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Tag: COVID-19

COVID-19 & Fertility Care: Remote Monitoring Meets Fertility Benefits for Better At-Home Option

By JESSICA DaMASSA, WTF HEALTH

Trying to achieve pregnancy with fertility treatments can be challenging, stressful, and expensive in the best of times — let alone a global pandemic. Since the COVID-19 outbreak in the U.S., fertility care has been basically “paused,” and women attempting to conceive have been left with a very different set of decisions and options for care than were available pre-pandemic. So, how does fertility care shift from the clinic to the home? Tammy Sun, co-founder & CEO of fertility benefits startup Carrot Fertility, and Lea Von Bidder, co-founder & CEO of Ava, a women’s health tech startup best-known for its ovulation tracking bracelet, stop by to talk about how they are redefining the how, when, and where of fertility care for greater success outside the doctor’s office.

What’s smart about this partnership? How the two companies are working together to build off the biometric data collected by Ava’s tracker, basically adopting a remote monitoring approach to collecting and analyzing data in the home in effort to either help optimize the chances of getting pregnant naturally, or better inform the IVF or other medically-assisted procedures that will return as options as the pandemic wanes. From the impact on would-be-parents and their employers to the sentiment of women’s health investors, we talk through the opportunities and challenges of expanding fertility care in the home.

Silence Can Be Deadly: Speak up for Safety in a Pandemic

By LISA SHIEH MD, PhD, and JINGYI LIU, MD

Jingyi Liu
Lisa Shieh

There have been disturbing reports of hospitals firing doctors and nurses for speaking up about inadequate PPE. The most famous case was at the PeaceHealth St. Joseph hospital in Washington, where Dr. Ming Lin was let go from his position as an ER physician after he used social media to publicize suggestions for protecting patients and staff.  At Northwestern Memorial Hospital in Chicago, a nurse, Lauri Mazurkiewicz warned colleagues that the hospital’s standard face masks were not safe and brought her own N95 mask. She was fired by the hospital. These examples violate a culture of safety and endanger the lives of both patients and staff. Measures that prevent healthcare workers from speaking out to protect themselves and their patients violate safety culture. Healthcare workers should be expected to voice their safety concerns, and hospital executives should be actively seeking feedback from frontline healthcare workers on how to improve their institution’s Covid-19 response.

Share power with frontline workers

According to the Institute for Healthcare Improvement, it is common for organizations facing a crisis to assume a power grab in order to maintain control. As such, it is not surprising that some hospitals are implementing draconian policies to prevent hospital staff from speaking out. While strong leadership is important in a crisis, it must be balanced by sharing and even ceding power to frontline workers. All hospitals want to provide a safe environment for their staff and high-quality care for their patients. However, in a public health emergency where resources are scarce and guidelines change daily, it’s important that hospitals have a systematic approach to keep up.

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Community Organizations Can Reduce the Privacy Impacts of Surveillance During COVID-19

By ADRIAN GROPPER, MD

Until scientists discover a vaccine or treatment for COVID-19, our economy and our privacy will be at the mercy of imperfect technology used to manage the pandemic response.

Contact tracing, symptom capture and immunity assessment are essential tools for pandemic response, which can benefit from appropriate technology. However, the effectiveness of these tools is constrained by the privacy concerns inherent in mass surveillance. Lack of trust diminishes voluntary participation. Coerced surveillance can lead to hiding and to the injection of false information.

But it’s not a zero-sum game. The introduction of local community organizations as trusted intermediaries can improve participation, promote trust, and reduce the privacy impact of health and social surveillance.

Balancing Surveillance with Privacy

Privacy technology can complement surveillance technology when it drives adoption through trust borne of transparency and meaningful choice.

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Three Things I Hope Health Care Won’t Recover From

By RANDY CARPENTER

The loss of lives and livelihoods from COVID-19 are almost too much to comprehend. And yet, slowly, conversations are emerging about the positives percolating from the pandemic.

It’s human nature to want to look for the positives in even the worst of situations, and I’ve noticed that in both my personal and my professional circles of late, people are talking about the things they hope we don’t lose when things go back to “normal.” 

Chief among them, especially in my healthcare technology circles, is a level of humanity that our previously faster-paced lives, ways and organizations had perhaps too often and too easily dismissed. The humans on the frontline of care delivery, for example. The effects of social isolation on healthy people, much less those who are sick. The struggle and juggle of modern work-life balance. Inequalities in healthcare access and delivery.

We’ve long talked about technology’s ability to make some of these things easier, to close some of these gaps, but now we know just how possible they are when people, politics and policy unite in the face of a pandemic. We now know just how quickly even the largest and slowest-moving of health systems can change course and even course correct.

Until now, it’s been far easier to talk about the promise of technology, telemedicine and remote workforce scenarios than it was to actually deploy them. Because before, to deploy such solutions also meant loss; loss of control, loss of normalcy, loss of humanity. Until now.

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Contact Tracing: 10 Unique Challenges of COVID-19

Deven McGraw
Eric Perakslis
Vince Kuraitis

By VINCE KURAITIS, ERIC PERAKSLIS, and DEVEN McGRAW

This piece is part of the series “The Health Data Goldilocks Dilemma: Sharing? Privacy? Both?” which explores whether it’s possible to advance interoperability while maintaining privacy. Check out other pieces in the series here.

A worldwide dialog about COVID-19 contact tracing is underway. Even under the best of circumstances, the contact tracing process can be difficult, time-consuming, labor-intensive, and invasive — requiring rigorous, methodical execution and follow-up.

COVID-19 throws curve balls at the already difficult process of contact tracing. In this post we will provide some basic background on contact tracing and will list and describe 10 challenges that make contact tracing of COVID-19 exceptionally difficult. The 10 unique challenges are:

1) COVID-19 is Highly Contagious and Deadly

2) Contact Tracing is Becoming Politicized

3) We Lack Scientific Understanding of COVID-19

4) Presymptomatic Patients Can Spread COVID-19

5) Asymptomatic Patients Can Spread COVID-19

6) Contact Tracing is Dependent on Availability of Testing

7) Contact Tracing is Dependent on New, Extensive Funding

8) Contact Tracing is Dependent on an “Army of Tracers” and Massive Support for Patients

9 ) The Role of Technology is Unclear — Is it Critical Support or a Distraction?

10) The U.S. Response Has Been Fragmented and Inconsistent

The thrust of this post is about traditional boots-on-the-ground contact tracing conducted by public health agencies. We will touch on a few aspects of digital contact tracing (e.g., smartphone apps), but we’ll go into much more depth on digital contact tracing in future posts.

How does contact tracing relate to the theme of this series — The Health Data Goldilocks Dilemma? It’s about obtaining the right amount and types of information — not too much, not too little. Not too much data so that privacy rights or civil liberties are infringed, or that contact tracers are overwhelmed with useless data; not too little data so that public health agencies aren’t handcuffed in protecting our safety in tracing COVID-19 cases.

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Defund Health Care!

By KIM BELLARD

In the wake of the protests related to George Floyd’s death, there have been many calls to “defund police.”  Those words come as a shock to many people, some of whom can’t imagine even reducing police budgets, much less abolishing entire police departments, as a few advocates do indeed call for.

If we’re talking about institutions that are supposed to protect us but too often cause us harm, maybe we should be talking about defunding health care as well.  

America loves the police.  They’re like mom and apple pie; not supporting them is essentially seen as being unpatriotic.  Until recent events, it’s been political suicide to try to attack police budgets.  It’s much easier for politicians to urge more police, with more hardware, even military grade, while searching for budget cuts that will attract less attention.  

It remains to be seen whether the current climate will actually lead to action, but there are faint signs of change.  The mayor of Los Angeles has promised to cut $150 million from its police budget, the New York City mayor vowed to cut some of its $6b police budget, and the Minneapolis City Council voted to “begin the process of ending the Minneapolis Police Department,” perhaps spurred by seeing the mayor do a “walk of shame” of jeers from protesters when he would not agree to even defunding it.  

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We Can’t Breathe

By KIM BELLARD

I was wondering what might crowd COVID-19 off the news.  The historic economic devastation caused by it has been subsumed into it, just another casualty of the pandemic.  In better times, perhaps SpaceX’s efforts would inspire us.  But, no, it took the police killing of yet another person of color to take our attention away.  

Now, let me say right off that I am not the best person to discuss George Floyd’s death and the woeful pattern it is part of.  I have certainly been the beneficiary of white male privilege.  I’ve never been unjustly pulled over or arrested.  I haven’t taken part in the protests.  But people like me need to speak out.  Writing about anything else right now seems almost irresponsible.  

OK: you’ve seen the video. You’ve heard Mr. Floyd protest that he can’t breathe, that the officer was killing him.  You’ve seen other officers stand by and not do anything — some even assisting — even as bystanders pleaded for them to let Mr. Floyd breathe.  It’s disturbing, it’s distressing, and it’s nothing new.  

I saw a video from one of the resulting protests where another officer restrained a protester — a black man, of course — in exactly the same way, although in this case another officer eventually moved the officer’s knee off the protester’s neck.  He’d learned what that video looked like.

There now have been protests in over 140 U.S. cities, with the National Guard mobilized in almost half the states.  Most protests have been peaceful, but there has been looting and there have been shootings. It’s a level of civil unrest not seen since the 1960’s.

And we thought it was bad when we just wanted the grocery stores to have toilet paper again, when wearing a mask was considered a hardship.

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The Lack of Persuasion as a Failure Against COVID-19

By RAFAEL FONSECA, MD

Reopening safely out of the current pandemic ought to be done via persuasion, not coercion.

It has been more than five months since the world first learned about COVID-19. Models predicted a sharp increase in the number of cases, and a seemingly high likelihood the pandemic would overwhelm our hospitals. These models were often inaccurate, and we have all come to learn about the imprecision of epidemiological prediction.  Nevertheless, the infection is far worse than anyone initially accepted – becoming a staple of our generation. Fearing uncountable deaths and the possible need to prioritize resources for those affected, initial government measures were put in place to curtail the spread of the virus. Images of the Lombardic tragedy compelled all to stay in place and wait for the storm to pass, and with few exceptions most complied. Realizing the gravity of the situation, governments gradually implemented measures to prevent infections.  With some vacillation, we evolved from travel restrictions, to social distancing, shelter in place and universal mask use.

As the pandemic ensued, we watched the horror stories taking place in New York City and Boston. Even while we are in the midst of the so-called first wave, with thousands of deaths per day, many have started to wonder how long society will remain isolated and locked. Politicians look to experts for recommendations regarding policies that might save lives, and for the most part they have complied. However, as the weeks ensue, we see growing jobless claims, lines for food banks, and impatience.

This brewing impatience is a response to an unknown future dictated by the vagaries of nature and the lack of a coherent strategy to resume a life with a resemblance to normal. The public searches for guidance from federal agencies, state governments, and health authorities. A lack of clear direction from these institutions has heightened this anxious impatience. Additionally, the conversation is now ideological, with an almost Manichaean division between those wanting to save lives more so than the economy, and vice versa, creating cartoons of opposing perspectives.  Even for those recognized as  accomplished, dissenting from orthodoxy is punished severely. In the background, the public’s patience is running thinner.

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Even Covid-19 May Not Be Causing Your Doctor To Wash His Hands

By MICHAEL MILLENSON

If you think the grim coronavirus death toll is causing health care workers everywhere to always wash their hands, think again.

A recent research letter published in The Journal of Hospital Infection examined whether it’s “possible to achieve 100 percent hand hygiene compliance during the Covid-19 pandemic.” The medical center involved in the research, Queen Mary Hospital in Hong Kong, had reached a pre-Covid-19 hand hygiene rate of over 75 percent.

Yet the hospital’s goal of complete compliance proved surprisingly elusive. In one pediatric ward devoted to suspected or confirmed Covid-19 patients, doctors and nurses followed hand hygiene rules 100 percent of the time, but in another ward with similar patients and staff, compliance was 83 percent, or about one-fifth less.

Given Covid-19’s risk to providers as well as patients, this was “unexpected,” the researchers admitted. 

The Queen Mary study supports what infection control experts have long maintained: awareness isn’t enough. Doctors and nurses, particularly during a pandemic, understand that hand hygiene is “the most important intervention” to reduce the staggering death toll from infections, as the American Journal of Infection Control put it.

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Primary Care Practices Need Help to Survive the COVID-19 Pandemic

Ken Terry
Paul Grundy

By PAUL GRUNDY, MD and KEN TERRY

Date: June 20, 2022.

The Smithsonian National Museum of Natural History has reported its biggest number of visitors in more than 2 ½ years. There’s a string of new Broadway musicals that are well-attended every night. It’s safe to shop in malls, eat out in restaurants and go to movie theaters again.

Of course, this has all been made possible by an effective vaccine against COVID-19 that was widely administered in the fall of 2021. Vaccinated citizens of the world are now confident that it’s safe to go out in public, albeit with appropriate precautions.

However, U.S. residents who have health problems are facing a new challenge. Five years ago, in 2017, the median wait time of new patients for doctor appointments was six days. In 2022, the wait time is six months or more.

The reason for this is no mystery. While life has started to return to what we think of as the new normal, the U.S. healthcare system has taken an enormous financial hit, and primary care practices have been especially affected. Many primary care physicians have closed their practices and have retired or gone on to other careers. Consequently, the shortage of primary care has been exacerbated, and access to doctors has plummeted. Urgent care centers, retail clinics and telehealth have not filled this gap.

Because of the long waiting times for primary care appointments, many more people now seek care in emergency departments (EDs). The waiting rooms of these EDs are overcrowded with people who have all types of complaints, including chronic and routine problems as well as emergencies. And this is not just a common sight in inner-city areas, as it once was; it’s now the same pretty much everywhere.

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