Tuesday, November 24, 2020

We are making sacrifices for you. Please make a sacrifice for us.

By Allison Ashford, MD
Omaha, Nebraska

Editor's note: This article originally appeared on KevinMD.com

I rarely post more than pictures on Facebook. In fact, I rarely use Facebook for much of anything anymore. But I need you all to just listen for a second.

I’m scared. For you and for me.

I need you all to take a minute and think of the last time that you interacted in-person with someone who does not live in your home. Did you see a friend this weekend? Did you go to the store? Did you go inside the gas station? Did family come in from out of state? How about that wedding shower that you went to? Your girls’ weekend? Do you have plans to watch the Husker game with people? Even if it’s only like one other person? Did you have your kids’ friends over to play in the basement?

I ask you these questions because though they may be low-risk to you, they are high-risk to me. Because my colleagues and I cannot take care of all of you currently needing to be admitted to the hospital. You’re right: Most people with COVID do just fine. But, a number of people do not. And if our health care workforce keeps getting stretched to the limits AND many of them keep needing time to quarantine due to COVID or positive exposures, then we are ALL going to be in a really dark(er) place. For example, my institution usually runs 2 general COVID teams. We are up to 6-7 teams with plans to increase to 10. You know what that also means? We will run out of space for non-COVID patients too. And we may not have enough people to take care of these folks.

Please. Please. Rethink interacting with people outside of your home. I know this exhausting. I’m tired. I miss my old life. You’re right; I don’t have older kids that need human interaction with others. But please help. I jokingly compare COVID to an STD: The person you are with may seem “safe,” but you never know where they have been. And though that’s rather funny, it’s scarily true. Asymptomatic carriers and or people that are positive but don’t have symptoms yet are a real problem. Don’t think negative COVID test excuses what you’ve done or clears you! You can still turn positive a day or two later, having exposed people in the meantime. Ugh.

Please don’t assume this isn’t about you and that I’m directing this to someone else not you. Don’t assume you’re doing enough. We all AREN’T doing enough. Take a step back and assume you aren’t doing enough: How you could have done better? How can you do better starting right now? I beg you all to make decisions for your health care providers. My colleagues and I are making sacrifices for you. Please make a sacrifice for us.

Allison Ashford is a hospitalist.

Tuesday, November 17, 2020

PODCAST: COVID-19: How to Stay Healthy This Holiday Season

With the holidays approaching, how can we celebrate with loved ones while reducing risks? The COVID-19 pandemic is nowhere near over, increasing the risk of transmission during one of the busiest travel and social-gathering periods of the year. 

The Texas Medical Association (TMA) unveils two new tools from doctors to help people make safe holiday plans. 

New podcast
Trish Perl, MD, and TMA public health staff member Meredith Vinez address how to reduce  your risk for COVID-19 during the holiday season, in the latest episode of the TMA’s Practice Well podcasts. Dr. Perl is a member of both TMA’s COVID-19 Task Force and Committee on Infectious Diseases, and chief of the infectious diseases division at UT Southwestern Medical Center in Dallas.

“This is the new normal, and until we really see that we have something like a vaccine or other measures that are going to prevent transmission, this is going to be our new normal,” Dr. Perl says in the podcast. 

That means everyone should balance healthy practices with pursuing holiday traditions.

Dr. Perl discusses the dangers of COVID-19 fatigue, and how wearing face masks, maintaining good hygiene (washing hands frequently), and social distancing can help stop the spread of the virus. Citing their own family situations, she and Ms. Vinez discuss what people should do if they decide to travel for the holidays, the safest way to travel, and the risks of visiting elderly relatives. 

The episode also covers how to deal with relatives who aren’t taking COVID-19 seriously, low risk holiday activities for the kids, potential tweaks to the traditional holiday to family dinners, and how to give back to the community this season. Some of their suggestions include hosting outdoor family gatherings, using disposable plates and utensils, and serving guests rather than passing a bowl of food with a single serving spoon.

Dr. Perl concluded with this reminder: “Stay safe, and everybody remember your three w’s: wear your mask, watch your distance, and wash your hands!” 

To listen to the holiday podcast and other episodes of TMA’s Practice Well podcast, visit us on our website, Apple Podcasts, Spotify, iHeartRadio and Podbean

New infographic
The TMA COVID-19 Task Force also released a holiday update to its popular COVID-19 risk assessment chart released in summer, 2020. How risky do the physician experts envision Thanksgiving dinner with family and friends? Where on the chart’s scale does group caroling fall? Find the answers in TMA’s new COVID-19 Winter Risk Assessment Chart

Wednesday, October 28, 2020

Dispelling Common Myths About COVID-19

Emily Dewar, MD
Emily Dewar, MD
Pediatric Resident at The University of Texas at Austin Dell Medical School
Member, Texas Medical Association

Valerie Smith, MD
Tyler Pediatrician
Member, Texas Medical Association COVID-19 Task Force and TMA Council on Science and Public Health

Valerie Smith, MD
These days, it seems like everywhere you look you see something new about COVID-19. Worse, much of this information is conflicting and often confusing. When you are constantly surrounded with new statistics, it can be difficult to determine what is fact and what is fiction. As a pediatrician and pediatric resident, we hear from many concerned parents that because of the constant information overload, they are not sure what to believe. We’re here to set the record straight on seven COVID-19/coronavirus myths. Below are the ones we hear most often, along with what makes them untrue.

1. Myth: COVID-19 causes the same symptoms in everyone.

Fact [or Reality]: The list of possible symptoms of COVID-19 is very long, and includes fever, chills, cough, congestion, runny nose, sore throat, shortness of breath, muscle aches, fatigue, nausea, vomiting, diarrhea, or even loss of taste or smell. With so many different symptoms, this virus might look slightly different in every person who has it. Additionally, some people may be asymptomatic carriers – this means that someone can have and spread COVID-19 without even knowing, because they do not feel sick. There is no way to tell just by looking at someone whether they have COVID-19.

2. Myth: “Only old people or people who are already sick end up in the ICU.”

Fact [or Reality]: It is true that older people and those with pre-existing health conditions are at the greatest risk for having a severe case of COVID-19. (If you think you may fall into this category but are not sure, please reach out to your doctor.) However, even people who are otherwise healthy have become severely ill from the virus. There are case reports of previously healthy adults and even children who have died from COVID-19, so everyone should practice careful social distancing and frequent hand washing.

3. Myth: “Face masks do not work.”

Fact [or Reality]: One of the most important things you can do to protect those around you is to wear a mask. Masks work to prevent COVID-19 by containing the respiratory particles that we exhale, which can spread the virus. It is important that all people who are physically capable wear a mask or face covering in public because it is possible to infect other people with COVID-19 before you show symptoms. (And as we mentioned above, you might be a COVID-19 carrier and not even know it.) Because masks are meant to protect those around you, masks with one-way valves or vents should be avoided, as they can allow infectious respiratory particles to escape. “Universal masking,” or having everyone wear a mask, has been shown to decrease the spread of the virus both in hospitals and in the community

Admittedly, early guidance around masks was confusing, as people were advised not to purchase surgical masks, respirators, and N95 masks due to worldwide hospital shortages. (Of note, the Centers for Disease Control and Prevention (CDC) still recommends that N95 masks and respirators continue to be prioritized for health care workers and other first responders.) 

4. Myth: “COVID-19 is scary. I should stay indoors all the time.”

Fact [or Reality]: While it is very smart to be cautious about going out, you can (and should) spend time outside during this pandemic. Because of better air circulation and UV light outside, you are at no greater risk outdoors than you are indoors, as long as you continue to practice social distancing and frequent hand hygiene. Spending time outdoors is important for maintaining physical activity, and has been shown to improve mental health in children, teens, and adults

5. Myth: “This pandemic would be over soon if we just let everyone catch the virus.”

Fact [or Reality]: When enough people are immunized against a virus or have been sick and recovered from it, eventually the spread slows. This is often called herd immunity, or community immunity. Much is still unknown about COVID-19, however, including whether natural immunity to COVID-19 (immunity a person has after contracting and recovering from the virus) will last or  decrease over time. Because we are still learning about this virus, it is difficult to determine the exact percentage of people who would need to have recovered from the virus to achieve herd immunity. More importantly, for the strategy in this myth to work, millions more people could become very sick and die. We also must keep in mind that if too many people were to contract COVID-19 all at once, our health care system would not have the resources necessary to care for every patient requiring hospitalization. This is why masking, physical distancing, handwashing, and ultimately developing a COVID-19 vaccine is so important!

6. Myth: “Hydroxychloroquine prevents COVID-19.”

Fact [or Reality]: Large, randomized trials have shown that hydroxychloroquine is not an effective treatment or preventative for COVID-19. Early studies – which suggested possible benefits of this drug against the virus – studied only a very small number of patients, had poor study techniques, and were unable to follow up with every participant over time. These issues make the results of these initial studies highly unreliable. The National Institutes of Health has discontinued its clinical trial of hydroxychloroquine for the treatment of COVID-19 after no benefit was shown. Additionally, the FDA has revoked the emergency use authorization of this medication for the treatment of COVID-19 due to the risk of harming the heart, without any proven ability to fight the virus.

7. Myth: “Hospitals and doctors’ offices aren’t safe. I should wait to get my kids vaccinated (and postpone other well-child medical visits).”

Fact [or Reality]: Hospitals and medical offices are taking extensive measures to ensure the safety of their patients, including universal masking, daily employee screening, separating incoming patients who are well from those who are sick, limiting visitors, cleaning frequently, and wearing appropriate protective equipment. Additionally, data at Boston’s Massachusetts General Brigham, have shown that there have been very few workplace transmissions of the virus within their health care system. More risky is the increase in delayed or cancelled preventive health care visits during this pandemic due to people’s fear of going to the doctor. For example, data from the CDC have shown sharp rates of decline in childhood vaccinations compared to last year. Doctors are concerned this could lead to outbreaks of measles or other vaccine-preventable diseases. The American Academy of Pediatrics urges parents to continue to maintain a normal vaccination schedule for their children, as it has never been more important to keep kids healthy.

This era may have a lot of unknowns, and one thing is certain – following all this data is challenging. This pandemic is not over yet, and there will be more questions to come. In a scary and uncertain time, remember to turn to the experts to find your information. CDC, the Texas Medical Association, and your local public health department are excellent resources. Additionally, the most important and productive conversations about your health will happen between you and your physician. 

Monday, October 26, 2020

Medicine With a Med Student: Vote, and Vote Safely! Part 2

Editor’s Note: Me&My Doctor is launching a new monthly series, Medicine With a Med Student, which features blog posts written exclusively by medical students studying to become physicians. In this second post in a two-part series on voting, the authors explain the significance of health care initiatives when deciding which political candidates to vote for. Part 1 provides tips on how to vote safely. For more information on the authors, visit below.

Voting is incredibly important for the health and well-being of our communities. The ballot initiatives we vote on and the candidates we vote for shape our health care and our lived experiences. Some states have had ballot initiatives on issues such as Medicaid expansion. Furthermore, the candidates we elect on the local, state, and national levels will often vote on issues important to health care during their term in office. 

Though it may seem like patient care is only one element that elected officials decide, many decisions have an impact on our health. When we think of health care policy, we often think of decisions affecting going to the doctor or getting a shot or medicine, but elected officials and policymakers also influence broader health issues, such as health care costs, health insurance, prescription drugs, and telemedicine. 

Our elected officials also enact policies that affect our community living experience and our health. Government action regarding school systems, housing, economic support, environmental changes, and much more all carry potential health effects. 

Your single vote combines with the votes of your family, neighbors, and community to elect people who reflect your values. Although national elections generally attract a high voter turnout, local elections are typically decided by a much smaller group of voters. Voting is a key component of keeping our democracy viable and ensuring we continue to make policies that benefit us.

Although we are in a global pandemic, local, state, and national voting is underway. Voting, and doing so safely, is of great importance. We urge everyone to research candidates’ positions on health care-related issues and consider those stances as you cast your ballot. Your and your neighbors’ access to quality health care might depend on the outcome.

Sarah Miller
Medical Student at UT Rio Grande Valley School of Medicine
Chair, Texas Medical Association Medical Student Section Executive Council

Swetha Maddipudi
Medical Student at UT Health San Antonio Long School of Medicine
Vice Chair, TMA Medical Student Section Executive Council

Ryan Wealther
Medical Student at UT Health San Antonio Long School of Medicine
Reporter, TMA Medical Student Section Executive Council

Alyssa Greenwood Francis
Medical Student at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, El Paso
TMA Delegate Co-Chair, TMA Medical Student Section Executive Council

Friday, October 23, 2020

Medicine With a Med Student: Vote, and Vote Safely! Part 1

Editor’s Note: Me&My Doctor is launching a new monthly series, Medicine with a Med Student, which features blog posts written exclusively by medical students studying to become physicians. In this first post in a two-part series on voting, the authors discuss how to vote safely during the COVID-19 pandemic. For more information on the authors, visit below.   

The 2020 election is here, and with early voting underway it’s important to vote – but very important to plan to do so safely – because we are still dealing with the COVID-19 pandemic. The  U.S. Centers for Disease Control and Prevention and other organizations have created guidelines about how to make voting safer during the COVID-19 pandemic. Everyone needs to assess what level of risk they are comfortable accepting to vote and decide which voting method works best for them. Texas is offering two different ways to vote this year, including voting by mail or voting in person at a polling location. 

The deadline to register to vote was Oct. 5, so if you did not make this deadline, you will not be able to vote in the November general election. The deadline to request a ballot by mail is Oct. 23. You can check whether you are registered to vote.

Voting by Mail:

Texas allows voting by mail if you meet certain criteria but are otherwise eligible to vote, that is, if you are:

  • 65 years of age or older,
  • Sick or disabled,
  • Out of the county on Election Day and during the early voting period, or
  • In jail.

Voting by mail could be a safer alternative than voting in person because it doesn’t require you to be in confined spaces with other people. Remember to follow basic safety guidelines if you take your completed ballot to the post office to vote by mail, such as wearing a mask and washing your hands frequently. The same applies for people who hand-deliver their completed mail-in ballot at a county drop-off location rather than mailing it.

The U.S. Postal Service is encouraging everyone to plan ahead. Mail your ballot at least seven days before Election Day (Oct. 27). The last day to mail your ballot is Tuesday, Nov. 3 (must be postmarked by 7 pm).

Voting in Person:

Voting in person is the other option for voting in Texas. There are two opportunities to vote in person: voting early or voting on Election Day (Nov. 3). Either option you choose, physicians and other medical experts recommend these public health guidelines to keep you safe:

  • Bring alcohol-based hand sanitizer with you in case there is none available at polling locations, and sanitize your hands before and after voting.
  • Bring your own pen, pencil and stylus.
  • Wear a mask.
  • Socially distance: Keep at least 6 feet of distance from others including standing in line, even though you are wearing a mask.
  • Try to vote during times when lines will be shorter, such as midmorning.
  • Do not disinfect the voting equipment yourself, as this could damage the equipment.
  • Cover your mouth with the inside of your elbow if you sneeze or cough, even while wearing a mask.
  • Stay at home if you are sick.

Early Voting – Oct. 13-30

Early voting might be a safer alternative than voting on Election Day because you might encounter fewer people at the polls, which decreases the chance of spread of COVID-19. In addition, voting early helps to decrease lines on Election Day, which helps keep other people safe on a day when millions of people are expected to vote. Early voting in Texas runs Oct. 13-Oct 30. Find out where to vote early and where to vote on Election Day. You can vote at any polling location in your county during the early voting period. 

Election Day – Nov. 3

Voting on Election Day, Nov. 3, often attracts more people, leading to longer lines. If this is the voting day that’s best for you, please make sure to follow the safety guidelines above. On this day, you might be able to vote at any polling location in your county or you may be restricted to voting in your precinct, depending on the county where you live. Make sure to confirm your polling location before you go to vote!

Voting is important in every election cycle, and it is possible to do so safely even with a global pandemic underway. It is essential to plan ahead and select the voting method that works best for you and is safest for you. If you have any questions, please contact your county’s election authority.

Stay tuned for Part 2 of our voting series on MeAndMyDoctor.com.

Sarah Miller
Medical Student at UTRGV School of Medicine
Chair, Texas Medical Association Medical Student Section Executive Council

Swetha Maddipudi
Medical Student at UT Health San Antonio Long School of Medicine
Vice Chair, TMA Medical Student Section Executive Council

Ryan Wealther
Medical Student at UT Health San Antonio Long School of Medicine
Reporter, TMA Texas Medical Association Medical Student Section Executive Council

Alyssa Greenwood Francis
Medical Student at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, El Paso
TMA Delegate Co-Chair, TMA Medical Student Section Executive Council

Monday, October 19, 2020

Ten Reasons to Get Your Flu Shot

With flu season starting as COVID-19 continues to spread, many health experts fear a "twindemic."
Getting a flu shot can help avoid that. Photo by Brent Annear

Fall is here, and so is the flu. With COVID-19 still a threat, it’s more important than ever to protect yourself from preventable illnesses, like the flu. Vaccines prevent sickness and make it easier for us to go about our everyday lives. Here are ten reasons getting the flu shot is so important. 

1. Save money: A flu shot is usually free or low cost, whether you have insurance, Medicaid, Medicare, or work for a company that provides the shot to prevent employees from getting sick. For employees’ sake, not getting the flu means no lost wages or missed work. 

2. Less chance of a heart attack: Getting the flu shot reduces your risk of having a heart attack, which occurs more frequently in the weeks following the flu. A recent study that examined more than 80,000 U.S. adults hospitalized with the flu over eight flu seasons found that one in eight flu patients experienced sudden, serious heart complications. 

3. Protect pregnant women: The flu vaccine protects pregnant women who are at risk for complications from the flu. Every pregnant woman deserves a pregnancy without fearing for the health of herself and her baby. Women who plan to get pregnant should also get the flu shot. Vaccines strengthen our ability to fight diseases, and studies show the shot works best among women of childbearing age.   

4. Protect newborn babies: The flu shot also helps protect babies under six months who are not yet eligible for a flu shot. When an expectant mom gets a flu shot, the protection gets passed on to her newborn until he or she is old enough to be immunized. 

5. Protect older people: It will protect your elderly relatives, who are less likely to receive as much protection from the flu shot as younger people get. If you don’t get the flu, you can’t pass it on to someone. 

By getting a flu shot, you help increase your 
area's herd immunity. Photo by Brent Annear
6. Protect people with chronic health conditions: You’ll also protect people who have conditions which can make the flu more serious for them. These include people with asthma, heart disease, cancer, chronic kidney disease, diabetes, and HIV/AIDS. 

7. Help defend your community from illness: The more people that get the flu shot, the stronger your area’s community immunity, or herd immunity is. Herd immunity is achieved when a large enough portion of the community becomes able to fight off a disease and is therefore less likely to spread it from person-to-person. This protects the whole community, especially those who are less able to fight illness or have chronic diseases. 

8. Avoid a hospital stay or doctor visit: Vaccines make you less likely to have to go to the doctor or end up in the hospital. Thanks to the flu shot, doctors and other health experts estimate two out of five older adults won’t have to be hospitalized this flu season because of the flu

9. Protect children: Influenza can be especially dangerous for children because they can develop complications like pneumonia, dehydration, brain dysfunction, sinus problems, and ear infections. According to the Centers for Disease Control and Prevention, in the past 10 years between 7,000 and 26,000 children younger than 5 years of age were hospitalized with the flu. Although it is rare, kids can die from the flu as well. If your child is afraid of needles, there is a nasal spray flu vaccine available for everyone six months and older with no underlying health issues. Talk to your child’s doctor about which vaccine is best.

10. Stay active: The flu vaccine helps keep you moving. It may not always prevent the flu, but it can lessen symptoms and shorten sick time. This means fewer missed work and school days, and more time to do the things you enjoy. 

Because COVID-19 is still spreading as flu season starts, many health experts fear a “twindemic.” While we wait for a COVID-19 vaccine, there is one for the flu. For more information on the flu shot, view this downloadable poster created in both English and Spanish by the Texas Medical Association’s Be Wise Immunize℠ program

Be Wise – Immunize is funded in 2020 by the TMA Foundation, thanks to major support from H-E-B and Permian Basin Youth Chavarim.

Be Wise – Immunize is a service mark of the Texas Medical Association. 

Thursday, October 1, 2020

Fight the Flu. Get Your Flu Shot.

Influenza affects millions of people each year, and because of the COVID-19 pandemic, many physicians and health experts are concerned that this year’s flu season will hit with full force. In the Lone Star State, it’s important for Texans to be proactive about their health by getting the yearly flu vaccination. One of the worst things that could happen would be having many people sick with the flu while many are ill with coronavirus.

Flu vaccination is the best way to reduce the risk of getting and spreading the flu. This year, it also will help keep hospitalizations down as physicians, nurses, and other medical staff continue to care for COVID-19 patients. Traditionally, Texas falls behind on flu vaccination. According to the Centers for Disease Control and Prevention (CDC), only 43.3% of Texas adults got a flu shot in 2018-2019, compared to the national average of 45.3%.

Although influenza viruses circulate throughout the year, flu season usually starts in the fall and winter, and peaks between December and February.

Like COVID-19, the flu is contagious. Both have some similar symptoms, including fever, chills, cough, fatigue, body aches, vomiting, and diarrhea. People with the flu may not experience symptoms until one to four days after catching the virus. The CDC outlines key similarities and differences between influenza and COVID-19 here.

While most people recover from the flu, many can experience complications, especially older adults, people with pre-existing medical conditions, young children, and pregnant women. If left untreated, infected patients can develop pneumonia, inflammation of the heart, brain, or muscle tissues, organ failure, sepsis, or they could even die. In Texas, more than 21,000 people died from the flu in the past two years. To put that into perspective, that is the population of Katy!

Everyone 6 months or older is encouraged to get the flu vaccine each year – especially adults aged 65 and older, pregnant women, young children, and people who have chronic illnesses such as diabetes, asthma, and heart disease. The CDC is urging the public to get the flu vaccine while maintaining social distancing, wearing a mask in public, and practicing good hygiene.

People who receive the flu shot may experience some mild side effects like aches and a mild fever, but they can’t get the flu from the shot. Those who get the flu after being vaccinated might have been exposed to the virus beforehand. The flu vaccination can help lessen flu symptoms and severity, helping reduce the amount of time spent away from work and school.

In a time when community health is front and center, getting a flu shot is more important than ever. The Texas Medical Association’s Be Wise Immunize℠ program recently created a downloadable poster below in English and Spanish with key takeaways about the flu vaccination. You can print the poster, or save it and share it on social media. 

Be Wise – Immunize is funded in 2020 by the TMA Foundation, thanks to major support from H-E-B and Permian Basin Youth Chavarim.

Be Wise – Immunize is a service mark of the Texas Medical Association. 

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