists/coronavirus/","description":"Country music star Brad Paisley announced that his free grocery store will be delivering to seniors during the coronavirus outbreak.","descriptionText":"Country music star Brad Paisley announced that his free grocery store will be delivering to seniors during the coronavirus outbreak."},{"title":"What seniors really need during the coronavirus pandemic","duration":"01:37","sourceName":"CNN","sourceLink":"http://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/health/2020/03/19/coronavirus-social-distancing-elderly-care-volunteers-orig-dp.cnn/index.xml","videoId":"health/2020/03/19/coronavirus-social-distancing-elderly-care-volunteers-orig-dp.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319095425-family-wishes-happy-birthday-from-distance-intl-large-169.jpg","videoUrl":"/videos/health/2020/03/19/coronavirus-social-distancing-elderly-care-volunteers-orig-dp.cnn/video/playlists/coronavirus/","description":"Volunteers around the country are providing social support for the elderly to decrease feelings of fear and isolation.","descriptionText":"Volunteers around the country are providing social support for the elderly to decrease feelings of fear and isolation."},{"title":"Oregon distillery making and giving away hand sanitizer","duration":"03:17","sourceName":"CNN","sourceLink":"http://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/us/2020/03/19/oregon-shine-distillery-making-hand-sanitizer-coronavirus-bts-ctn-vpx.cnn/index.xml","videoId":"us/2020/03/19/oregon-shine-distillery-making-hand-sanitizer-coronavirus-bts-ctn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319005934-oregon-shine-distillery-making-hand-sanitizer-coronavirus-bts-ctn-vpx-00014512-large-169.jpg","videoUrl":"/videos/us/2020/03/19/oregon-shine-distillery-making-hand-sanitizer-coronavirus-bts-ctn-vpx.cnn/video/playlists/coronavirus/","description":"u003ca href="http://www.cnn.com/2020/03/16/us/distilleries-hand-sanitizer-coronavirus-trnd/index.html" target="_blank">Distilleries are stepping inu003c/a> to help combat the hand sanitizer shortage by using the alcohol in their facilities to create their own alcohol-based solutions. CNN's u003ca href="http://www.cnn.com/profiles/don-lemon-profile" target="_blank">Don Lemonu003c/a> speaks with Jon Poteet and Ryan Ruelos, co-owners of Shine Distillery & Grill, about their efforts in Portland, Oregon.","descriptionText":"u003ca href="http://www.cnn.com/2020/03/16/us/distilleries-hand-sanitizer-coronavirus-trnd/index.html" target="_blank">Distilleries are stepping inu003c/a> to help combat the hand sanitizer shortage by using the alcohol in their facilities to create their own alcohol-based solutions. CNN's u003ca href="http://www.cnn.com/profiles/don-lemon-profile" target="_blank">Don Lemonu003c/a> speaks with Jon Poteet and Ryan Ruelos, co-owners of Shine Distillery & Grill, about their efforts in Portland, Oregon."},{"title":"Mom felt slight fever, hours later tested positive for coronavirus","duration":"02:18","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/us/2020/03/19/amy-driscoll-eric-elnes-coronavirus-symptoms-intv-ebof-vpx.cnn/index.xml","videoId":"us/2020/03/19/amy-driscoll-eric-elnes-coronavirus-symptoms-intv-ebof-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200318220027-coronavirus-patients-stories-large-169.jpg","videoUrl":"/videos/us/2020/03/19/amy-driscoll-eric-elnes-coronavirus-symptoms-intv-ebof-vpx.cnn/video/playlists/coronavirus/","description":"u003ca href="http://www.cnn.com/2020/03/18/us/coronavirus-patients-stories/index.html" target="_blank">Two Americans battling coronavirusu003c/a> share their stories with CNN's u003ca href="http://www.cnn.com/profiles/erin-burnett-profile" target="_blank">Erin Burnett u003c/a>as the number of virus cases increases throughout the country.","descriptionText":"u003ca href="http://www.cnn.com/2020/03/18/us/coronavirus-patients-stories/index.html" target="_blank">Two Americans battling coronavirusu003c/a> share their stories with CNN's u003ca href="http://www.cnn.com/profiles/erin-burnett-profile" target="_blank">Erin Burnett u003c/a>as the number of virus cases increases throughout the country."},{"title":"Gupta: Healthcare workers concerned by new CDC guidelines","duration":"02:29","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/health/2020/03/19/cdc-guidelines-masks-coronavirus-gupta-newday-vpx.cnn/index.xml","videoId":"health/2020/03/19/cdc-guidelines-masks-coronavirus-gupta-newday-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319104640-cdc-guidelines-masks-coronavirus-gupta-newday-vpx-00000000-large-169.jpg","videoUrl":"/videos/health/2020/03/19/cdc-guidelines-masks-coronavirus-gupta-newday-vpx.cnn/video/playlists/coronavirus/","description":"CNN's Dr. Sanjay Gupta explains how the CDC is adapting its guidelines to health providers because of the coronavirus pandemic, saying they are "loosening" some regulations to deal with stress of the pandemic. ","descriptionText":"CNN's Dr. Sanjay Gupta explains how the CDC is adapting its guidelines to health providers because of the coronavirus pandemic, saying they are "loosening" some regulations to deal with stress of the pandemic. "}],currentVideoCollectionId = '',isLivePlayer = false,mediaMetadataCallbacks,mobilePinnedView = null,moveToNextTimeout,mutePlayerEnabled = false,nextVideoId = '',nextVideoUrl = '',turnOnFlashMessaging = false,videoPinner,videoEndSlateImpl;if (CNN.autoPlayVideoExist === false) {autoStartVideo = true;if (autoStartVideo === true) {if (turnOnFlashMessaging === true) {autoStartVideo = false;containerEl = jQuery(document.getElementById(configObj.markupId));CNN.VideoPlayer.showFlashSlate(containerEl);} else {CNN.autoPlayVideoExist = true;}}}configObj.autostart = CNN.Features.enableAutoplayBlock ? false : autoStartVideo;CNN.VideoPlayer.setPlayerProperties(configObj.markupId, autoStartVideo, isLivePlayer, isVideoReplayClicked, mutePlayerEnabled);CNN.VideoPlayer.setFirstVideoInCollection(currentVideoCollection, configObj.markupId);var videoHandler = {},isFeaturedVideoCollectionHandlerAvailable = (CNN !== undefined &&CNN.VIDEOCLIENT !== undefined &&CNN.VIDEOCLIENT.FeaturedVideoCollectionHandler !== undefined);if (!isFeaturedVideoCollectionHandlerAvailable) {CNN.INJECTOR.executeFeature('videx').done(function () {jQuery.ajax({dataType: 'script',cache: true,url: '//www.i.cdn.cnn.com/.a/2.193.9/js/featured-video-collection-player.min.js'}).done(function () {initializeVideoAndCollection();}).fail(function () {throw 'Unable to fetch /js/featured-video-collection-player.min.js';});}).fail(function () {throw 'Unable to fetch the videx bundle';});}function initializeVideoAndCollection() {videoHandler = new CNN.VIDEOCLIENT.FeaturedVideoCollectionHandler(configObj.markupId,"cn-featured-uao68e",'js-video_description-featured-uao68e',[{"title":"Here's how the novel coronavirus outbreak unfolded","duration":"02:32","sourceName":"CNN","sourceLink":"","videoCMSUrl":"/video/data/3.0/video/health/2020/02/20/coronavirus-how-it-unfolded-lon-orig-ja-tp.cnn/index.xml","videoId":"health/2020/02/20/coronavirus-how-it-unfolded-lon-orig-ja-tp.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-large-169.jpg","videoUrl":"/videos/health/2020/02/20/coronavirus-how-it-unfolded-lon-orig-ja-tp.cnn/video/playlists/coronavirus/","description":"With tens of thousands of infections and more than 4,000 deaths across dozens of countries, the virus' rapid spread has caused quarantines, production issues for global brands and travel restrictions.","descriptionText":"With tens of thousands of infections and more than 4,000 deaths across dozens of countries, the virus' rapid spread has caused quarantines, production issues for global brands and travel restrictions."},{"title":"Is delivery dangerous? Can I go outside? Your Qs answered","duration":"03:42","sourceName":"CNN","sourceLink":"","videoCMSUrl":"/video/data/3.0/video/health/2020/03/20/coronavirus-town-hall-questions-answered-mh-orig.cnn/index.xml","videoId":"health/2020/03/20/coronavirus-town-hall-questions-answered-mh-orig.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319201203-03-coronavirus-town-hall-0319-large-169.jpg","videoUrl":"/videos/health/2020/03/20/coronavirus-town-hall-questions-answered-mh-orig.cnn/video/playlists/coronavirus/","description":"At CNN's coronavirus town hall, doctors answered your questions about testing, a possible antidote and social distancing.","descriptionText":"At CNN's coronavirus town hall, doctors answered your questions about testing, a possible antidote and social distancing."},{"title":"Dr. Fauci: There is no 'magic drug' for coronavirus","duration":"01:52","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/health/2020/03/20/anthony-fauci-coronavirus-no-magic-drug-sot-vpx.cnn/index.xml","videoId":"health/2020/03/20/anthony-fauci-coronavirus-no-magic-drug-sot-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319204643-dr-anthony-fauci-coronavirus-town-hall-03192020-large-169.jpg","videoUrl":"/videos/health/2020/03/20/anthony-fauci-coronavirus-no-magic-drug-sot-vpx.cnn/video/playlists/coronavirus/","description":"In a press conference, President Donald Trump said a drug called chloroquine could be a "game-changer" in treating coronavirus. Dr. Anthony Fauci, National Institute of Allergy and Infectious Diseases Director, says u003ca href="http://www.cnn.com/2020/03/19/health/us-coronavirus-case-updates-thursday/index.html" target="_blank">he doesn't think it was described that way.u003c/a>","descriptionText":"In a press conference, President Donald Trump said a drug called chloroquine could be a "game-changer" in treating coronavirus. Dr. Anthony Fauci, National Institute of Allergy and Infectious Diseases Director, says u003ca href="http://www.cnn.com/2020/03/19/health/us-coronavirus-case-updates-thursday/index.html" target="_blank">he doesn't think it was described that way.u003c/a>"},{"title":"Dr. Fauci: Testing asymptomatic patients is not the highest priority ","duration":"02:29","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/health/2020/03/20/coronavirus-testing-accessibility-anthony-fauci-cooper-vpx.cnn/index.xml","videoId":"health/2020/03/20/coronavirus-testing-accessibility-anthony-fauci-cooper-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200315102410-01-fauci-presser-0314-large-169.jpg","videoUrl":"/videos/health/2020/03/20/coronavirus-testing-accessibility-anthony-fauci-cooper-vpx.cnn/video/playlists/coronavirus/","description":"Dr. Anthony Fauci answers common questions concerning coronavirus testing availability in a CNN Town Hall hosted by u003ca href="/profiles/anderson-cooper-profile" target="_blank">Anderson Cooperu003c/a> and u003ca href="/profiles/sanjay-gupta-profile" target="_blank">Dr. Sanjay Guptau003c/a>.","descriptionText":"Dr. Anthony Fauci answers common questions concerning coronavirus testing availability in a CNN Town Hall hosted by u003ca href="/profiles/anderson-cooper-profile" target="_blank">Anderson Cooperu003c/a> and u003ca href="/profiles/sanjay-gupta-profile" target="_blank">Dr. Sanjay Guptau003c/a>."},{"title":"Here's how the novel coronavirus outbreak unfolded","duration":"02:38","sourceName":"CNN","sourceLink":"","videoCMSUrl":"/video/data/3.0/video/world/2020/03/19/how-the-coronavirus-pandemic-unfolded-lon-orig-ja-tp.cnn/index.xml","videoId":"world/2020/03/19/how-the-coronavirus-pandemic-unfolded-lon-orig-ja-tp.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200220164113-coronavirus-how-it-unfolded-explainer-thumbnail-lon-orig-large-169.jpg","videoUrl":"/videos/world/2020/03/19/how-the-coronavirus-pandemic-unfolded-lon-orig-ja-tp.cnn/video/playlists/coronavirus/","description":"With more than 200,000 infections and 8,000 deaths across dozens of countries, the virus' rapid spread has caused quarantines, production issues for global brands and travel restrictions.","descriptionText":"With more than 200,000 infections and 8,000 deaths across dozens of countries, the virus' rapid spread has caused quarantines, production issues for global brands and travel restrictions."},{"title":"Former Obama official: We knew we were due for a pandemic","duration":"03:30","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/politics/2020/03/19/susan-rice-trump-administration-coronavirus-warning-sot-tsr-vpx.cnn/index.xml","videoId":"politics/2020/03/19/susan-rice-trump-administration-coronavirus-warning-sot-tsr-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200318021832-coronavirus-testing-united-states-0316-large-169.jpg","videoUrl":"/videos/politics/2020/03/19/susan-rice-trump-administration-coronavirus-warning-sot-tsr-vpx.cnn/video/playlists/coronavirus/","description":"Ambassador Susan Rice, National Security Adviser to President Obama, said that the US government has been aware of the threat of a global health crisis for decades, and she personally briefed President Trump's then-incoming National Security Adviser Gen. Michael Flynn on the matter during the transition. ","descriptionText":"Ambassador Susan Rice, National Security Adviser to President Obama, said that the US government has been aware of the threat of a global health crisis for decades, and she personally briefed President Trump's then-incoming National Security Adviser Gen. Michael Flynn on the matter during the transition. "},{"title":"Don't blame bats for coronavirus pandemic, blame humans","duration":"03:07","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/world/2020/03/19/coronavirus-human-cost-nick-paton-walsh-pkg-vpx.cnn/index.xml","videoId":"world/2020/03/19/coronavirus-human-cost-nick-paton-walsh-pkg-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319110921-01-bats-coronavirus-study-large-169.jpg","videoUrl":"/videos/world/2020/03/19/coronavirus-human-cost-nick-paton-walsh-pkg-vpx.cnn/video/playlists/coronavirus/","description":"Reclusive, nocturnal, numerous - bats are a possible source of the coronavirus. Yet some scientists concur they are not to blame for the transfer of the disease that's changing daily life - humans are.","descriptionText":"Reclusive, nocturnal, numerous - bats are a possible source of the coronavirus. Yet some scientists concur they are not to blame for the transfer of the disease that's changing daily life - humans are."},{"title":"Doctor says hospitals don't have supplies Trump talks about","duration":"01:05","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/health/2020/03/19/ranney-intv-trump-pence-need-medical-supplies-hospital-masks-gowns-sot-crn-vpx.cnn/index.xml","videoId":"health/2020/03/19/ranney-intv-trump-pence-need-medical-supplies-hospital-masks-gowns-sot-crn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319134317-dr-ranney-large-169.jpg","videoUrl":"/videos/health/2020/03/19/ranney-intv-trump-pence-need-medical-supplies-hospital-masks-gowns-sot-crn-vpx.cnn/video/playlists/coronavirus/","description":"Emergency physician Dr. Megan Ranney said that despite President Trump saying supplies like hospital masks and gowns are available, they aren't showing up to hospitals. ","descriptionText":"Emergency physician Dr. Megan Ranney said that despite President Trump saying supplies like hospital masks and gowns are available, they aren't showing up to hospitals. "},{"title":"Gov. Andrew Cuomo announces 90-day mortgage relief plan","duration":"01:37","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/politics/2020/03/19/andrew-cuomo-new-york-governor-90day-mortgage-relief-vpx.cnn/index.xml","videoId":"politics/2020/03/19/andrew-cuomo-new-york-governor-90day-mortgage-relief-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200316213026-andrew-cuomo-coronavirus-military-large-169.jpg","videoUrl":"/videos/politics/2020/03/19/andrew-cuomo-new-york-governor-90day-mortgage-relief-vpx.cnn/video/playlists/coronavirus/","description":"Governor Andrew Cuomo (D-NY) has announced a 90-day mortgage relief plan that will waive payments for families experiencing economic hardships due to the coronavirus.","descriptionText":"Governor Andrew Cuomo (D-NY) has announced a 90-day mortgage relief plan that will waive payments for families experiencing economic hardships due to the coronavirus."},{"title":"Doctor: We're seeing people in their 40s on ventilators","duration":"01:26","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/health/2020/03/19/sanjay-gupta-darria-long-coronavirus-ventilators-newday-vpx.cnn/index.xml","videoId":"health/2020/03/19/sanjay-gupta-darria-long-coronavirus-ventilators-newday-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319090027-darria-long-new-day-large-169.jpg","videoUrl":"/videos/health/2020/03/19/sanjay-gupta-darria-long-coronavirus-ventilators-newday-vpx.cnn/video/playlists/coronavirus/","description":"CNN's Dr. Sanjay Gupta says data out of China claims that 4 out of 5 people who contracted the novel coronavirus there did so from someone who didn't know they had it. Dr. Darria Long, an emergency room physician, says she is seeing people in their 40s on ventilators.","descriptionText":"CNN's Dr. Sanjay Gupta says data out of China claims that 4 out of 5 people who contracted the novel coronavirus there did so from someone who didn't know they had it. Dr. Darria Long, an emergency room physician, says she is seeing people in their 40s on ventilators."},{"title":"Former FDNY fire marshal among victims of coronavirus","duration":"02:40","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/us/2020/03/19/fdny-fire-marshal-coronavirus-john-knox-intv-cooper-ac360-vpx.cnn/index.xml","videoId":"us/2020/03/19/fdny-fire-marshal-coronavirus-john-knox-intv-cooper-ac360-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319012530-john-knox-large-169.jpg","videoUrl":"/videos/us/2020/03/19/fdny-fire-marshal-coronavirus-john-knox-intv-cooper-ac360-vpx.cnn/video/playlists/coronavirus/","description":"CNN's Anderson Cooper pays tribute to a former FDNY fire marshal John Knox who passed away after contracting the novel coronavirus. His son, Zachary Knox, tells CNN that his father came out of retirement to help after the 9/11 terror attacks.","descriptionText":"CNN's Anderson Cooper pays tribute to a former FDNY fire marshal John Knox who passed away after contracting the novel coronavirus. His son, Zachary Knox, tells CNN that his father came out of retirement to help after the 9/11 terror attacks."},{"title":"Brad Paisley says free grocery store will deliver to seniors","duration":"00:57","sourceName":"HLN","sourceLink":"https://www.cnn.com/specials/videos/hln","videoCMSUrl":"/video/data/3.0/video/us/2020/03/19/brad-paisley-free-grocery-store-delivery-to-seniors-mxp-vpx.hln/index.xml","videoId":"us/2020/03/19/brad-paisley-free-grocery-store-delivery-to-seniors-mxp-vpx.hln","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/171109012040-cma-awards-paisley-large-169.jpg","videoUrl":"/videos/us/2020/03/19/brad-paisley-free-grocery-store-delivery-to-seniors-mxp-vpx.hln/video/playlists/coronavirus/","description":"Country music star Brad Paisley announced that his free grocery store will be delivering to seniors during the coronavirus outbreak.","descriptionText":"Country music star Brad Paisley announced that his free grocery store will be delivering to seniors during the coronavirus outbreak."},{"title":"What seniors really need during the coronavirus pandemic","duration":"01:37","sourceName":"CNN","sourceLink":"http://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/health/2020/03/19/coronavirus-social-distancing-elderly-care-volunteers-orig-dp.cnn/index.xml","videoId":"health/2020/03/19/coronavirus-social-distancing-elderly-care-volunteers-orig-dp.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319095425-family-wishes-happy-birthday-from-distance-intl-large-169.jpg","videoUrl":"/videos/health/2020/03/19/coronavirus-social-distancing-elderly-care-volunteers-orig-dp.cnn/video/playlists/coronavirus/","description":"Volunteers around the country are providing social support for the elderly to decrease feelings of fear and isolation.","descriptionText":"Volunteers around the country are providing social support for the elderly to decrease feelings of fear and isolation."},{"title":"Oregon distillery making and giving away hand sanitizer","duration":"03:17","sourceName":"CNN","sourceLink":"http://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/us/2020/03/19/oregon-shine-distillery-making-hand-sanitizer-coronavirus-bts-ctn-vpx.cnn/index.xml","videoId":"us/2020/03/19/oregon-shine-distillery-making-hand-sanitizer-coronavirus-bts-ctn-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319005934-oregon-shine-distillery-making-hand-sanitizer-coronavirus-bts-ctn-vpx-00014512-large-169.jpg","videoUrl":"/videos/us/2020/03/19/oregon-shine-distillery-making-hand-sanitizer-coronavirus-bts-ctn-vpx.cnn/video/playlists/coronavirus/","description":"u003ca href="http://www.cnn.com/2020/03/16/us/distilleries-hand-sanitizer-coronavirus-trnd/index.html" target="_blank">Distilleries are stepping inu003c/a> to help combat the hand sanitizer shortage by using the alcohol in their facilities to create their own alcohol-based solutions. CNN's u003ca href="http://www.cnn.com/profiles/don-lemon-profile" target="_blank">Don Lemonu003c/a> speaks with Jon Poteet and Ryan Ruelos, co-owners of Shine Distillery & Grill, about their efforts in Portland, Oregon.","descriptionText":"u003ca href="http://www.cnn.com/2020/03/16/us/distilleries-hand-sanitizer-coronavirus-trnd/index.html" target="_blank">Distilleries are stepping inu003c/a> to help combat the hand sanitizer shortage by using the alcohol in their facilities to create their own alcohol-based solutions. CNN's u003ca href="http://www.cnn.com/profiles/don-lemon-profile" target="_blank">Don Lemonu003c/a> speaks with Jon Poteet and Ryan Ruelos, co-owners of Shine Distillery & Grill, about their efforts in Portland, Oregon."},{"title":"Mom felt slight fever, hours later tested positive for coronavirus","duration":"02:18","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/us/2020/03/19/amy-driscoll-eric-elnes-coronavirus-symptoms-intv-ebof-vpx.cnn/index.xml","videoId":"us/2020/03/19/amy-driscoll-eric-elnes-coronavirus-symptoms-intv-ebof-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200318220027-coronavirus-patients-stories-large-169.jpg","videoUrl":"/videos/us/2020/03/19/amy-driscoll-eric-elnes-coronavirus-symptoms-intv-ebof-vpx.cnn/video/playlists/coronavirus/","description":"u003ca href="http://www.cnn.com/2020/03/18/us/coronavirus-patients-stories/index.html" target="_blank">Two Americans battling coronavirusu003c/a> share their stories with CNN's u003ca href="http://www.cnn.com/profiles/erin-burnett-profile" target="_blank">Erin Burnett u003c/a>as the number of virus cases increases throughout the country.","descriptionText":"u003ca href="http://www.cnn.com/2020/03/18/us/coronavirus-patients-stories/index.html" target="_blank">Two Americans battling coronavirusu003c/a> share their stories with CNN's u003ca href="http://www.cnn.com/profiles/erin-burnett-profile" target="_blank">Erin Burnett u003c/a>as the number of virus cases increases throughout the country."},{"title":"Gupta: Healthcare workers concerned by new CDC guidelines","duration":"02:29","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/health/2020/03/19/cdc-guidelines-masks-coronavirus-gupta-newday-vpx.cnn/index.xml","videoId":"health/2020/03/19/cdc-guidelines-masks-coronavirus-gupta-newday-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200319104640-cdc-guidelines-masks-coronavirus-gupta-newday-vpx-00000000-large-169.jpg","videoUrl":"/videos/health/2020/03/19/cdc-guidelines-masks-coronavirus-gupta-newday-vpx.cnn/video/playlists/coronavirus/","description":"CNN's Dr. Sanjay Gupta explains how the CDC is adapting its guidelines to health providers because of the coronavirus pandemic, saying they are "loosening" some regulations to deal with stress of the pandemic. ","descriptionText":"CNN's Dr. Sanjay Gupta explains how the CDC is adapting its guidelines to health providers because of the coronavirus pandemic, saying they are "loosening" some regulations to deal with stress of the pandemic. "}],'js-video_headline-featured-uao68e','',"js-video_source-featured-uao68e",true,true,'coronavirus');if (typeof configObj.context !== 'string' || configObj.context.length

Read this article:

Thousands of medical students are being fast-tracked into doctors to help fight the coronavirus - CNN

Medical Training Must Include Education in Abortion Care. Here’s Where to Start. – Ms. Magazine

As Congress formulated an emergency bill to alleviate the effects of COVID-19 last week,abortion rights and access arose as an issue, delaying negotiations.

For me, the issue is personal: I am a medical student and future abortion provider. I am also the daughter of a former provider whose practice was threatened by protesters and life was changed by an abortion. My reproductive health traininghowever it is impacted by the national health crisis of COVID-19will not be complete without this critical education in abortion care.

While applying to Obstetrics and Gynecology (Ob-Gyn) residency this year, I learned that abortion care training varies widely across residencies.

A survey of Ob-Gyn applicants across the country found that55 percent of medical students rated abortion training as an important factor. However,over a third of Ob-Gyn residency directors reported abortion training was not a routinepart of their residency.

Furthermore, only22 percent of residency directorsreported Ob-Gyn residents had adequate surgical abortion training. This means nearly four in five Ob-Gyn programs provide inadequate abortion trainingin spite of theAmerican College of Obstetrics and Gynecologys recommendation.

The process of applying to residency is a dizzying experience even without considering training in abortion care. We must determine which training environment, location and people to commit 80 hours per week for four years to while coordinating rotations, accommodations and interviews. Then, we rank our choices and an algorithm matches us with a residency.

Unfortunately, state-level abortion restrictions add an additional challenge for residency programs and applicants.Nine states passed legislation banning or restricting abortionearlier in pregnancylast yearbefore the fetus can survive independentlyincluding Georgia.

Although afederal judge blocked the ban on nearly all abortion care from going into effect, the legal battle continues. Restrictive abortion laws will further limit in-state abortion training opportunities.

Abortion restriction will widen health care disparities and may reduce provider access for pregnancy care. Sinceover half of physicians practice in the state they completed their residency, states with restrictive abortion laws will struggle to employ physicians who want to offer abortion in their practice.

On top of this, were in the midst of a national maternal mortality crisis, and Georgia reports some of the worst pregnancy outcomes of any state. Black women die of pregnancy related causes ata rate three times higher than white women and will bedisproportionately affected by abortion restrictions.

When thinking about abortion, I remember the difficult decisions my patients faced. While caring for these patients, I felt the heaviness of the choice in my chest. However, this is also a necessary choice. I fear that some day, I may not be able to offer this option to my patients.

I also wonder what I would do if I became unexpectedly pregnant during my medical training. If I desired an abortion, how far would I travel if my state restricted it? What if I had a serious medical condition, or was low-income or had lower access to care? The answers are unknowable. Sincealmost half of pregnancies in the U.S. are unplanned, these questions are painfully relevant to all of us.

I am unequivocally in support of the right to choose what care to access in pregnancy. If we care about the improvement and prolongation of life, then we must protect the life of every pregnant person by ensuring both abortion access and pregnancy care.

Anyone who becomes pregnant must have access to compassionate, timely, affordable abortion careregardless of state of residence. A healthcare provider must also deliver patient-centered care without fearing for their life or liberty.

There are several avenues for increasing abortion training. First and foremost, abortion training should be routine for Ob-Gyn and Family Medicine residentsas isrecommended by American College of Obstetrics and Gynecology. Since only 6 percent of abortions occur in academic centers, residencies could better incorporate community settings into training programs.

Residencies in states with restrictive laws should also partner with abortion-providing institutions across state lines. Additionally, we shouldtrain other health professionalsto provide certain abortion services in order to further expand access.

This next year will be exhilarating and terrifying as I assume the role of a doctor amidst a national health crisis brought by COVID-19. I hope to support my patients while synthesizing knowledge and staying well. Access to abortion training or care need not be among my considerations.

It is time once again to speak up and defend the basic liberty of control over our own bodies, and those of our loved ones and patients during this trying time.

Link:

Medical Training Must Include Education in Abortion Care. Here's Where to Start. - Ms. Magazine

Expert advice and tips from Warwick Medical School on how to look after our wellbeing and mental health during the coronavirus pandemic – Warwick…

Looking after our wellbeing and mental health is vital in difficult times. Fear and anxiety can suppress our immune system, so finding ways to be kind to ourselves and others while we deal with the spread of COVID19 will boost our immune system and help fight infection explains Sarah Stewart-Brown, professor of public health and expert in mental wellbeing from Warwick Medical School.

As schools close, some shops shelves become empty and many people go into voluntary self-isolation, most of us are focusing on how to manage in this very different world and there is not much headspace to think about what happens next. One unspoken view many of us are hanging on to that if we self-isolate for a week or so the problem will pass and all will be well. That is very comforting, but likely to be overly simplistic.

What tends to happen with viruses is that we develop immunity or we succumb. The proportions recovering or dying depend on how dangerous the virus is. Rhinoviruses cause symptoms of the common cold and are only hazardous to the very sick, the very old or sometimes very small babies. The proportions are different with Ebola virus. If a virus is circulating in the population all the time, people get sick, get immune and recover, or succumb at a steady state and health services can cope with caring for those who get very sick and need intensive or palliative care. We are used to this happening and take for granted that people who are very elderly or sick could die in this way.

New virus no immunity

When the level of immunity in the population is high it is difficult for a virus to circulate because it only meets people who are immune and cannot spread from person to person. At that point the population is said to have herd immunity. Viruses circulate freely in day nurseries amongst children who have not met them before and so there is no herd immunity. New viruses like Covid-19 create the mayhem we are currently experiencing because at the beginning of the outbreak no-one has immunity and the virus has a lot of choice about whom it spreads to. Hand washing, binning tissues, and self-isolation reduce the rate of spread.

Not everyone who meets viruses gets symptoms. If the immune system is working well and the dose is small it is possible to develop immunity without disease the technical term is sero-conversion. This is the principle that is exploited in the development and administration of vaccines. At present, because we do not have population testing, we do not know what proportion of the population is meeting Covid-19, sero-converting and not getting symptoms. We do not even know what proportion of people self-isolating with fevers and coughs have symptoms caused by Covid-19 rather than one of the many other viruses that cause these symptoms. The government announced yesterday that they will be stepping up their testing programme and so these facts will emerge before too long. Until they do we will not be able to calculate accurate sickness or mortality rates from Covid-19 because we do not have an accurate denominator.

The UK Governments strategy aims to slow the spread of the virus rather than prevent it altogether. It is unlikely that spread can be prevented until there is a vaccine and that could take 18 months. The reason why this helps is that our health services will not be overwhelmed with demand to provide life-saving support to the small proportion of people who meet this virus and become very seriously ill. If we slow the rate fewer people will need this help at any one time. The aim of this policy is to enable herd immunity to develop in a controlled way because that is the only way we can bring this outbreak to a close until a vaccine emerges.

Fear suppresses the immune system

Understanding this matters because it means that we are better able to protect ourselves.

And it suggests that alongside following all governments advice to help slow the spread of the virus, the most important thing we should be doing is boosting our immune systems. Doubtless supplements and herbs which are thought to boost immunity are flying off the shelves at the moment for that reason, but they may or may not work.

What is not widely appreciated by the public and what is not being said by the government because the research is not widely known and accepted by the medical profession is that an important dampener of the immune system is fear and panic. It is likely for example that the Spanish flu after the First World War was so dangerous, and particularly to young men, because the level of PTSD post traumatic stress disorder in the population was very high. We dont know this for sure and will not be able to find out in retrospect but given what we now know about fear and the immune system that is very likely.

There is plenty of fear about at the moment and not much being offered in the way of advice and support about how to calm the nervous system. Many people know ways to do this intuitively: listening to music, singing, walking in green spaces. Others have been taught in mindfulness groups or Yoga classes or a myriad of other approaches like Emotional Freedom Technique (EFT or tapping). For most of these approaches there is scientific evidence to show that they work calm the nervous system, that they enhance learning and creativity and boost the immune response. One approach with an evidence base not much known about is visualisation of the immune system functioning under self-hypnosis. Ensuring you have enough sleep is another evidenced way of enhancing immunity.

Many people have already learnt one of more of these skills. People who have this knowledge and skill should be using their skills now and practicing as much as they can. Some people prefer to learn in groups, others individually, some self-directed on line and some from teachers. It is difficult for teachers to teach these skills to others now that groups are closed, but it is possible for those who know how to do them to practice themselves. And on-line classes and webinars are appearing for many of these approaches. Some practitioners are also teaching one to one on skype. There are also Apps which can be downloaded. Some children are being taught some of these skills at school in programmes like .B. Now that they are going to be at home all the time perhaps they might be able to show these to their parents.

Positive social contact is protective technology can help

One area of research which is not being much talked about at the moment is that positive social connectedness is an important enhancer of the immune system is. People who are getting together to create WhatsApp groups in their local communities or setting up organisations like CovidMutualAid probably know, intuitively, that it is important to counter the inadvertent fear of others that is created when we are asked to keep away from other people.

Self-isolation when we are ill, at risk of illness or just plain frightened, cuts us off from the beneficial effects of other human beings. Undoubtedly social media and internet connectedness can fill that gap to some extent and we should all be exploiting those resources now. And for those of us self-isolating at home with friends or family, trying to ensure that relationships are positive and supportive is important. At the same time we need to remember that it is difficult to learn new skills when anxious or afraid. So the elderly who are not connected into social media already may need help to do so.

If we do not develop herd immunity to this virus because the isolation policy suppresses rather than controls the spread, then the outbreak will re-emerge as restrictions are lifted and we will see more peaks in the infection. That is why the government did not close schools straight away. Controlled exposure is a good public health policy. If we add to this as many activities which boost immunity as possible we will increase the number of people who develop immunity without illness or only a mild infection. There will then be a substantial number of people who can keep services running and look after those who are getting ill as the outbreak comes to a close and we all get back to normal.

Top Tips for boosting natural resistance to viral infections

- Take notice of how you feel

- Be kind to yourself and others have patience

- Stay in touch with people who calm you down. Use the telephone or social media. Avoid those who make you anxious

- Regulate your nervous system for a period of time each day with things that work for you. People are different and not everything works for everyone.

- Meditating or doing mindfulness practice

- Mindful movement like Yoga or Tai Chi something that gets you out of your mind into your body

- Getting enough sleep - ideally 8 or more hours

- Get effective sleep - good sleep hygiene practices include: no screens before bed or in the bedroom, no caffeine, alcohol or heavy meals in the evenings. Keep your bedroom dark and cool

- Self-hypnosis and guided imagery visualising your immune system functioning effectively

- Emotional Freedom Technique or tapping

- Listening to or making music especially singing

- Walking in green spaces or near water

If these arent possible other things that are known to reduce stress are:

- Noticing the unusual and positive things that have happened in the day and recalling them before sleep.

Written by Sarah Stewart-Brown, professor of public health and expert in mental wellbeing from Warwick Medical School.

Read the original post:

Expert advice and tips from Warwick Medical School on how to look after our wellbeing and mental health during the coronavirus pandemic - Warwick...

Coronavirus Live Updates: Hospitals on Both Sides of the Atlantic Struggle as Cases Climb – The New York Times

The peace agreement in Afghanistan, already stalled by delays in the release of Taliban prisoners and by a political stalemate in Kabul, is increasingly being defined and constricted by the coronavirus crisis.

The U.S. peace envoy, Zalmay Khalilzad, fired off a series of Twitter posts this week that cited the coronavirus as both an impediment to negotiations and a reason to urgently resolve political differences.

Its time for Afghans to compromise, one of Mr. Khalilzads posts read. In another, he wrote, coronavirus makes prisoner releases urgent.

Mr. Khalilzad also acknowledged that disruptions triggered by coronavirus measures have made face-to-face negotiations increasingly difficult.

Coronavirus and the resulting travel restrictions likely requires virtual engagement now, he wrote.

Already, President Ashraf Ghani, 70, is spending time in self-imposed isolation in his private residence at the palace complex in Kabul. The palace Facebook site posted photos of Mr. Ghani alone at home, conferring with cabinet ministers and aides by video link.

Reporting and research were contributed by Raphael Minder, Megan Specia, Marc Santora, Elisabetta Povoledo, Aurelien Breeden, Melissa Eddy, Edward Wong, David E. Sanger, David D. Kirkpatrick, Sui-Lee Wee, Katrin Bennhold, Richard Prez-Pea, Tim Arango, Jill Cowan, Emily Cochrane, Jim Tankersley, Alan Rappeport, Maya Salam, David Zucchino, Isabella Kwai and Dan Barry.

Follow this link:

Coronavirus Live Updates: Hospitals on Both Sides of the Atlantic Struggle as Cases Climb - The New York Times

Chloroquine May Fight Covid-19and Silicon Valleys Into It – WIRED

The chatter about a promising drug to fight Covid-19 started, as chatter often does (but science does not), on Twitter. A blockchain investor named James Todaro tweeted that an 85-year-old malaria drug called chloroquine was a potential treatment and preventative against the disease caused by the new coronavirus. Todaro linked to a Google doc hed cowritten, explaining the idea.

Plus: How can I avoid catching it? Is Covid-19 more deadly than the flu? Our in-house Know-It-Alls answer your questions.

Though nearly a dozen drugs to treat coronavirus are in clinical trials in China, just oneremdesivir, an antiviral that was in trials against Ebola and the coronavirus MERSis in full-on trials in the US. Nothing has been approved by the Food and Drug Administration. So a promising drug would be greatand even better, chloroquine isnt new. Its use dates back to World War II, and its derived from the bark of the chinchona tree, like quinine, a centuries-old antimalarial. That means the drug is now generic and is relatively cheap. Physicians understand it well, and theyre allowed to prescribe it for anything they want, not just malaria.

Todaros tweet got thousands of likes. The engineer/tech world picked up the idea. The widely-read blog Stratechery linked to Todaros Google document; Ben Thompson, the blogs editor, wrote that he was wholly unqualified to comment but that the anecdotal evidence favored the idea. Echoing the document, Thompson wrote that the paper was written in consultation with Stanford Medical School, the University of Alabama at Birmingham medical school, and National Academy of Sciences researchersnone of which is exactly true. (More on that in a bit.) One of Todaros coauthors, a lawyer named Gregory Rigano, went on Fox News to talk about the concept. Tesla and SpaceX CEO Elon Musk tweeted about it, citing an explanatory YouTube video from a physician whos been doing a series of coronavirus explainers. To be fair, Musk wasnt all-in on the idea absent more data, though he wrote that hed received a life-saving dose of chloroquine for malaria.

Its the definition of big if true. Part of the story of Covid-19, of the coronavirus SARS-CoV-2, is that it is novel. Humans dont have any immunity to it. Theres no vaccine, no drug approved to treat it. But if a drug did existif a cheap, easy drug can stave off the worst, ventilator-requiring, sometimes-fatal complications of coronavirus infection, or maybe prevent that infection in the first place, what are we all socially isolating for, like suckers?

That ifas the saying goesis doing a lot of work. The Covid-19 pandemic is causing, reasonably, a worldwide freak-out as scientists and policymakers race to find solutions, not always competently or efficiently. Its the kind of thing that rankles the engineer-disruptor mindset. Surely this must be an easily solved problem thats primarily the fault of bureaucracy, regulation, and people who dont understand science. And maybe the first two things are true. The third thing, though, is where the risks hide. Silicon Valley lionizes people who rush toward solutions and ignore problems; science is designed to find solutions by identifying those problems. The two approaches are often incompatible.

What happened here, specifically, is that Rigano sought Todaro out. Todaros tweet identified Rigano as being affiliated with Johns Hopkins; Riganos LinkedIn profile says hes on leave from a masters degree program there in bioinformatics, and has been an advisor to a program at Stanford called SPARK, which does translational drug discoveryfinding new uses and applications for approved drugs. I have a very unique background at the crossroads of law and science, Rigano tells me. I have been working with large pharmaceutical companies, universities, biotechs, and nonprofits in the development of drugs and medical products. He says those contacts told him about the use of chloroquine against Covid-19 in China and South Korea, so he started reading up on it.

(Johns Hopkins did not return a request for comment; a spokesperson for Stanford Medical School emails: Stanford Medicine, including SPARK, wasnt involved in the creation of the Google document, and weve requested that the author remove all references to us. In addition, Gregory Rigano is not an advisor with Stanford School of Medicine and no one at Stanford was involved in the study.)

It turns out that people have been pitching chloroquine as an antiviral for years. In the early 1990s researchers proposed it as an adjunct to early protease inhibitor drugs to help treat HIV/AIDS. A team led by Stuart Nichol, the head of the Special Pathogens Unit at the Centers for Disease Control and Prevention, published a paper in 2005 saying that the drug was effective against primate cells infected with SARS, the first big respiratory coronavirus to affect humans. Thats an in vitro test, not live animalsjust cells.

Visit link:

Chloroquine May Fight Covid-19and Silicon Valleys Into It - WIRED

As COVID-19 battle escalates, U of T students offer busy health-care workers help on the home front – News@UofT

In the week leading up to the declaration of the COVID-19 pandemic, as it became clear the virus would have a wide-ranging impact, four students at the University of Torontos Faculty of Medicine found themselves searching for a way to help.

Knowing the toll the outbreak would take on the health-care system, the students Jordynn Klein,Daniel Lee, Tingting Yan and Orly Bogler organized their peersto babysit, fetch groceries and carry out other domestic tasksfor health-care workers and hospital support staff who are increasingly at risk of being stretched to the limit.

Daniel and I reached out to some members of our class to see if they would be interested in designing some kind of initiative to help health-care workers who are on the front line, Kleinsays.

Within an hour of putting the call out on Twitter, they had dozens of responses from students who wanted to help in any way possible.

The initiative quickly grew larger than the four medical school students could handle themselves, so they recruited other students in medicine and nursing to help co-ordinate the effort. As of Wednesday, the organizers had signed up over 240 volunteers and have received requests for help from more than 130 health-care workers.Students sign up to volunteer using one online form, while health-care providers fill out another form to ask for help. Already, volunteers have been dispatched all across the Greater Toronto Area.

Nelson Saddler, a second-year medical student, has been putting in six to eight hours per day driving around town in his Hyundai SUV fetching groceries or babysitting. On Wednesday, he did three grocery drop-offs, picking up chicken breasts, fruits and vegetables and salt-and-vinegar potato chips for busy health-care staff.

These health-care workers are trying to keep us safe and treat our community, he told U of T News over the phone. The only way they can keep doing that is by being supported by all of us with the little things like groceries, pet careso they can focus.

Many parents have asked the students for help taking care of their kidsnow that school has been cancelled to promote social distancing, or because grandparents can no longer look after their grandkids because the elderly are at higher risk of serious illness from COVID-19.

Weve been receiving a lot of gratitude from those folks for offering some stopgap coverage for them so they can be at work and not worry about whos going to take care of their child while theyre taking care of other people, Kleinsays.

Nelson Saddler, a second-year medical student at U of T, gets groceries for busy health-care staff duringthe novel coronavirus outbreak (photo by Nick Iwanyshyn)

Before even launching their initiative, the students thought hard about what precautions the volunteers should take so that they didnt inadvertently make the problem worse. Students arent allowed to volunteer if they have been out of the country in the last 14 days, or if they have been in contact with anyone who has. They cant volunteer if theyre involved in high-risk work such as screening patients in an emergency room. And they cant sign up if they are experiencing any upper-respiratory symptoms, according to Lee. As an added safety measure, the organizers assign a single volunteer per family to limit exposure. (U of T News also took precautions while reporting this story by interviewing and photographing the students from a safedistance or over the phone.)

The U of T students say they are in touch with more than a dozen medical students at other Canadian universities who are interested in launching their own volunteer network. I think in a way eyes are on us, says Lee, adding that the U of T students are the only ones who have so farconnected volunteers with families.

Meanwhile, Kleinsays students from Case Western Reserve University in Cleveland, Ohio and New York University have also reached out.

Yan, a first-year medical student, says that seeing how the medical community is responding to the crisis has strengthened her resolve to join the profession. People are in the midst of a crisis and [yet they] are able to rush in and help as best they can and [be] really brave and generous and caring, she says.

Bogler, a fourth-year student whose residency in internal medicine is supposed to begin in July, says she felt a pull to help front-line workers. I was very motivated to get this off the ground, to ensure our year collectively contributes to the cause, she says.

For Klein, whohas spent much of the last few days fielding calls and answering emails, the way the medical community has responded to the outbreak has been inspiring.

If theres one thing that we had reinforced over the course of this initiative, its that bravery is doing what you think is right, especially when youre scared," the second-year student says. To go in and feel that fear, and go in and do it anyway because you know its the right thing to do.

Follow this link:

As COVID-19 battle escalates, U of T students offer busy health-care workers help on the home front - News@UofT

Stopping Contagion With Science at UM: A Look Back – University of Michigan Health System News

Right now in hospitals around the world, health care professionals taking care of patients with COVID-19 are going to great lengths to protect themselves and other patients from the coronavirus that causes the disease.

They might not realize it, but some of the techniques theyre using date back more than 100 years, when hospitals adopted the aseptic technique for inpatient care.

The idea that infections didnt spread via some mysterious process in the air, but rather through contact with something that a sick person had touched, was still a novel one in the late 19th and early 20th centuries.

In fact, it was still called the germ theory of disease because medical science hadnt yet discovered the true causes of most infectious diseases and their complications, and medical professionals hadnt yet understood their own role in transmitting disease.

Emerging science

Even though bacteria were being studied in research laboratories at the University of Michigan and elsewhere by the late 1800s, viruses were still years away from being seen and understood by anyone.

Not to mention the fact that antibiotics, antiviral medications and modern vaccines were decades away from being developed by university scientists and drug companies.

But the growing realization that touch could transfer disease helped drive new developments in hospitals for people with contagious illnesses in the early 20th century. It ushered in special processes that health care workers and trainees had to follow, and research showing that these steps could reduce disease.

Those changes are still considered best practice today: thorough hand-washing by clinicians as they moved between patients; covering the clothes of patient-care staff with a new gown every time they entered contagious patients rooms and taking it off when they left; and sterilizing or disposing of everything a contagious patient touches.

In August 1914, the University of Michigan opened its first facility designed specifically for this kind of care: a24-bed Contagious Hospital, on the site where a main Medical School building now stands.

It had an ingenious design, created entirely for infection prevention. Each room held two patients, and had two doors: one that opened into a central hallway, for doctors, nurses, cleaning staff and medical trainees to pass through, and one that opened onto a porch that wrapped around the entire building.

The porch door allowed the patients bed to be wheeled through without passing other patients when they entered or left the hospital. It also allowed them to be taken out on the porch for some fresh air, which was considered to have healing properties. And large windows allowed medical students to stand on the porch as their professors discussed the care inside.

It started in a shack

U-M had actually opened its first contagious disease facility in 1897, in a shack that had served as the former hospital laundry. It stood a short distance away from the main Catherine Street hospitals.

But after smallpox ravaged the city of Ann Arbor in 1908, and patients overflowed into a hastily retrofitted house, the city offered money to build a new facility if the university would provide the land and staff.

It wasnt big 40 feet by 100 feet. But the Contagious Hospitals three stories even had living quarters upstairs for nurses, complete with a dining room and living room. The lower level included a large area for sterilization equipment, as well as a morgue.

The design, and the techniques the nurses, doctors, maids, janitors and medical students were trained to use, were inspired by trips to other hospitals that U-M medical leaders David Cowie, M.D. and Reuben Peterson, M.D., and a lead nurse had taken.

They especially focused on care at the city hospital in Providence, Rhode Island, which had been patterned on similar hospitals in London and Paris. There, patients with different diseases were cared for in separate buildings. But U-M and Ann Arbor couldnt afford that.

Safety and efficiency

Petersondescribed the hospital in the Journal of the Michigan State Medical Society a few months before the building opened.He described how the aseptic technique itself could make it possible for patients with different diseases to be cared for in the same facility.

And as Cowie wrote in 1916 in the Transactions of the Clinical Society of the University of Michigan, the aseptic technique supports the idea that the very great majority of contagious and infectious diseases are communicated from one individual to another, or from one place to another, by means of direct or indirect contact. In other words, the infected person has come either in direct contact with the patient or with something that has, directly or indirectly, touched him, Cowie wrote. If this idea can be proved to be correct or adequate, at once a great economic factor has been introduced into contagious hospital work.

One nurse could take care of multiple patients, so long as she (and in those days, they were all women) washed thoroughly and changed gowns in between.

In essence, the new hospital, and others like it, used the same approach for inpatient care that surgical teams had recently started using in their operating rooms.

Previously, surgical infection prevention had focused on fumigating the air in the room with chemicals before an operation, which Peterson recalled doing as a medical student. But as evidence grew of the role of touch, hospitals switched to making sure that everything that came in contact with the patients open surgical site was sterile going in, and disposed of or sterilized afterward.

At U-M and other sites, that same new concept came to inpatient care. Besides handwashing and gowning, the dishes that patients used at the new hospital were sterilized before and after use, as were clothes and bedding. Staff walked on cocoa-fiber mats saturated with mercuric chloride as they left, to keep from bringing infection out on their shoes. Staff couldnt eat on the clinical levels of the building. Cases of cross-infection among the patients were carefully traced.

Early success

Even while the new hospital was under construction, the team used the technique in the Palmer Ward for children, and showed that a case of chicken pox could be contained to the original patient without sickening other children.

Before, there had regularly been outbreaks of disease in both the adult and pediatric hospitals that required quarantining of entire areas after one patients infection spread to others. In 1911 alone, the Palmer Ward had been cordoned off for five months for a quarantine, and all but the most urgent surgical area had been stopped for a month.

In the first 11 months after the Contagious Hospital opened, its teams cared for 223 patients, most of them with chicken pox, mumps, scarlet fever, diphtheria and acute tonsillitis.

Only one trainee caught scarlet fever, but no others -- including the maids and janitor -- got sick.

And no quarantines were necessary in the main hospitals after the aseptic technique began being used there.

When the deadly influenza of 1918 hit Ann Arbor on September 23, after a soldier who had traveled from epidemic-stricken Massachusetts was admitted to the hospital, the aseptic tactics were well in use.

The U-M hospital admitted 130 other influenza patients in less than two months, even though half the doctors at the Medical School had been called up to military duty in World War I at the time. Only 13 of those hospitalized died. A report to the U-M Board of Regents in 1919 also noted that only five U-M students had died of the flu despite being in the highest-risk age group.

A long legacy

Even as the influenza pandemic raged, Dr. Cowie was fitting in research along with caring for patients. He studied what the infection was doing to patients adrenal glands, and tried injections of epinephrine and dead typhus bacteria on those with influenza-related pneumonia.

Though neither approach had a great effect, the research-based approach continued.

As Cowie wrote in a 1942 history of the Department of Pediatrics and Communicable Diseases, Immunizations of all kinds are made in this division of the clinic, not only for the patients but for the entire personnel of the University Hospital. These immunizations consist of vaccinations against smallpox, typhoid fever, diphtheria, and whooping cough, the giving of antitoxins, of immune serums, and of immune blood transfusions, and the carrying out of desensitizations of various kinds for those who are allergic. The Contagious Hospital laboratories employ a fulltime chemist and a full-time bacteriologist.

The Contagious Hospital continued to serve patients until 1956, around the time when the Division of Infectious Disease was formally created in the Department of Internal Medicine and intensive care units were proliferating in major hospitals.

Research on the prevention of cross-contamination of patients, and the protection of health care workers from occupational infectious hazards, has come a long way including a large body of work by U-M and VA Ann Arbor researchers. But the legacy of that first evidence-based facility lives on in some of the precautions taken today.

Read the rest here:

Stopping Contagion With Science at UM: A Look Back - University of Michigan Health System News

Research Associate – Bristol Medical School job with UNIVERSITY OF BRISTOL | 200491 – Times Higher Education (THE)

Research Associate

Job number ACAD104526Division/School Bristol Medical SchoolContract type Fixed Term ContractWorking pattern Full timeSalary 33,797 - 38,017 per annumClosing date for applications 29-Mar-2020

The University of Bristol is seeking a Research Associate to work with Dr Foster and team developing new therapeutic agents for diabetic kidney disease. This project is funded by an MRC Confidence in Concepts award. The primary aim is to lead to larger translational grant applications and industry investment to carry this therapy to the clinic.

The role will include tissue culture work with glomerular endothelial cells and in vitro expression systems. mRNA and protein quantification will be carried out in the form of qPCR, Western blotting and ELISAs. Mouse models of type 1 diabetes will be used (Streptozotocin). In vivo techniques such as urine collection, i.v. injection, blood extraction and cardiac perfusion will be carried out. An ex vivo glomerular albumin permeability assay will be used on glomeruli isolated from mouse kidneys.

For informal queries, please contact Becky Foster - 0117 331 3165, Becky.Foster@bristol.ac.uk

We welcome applications from all members of our community and are particularly encouraging those from diverse groups, such as members of the LGBT+ and BAME communities, to join us.

Read more:

Research Associate - Bristol Medical School job with UNIVERSITY OF BRISTOL | 200491 - Times Higher Education (THE)

Understanding what works: How the coronavirus is being beaten back – STAT

With Europe and the United States locked in deadly battle with the coronavirus that causes Covid-19, a number of countries that were hit early by the virus are doing a far better job of beating it back.

China, which is now diagnosing more cases in returning travelers than in people infected at home, reported no new domestically acquired cases on Wednesday, for the first time in more than two months. South Korea, which had an explosive outbreak that began in February, is aggressively battering down its epidemic curve. Singapore, Hong Kong, and Taiwan have together reported only about 600 cases.

Those successes have been bought by a layering of what are known as non-pharmaceutical initiatives including social distancing and travel restrictions aimed at severing chains of transmission to keep the virus from going into an exponential growth cycle.

advertisement

None of the other countries has been as aggressive as China, which put tens of millions of people into forced quarantine for weeks. And these other locales have not all adopted an across-the-board checklist of measures. While kids in Hong Kong havent been in school since late January, class continues in Singapore.

Heres a look at some of the techniques these governments employed, and how they stack up to steps being taken in the United States as well as the United Kingdom, which has come under heavy scrutiny for its approach, fairly or not.

advertisement

The island city-state was one of the first places to ban incoming flights from the Chinese city of Wuhan, where the virus originated. And it placed people coming into the country from countries affected by Covid-19 into mandatory quarantine.

Singapore has seen its numbers gradually tick up. But it hasnt had an explosion of cases, likely because it has aggressively tracked where the virus was circulating. Of the 345 cases it has recorded, 124 have recovered and 221 are considered active cases. It has not yet recorded a death.

Singapore has done everything right, said David Heymann, who led the World Health Organizations response to the 2003 SARS outbreak and now teaches infectious diseases epidemiology at the London School of Hygiene and Tropical Medicine. Theyve been openly communicating every day on whats going on. And theyve made it clear to the population and the population understands that they are not only to protect themselves but protect others.

Health authorities have severed several transmission chains, tracking down people who have been in contact with a known case and ordering them into home quarantine. They are checked twice daily to see if they developed a fever.

Mass gatherings were canceled. Schools have not been closed, though students go through temperature screening to enter. So does anyone entering most buildings or restaurants.

Heymann, who was in Singapore recently to lecture at Duke-NUS Medical School, said at the start of each class, a picture would be taken of the classroom, so that if any student became ill, there would be a record of who had been in close contact with him or her. So theres all kinds of innovations and measures going on, he told STAT.

Singapore also quickly developed a much-needed serology test a blood test used to look for antibodies in blood that are a sign of previous infection. Getting a handle on how many people have been infected is critical to understanding how deadly this virus really is, experts stress. Authorities in Singapore actually used the serology test in late February to find the source of a cluster of cases in a church group.

Hong Kong, like Taiwan and Singapore, bears deep psychological scars from the 2003 SARS outbreak. Hong Kong had the most cases of the disease outside of mainland China and people there remember the trauma that came with it.

So do their public health leaders, who have prepared for disruptive infectious diseases outbreaks in the years since SARS and the 2009 H1N1 flu pandemic. People take respiratory health hygiene seriously, routinely wearing surgical masks in public if they are sick to prevent spread to others.

These places were better equipped to face an outbreak of the new coronavirus than many others, Ben Cowling, a professor of infectious diseases epidemiology, and Wey Wen Lim, a graduate student in infectious disease epidemiology at the University of Hong Kong, wrote in a recent opinion piece in the New York Times.

Hong Kong responded very quickly within days of Chinas Dec. 31 announcement that it was finding unusual cases of pneumonia. Doctors were told to report any patient who had influenza-like illness and a travel history to Wuhan. Borders crossings into China were closed first some, then all.

Schools and universities havent been open since the Lunar New Year, on Jan. 23, though online learning has replaced classroom teaching in some circumstances.

Hong Kong has been testing for the virus, aggressively trying to locate cases. People have been urged to telework if possible and to practice social distancing.

Gabriel Leung, dean of medicine at the University of Hong Kong, said measures have largely worked, but the toll is high. And both he and Cowling are concerned people are starting to let down their guard.

I think we are already beginning to see a little bit of response fatigue among the people, Leung said, noting it has become apparent over the past couple of weeks. You see that people are beginning to mix again, theyre beginning to come out again, because its been two months already. So how do you still keep alert and keep this up? There is only so much that any population would be able to tolerate.

Taiwan didnt move initially to cut off air travel with Wuhan, as Singapore did. But doctors boarded incoming flights with temperature scanners looking for people who were unwell. Later it did ban most flights from China.

Mass gatherings were not banned, but were discouraged. The government controlled the distribution and pricing of medical masks, Cowling and Lim wrote. Stiff fines up to more than $30,000 were threatened for people who violated home quarantine orders.

All of these places are coupling aggressive testing strategies to identify cases, with isolation, contact tracing and sometimes quarantine of at-risk people, said Caitlin Rivers, an assistant professor of epidemiology at the Johns Hopkins Center for Health Security, speaking of Singapore, Taiwan, Hong Kong, and South Korea. And they have also layered on community mitigation strategies, school closures and other closures. So what I take away from that is that its important to layer these strategies to try to accommodate both of them.

Rivers tried to look at whether the measures were being successful at driving down new infection rates by pulling up data on other types of communicable infections, both respiratory illnesses, diarrheal diseases, and conjunctivitis. In a short analysis she posted on Twitter, Rivers noted that rates of these other infections declined after stringent social distancing practices were put into place.

The things that are also spread through close contact have fallen dramatically, and so that tells me its individual-level social distancing behavior that is contributing to the control, she said.

Indeed, the Republic of Korea has had a different trajectory than Hong Kong, Taiwan, and Singapore.

The new coronavirus took root in a large and closely knit religious sect, a development that led to an explosive outbreak, which the other three have not experienced. As of Wednesday South Korea has reported just over 8,400 cases and 91 deaths.

But whereas Western countries that have reached numbers like those see daily and every larger rises in their case counts, South Koreas outbreak curve has been beaten back. From a one-day high of 909 new cases on Feb. 29, South Korea has seen its daily case count rise by as few as 74 cases on Monday. That swung back up, though, on Thursday to 152.

The country is testing aggressively more than a quarter of a million people had been tested by March 15, Foreign Minister Kang Kyung-wha told the BBC recently.

Testing is central because that leads to early detection. It minimizes further spread and it quickly treats those found with the virus, she said, suggesting early detection and treatment may explain why South Koreas death rate is lower than other places with large numbers of cases.

South Korea introduced drive-through testing, allowing people to be checked for disease without even leaving their vehicles. Travelers returning from abroad have to provide contact information and report their health status for 14 days after their return via a mobile app, the South Korea CDC website reports.

It has recommended Koreans refrain from international travel at this time and urged people to avoid large gatherings and church services. Companies have been encouraged to allow workers who are able to work from home.

Many epidemiologists and mathematical modelers who have been plotting the possible trajectory of this pandemic think there is no choice but to try some of the serious social distancing measures other countries have taken.

But Marc Lipsitch, an infectious diseases epidemiologist at Harvards T.H. Chan School of Public Health, said the possibility of containment stopping spread through rigorous tracing of all contacts of known cases is not realistic. That window has closed, he said.

I think one thing to learn from those experiences is that whats appropriate when an epidemic is small and mostly ascertained is not appropriate when an epidemic is large and mostly not ascertained, he said.

I would say put in place as intense as possible social distancing and get the messaging from the White House consistent with that, Lipsitch said. Right away, everywhere, with the short-term goal of trying to reduce the demand on the health care system.

Any universities still in session should send students home, especially those living in dormitories which are one step away from cruise ships in terms of density and poor ventilation, he said.

Lipsitch said time is limited to make a difference.

The data that we just assembled from Wuhan about the timing and magnitude of the peak demand for critical care shows first that it can very quickly even without that many people being infected compared to the whole population exceed per capita bed capacity in the United States, Lipsitch said.

He noted there was a four-week lag between the shutdown of Wuhan and the overwhelming of critical care units. So if you wait till you see a problem, then you have another month of agony, at least.

It appeared that was the kind of message Britain was not heeding.

There was a huge controversy late last week when it seemed like the country intended to simply allow enough people to become infected so that the population would develop herd immunity.

Adam Kucharski, an associate professor of infectious diseases epidemiology at the London School of Hygiene and Tropical Medicine, said it was never the governments plan to drive toward herd immunity; rather, there was an acknowledgment that might be what happens because the virus could be so hard to control.

Its not been an aim to get everyone infected as soon as possible. Its more this really tough situation weve got where the options we have are probably not going to be able to fully control this in the long term, Kucharski said.

The country has now taken a swing toward the types of early and aggressive social distancing methods other countries are trying to implement. The government is urging people with even mild symptoms to self-isolate; but Kucharski worried that message was going unheard in the din about herd immunity.

The country, he said, was trying to save some of the more difficult measures really stringent social distancing approaches that are hard to sustain over time for closer to when they are needed.

It makes sense to use them, given that theyre short-term measures, use them when theyve got the most impact, Kucharski said. You cant shut down your country for months.

Rivers suggested that was a risky approach. I think thats a difficult thing to time. My recommendations for the U.S. context at least, is to begin social distancing measures early, she said.

In the United States, a tepid early response marked by a prolonged delay in ramping up testing and a White House that initially seemed intent on playing down the scale of the threat has given way to a war footing.

This week the White House urged Americans to embrace social distancing by not taking part in gatherings of more than 10 people. In a number of communities, restaurants are closed to all but takeout or delivery service. Some states have closed schools. The country is on edge.

But with large-scale testing capacity still coming up to speed, it remains unclear how deeply the virus has embedded itself into the country, and whether the measures people and their local, state, and national governments are trying to adopt can slow the coronavirus progress.

It is also unclear how long communities can sustain the dramatic lifetime changes that appear to be needed to slow the viruss spread.

Right now people are approaching this if they are basically sheltering in place for a Minneapolis blizzard, lasting two or three days. And thats the mindset that they have. Where, in fact, we need to look at this like a coronavirus winter, where were only in the first weeks of what could be a long season, warned Michael Osterholm, director of the University of Minnesotas Center for Infectious Diseases Research and Policy.

This could last easily many months. And we need to make our actions proportional to the risk in the community or else we run the risk of people just getting tired of them when that particular community has not seen increased transmission of the virus.

Read this article:

Understanding what works: How the coronavirus is being beaten back - STAT

Medical education in 2020: How we got here, where we’re headed – American Medical Association

More than a century ago, medical education in the U.S. was plagued by lax admission standards, unscientific protocols and shallow curricula. Several catalyzing events standardized American medical education, grounding it in protocols of scientific research and greatly boosting physician quality. A webinar explores the role of the AMA in these movements and outlines how the medical education system can further transform its approach to the betterment of public health.

The webinar, The AMA and medical education: How did we get here, and where are we going?, was produced by the AMA Accelerating Change in Medical Education initiative and featured speakers from the AMAs senior medical education staff.

One of the earliest milestones in the improvement of U.S. medical education was, in fact, the founding of the AMA, in 1847, with the goals of setting standards for ethics and medical education. Later, in 1904, the AMA established its Council on Medical Education, which began rating medical schools as a way to measure quality. One of its first outputs was a survey of 160 medical schools, which found only about half deserved an acceptable rating. Dozens later went out of business.

The council also played a key role in Abraham Flexners landmark 1910 report, Medical Education in the United States and Canada, which found huge variations in curricula and served as a wakeup call to the medical profession to standardize its education processes. By 1915, the standards advocated by the AMA Council on Medical Education had largely been adopted.

For the next hundred years or so, howeverdespite changing demographics, economics and technologythe curriculum and culture of medical education changed little. In 2013, in an effort to stimulate innovation, the AMA created the Accelerating Change in Medical Education initiative, which, over the next seven years, made $30 million in grants to 32 medical schools to jumpstart curricular and process changes and disseminate ideas. Thirty-seven schools now take part in the effort.

In 2019, the AMA launched its Reimagining Residency initiative, which has provided $15 million in five-year grants to eight projects to address the lack of continuity between medical school and residency, close gaps in preparation for residency and practice, and find new ways to support well-being for trainees.

Join the AMA at the inaugural GME Innovations Summit, Oct. 56, in Sacramento.

The presenters noted several areas in which educators, students and other stakeholders should expect the AMA to continue driving change in medical education:

Diversity of trainees. Health outcomes in underserved communities are improved when physicians are more representative of populations who live there. The AMA has numerous member groups that provide opportunities for members to influence policymaking, including the AMA Medical Student Section, the AMA Minority Affairs Section, the AMA Women Physicians Section and the AMA Advisory Committee on LGBTQ Issues.

Best practices in health systems science. Drawing on the AMA Health Systems Science textbook, medical schools across the U.S. have begun implementing this third pillar of medical education. A second edition will be published later this year. The AMA Health Systems Science Academy provides faculty, research and curriculum development resources.

Policy changes to support systemwide change. The recent change of the United States Medical Licensing Examination Step 1 exam from a three-digit score to pass-fail grading is one example of successful national efforts.

Coaching. The Accelerating Change in Medical Education Consortium has released It Takes Two: A Guide to Being a Good Coachee, a handbook focusing on what learners need to know to get the most out of a coaching relationship, as well as a corresponding text, Coaching in Medical Education: A Faculty Handbook, which provides a coaching framework and other tools for educators.

Lifelong learning. A new handbook from the AMA, Master Adaptive Learner, is an instructor-focused guide highlighting models for training future physicians to develop adaptive skills and utilize them throughout their careers.

Slides and an audio recording of the webinar are available in the Resources section of the AMA Accelerating Change in Medical Education digital community (registration required).

Read the original:

Medical education in 2020: How we got here, where we're headed - American Medical Association

Medical Student Organizing in the Time of COVID-19 – Pager Publications, Inc.

On Friday, March 13, my medical school canceled our classes.

I remember looking at the screen for a full minute, then searching for a loophole can we volunteer in the clinics? before concluding there wasnt one. As a third-year medical student, everything seemed to have fallen away Step 2 CS, away rotations, a planned infectious disease rotation in Thailand with nothing in its place. Nothing can be frightening, but it can also be an opportunity.

During medical school, I have become increasingly aware of how childcare needs put pressure on parents especially women in medicine. I have seen my peers struggle to balance didactic or clinical responsibilities with the needs of their families, and thats just with the usual demands of training. In a pandemic, with multiple school and day care closures, its completely unworkable.

Working with other medical students at Oregon Health & Science University, and with others all across the country, we have developed an initiative designed to match students with health care workers in a longitudinal one-to-one relationship to adhere to social distancing guidelines and provide necessary services such as childcare, petsitting, and errands. The initiative is still growing and changing into its final form, and its too early to say what that will be, but it has already helped our health care workers feel supported and made our community stronger.

Here are a few tips for anyone who would like to develop a similar initiative at their institution:

Image credit: hold | cancel (CC BY-NC 2.0)bywootam

Contributing Writer

Oregon Health & Science University

Emily is a third year medical student at Oregon Health & Science University in Portland, Oregon class of 2021. In 2015, she graduated from Reed College with a Bachelor of Arts in biology-psychology. She enjoys hiking, gardening, and experimenting with food preservation techniques in her free time. After graduating medical school, Emily would like to pursue a career in developmental and behavioral pediatrics.

View original post here:

Medical Student Organizing in the Time of COVID-19 - Pager Publications, Inc.

Marianne Neifert: Find a need and fill it – The Denver Channel

This is one of a series of stories about the ten women being inducted into the Colorado Women's Hall of Fame. Click here to learn more about this year's honorees and the women being inducted.

Tell us a little bit about your upbringing and family. How did your childhood shape who you are today?

I was the middle of five children--a boy, three girls, and a boy. People often talk about the middle child syndrome. However, I thought I was the luckiest one in the family, since I was the only child who had both an older brother and sister and a younger brother and sister. My middle position age-wise also helped me to be closer to each sibling, which was another bonus.

I was born at Bethesda Naval Hospital and grew up in a military family. My father was a WWII veteran and a Navy JAG officer. We didnt move as often as many military families do, although we re-located every 2-4 years during my childhood. When I was 9, while we were living in Northern Virginia outside Washington DC, my Dad was reassigned to the island of Guam in the Western Pacific for 2 years. I cherished that unique experiencethe local customs, diverse ethnicities, breathtaking setting, and recent WWII history. Even as a young child, I was keenly aware how fortunate I was to have such a unique cultural experience.

Education was a very high priority in my family. My mother not only was a college graduate, she earned a Masters Degree in 1941 from the University of Michigan at a time when very few women achieved such educational milestones. She was a high school English teacher, and could teach other subjects, as needed. My father was the youngest of five surviving boys, born to immigrant parents. His mother was widowed when he was 9 months old and struggled to provide for her 5 sons, 10 years and younger. Like my mom, my dad placed a high value on education and was the only one of his brothers who graduated college, and then earned a law degree.

As a middle child, I carved out a unique identity by striving to excel academically, with strong support from my parents. I have many fond memories of my father reviewing my homework, helping me find a show-and-tell item, and reassuring me that I could achieve any academic goal that I set. Although transferring to a new school can be challenging for children, I actually enjoyed the adventure of moving, crossing the country from coast to coast for our trips to Guam and later to Hawaii, which was the last place my father was stationed.

I completed the last two years of high school in Hawaii, where I loved being exposed to the diverse ethnicities, as well as living with other military families on a Naval base. After high school, I enrolled as a premedical student at University of Hawaii and had completed the first year of college when my father retired from military service. This was a decisive moment for me, since I had become engaged to another military dependent, Larry, during my first year of college. We met through the Navy bases chapter of DeMolay, where I had been selected as their Chapter Sweetheart. Larry, who was both Master Councilor of the chapter and Hawaii State Master Councilor, was my escort for the State Sweetheart Ball. That evening I was selected as State Sweetheart, based on the speech I had written and delivered on my chosen topic, How DeMolay Builds Self-Esteem in Boys.

Larry and I hit it off right away. You just know when its the right match. We met in July, and by Christmas Eve we were engaged. My family moved back to the Washington D.C. area the next Summer and Larrys family relocated to California. With only each other, we decided to get married on the anniversary of our engagement. I was just 18. By this time, Larry had joined the Navy Reserves, and his unit was being activated during the Vietnam War.

Meanwhile, I continued my pre-med studies at University of Hawaii in earnest. I began taking a very heavy course load so that I could graduate a year early and start medical school. As long as I can remember I had wanted to be a physician. Whenever I saw others who were dealing with disabilities, illness, or loss, I felt profound empathy. I wished I could somehow enter into their lives, appreciate what they were experiencing, and learn how I might alleviate their suffering. However, attending medical school on the mainland was no longer realistic, due to Larrys enlistment and our extremely limited financial resources. Miraculously, University of Hawaii opened a brand new, 2-year medical school the year before I graduated college.

Not long after marrying, my maternal instinct intensified, and I longed to become a mother. However, shortly after I became pregnant, Larry was deployed to the West Pacific aboard a Navy destroyer, and I was left alone. We had moved to a new neighborhood 3 days before he departed, and I felt more alone than I had ever been. I didnt yet have a drivers license and took public transportation everywhere, including to the University. It was a really low point in my life.

While Larry was deployed, I continued my studies and applied to the new U.H. Medical School. I was visibly pregnant for my interviews--all with male physicians. As my pre-med friends began receiving letters of admission, I received no response. When I inquired about my application status, I was told that the admissions committee was uncertain how to handle my application due to my pregnancy and that they preferred to defer my application until next year. I petitioned to address the committee members, and at this meeting, I explained that I had met all of the academic requirements to date and felt that I deserved to be admitted. I reasoned that if I could give birth in the middle of the semester, complete my courses, and attend Summer school to fulfill the final requirements to graduate early, that I deserved the right to start medical school in the Fall. Furthermore, if I failed to do all that, I knew there was a lengthy waiting list of applicants to fill my spot, and thus, the committee had nothing to lose by betting on me. A couple days later, I found a letter of acceptance in my mail box!

I learned several lessons that day: never underestimate the power of appeal; when you really want something, perseverance and dogged determination are required; and youthful exuberance can be a powerful asset! Fortunately, Larry returned home shortly before Peter was born. I got my drivers license two weeks later, attended summer school, graduated from U.H., and started medical school a month later.

I LOVED being a mom, and our second baby was born early in my second year of medical school. I had her induced after class on a Friday, and was back in class on Monday. This irrational birth plan was the result of a professors insensitive comment to me days earlier: When I was in medical school, pregnant women were expelled. I decided that it was imprudent to ask for time off and that I would have my baby without missing a beat. However, I am not proud of that decision today.

Since U.H. medical school did not yet have the clinical years of training, I transferred to University of Colorado School of Medicine (UC SOM) for the 3rd and 4th years of medical school. I chose UC SOM due to its strong reputation in pediatrics and because of the many Neifert extended family members who had lived here for several generations. I gave birth to our 3rd child during the 4th year of medical school, and our 4th child was born late in my Internship year. Our 5th baby arrived on the final day of my pediatric residency training.

The privilege of attending medical school at a time when women comprised only 10% of medical students nationwide was the fulfillment of a lifelong dream. To this day, I remain deeply grateful to have been awarded a Bernice Piilani Irwin (a friend of Hawaiian Queen Liliuokalani) Scholarship after high school that paid my tuition for University of Hawaii and U.H. Medical School, and also helped offset the cost of my UC SOM tuition for the 3rd and 4th clinical years. We each owe a great debt to all those who smoothed lifes paths for us.

Early in your career you developed an interest in lactation challenges and breastfeeding education. What inspired that?

I knew that my mother had been breastfed, so I always imagined that I would breastfeed my own babies. However, breastfeeding in the US was relatively uncommon during the 1940s, 50s, and 60s, due to a combination of influences, including: the development of infant formulas, the influx of women into the workforce, and the belief that bottle-feeding of formula was convenient, scientific, and modern. By 1968, when my first baby was born, only 18% of US infants were being solely breastfed at hospital discharge. By the 1970s, when US breastfeeding rates began to rise, a generation of unsupportive hospital maternity practices kept women from getting an optimal start breastfeeding after giving birth. Furthermore, health professionals received little to no training in the art of breastfeeding or the physiology of lactation so they were not equipped to knowledgeably counsel breastfeeding mothers or manage their lactation challenges. As a 3rd year medical student, I was expected to know about various specialty formulas, but was taught almost nothing about breastfeeding.

I was deeply committed to breastfeeding all of my children. However, I was unable to sustain breastfeeding as long as I would have liked, due to inadequate maternity leave; long separations from my babies, including overnight call; the lack of effective breast pumps or break times; and essentially no workplace support or knowledge about maintaining lactation when separated from an infant. Although I was grateful for the months of breastfeeding I was able to achieve with each of my first four babies, I experienced the intense disappointment and loss of untimely weaning. My 5th baby was born on the last day of my pediatric residency training, and I finally was able to make breastfeeding my high priority. By this time, I had already been helping mothers maintain lactation for their premature and sick infants in the Neonatal Intensive Care Units (NICUs) at University Hospital and Childrens Hospital. I had immersed myself in learning about the physiology of lactation and the management of breastfeeding challenges and had read countless books and articles about breastfeeding and lactation published in medical journals.

A 2012 CWHF inductee, Mary Ann Kerwin, was one of the founding mothers of La Leche League, International (LLLI) in 1956, and she had moved to Colorado shortly thereafter. Mary Ann was a powerful and inspirational role model for me and helped advance my career by recommending me to speak at national LLLI conferences, thereby launching my educational and thought leadership. During this era, LLLI was the preeminent source of breastfeeding information and support, and I rapidly became part of their movement to empower women to trust their own bodies and restore breastfeeding as a community norm.

Your nomination states that you were the first physician to identify and widely publicize examples of women who are unable to produce enough milk and newborns who may be at-risk for ineffective breastfeeding. This seems like a big deal. What do you think made other physicians miss, or dismiss, these observations?

As breastfeeding was making a comeback in the 1970s after 3 decades of a formula-feeding norm, breastfeeding proponents emphasized that every woman can breastfeed and every nursing baby will get exactly what s/he needs. If a breastfed baby wasnt thriving, it was believed that nursing more often would solve the problem (the more you nurse, the more you make.) This overly simplistic dogma was helpful in building womens confidence in their ability to nurse their baby. However, it contributed to baseless guilt among many disappointed women, who for legitimate medical reasons, were unable to produce enough milk. Furthermore, it placed babies in peril when they were unable to obtain sufficient milk by breastfeeding.

Early in my pediatric career, as I began helping breastfeeding mothers struggling with low milk supply, I conducted in-depth interviews and began examining womens breasts. I learned so much from my detailed conversations with mothers and by following their breastfeeding experience over time. One of the first key observations I made was the link between breast surgeries, marked breast asymmetry, and other breast variations and an increased risk of insufficient milk.

When my close colleague, Joy Seacat, and I co-founded the first center for comprehensive breastfeeding services in 1985, our learning curve increased dramatically. We had begun using highly accurate infant scales to measure an underweight babys milk intake when breastfeeding. The results were startling, as some babies who appeared to be nursing effectively actually transferred very little milk. The rule of supply and demand translates to the more milk that is removed, the more a mother makes. The converse also is true: If milk is not removed, the supply will dwindle. Thus, when a newborn is unable to remove milk effectively, mothers milk supply declines, making it even harder for the baby to obtain enough milk.

When the highly accurate infant scales showed that infants were not effectively removing milk, we began advising mothers to express any remaining milk with an effective electric breast pump to help maintain, and even increase, their milk supply. Plus, the extra milk expressed could be used to supplement the baby, thereby minimizing the use of essential formula.

Initially, many breastfeeding proponents argued that using accurate infant scales to measure an at-risk infants milk intake while breastfeeding would be intimidating for mothers. However, today the infant test-weighing procedure is standard practice in many settings, including in NICUs to monitor premature infants progress transferring milk as they gradually learn to breastfeed. It is now commonly recognized that many newborns are at risk for ineffective breastfeeding, such as late-preterm infants born at 34-36 weeks of gestation, early term newborns born at 37-38 weeks of gestation, newborns with even moderate jaundice, or smaller newborns, weighing less than 6 or 6 lbs. at birth.

Perhaps what I have enjoyed most in my career is sharing what I have learned about breastfeeding with diverse lactation care providers throughout Colorado and nationwide. I have been privileged to educate health professionals about breastfeeding management across Colorado and in all 50 states at diverse venues, ranging from presenting Grand Rounds at prestigious medical schools and lecturing to large audiences at national meetings of professional associations to speaking to staff at community hospitals in rural areas and health care workers on Native American reservations. I have been inspired and informed by dedicated breastfeeding champions and devoted nursing mothers wherever my travels have taken me.

When I first got involved in helping women overcome their breastfeeding challenges, breastfeeding was considered an individual womans personal choice. Today, I am proud to say that the maternal and infant health benefits of breastfeeding are so widely recognized that breastfeeding has been elevated to a public health priority, warranting society-wide support! In Colorado 90% of mothers begin breastfeeding their newborns, and more than 60% are still breastfeeding by 6 months. Early in my career, breastfeeding was not considered a legitimate topic in medical academia. Today, breastfeeding medicine increasingly is taught in medical schools, and physician experts in breastfeeding medicine are commonly represented on prestigious medical school faculties. When I first got involved in helping women overcome their breastfeeding challenges, breastfeeding was considered an individual womans personal choice. Today, I am proud to say that the maternal and infant health benefits of breastfeeding are so widely recognized that breastfeeding has been elevated to a public health priority, warranting society-wide support! In Colorado 90% of mothers begin breastfeeding their newborns, and more than 60% are still breastfeeding by 6 months. Early in my career, breastfeeding was not considered a legitimate topic in medical academia. Today, breastfeeding medicine increasingly is taught in medical schools, and physician experts in breastfeeding medicine are commonly represented on prestigious medical school faculties. You co-founded the Denver Mothers Milk Bank (MMB) in 1984. How did you come up with the idea, and what challenges did you have getting it started?

Well, like so much of my career, this was a very collaborative effort and another find a need and fill it story. In the early 1980s, a Denver mother, Joyce Ann, had given birth to a premature infant at a major local maternity hospital. She was unable to produce sufficient milk for her sick newborn. However, she knew human milk was superior to formula and had heard of donor human milk banks, so she asked the hospital staff about using donor milk. When she learned there was no MMB in Colorado, she met with me to inquire about starting one. I learned that the nearest MMB was in San Jose, CA, so we contacted staff there and began collaborating with them. My close colleague and I enlisted experts in infectious diseases, neonatology, and pathology, and we began meeting at Joyce Anns house to develop safe milk banking protocols.

When the Denver MMB opened its doors in 1984, I was the first Medical Director, and I continue to serve on the Advisory Committee. Today, the Denver MMB is the largest non-profit human milk bank in North American, and has distributed more than 6 million ounces of human milk from more than 14,000 donors who have come from every state, and has served hospitals in 33 states. As their vulnerable babies are helped by receiving donor human milk, mothers of recipient infants gain peace of mind and a sense of kinship with an unseen community of selfless women. When donor mothers express and share their surplus milk, they help ensure that they continue to produce more than enough for their own baby, making donation a win for everyone.When the Denver MMB opened its doors in 1984, I was the first Medical Director, and I continue to serve on the Advisory Committee. Today, the Denver MMB is the largest non-profit human milk bank in North American, and has distributed more than 6 million ounces of human milk from more than 14,000 donors who have come from every state, and has served hospitals in 33 states. As their vulnerable babies are helped by receiving donor human milk, mothers of recipient infants gain peace of mind and a sense of kinship with an unseen community of selfless women. When donor mothers express and share their surplus milk, they help ensure that they continue to produce more than enough for their own baby, making donation a win for everyone.What do you see as the biggest challenge for todays generation of breastfeeding mothers?

Women today not only want to breastfeed their babies, many experience intense pressure to do so in order to be a good mother. Ideal infant feeding recommendations include an emphasis on achieving exclusive breastfeeding until solid foods are introduced around 6 months and continuing breastfeeding for at least a year. Enthusiastic promotion of breastfeeding is often coupled with the maligning of infant formulas and a campaign to promote the risks of feeding artificial baby milk. Yet, insufficient breastmilk remains an all-too-common lactation challenge, and less than a quarter of mothers actually achieve the 6-month exclusive breastfeeding ideal. This dilemma for mothers has led to a dramatic rise in informal milk sharing, whereby mothers who have a surplus of milk share (or sell) their milk among mothers who dont produce enough. Although the FDA discourages the use of unscreened, unprocessed milk from another mother, the practice appears to be growing.

Our modern electric breast pumps with dual collection kits allow mothers to express milk from both breasts faster than they can nurse their baby. For a variety of personal reasons, at least 5% of women exclusively pump and feed expressed milk. Since employed mothers are separated from their infants for many hours each day, expressed milk is often fed by another caretaker. The dramatic rise in feeding expressed breast milk and informal milk sharing suggest that our society values the product, human milk, more than the relational process of breastfeeding. I want to remind mothers that breastfeeding is both a source of nutrition and an intimate relationship. Even moms who are unable to supply all of their babies nutritional needs by nursing, and thus need to offer supplements to their infant, can reap the significant mutual rewards of the cherished, intimate breastfeeding relationship.

I fear that breastfeeding has become one more source of pressure on women, many of whom still fall victim to the Superwoman Syndromethe unrealistic expectation that we must achieve perfection in every life arena, and that anything less than perfection is equated with failure. The widespread use of social media further exacerbates the pressure many women experience to be viewed as perfect. A new term, Breastfeeding Guilt, has been coined to described the profound sense of loss, sadness, and even shame that can result from a disappointing breastfeeding experience. Rather than increasing the pressure on women to breastfeed, we need to further increase society-wide breastfeeding support and services to enable women to reach their personal breastfeeding goals.

Is there a message you want to make sure we are sharing with others?

When I was young, I thought I had to do everything at once. Now, I have learned the value of doing things more sequentially, and I recognize that there are different seasons of life. Being a mom is an awesome, indeed a sacred, privilege. If I could go back, I would take more time to integrate each baby into our family. I would work part-time, instead of full-time, when my children were young. I would savor more precious moments, and say no to the requests of others more often in order to say yes to my own priorities. I want to make sure other women are encouraged to live authentically within their personal value system.

Each one of us has unique signature strengths, and its important to get in touch with those special, individual attributes. We are richly blessed when we find a way to use those signature strengths in as many life arenas as possible (family, career, community), and in service to something greater than ourselves. In my own journey, it has been an immense privilege to find a need and fill it and to be fulfilled in the process. I consider my work with breastfeeding mothers to be integrally linked with launching families, with helping new parents navigate such a precarious transitionin a way, giving other mothers what I would have loved to receive as an, often overwhelmed, new mother myself. Looking back, I can say with immense satisfaction, Hasnt it been great!?

Continued here:

Marianne Neifert: Find a need and fill it - The Denver Channel

UK universities switching to online lectures and exams – The Guardian

British universities are ending in-person lectures in an effort to arrest the spread of Covid-19, saying they will switch to remote learning and even online exams for students within weeks.

The London School of Economics, Kings College London, the University of Durham and Manchester Metropolitan University said they would soon end face-to-face teaching in favour of digital delivery, including video lectures and online seminars.

The announcements came as several universities said they planned to curtail public events, with Cambridge Universitys medical school and others looking to pause teaching and clinical exams because of the pressures on the NHS.

The LSE announced the most ambitious plans, saying all undergraduate and postgraduate courses will be delivered online by 23 March for the rest of the academic year, with many of its overseas students wanting to return home immediately.

Kings College London and the LSE also plan to stop in-person examinations, with the LSE saying that all undergraduate and taught postgraduate exams and assessments this summer would be taken online or graded using alternative methods.

LSE has been preparing for a range of scenarios and, given the exceptional circumstances, we believe the best decision is to move to online assessments now, to give you as much notice as possible, the LSEs director, Minouche Shafik, told students.

Whilst we are changing our mode of teaching and learning and taking measures to be responsive to an evolving situation, LSEs campus will remain open. We have had no indication from Public Health England that we should close, and buildings, services and facilities will run as usual.

Staff and students can be on campus and our LSE Library and halls of residence are also open to you.

The decisions to stop students congregating in lecture halls are at odds with the UK governments position that schools and colleges should remain open where possible. The universities stance follows that of US institutions, such as Harvard, which have kept campuses open but ended lectures and seminars in favour of remote learning.

Durham University said all forms of campus teaching, including field trips and one-to-one tutorials, would be replaced with remote learning from next Monday for the final week of term before the Easter holidays.

Please do not turn up to classrooms next week, Claire OMalley, Durhams pro-vice-chancellor, told students in an email.

We know that this may be not be your preferred method of learning and that being in classrooms is an important part of your university experience. However, moving to online learning will help limit exposure to Covid-19 by reducing group activities. This will help all of us as the coronavirus spreads.

Malcolm Press, Manchester Metropolitan Universitys vice-chancellor, warned students that the university is also planning how best to deliver assessments, exams and credits, should we need to change our usual processes for the summer term.

Cambridge University confirmed that its medical school is among those that are planning to halt clinical teaching for its trainee doctors.

In the light of the Covid-19 outbreak and the pressure this is putting on the NHS, the University of Cambridge School of Clinical Medicine has cancelled its final clinical examinations, subject to approval from the General Medical Council, the university said.

The exams would have involved students interacting with large numbers of NHS patients and they require over 200 examiners, all hospital doctors or GPs, over a two-week period.

The students have already completed their final written examinations and been assessed on clinical competence in previous examinations and on placements in a range of clinical environments.

An email to Cambridge medical students from the school said: We have had to make some extremely difficult decisions based on the principle that students going in and out of clinical environments could be an unnecessary source of virus transmission, they may be putting their patients and themselves at greater risk and there may be too few staff available to deliver formal clinical teaching, either through pressure of work or illness.

Follow this link:

UK universities switching to online lectures and exams - The Guardian

Medical School Coming to Northside Regeneration in St. Louis – ConnectCRE

March 13, 2020

PonceHealth Sciences University plans to build an $80-million medical school campus in the heart of locally-based M Property Services NorthSide Regeneration development in North St. Louis. The school will support up to 1,200 students and create up to 120 staff and faculty positions in the St. Louis area. Construction is set to begin later this year or early 2021.

The new medical school campus will be located in North St. Louis near Jefferson and Cass Avenues on the former Pruitt-Igoe site and is one of several projects underway within the NorthSide Regeneration development, which also includes a new $1.75 billion National Geospatial-Intelligence Agency West headquarters currently under construction. The school is tentatively scheduled to open in fall 2021.

PonceHealth Sciences University is going to be significant to our town, said M Property Services chairman Paul McKee, Jr.

Connect With M Property Services

Get CRE News in 150 words

For comments, questions or concerns, please contact Paul Bubny

Tags: Development, Healthcare, Mixed-Use

development healthcare mixed-use

chicago-news midwest-news

Medical School Coming to Northside Regeneration in St. Louis

Paul Bubny

More here:

Medical School Coming to Northside Regeneration in St. Louis - ConnectCRE

Aging Out of the Mammogram – The New York Times

When Janet Halloran last saw her primary care physician, the doctor asked whether she had undergone her annual mammogram. Yes, she replied, she had.

At 76, Ms. Halloran, a real estate broker in Cambridge, Mass., is past the age that most medical guidelines recommend breast cancer screening for someone with no history of the disease. Even for younger women, the guidelines call for a mammogram every other year, not annually.

So Ms. Halloran could consider stopping mammograms, or at least having them less often. But her doctor has never discussed that prospect. She says, These are the things you need to do, Ms. Halloran said. Besides, she added, its an easy test: Go once a year, hold your breath and youre done for another year. Its just routine.

But for older women, should it be?

Theres been a lot of uncertainty, said Dr. Xabier Garcia-Albniz, an oncologist and epidemiologist at RTI Health Solutions and lead author of a new observational study that tries to answer that question. This is an area with a complete lack of randomized clinical trials.

Breast cancer studies, like medical research in general, have often excluded older subjects. So the data on whether mammography improves survival is very limited in women ages 70 to 74, and nonexistent for those 75 and older.

Thats why the independent U.S. Preventive Services Task Force has concluded that while having mammograms every other year improves survival for women ages 50 to 74, theres insufficient evidence to assess their use for those over 75.

The American Geriatrics Society includes screening for breast and other cancers on its Choosing Wisely list of tests that should be questioned. It urges doctors not to recommend it without considering life expectancy and the risks of testing, overdiagnosis and overtreatment.

Yet more than half of women over 75 have had a screening mammogram (a test for individuals with no history or symptoms of breast cancer) within the past two years, the Centers for Disease Control and Prevention reported in 2018.

Whether this investment in breast cancer screening alters survival is a critical question, said Dr. John Hsu, a health services researcher at Harvard Medical School and senior author of the new study, published in the Annals of Internal Medicine.

The research team used Medicare claims from 2000 to 2008 to follow more than one million women, ages 70 to 84, who had undergone a mammogram.

They had never had breast cancer and had a high probability, based on their medical histories, of living at least 10 more years. Thats the population who will reap the benefit of screening, Dr. Garcia-Albniz said, because it takes 10 years for mammography to show reduced mortality.

The researchers divided the subjects into two groups: one that stopped screening, and another that continued having mammograms at least every 15 months. They found that mammograms provided a survival benefit, if a modest one, for women ages 70 to 74. In line with previous research, the study found that annually screening 1,000 women in that age group would result, after 10 years, in one less death from breast cancer.

But among the women who were 75 to 84, annual mammograms did not reduce deaths, although they did, predictably, detect more cancer than in the group that discontinued screening.

Youre diagnosing more cancer, but thats not translating to a mortality benefit, Dr. Garcia-Albniz said.

Why not? The cancers themselves might be different at different ages, Dr. Hsu said. They might grow faster or slower, or be more likely to spread.

Treatments may also be less effective at older ages, said Dr. Otis Brawley, an oncologist and epidemiologist at the Johns Hopkins University School of Medicine, who wrote an editorial accompanying the study.

But older people typically are also subject to what researchers call competing mortality. Many of the cancers detected by mammography tiny tumors that earlier technology wouldnt have spotted are unlikely to cause any harm if left untreated. But most older people have other diseases that will progress.

Its very difficult to tell someone in her 70s or 80s that were going to modify your treatment, or not treat you, because of the likelihood that something else will kill you before this cancer will, Dr. Brawley said.

That reluctance to discuss life expectancy and the limitations of screening also means that many women dont recognize that, in addition to being inconvenient, expensive and a cause of discomfort or anxiety, mammograms can actually do harm. The tests often prompt unneeded surgery, radiation or drug regimens for cancers that would never have caused symptoms or shortened lives.

Still, because life expectancy varies widely, some very healthy older women may live long enough to benefit and may indeed want screening. Mammograms could lead to treating an aggressive cancer earlier, and with less extensive surgery, for instance.

I would be very happy if doctors started using our paper to inform the discussion they have with their patients, Dr. Garcia-Albniz said.

Yet women remain so committed to regular mammograms that experts doubt they could recruit enough people for a large randomized trial in which half the subjects forgo the tests.

Dr. Mara Schonberg, an internist at Beth Israel Deaconess Hospital in Boston, has worked for years to help women make decisions about breast cancer screening, and has found it tough going.

These women were told for 40 years to get screened, Dr. Schonberg said. They get reassurance from a negative mammogram. And its very hard to understand that finding breast cancer early may not help you live longer or better.

To help explain, Dr. Schonberg developed a decision aid: a brochure, written at a sixth-grade reading level, that uses research findings to explain the pros and cons.

A pilot study showed that, after reading it, women from 75 to 89 were more knowledgeable about mammography, more apt to discuss it with their doctors and less enthusiastic about continuing it.

But they did continue. More than 60 percent, including those with lower life expectancies, had another mammogram within 15 months. A larger study with 546 participants, being readied for publication, will report similar results, Dr. Schonberg said.

Perhaps, as Dr. Brawley said, the most important thing we can do is get people to understand what the questions are, and to understand that nobody has the exact answers.

But Dr. Schonbergs grandmother, who followed her doctors recommendation and had a mammogram at age 78, came to a more definitive conclusion.

Ann Schonberg was a Detroit homemaker and a lifelong smoker with mild emphysema. When her mammogram found a small Stage 1 cancer, she underwent a lumpectomy and began endocrine therapy, taking drugs that might lower the risk of recurrence. She didnt like how she felt, so she stopped everything after three years, Dr. Schonberg said.

When Ann Schonberg reached her mid 80s, a mammogram picked up another small cancer, prompting another lumpectomy. At the same time, although she had stopped smoking at 80, her emphysema worsened steadily. That is what caused her death at 88, not breast cancer.

All the doctors appointments, the surgeries, the worry for her, it was all for naught, Dr. Schonberg said. Shortly before Ann Schonbergs death, she told her granddaughter, I wish Id never had that mammogram.

[Like the Science Times page on Facebook. | Sign up for the Science Times newsletter.]

Continued here:

Aging Out of the Mammogram - The New York Times

Medical Students Proceed with Caution as New York City Campuses Maintain Some Activity – Cornell University The Cornell Daily Sun

While Tompkins County has no confirmed cases of COVID-19, New York City the location of both Weill Cornell Medicine and Cornell Tech is in the epicenter of an outbreak with more than 300 cases between New York City and nearby Westchester County.

Cornell Tech transitioned to online classes on March 12, and Weill Cornell Medical followed, announcing the shift to online classes earlier in the week.

Despite Cornell Techs move to online instruction, major facilities, including main residence hall The House and its on-campus cafe are still in operation. Employees at Cornell Tech are expected to carry out their duties as normal, unless they are feeling ill.

While Weill Cornell has transitioned its lectures to digital alternatives, there are educational activities that cannot as easily be transitioned online, like cadaver dissections, clinical rounds and laboratory work.

The top-tier medical school is structured in a way that students spend the first year-and-a-half studying in a traditional classroom setting. For these students, the transition to digital education was not new.

A lot of med students are used to watching lectures online because they record and post them. From my experience half of [the students] would go to lecture and half of them would watch them online, said Arpita Bose, a third-year medical student at Weill Cornell Medicine.

To adapt, larger lectures will be substituted with archival recordings from previous years, while smaller group discussions will be conducted via video conferencing.

In the middle of their second year, students begin clinical rotations, following physicians in traditional medical settings.

For these students, circumstances are ever-evolving. Currently, those in clinical rotations are expected to report to their rounds as normal, but are prohibited from interacting with individuals that have tested positive, or are being tested for COVID-19, according to Bose.

As it stands, student researchers are continuing their activities, but principal investigators have been asked to weigh the benefit of continued research against the possible risk of interacting with a patient that knowingly or unknowingly has COVID-19.

With these unprecedented circumstances come many fast-evolving questions that have yet to be answered.

I think everything is so fast paced and everything is changing so quickly its hard to get a good understanding of whether or not we should be concerned or what we should be telling friends and family, Bose said.

University administration is doing its best to answer these questions, interacting with different student committees to provide the necessary information and resources should any students test positive for COVID-19.

One question that looms over the administration is the status of graduation and match day a momentous day where medical students are told where they will complete their residency and spend the next several years of their lives.

Match day is the cumulation of years of work for medical students, similar to high school students receiving college acceptances. However, many schools are canceling Match Day festivities in light of the necessity for social distancing.

Fellow New York City medical schools, including Columbia University Vagelos College of Physicians and Surgeons and Icahn School of Medicine at Mt. Sinai, have canceled their events.

The administration at Weill Cornell is hesitant to cancel these significant occasions, according to Bose, but it is closely monitoring the spread of the pandemic and assessing the possible risk of these gatherings.

See original here:

Medical Students Proceed with Caution as New York City Campuses Maintain Some Activity - Cornell University The Cornell Daily Sun

Cured: inside the remarkable world of unexplained medical recoveries – Telegraph.co.uk

At 63, Claire Haser was looking forward to a quiet retirement in Hawaii when she was diagnosed with pancreatic adeno-carcinoma, the most lethal form of pancreatic cancer, which kills 96 percent of those it affects within five years. The former healthcare administrator was offered Whipple surgery, a risky and invasive treatment which would remove part of her pancreas and stomach, leaving her in her debilitating pain. But she decided against it after watching hours of YouTube footage of Whipple patients writhing in agony.

Instead, Haser changed her diet, shifting towards plant-based foods and eliminating sugar; and, psychologically, she accepted the inevitability of her own demise, forgiving those with whom she had quarrelled and embracing friends and family in her tight community in Portland, on the west coast of the United States. In 2013, five years after her dismal prognosis, Hasers doctors were baffled when a CT scan showed the tumour had vanished.

Dr Jeff Rediger uses Hasers story at the beginning of his provocative new book, Cured: The Remarkable Science and Stories of Spontaneous Healing and Recoveries, to help his readers understand the phenomenon of spontaneous remission: recoveries that cannot be explained by conventional medicine.

Historically, doctors have tended to ignore stories like Hasers because they are not seen to hold medical value. Rediger writes: We have almost never used the tools of rigorous science to investigate remarkable recoveries from incurable illnesses its as if were embarrassed.

A psychiatrist on the faculty at Harvard Medical School, and director of the Harvard-affiliated McLean SouthEast adult psychiatry programme, Rediger draws heavily from the thinking of Claude Bernard, a French physiologist who argued in the 1860s that illness could not be explained only by germ theory, the dominant explanation for viruses since the 19th Century, which attributes illness to the spread of deadly pathogens. Bernard said it is also worth considering our milieu interieur, or inner environment. Viruses only attach themselves inside our body because we have poor immune systems, he argued, in much the same way that deadly mosquitoes assemble at stagnant water; they do not make the water stagnant in the first place. To impress his students, Bernard even drank a glass of cholera-infected water, explaining that the fact he did not become ill was because of his healthy inner terrain.

And the best way you can strengthen your own inner terrain, Rediger says, is by soothing chronic inflammation, which he describes as the immune system gone awry. Inflammation is the redness and swelling found in your skin or tissue when it gets infected; it is a sign of your immune system fighting germs, and it normally comes and goes within hours. But problems occur when inflammation persists, wearing down the bodys tissue and creating conditions that are ripe for disease.

He meets Juniper Stein, for example, an accountant from Philadelphia who was diagnosed in her twenties with autoimmune disease (AS); her immune system mistakenly believed it had found an enemy virus, and sent out armies of defend and repair cells to the sacroiliac area of her pelvis. As a result, her body became locked in a vicious cycle of inflammation. She took Naproxen, an anti-inflammation medicine, but eventually abandoned it after deciding it was having little effect. She turned instead to a daily practice of yoga and Rolfing, an intense form of massage, and felt her pain gradually disappear. Three decades later, there is no trace of AS in her body.

By focusing his attention on inflammation, Rediger builds on a growing body of research which blames the over-active immune system for a range of ailments, including debilitating physical conditions like chronic fatigue syndrome or Myalgic Encephalomyelitis (ME). It has even be linked to mental illness; in last years book, The Inflamed Mind, Ed Bullmore argues that some cases of depression might be caused by inflammation, and argues for the integration of mental and physical care within the NHS.

Changing your diet is another way of soothing inflammation. Rediger recommends eliminating toxins by cutting out all processed foods and sugar. 100 years ago, wed eat four pounds of sugar a year. Now we eat 154 pounds. Ive seen my own health transform because Ive followed [this advice]. I cant get sick anymore.

Perhaps the most exciting of Redigers recommendations is his chapter on stress reduction and positive social interaction, or spending time with the people you love and the people who make you laugh, as he puts it. Historically, he says, doctors have struggled to discuss so-called healing heart because of its proximity to the controversial world of faith healers. Some of his doctor friends have gone as far as to keep their faith a secret.

But now he thinks we are seeing the emergence of a modern spirituality, which focuses on how a positive outlook can improve your physical health, and is perfectly compatible with medicine and science. They are deeply complementary and not at all bitter bedfellows, says Rediger, who was raised in an Amish family and, on top of his esteemed medical qualifications, earned a degree in divinity from Princeton Theological Seminary.

Indeed, he says there is strong evidence that positive emotions boost our immune system because they stimulate serotonin and dopamine, the pleasure hormones; and turn down cortisol and norepinephrine, the stress hormones. He quotes Barbara Fredrickson of the University of North Carolina, who has shown in study after study that small moments of connection with the people around us - everybody from our husband or wife to the barista who serves us coffee - helps to tone our vagus nerve, which emits into our blood oxytocin, our bodys wonderful love hormone. Crucially, these good hormones have anti-inflammatory qualities, helping to soothe your inflamed tissue.

At no point in the book does Rediger question the value of traditional medicine. I believe in vaccines, I believe in medicines, he says, firmly. Indeed, it is inadvisable and highly dangerous to rely on one of these alternative solutions instead of a doctor-backed treatment like chemotherapy, and virtually all of his examples are patients who had run out of road as far as conventional treatments were concerned. Claire Haser, for example, was told that her likelihood of living another five years was just five percent, even with a successful Whipple surgery. Rediger simply wants his readers to realise that medicine may be more complicated than we think.

Doctors are trained not to give false hope, Rediger says. I think thats good, but its not the whole story. When facing an awful diagnosis, people need grounded, realistic advice, but also something that says, What is your situation? What do you want to do? Whatever path that person takes, it needs to feel liberating.

Dr Jeff Redigers Cured: The Remarkable Science and Stories of SpontaneousHealing and Recoveries (Penguin Life) is available to buy for 9.99 from 19th March.

Read more here:

Cured: inside the remarkable world of unexplained medical recoveries - Telegraph.co.uk

Mass. General, Brigham and Women’s, Harvard Medical School shutting down most research labs to try to slow spread of coronavirus – Universal Hub

Officials at Partners HealthCare - which includes MGH, Brigham and Women's and McLean Hospital - yesterday directed their large research staffs to begin shutting down their labs to keep people away from each other, and told them to expect the labs to stay shut for up to eight weeks. Researchers working on Covid-19, however, will be allowed to continue their lab work.

We realize that our investigators are working hard to improve our understanding of disease and develop new treatments for our patients. This is essential work that we dont want to derail, but the urgency of the current pandemic will require that some of this work be temporarily put on hold.

The memo alerts researchers that, as employees of hospitals at the center of the crisis, they could be called back to work to help clinicians deal with a possible crush of Covid-19 patients.

The memo details the new policy:

In response to the rapid spread of COVID-19, it is imperative that we minimize to the greatest extent possible the number of personnel working in our laboratories. Therefore, we are moving policy for research operations to Level 4 - Only work needed to perform essential maintenance activities such as preserving important samples and critical animals may be performed. [Principal investigators] must begin to implement Level 4 immediately and have their entire lab in compliance not later than 5pm, Friday, March 20. We will reassess as the situation evolves, but anticipate being at Level 4 for the next 6-8 weeks.

It continues:

Lab experiments/operations will shut down completely with virtually no one remaining in a lab or research core after 5pm on Friday, March 20. Only personnel who, in the judgment of their supervisor/PI, are in Level 4 (needed to perform essential maintenance activities such as preserving important samples and critical animals) may access our laboratories. Those who do are reminded that they must still abide by the current published Partners guidance related to social distancing and reporting illness symptoms.

All personnel in Level 1 (work that can be accomplished remotely), Level 2 (work that can be delayed or stopped, i.e., non-essential lab experiments that would require onsite presence to continue), and Level 3 (work to ensure that long-term experiments and vital lab programs remain operational) are directed to stay home and work remotely.

Supervisors/PIs should have staff members perform tasks that can be done remotely. This could include writing a paper, literature searches on new techniques, assistance with grant applications, online training, updating documentation in LabArchives, updating online research profiles and lab websites, etc. For clinical researchers, consider updating clinicaltrials.gov records, protocol reviewing/writing/updating, completing OnCore reconciliations, and conducting virtual or phone clinical trial visits. For animal researchers, complete triennial review protocols and review/write/update IACUC applications.

In addition to Covid-19 researchers, researchers with "a long-term experiment underway that is critical to the survival of their lab once operations resume" can petition to be allowed into their labs.

The memo adds that "the salaries of personnel directed to stay at and work from home will be covered for a period of time," but that Partners is still figuring out a long-term policy.

Read more from the original source:

Mass. General, Brigham and Women's, Harvard Medical School shutting down most research labs to try to slow spread of coronavirus - Universal Hub

Mount Sinai boosts diversity with education programs – ModernHealthcare.com

Despite projections by the U.S. Census Bureau that more than half of the total population will belong to a racial minority group by 2044, healthcare currently is fairly racially homogenous.

African-Americans account for more than 13% of the total population yet make up only 5% of active physicians, according to the Association of American Medical Colleges. Latinos represent nearly a fifth of the total population in the U.S., but only account for 5.8% of all active physicians.

Healthcares lack of diversity can result in biases and miscommunication, and gaps in care.

Black and Latino adults in 2016 were less likely than white adults to receive regular care and were less likely to have had a medical visit over the previous 12 months, according to a 2018 research brief by the Kaiser Family Foundation.

The Affordable Care Act attempted to abate this disparity by supporting several key programs.

The National Health Service Corps received up to $4 billion from 2010 to 2015. The Corps provides scholarships and loan repayment help to healthcare professionals who serve for a period in medically underserved areas. Racial and ethnic minorities make up approximately one-third of program participants.

The ACA also reauthorized the Health Resources and Services Administrations Health Careers Opportunity Program and gave it $60 million from 2011 to 2014. Established in 1972, the program helps students from economically or educationally disadvantaged backgrounds enter and graduate from health professional schools.

That program bolstered institutions like the Icahn School of Medicine at Mount Sinai Health System in New York City, which received $3.2 million over five years.

We needed to make sure that our high school and college students understand how different the world of medicine might be when theyre ready to practice medicine, said Dr. Gary Butts, chief diversity and inclusion officer at Mount Sinai Health System and senior associate dean for diversity programs for the Icahn school.

But Mount Sinais effort began around 1998 when the medical school dean at the time felt a desire for the student body to better reflect the surrounding community of East Harlem. The school ended up producing relatively few minority medical graduates to employ at the system since competition for them was tight.

Butts said it became clear that the way forward was to implement what he called the grow our own model. The approach called for investing in a pipeline to increase the number of minority students who matriculate into medical school.

See the original post here:

Mount Sinai boosts diversity with education programs - ModernHealthcare.com


12345...102030...