SBA Finalist Spotlight: Northern Virginia Orthodontics

Thank you to Northern Virginia Orthodontics for answering a few of our questions.
Congratulations on being named a finalist for Health & Wellness Business of the Year!

1.Tell us your story of how your company got to where it is today? 

After finishing my orthodontic residency at the Medical College of Virginia in Richmond in 2006, my wife and I knew we wanted to move to Loudoun County. We both grew up nearby, and were aware of the planned residential growth, excellent schools, and the fact that Loudoun would be a great place to raise our kids and open an orthodontic practice. We settled on Brambleton Town Center, centrally located in Loudoun, to both live and work. With my vision to make an impact on patients, my team, and my community, I opened Northern Virginia Orthodontics in February of 2008. We saw just two patients that day, and despite the economy crashing in 2008 and 2009, NVO continued to grow thanks to our dedication to treating patients like our own family, over-delivering on top-notch service, and changing lives both inside and outside our office.

Since opening our doors in 2008, we’ve expanded twice in our Brambleton office, added the East Coast’s first, adult-only Invisalign Center, earned the title of Washingtonian Magazine’s Top 50 Places to Work, treated the most Invisalign patients in the state of Virginia, and in 2017 became the #2 Invisalign provider in the entire country.

Despite all these incredible accomplishments, what I’m most proud of is NVO’s impact on the local community. To date, NVO has donated over $1 million to local schools and organizations, as well as to pediatric cancer research and awareness. With our brand new 501(c)(3), The NVO Foundation, we can continue to do even more to help those in need right here in Loudoun County. It’s been an incredible ride going from just two patients that very first day to now seeing over 100 patients on a daily basis, but NVO is just as committed as ever to changing smiles and impacting lives.

2. What would it mean to you and your company to win a Small Business Award?  

Winning an award of this magnitude would serve as affirmation that Northern Virginia Orthodontics is impacting and improving the Loudoun County community, and would serve as fantastic recognition for our entire team.

3. If you weren’t running your own business/working at this business, what would you be doing?

I’ve always had a passion for medicine and helping others, hence becoming an orthodontist. I couldn’t imagine not working at NVO, but if I had to do anything else, I’d probably be a pilot.  I love flying and aeronautics.

4. What book are you reading right now? / What is your favorite book?

“Tools of Titans” by Tim Ferriss. It’s a study of successful people’s habits, and focuses on three critical elements – health, wealth and wise. Great read for anyone, especially business owners.

5. If you have 24-hours off, and your family was out of town, what would you do?

I’d work out, eat a healthy breakfast, then look for a D.C. sporting event to attend, like a Nationals or Capitals
game. Then a good glass of wine with dinner and call it a day – but I’d rather be with my family!

6. What is the smallest thing that has made the largest impact on your business?

Having no fear of change. It’s absolutely essential to assume risk, and to be open to change as your business grows.

7. What did you want to be when you grew up as a child? / What was a childhood dream that you had?

A professional baseball player. Baseball was my passion growing up, and remains a giant part of my family. My oldest son is currently plays baseball at the University of Arizona, and my wife and daughters love the sport as well.

8. Who is the one person that has influenced you the most in your career?

There are so many people that have influenced me along the way, but my older brother has definitely influenced me the most. He has a solution for every problem. He is an attorney by trade, but is always there when I need an opinion on anything business-wise and has been a huge part of NVO’s success.

9. What is your favorite thing about running a business in Loudoun County?

The growth and success of the county, and the pro-business mindset of its leaders.

10. If you’re not in the office where can we find you?

At my son’s baseball game, my daughters’ soccer games, a local winery, a D.C. sporting event, teaching the orthodontic residents at MCV (Medical College of Virginia), or out helping others.

11. What is your favorite weekend activity in Loudoun County?

Visiting one of Loudoun County’s many incredible wineries with family and friends.

The post SBA Finalist Spotlight: Northern Virginia Orthodontics appeared first on Loudoun Chamber.

This content was originally published here.

CDC director says U.S. could have “worst fall” ever if public health measures are not followed – CBS News

This fall could be the worst in the history of American public health if people do not heed guidance from health officials to stop the coronavirus, CDC Director Dr. Robert Redfield warned Wednesday. Redfield said skyrocketing cases of COVID-19 combined with the annual flu season could create the “worst fall” that “we’ve ever had.”

“I’m asking you to do four simple things: wear a mask, social distance, wash your hands, and be smart about crowds. If you do those four things it will bring this outbreak down,” Redfield said in an interview with WebMD. “But, if we don’t do that… this could be the worst fall from a public health perspective we’ve ever had.”

“I keep telling people, I’m not asking some of America to do it — we all got to do it. This is one of those interventions that’s got to be 95, 96, 97, 98, 99 percent if it’s going to work,” he said.

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Redfield stressed that more widespread use of face masks could make a big difference. “The mask really does work. It’s really important,” he said.

The United States, which has become the epicenter of the global coronavirus crisis, has seen over 166,000 COVID-related deaths and over 5 million confirmed cases, according to data from Johns Hopkins University. The disease is expected to be one the leading causes of death in the U.S. by the end of the year, according to Redfield.

“Eventually this virus is going to have its day,” he said. “It’s either going to infect a majority of the global population, or we’re going to have a biological countermeasure that’s going to be an effective vaccine.”

There are currently numerous potential COVID-19 vaccines in development, three of which are already in Phase 3 trials. Redfield said he’s “cautiously optimistic” that there will be “one or more vaccines” ready to deploy in the U.S. before the first of the year. 

He stressed, however, that the annual flu vaccine is also of crucial importance. 

“If there’s one thing we all can do — besides the importance of wearing a mask, social distancing, hand washing, and being smart about gatherings… to ultimately prepare ourselves for the fall, is to get the flu vaccine,” he said. 

While common, the flu remains a major cause of death in the United States. Less than half of the U.S. population received a flu vaccine last year, but Redfield said his goal this year is to have at 65% of people get vaccinated. 

The CDC is urging people to get the flu shot not only to protect themselves from a potentially deadly disease, but to protect the American health system. 

“We’re going to have COVID in the fall, and we’re going to have flu in the fall, and either one of those by themselves can stress certain hospital systems,” Redfield said. “I’ve seen hospital intensive care units stretched by a severe flu season, and clearly we’ve all seen it recently with COVID.”

“So, by getting that flu vaccine, you may be able to negate the necessity to have to take up a hospital bed, and then that hospital bed can be more available for those that get hospitalized with COVID,” he said.

The CDC is working closely with companies to ramp-up flu vaccine production. According to Redfield, close to 190,000 million doses are being made, and an extra 10 million are being purchased by the CDC for uninsured adults. The agency normally only purchases about 500,000 doses for the uninsured, he said.

“This year we’ve purchased 10 million … to make sure states can get this flu vaccine out,” he said. 

Without sufficient vaccination, flu cases could rise, leading to an increased demand for tests needing to be processed by labs. American labs are already struggling to keep up with the demand for coronavirus tests, resulting in backlogs. Earlier this summer people in many states had to wait days — in some cases even weeks — to receive results. 

Dr. Bobbi Pritt, chairwoman of the division of clinical microbiology at the Mayo Clinic, recently told CBS News that a bad flu season could make testing volume double or even triple, exacerbating every existing issue that labs are already experiencing. 

Asked what Thanksgiving will look like in the U.S., Redfield said it depends on “how the American people choose to respond.”

“It’s really the worst of times or the best of times, depending on the American public. I’m optimistic.”

Max Bayer contributed to this report.

This content was originally published here.

Judge halts Trump’s rollback of transgender health protections


A federal judge on Monday froze the Trump administration’s rollback of Obama-era anti-discrimination protections for transgender patients, citing a recent landmark Supreme Court decision awarding workplace discrimination protections to LGBTQ employees.

U.S. District Court Judge Frederic Block halted the new policy one day before it was slated to take effect and admonished the Trump administration for pursuing the change after the Supreme Court ruling.

The decision was a last-minute break for LGBTQ advocacy groups who had hoped to halt the administration’s implementation of the policy, warning it would especially create new challenges for patients during the coronavirus pandemic. However, the Obama rules have also been stalled in court under separate litigation, so the decision will change little for now.

Inside the decision: Block’s 26-page order focused on the Supreme Court’s 6-3 decision from June that extended civil rights protections to employees based on their gender identity or sexual orientation. He specifically questioned the Trump administration’s decision to advance its rewrite of the Obama policy without considering the impact of the Supreme Court decision, which came down just three days after Trump’s health department finalized the rollback of transgender health protections.

“When the Supreme Court announces a major decision, it seems a sensible thing to pause and reflect on the decision’s impact,” wrote Block, a Clinton appointee. “Since HHS has been willing to take that path voluntarily, the court now imposes it,” he added.

A long legal battle: A challenge over the merits of the Trump policy will continue, but Block said plaintiffs challenging the rule are likely to succeed in their lawsuit.

The previous Obama-era anti-discrimination rules had been blocked by a federal judge in 2016 and never took effect. Religious groups argue that the Obama policy would force doctors to offer gender transition services or abortions even if it conflicted with their beliefs.

The legal fight over the Obama rules is still playing out, even as the Trump administration issued new policies. At least five lawsuits have already been lodged against the new Trump rules.

Monday’s decision didn’t address otherprovisions of Trump’s revised nondiscrimination rules, which eased requirements for health care providers and insurers togive information in 15 languages and offer translation services. It also left alone Trump’s rollback of protections for patients seeking abortion.

A spokesperson for the Department of Health and Human Services didn’t immediately respond to a request for comment.

This content was originally published here.

Pentagon Weighing $2.2 Billion in Cuts to Military Health Care

Just weeks after both chambers of Congressapproveda $740 billion Defense Department budget for fiscal year 2021, Pentagon officials are reportedly pushing for more than $2 billion in cuts to military healthcare over the next five years, potentially threatening the coverage of millions of personnel and their families amid a global pandemic.

PoliticoreportedSunday that the proposed $2.2 billion cut to the military healthcare system is part of a “sweeping effort” by Defense Secretary Mark Esper to “eliminate inefficiencies within the Pentagon’s coffers.”

“Ever notice that it’s never a cut to things used to send kids to war?”askedJosh Moon of the Alabama PoliticalReporter. “It’s always — always — a cut to the promises we make to get them to volunteer for us. What a disgrace.”

According toPolitico, “Esper and his deputies have argued that America’s private health system can pick up the slack” for any servicemembers who lose coverage.

“Roughly 9.5 million active-duty personnel, military retirees, and their dependents rely on the military health system, which is the military’s sprawling government-run healthcare framework that operates hundreds of facilities around the world,” Politiconoted. “The military health system also provides care through TRICARE, which enables military personnel and their families to obtain civilian healthcare outside of military networks.”

Rep. Mark Pocan (D-Wis.), co-chair of the Congressional Progressive Caucus,saidthe push for billions in healthcare cuts shows once again that the Pentagon “puts more effort in protecting defense contractor profits than the lives of our troops.”

Alongside Rep. Barbara Lee (D-Calif.), Pocan co-sponsored an amendment to the National Defense Authorization Act that would have cut the proposed $740 billion budget by 10% without touching the military healthcare program. The amendmentfailedlast month by a vote of93-324, with 139 Democrats joining 185 Republicans in voting no.

A companion amendment in the Senate led by Sens. Bernie Sanders (I-Vt.) and Ed Markey (D-Mass.) alsofailed to pass.

The Trump administration is ALWAYS looking for ways to cut your health care, regardless of who you are, where you live or what you do.https://t.co/0SnpVt9jGi

— Planned Parenthood Action (@PPact) August 16, 2020

This is who they are: “Esper eyes $2.2 billion cut to military health care” https://t.co/w1YT6LANCS

— Keith Ellison (@keithellison) August 17, 2020

Unnamed Defense Department officials toldPoliticothat, if approved, the cuts “could effectively gut the Pentagon’s healthcare system,” adding to the rapidly swelling ranks of the uninsured. Areleased last month by advocacy group Families USA found that at least 5.4 million Americans have lost their health insurance during the coronavirus pandemic.

Politicoreported that the proposed $2.2 billion in cuts includes “eliminating all basic research dollars for combat casualty care, infectious disease and military medicine for [Uniformed Services University of the Health Sciences], as well as slicing operational funds.”

“What’s been proposed would be devastating,” warned one anonymous senior official.

This content was originally published here.

Illinois orthodontist wins ADA Stanford Award for retainer research

An Illinois orthodontist won the American Dental Association’s 2019 John W. Stanford New Investigator Award for her research paper evaluating the effects of eight cleaning methods on copolyester polymer, a material commonly used in clear thermoplastic retainers.

This content was originally published here.

Interest in vampires boosts the fang trade – Dentistry for the undead

VAMPIRES HAVE been a boon for Maven Lore’s bottom line. Once a graphic designer by trade, Mr Lore now makes fangs full-time in New Orleans. He attributes an increase in demand for his prosthetic vampire teeth to a growing interest in the undead. The popularity of vampire-themed films, novels and television programmes has helped create a customer base with a growing taste for fangs.

Halloween is now a billion-dollar industry in America. The National Retail Federation expected consumers to spend $8.8bn this year. Yet unlike candy corn or spider-web decorations, fangs have become a year-round phenomenon. Most of Mr Lore’s clients wear their fangs—which can cost as much as $1,200—regularly. Ninety percent of his customers are women between the ages of 20 and 40. They tend to be active in the vampire subculture of people who identify as or at least behave like vampires. Other customers want pointier teeth or simply think fangs will help them express their personalities better—“like jewellery”, Mr Lore says.

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A “fangsmith” in industry parlance, Mr Lore begins making vampire teeth by examining a client’s face and smile. He then tries to match the shade of the client’s human teeth to one of six acrylic tones. Next, he rolls two small balls of putty between his fingers and places each shaped fang on the tooth it is meant to cover—either the canine or the incisor, depending on the style. Finally, Mr Lore asks clients to hold their lips up for about five minutes as the acrylic sets.

Ninety percent of the time the fit is so precise that the fangs—which are otherwise removable—remain in place without glue. Unless, that is, they are being fitted on dentures, in which case they require a bit of adhesive.

Among Mr Lore’s most popular fangs are his Classic Canines, which look friendly, as fangs go. The Daywalkers are a double set covering the canine and the lateral incisor teeth that mimic fangs appearing in films such as “Underworld” and “The Vampire Diaries”.

Teresia Lischewski (pictured) bought a pair of Mr Lore’s fangs last Halloween and wears them “as often as humanly possible”. She says she gets regular use out of her fangs by attending vampire balls, comic-book conventions and events in the world of cosplay, in which humans dress up as characters from cartoons or video games. Ms Lischewski’s vampire teeth have been so well received that her human husband is even saving up for a pair of his own.

This content was originally published here.

Japan’s Abe to meet media as hospital visits fuel health concerns | News | Al Jazeera

Japanese Prime Minister Shinzo Abe is set to hold a news conference on Friday afternoon in which he is expected to address growing concerns about his health after two recent hospital examinations within a week.

Ruling party officials have said Abe’s health is fine, but the hospital visits, one lasting more than seven and a half hours, have fuelled speculation about whether he will be able to continue in the job until the end of his term in September 2021. On Monday, he became Japan’s longest-serving leader, beating a record set by his great-uncle Eisaku Sato half a century ago.

Under fire for his handling of the coronavirus pandemic and scandals among party members, Abe – who vowed to revive the economy with his “Abenomics” policy of spending and monetary easing – has recently seen his support decline to one of the lowest levels of his nearly eight years in office.

While he has beefed up Japan’s military spending and expanded the role of its armed forces, his dream of revising the country’s pacifist constitution has failed because it lacks broad public support. 

Shinzo Abe becomes Japan’s longest continuously serving PM

Sources have told Reuters that Abe would consult his doctors before meeting the media, either by phone or another hospital visit.

COVID-19 measures

The prime minister is expected to provide an explanation about his health and lay out new measures to fight the coronavirus at the news conference which is due to start at 5pm (08:00 GMT). Among them will be a pledge to secure enough vaccines for everyone in the nation by early 2021, paying for this with reserve funds, Japanese media said.

Abe, who has been struggling with the chronic condition ulcerative colitis since his teens, has not provided any detail about the hospital visits. Returning from the last visit on Monday, he said he wanted to take care of his health and do his utmost at his job.

Speculation that he would step down has been dismissed by allies in his ruling Liberal Democratic Party including Chief Cabinet Secretary Yoshihide Suga, who told Reuters on Wednesday that he meets Abe twice a day and has not seen any change in his health.

He added that Abe’s comments on Monday that he would continue to do his best in the job “explains it all”.

Abe has been prime minister since 2012; his second stint in the role. He resigned abruptly from his previous term in 2007 because of his illness, which he has been able to keep in check with medicine that was not previously available.

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Pedophilia Is a Mental Health Issue. It’s Still Not Treated as One

On the nights when the mental sexual images of children were most overwhelming, Joseph Parker took cold showers and baths, hoping the shock of freezing water would push his intrusive thoughts away. Other times, he would fixate on a picture of the Sri Lankan Buddhist monk Henepola Gunaratana, so that the monk’s “wrinkly face” might replace the disturbing imagery in his head.

Parker, who is using a pseudonym to protect his identity, had known he was attracted to children since he was 17, but he didn’t start having overpowering sexual urges until he was 24. (He’s now 26.) These urges were the worst when he was falling asleep. “As soon as I tried to release myself from wakefulness, my mind would sink into the pool of sexual energy, and I would feel this horrible sense of joy and happiness towards children,” he said.

He read online about medications that could lower testosterone levels and, as a result, sex drive—a process sometimes referred to as “chemical castration.” When he asked a psychiatrist for these drugs, he was given Risperidone, an antipsychotic, instead. He took that for about a year, then added on Sertraline, an antidepressant, but only found these drugs mildly helpful. He turned to the internet to get what he had wanted in the first place.

From a Turkish division of the pharmaceutical company Bayers, he ordered cyproterone acetate, which lowers testosterone, along with the female hormone estradiol, and now takes the two medications together. The website that processes the sales is frequently shut down because of its illicit nature: “To my knowledge this is their third or fourth website change, at least, since I came upon them 14 months ago,” he said.

Parker wishes it wasn’t this hard for pedophiles to get sex-drive reducing medications. But for many pedophiles—and especially pedophiles who have not committed crimes—access to even talk therapy, let alone medication, can be difficult to come by, and the process is riddled with fears about being reported to legal authorities.

In the past several decades, researchers have arrived at new understandings about pedophilia, the sexual attraction to children. Pedophilia appears to be an in-born sexual preference, something a person does not choose and cannot change. A pedophile’s attraction to children is consistent—not a phase—and they develop their attraction to children around the same time that other people develop sexual attractions.

While researchers’ knowledge has been evolving, access to widespread, up-to-date healthcare hasn’t kept up pace. Outside of the handful of researchers who provide therapy and medication to pedophiles, the barriers to finding an informed therapist or psychiatrist remain high. This has led to a hodgepodge of therapeutic approaches in the community, or people self-medicating, like Parker did. Many pedophiles are only directed towards treatment in the context of the criminal justice system, where in some states, chemical castration is used on sex offenders.

Yet importantly, researchers have established there’s a distinction between pedophilia and child molestation, a difference between the attraction itself and the crime. “Most people hear these words and think that they’re synonyms. They’re not,” said James Cantor, a Canadian clinical psychologist and neuroscientist who studies pedophilia.

Only about half of child sex offenders are genuine pedophiles. The other half prefer adults sexually, and are abusing children because they’re available or easily manipulated. (Child porn offenders, on the other hand, are nearly always pedophiles because of the ready availability of adult porn alternatives.)

The goal of any modern, preventative treatment for pedophila should be to help people manage their sexual interests rather than try to change them, Cantor said. This can involve the voluntary use of hormone-reducing medication to control urges or therapy. Since pedophilia and sexual abuse are not synonymous, treatment for pedophilia is also not solely about preventing child sexual abuse—it’s about helping people with their overall mental health and well-being too. That’s a concept that may be hard to accept. It involves recognizing that people who are sexually attracted to children deserve to live healthy and meaningful lives.

Online support groups for non-offending pedophiles have only recently entered the public eye. The most well-known group, the Virtuous Pedophiles, was formed in 2012 as a safe place for pedophiles to discuss their struggles and commitment to not offend. Parker belongs to the Virtuous Pedophiles and is known to the community as Double22. Another organization, the Association for Sexual Abuse Prevention (ASAP) was formed by some members of the Virtuous Pedophiles, and they are currently ramping up their goal to create a platform to connect pedophiles to mental health professionals.

“In my opinion, they should not be seen as second class patients.”

In April of this year, the first randomized placebo-controlled study of a hormone-reducing drug for pedophilia took place in Sweden. Published in JAMA Psychiatry, it found that the drug reduced both high sexual desire and sexual attraction to children, and that the effects were noticeable within two weeks.

The study is the first to include people who self-identified as pedophiles and were seeking help of their own accord, not just people funneled from the criminal justice system. What’s even more remarkable about the study is that it included a placebo group—the first pedophilia study to do so. In an editorial about the study, Peer Briken, a professor of sex research at the University Medical Centre Hamburg-Eppendorf in Germany, wrote that it “marks a milestone in clinical sexual science and the field of forensic psychiatry.”

“I think one of the biggest problems is that people just don’t understand this as a mental health issue,” said Fred Berlin, an associate professor in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. “Rightfully, people are concerned about protecting children. And so we just quickly stigmatize people who are attracted to children and often don’t even see them as human beings with a problem who might be deserving of help.

“In my opinion, they should not be seen as second class patients.”

In 2014, journalist Luke Malone wrote an article about young people, some of them minors, who were discovering that they were attracted to children, and how they were coping with it. It was adapted as an episode of This American Life, one of several high-profile media pieces about pedophiles that explored the complicated existence of being born attracted to children—and how hard it is to get help.

When Adam, one of the young pedophiles in Malone’s story, admitted to a therapist what was wrong, “she just became extremely cold and harsh,” he told Malone. “She even, a few times, almost got to the level of shouting.” She ended up telling Adam’s mother.

“There is a huge reason [pedophiles] would avoid therapists and doctors—those people have an obligation to report them to police if they think children might be in danger in the future,” said Ethan Edwards, one of the co-founders of the Virtuous Pedophiles, who uses a pseudonym.“Especially if they are not specifically trained in the issue, and with the common belief that all pedophiles molest children sooner or later, it is very perilous for a pedophile to seek out a therapist.”


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Christoffer Rahm, a psychiatrist, researcher at the Karolinska Institute, and the senior author on the JAMA study from April, once worked at a clinic linked to a Swedish national helpline focused on sexuality, PrevenTell. Rahm ended up meeting some pedophiles who called in; one was a bus driver who brought children to school. The bus driver was struggling with his impulses and fantasies, but had not sexually offended in any way. Rahm looked for research to help determine the best treatment for his patient and found a gap in the literature: There were no rigorous comparisons of different medications, or recommendations about who might do best with therapy. (As far as we know, female pedophiles are rarer, and the research on treatment for them even more sparse.)

Cantor feels it’s more than just a gap when it comes to pedophilia. “It is a black hole,” he said. “This is a topic that scientists in the fields of mental health are not just uninterested in—it is actively repugnant.”

That’s what motivated Rahm to conduct his study. “If there are people seeking help for this, the best thing would be to manage it in a preventative phase before the damage is done,” he said. “Of course, society needs to say that any kind of abuse against a child is not okay. But it is counterproductive if these people can’t even seek help with a professional.”

The medication Rahm studied is Degarelix, approved by the FDA in 2006 for treatment of advanced prostate cancer. This is the first time that it’s been used off-label for pedophilia. It’s an injection that starts working right away and lasts for about three months. It works by shutting down signals from the brain to the body to produce testosterone.

In qualitative interviews Rahm’s team did during the study, they found that some of their participants experienced positive effects. “They described feeling an inner calm,” Rahm said. “They felt less pressure, that they had a better intimate life with their partners. Some described that the annoying thoughts around children disappeared so they can focus on other things. And many described that they had lost that enervating impulse to masturbate, and were able to see children as just human beings and not sexual symbols.” A majority of the participants in the group that got the active drug said that they would want to continue taking it.

Many of the therapies that have been used for pedophiles have not been validated this way, but deployed through forensic psychology and the criminal justice system. Though Berlin has prescribed hormone-reducing medications to countless patients, he feels that the legal system usually doesn’t collaborate with doctors and scientists who are studying the use of these drugs. “As a physician, I think that’s completely inappropriate,” he said.

If someone goes to prison being sexually attracted to children, there’s nothing about prison that can get rid of that attraction, or enhance a person’s ability to resist temptation later on, Berlin said. It also leads to a mistrust of treatment, because of a history of involuntary use of chemical castration and aversion therapy—a therapy that associates negative cues with images of young children to dissuade future attraction.

“The idea that we can solve this simply through punishment and incarceration is very naive,” Berlin said.

Talk therapy should focus on managing a person’s sexual interests, with an explicit acknowledgment that those interests will likely never change. In the past, therapy sometimes focused on searching for trauma, because of the belief that a history of abuse led someone to abuse. The truth is a bit more complicated. Having been sexually abused in your own childhood could be a factor in committing sexual abuse as an adult, but is not necessarily a factor in pedophilia.

“This is what I’ve heard over and over,” Cantor said. “They knew. They always knew it. All their past therapists were telling them to focus on trauma, what happened in their childhood. But their genuine experience of it was that they were born this way.”

“We need to move on to the next generation of research and quality development.”

Cantor said that once that basic framework of therapy changes from changing one’s sexuality to managing it, people adapt very quickly. It makes more sense to his patients, and they’re able to better commit. If a person has looked at child porn or committed sexual abuse in the past, a therapist would help them examine how and why their self-control broke down, and how to set up their life so that it doesn’t happen again—not how to stop being attracted to children.

For some people, this process could be paired with sex-drive reducing drugs. “Some people find they would rather live in that state than with those nagging sex drive that they can’t express and can do anything to do anything about,” Cantor said.

Yet even in those states that have issued mandates for sex offenders to receive hormone-reducing drugs as punishment, it can be incredibly difficult for non-offending pedophiles who want it to get medication. “I get letters from people around the country all the time wanting access and they can’t even get access to it,” Berlin said.

Rahm doesn’t advocate for medication to be used for every pedophile for life—his study explores whether this specific drug could help. He said a person may only want and need it for a few months. It could help a person through a difficult time, or be combined with the start of a behavioral therapy practice. “We need to move on to the next generation of research and quality development,” Rahm said. “We need to evaluate our treatments and to get evidence-based treatments out there so we know what we’re doing.”

The word “castration” has a dark history, and dark connotations. It’s often been wielded involuntarily: In Germany the number of involuntary castrations of sex offenders increased as a result of the Nazi German Act, with at least 2,800 sex offenders were castrated between 1934 and 1944. In the United States, Black men accused of raping or sexually assaulting white women could find themselves subject to castration. For reasons like these, Rahm is torn about calling Degarelix “chemical castration.” While he thinks researchers and clinicians should accurately describe what the drug is doing and its side effects, he worries that referring to it as castration could scare people away, or disregard the consent and autonomy of patients who want it.

Rahm said that every person who participated in their study did so voluntarily, and was informed in detail about any possible side effects from taking Degarelix. They had the option to quit the study at any moment. He’s also currently running another placebo-controlled study on a non-pharmacological option: therapy geared specifically towards pedophiles that they can access anonymously, through the dark web.

The mere existence of Rahm’s studies is important, outside of the details of the findings. Doing placebo-controlled studies on pedophilia was previously thought to be impossible, because of the ethical implications of not giving an active treatment to a group of people attracted to children.

In Briken’s editorial, he wrote that because the medication they used was fast-acting, and they allowed anyone with pedophilia into the study—not just those who were high-risk for offending—it helped make the placebo group ethically possible. Briken concluded that Rahm’s study was “the most important contribution to the field of pharmacotherapy of pedophilic disorders since” the original study of hormone reducing drugs in 1998, and offers a starting point for a more comprehensive approach to pedophila treatment.

In Germany, Prevention Project Dunkelfeld, which offers therapy and medication, has 10 locations throughout Germany, and a person can get help while remaining completely anonymous.

The demand for their work is high: After a BBC documentary on the Dunkelfeld Institute aired, the Guardian reported that Dunkelfeld’s hotline was overwhelmed with calls from British pedophiles. “One British man was so desperate, he moved to Germany to be able to access a Dunkelfeld programme,” the Guardian wrote. “In an email exchange with the Guardian, the man, who wished to remain anonymous, wrote: ‘So far, all I have ever received from the NHS is doors slammed in my face.'”

There’s not as well-known a center for pedophiles in the U.S. to go to. Richard Kramer, the educational director at B4U-ACT, an online support group for pedophiles, said he figured out he was attracted to pubescent boys in his 20s. (His attraction is to boys around the age of 12 or 13, which is technically called hebephilia.) “I was very ashamed about it and thought that I was seriously defective as a human being,” Kramer said, who is using a pseudonym. “I really wasn’t able to find any information about it. They didn’t want to go to the library for fear that people would see what I’m looking up.”

When he began reading information online, he said, everything he encountered was very negative. “It said that I would be a monster, I would have hundreds of victims, and that my entire life would be centered around an elaborate plot to deceive parents and to manipulate children into abusing them,” he said. “So I thought, well, this is what they think about me. I have no interest in seeing them and seeing a therapist.”

A big part of being successful in therapy is having the support of family and friends, something that pedophiles can lack. They often are going through difficult treatments alone, and are unable to talk about it to others. You can’t tell co-workers, or ask a boss for time off for your appointments. “You have two choices,” said Michael Seto, a forensic psychologist and sexologist at the University of Toronto. “You don’t do it or you lie about it.”

When Kramer was ready to look for a therapist again, he didn’t really care what kind of approach they used, but was more concerned about whether they understood enough about pedophiles to not treat him like a criminal. His goals didn’t involve a struggle to control his impulses, but to manage the shame and sense of isolation from others because he couldn’t be honest.

“We have to insist that people who have this orientation not act upon it,” Berlin said. “If we think about that, that can be quite a burden. It’s not surprising that some of these folks might be in need of mental health assistance, because of the effect of experiencing these attractions on their sense of self-esteem and self-worth.”

“Happy, mentally healthy people do not molest children.”

Some pedophiles are attracted to adults and children; some, only children. For those who are exclusively attracted to children and dedicated to non-offending, Kramer said, there needs to be a space for helping them grieve over not being able to have romantic and sexual relationships. “How do they deal with loneliness?” he said. There are other concerns, some almost mundane: How, for instance, do they deal with answering questions friends and co-workers ask about their personal lives? He’s had friends who asked him if he was gay, and he said he wasn’t sure how to answer.

“I’m not exactly gay, but I’m definitely not straight and I’m definitely not asexual,” he said. “How do you respond to that?”

Gary Gibson founded the ASAP as one potential solution to this problem. Through an involvement with the Association for the Treatment of Sexual Abusers (ATSA), Gibson has been curating a list of therapists to whom he can refer pedophiles. The list is now around 400 names long. ASAP primarily focuses on non-offending pedophiles, but they will also help people who have offended and want to stop. “People are just desperate out there,” Gibson said.

He has worked with pedophiles who were so desperate for help that they underwent physical castrations. One man traveled to Mexico to have the operation done; when he returned, he tried to find a doctor to supervise his recovery and medications. “I could not find a doctor who would take him on,” Gibson said. “They didn’t want him in the office. I did find a therapist to work with him, and I kind of lost contact with him. I’m worried about what happened to him.”

Until recently ASAP has been handled almost entirely by Gibson, but ASAP is currently undergoing a significant expansion. It has increased its office and volunteer staff, is making a new, online database of mental healthcare providers, and creating a 24/7 helpline. Gibson said his dream is to get a multimillion dollar grant to create a mentor program for teenagers, aged 13 to 17, who are learning that they’re pedophiles. “I’ve applied three times,” he said. “Maybe the third time’s the charm, because I’ve been denied twice.”

The goal is to help every non-offending person attracted to children find therapy if they want or need it, said Robert Hillman, a “lifelong virtuous (non-offending) pedophile,” and the new president of ASAP.  Hillman said that the mantra is: “All pedophiles are born non-offending,” and the aim is to help keep it that way. “Happy, mentally healthy people do not molest children,” he said.

“People do the most desperate things when they feel the most desperate,” Cantor said. “A lot of what these groups and therapy provide is helping people lead a life that is worth protecting. When they have a life worth protecting, that’s when people get the energy and the willpower to control themselves, because they don’t want to risk the life that they have.”

What Hillman and Gibson want is the opportunity for any person attracted to children to chart their own path, and figure out what works best for them. That may include an experimentation with medication, and it may not. ASAP doesn’t control their therapists—they all operate independently, using different methods of treatment. They’re not always successful. “One guy has committed suicide that I know of,” Gibson said said. “But I think that we have probably saved a few lives and saved many children from being abused.”

These support groups and therapy networks are providing a lifeline, but alone, they don’t guarantee a consistency in treatment, nor fill the gaps in the scientific literature when it comes to which treatments might be best for a certain person. There might be certain hormone-reducing medications that are less risky or work better than others; certain pedophiles that fare better without drugs; certain therapeutic practices that are more helpful than others. Those answers aren’t clear-cut.

As with all medications, some people have good experiences and others do not. Pedophiles can identify as “ego-dystonic” or “ego-syntonic.” Ego-syntonic people consider pedophilia as part of their identity, and can be okay with fantasizing and masturbating about children (though not with porn), while ego-dystonic people are not. It may be that treatment should be different with those who have different attitudes towards their attraction, even if members of both groups have the same commitment to not offend.

After about five weeks, Parker said that he felt better from the medication he had ordered online. “It was night and day,” he said. “I can’t tell you what a weight was lifted off of me, or a pressure from under me that was relieved. Whenever I think about it I just lay back in my chair and breathe a contented sigh, knowing that I won’t suffer like that again. Both physical urges in my body and intrusive imagery in my mind have disappeared.”

He doesn’t think that medication should be thought of only as a stop-gap to a person committing sexual abuse. “Offending was never a danger for me in the first place,” he said. He doesn’t take the medication to stop himself from molesting a child, but as a way to improve his quality of life.

When Max Weber, who helps run a peer-support website for pedophiles in Germany, realized his attraction to young girls in his early 20s, he said, he was terrified. “My picture of pedophilia at the time was the same wrong impression most parts of society have: that pedophiles were bound to offend,” he said.

Weber got treatment at Dunkelfeld, and said he views medication like a pair of eyeglasses. “You can put [them] on to help yourself focus on things that you want to change about your life.”

To Weber, pedophilia was like being surrounded by deep water; he had to struggle to stand on his toes to avoid drowning. “I needed all my strength to cope with it and don’t drown in my own fears and self-hate,” he said. “As a result sexual impulses felt very powerful since, when you are standing on your toes, even the slightest push could throw you over.”

He took medication for about nine months. During that time when his sexual feelings were repressed, he regained a foothold on his life, he said, and found that even without medication he is able to be around children without issue. “I now know that I am in charge, and no one can make me offend other than myself,” he said.

Two years ago, David, a 22 -year-old recent college graduate from New York and a volunteer for a peer-support group including pedophiles, desperately wanted to take hormone-altering medication. “I hated myself for having feelings about children, and I just wanted to be like everyone else,” he said. “I was also going online and finding articles about how to raise libido, and doing the opposite of all of the advice I found. But I couldn’t find a therapist I felt safe coming out to.”

Since then, he said that support groups like Virtuous Pedophiles have helped him realize that being attracted to children is not something he chose, and he’s not tempted towards any illegal behaviors. “In the end, there was no need for me to go through such a treatment with dangerous side effects,” he said.

Though he never ended up trying medication, David thinks his experience with peer support reveals something important about. It can help reduce physical symptoms, but the rest—the support, the isolation, the shame—all needs to be addressed outside of just taking a pill.

“I struggled with serious depression, anxiety, and self-hatred as a teenager starting to understand that I was a pedophile,” David said. “Becoming less isolated, having people to help when I was hurting, and being able to help others in the same way is what brought me back from that.”

Hillman was a patient of Berlin’s about 25 years ago. “I was on the brink of madness from the desires and from the shame and self-hatred and loathing,” he said. “It was crushing me and I was not going to survive it.” He took hormone-reducing medication with Berlin’s help, and said that combined with therapy, it saved his life. “Since I was at that time and have always been non-offending, my anti-androgen therapy was not mandatory in any way and thus I started and stopped it several times, because of the affordability issues,” Hillman said. “But I can attest that the medication did reduce my thoughts and therefore some of my distress.”

Then he found the Virtuous Pedophiles group about one year ago, and the support he’s culled from the others there has given him a new gusto for life, without medication. “Now I am dedicated to living. And I am dedicated to making sure no one else has to waste their life just to be virtuous,” he said.

Hillman said that these narratives reveal how all pedophiles are different. “Some will benefit from meds and some will not,” he said. “Some are against medication, some are not.”

Rahm hopes to continue studying treatment options for pedophilia, in a rigorous way. In his view of a forthcoming modern pedophile treatment, each person would get an individual assessment and be offered an evidence-based treatment. It would work with helping a pedophile address both their personal feelings and concerns, and also their risk of offending.

“In my vision, some people need therapy, some need medication, some need both, and some won’t have any effect on any of these. They need something else,” Rahm said. This is nothing novel or groundbreaking, he added. “I would just like to apply modern psychiatric thinking to this group.”

Follow Shayla Love on Twitter.

This content was originally published here.

Boris Johnson plans to resign in 6 months because of lingering coronavirus health problems, according to Dominic Cummings father-in-law

  • Boris Johnson plans to resign in six months, according to the father-of-law of his chief adviser.
  • Dominic Cummings’ father-in-law Sir Humphry Wakefield reportedly said that the prime minister would quit early next year due to lingering health problems caused by the coronavirus.
  • Johnson was admitted to an intensive care unit with COVID-19 in April but returned to work just weeks later.
  • Wakefield compared Johnson’s condition to an injured horse who returns to work too soon.
  • “If you put a horse back to work when it’s injured it will never recover,” he is quoted as saying.
  • A Downing Street source described the claim he plans to stand down as “utter nonsense.”

UK prime minister Boris Johnson plans to stand down in 6 months time because of lingering health problems caused by the coronavirus, the father-in-law of his closest aide Dominic Cummings, has reportedly said.

The Times of London diary reported a conversation between Sir Humphry Wakefield, father of Cummings’ wife Mary, and Anna Silverman last week, in which he is alleged to have revealed that Johnson would resign early next year due to the lasting effects of his time in intensive care.

Silverman says she had the conversation with Wakefield when she bumped into him on a trip to Chillingham Castle in Northumberland, northeast England.

Wakefield reportedly compared Johnson’s condition to that of an injured horse who is brought back too early.

“If you put a horse back to work when it’s injured it will never recover,” the Times quotes him as saying.

However, a Downing Street source strongly denied the claim that Johnson was planning to resign in six months’ time, describing it to Business Insider as “utter nonsense.”

Prime Minister Johnson spent five days in intensive care at London’s St Thomas’ Hospital in April after catching the coronavirus. He has since revealed that doctors made “arrangements” for his death and that he was given “litres and litres of oxygen” at the height of his illness in order to keep him alive.

“It was a tough old moment, I won’t deny it. They had a strategy to deal with a ‘death of Stalin’-type scenario,” Johnson said in an interview with The Sun newspaper in May.

“I was not in particularly brilliant shape and I was aware there were contingency plans in place.”

He said: “The doctors had all sorts of arrangements for what to do if things went badly wrong.

“They gave me a face mask so I got litres and litres of oxygen and for a long time I had that and the little nose jobbie.”

There have been multiple reports in the months following his hospitalisation, that his health remains poor.

However, Downing Street has been keen to dispel any suggestions of lingering health problems, with the prime minister posing for photographs whilst doing press-ups, and photos of Johnson jogging being distributed to UK news outlets.

Johnson has been UK prime minister for just over a year after succeeding Theresa May as Conservative party leader in July last year.

He will have to stay on as prime minister for nearly another four years in order to fight the next general election, which is due to take place in May, 2024.

Join the conversation about this story »

This content was originally published here.

The Sneaky Trick a Public Health Official Used to Make Mask Mandates Look Super Effective – Foundation for Economic Education

As of early August, 34 US states mandate the use of masks in public to limit the spread of COVID-19.

The efficacy of face masks has been a subject of debate in the health community during the pandemic. Because health experts disagree on their effectiveness, countries and health agencies around the world, including the World Health Organization and the CDC, have done a reversal on their mask recommendations during the pandemic.

Reasonable and persuasive cases can be made both for and against the use of masks in the general population. Unfortunately, the science of masks and viruses is becoming less clear because of the politicized nature of the debate.

A case in point is the Kansas public health official who made news last week after he was accused of using a deceptive chart to make it appear counties with mask mandates had lower COVID-19 case rates than they actually did.

At a press conference, Kansas Department of Health and Environment Secretary Dr. Lee Norman credited face masks with positive statewide COVID-19 trends showing a general decline in deaths, hospitalizations, and new cases.

Norman pointed to a chart (see below) that depicted two lines tracking cases per 100,000 people between July 12 and August 3. The red line begins higher than the blue line but then falls precipitously as it travels down the X-axis, ending below a blue line.

Can you tell from this chart which line — the red or blue — had a higher 7-day rolling average of COVID-19 cases/Per 100k as of Aug. 1?

The red = counties in Kansas with mask mandates.

The blue = counties in Kansas without mask mandates. pic.twitter.com/verLhnni1K

— Jon Miltimore (Parler: @Miltimore79) (@miltimore79)

Norman explains that the red line represented the 15 counties with mask mandates, which account for two thirds of the state’s population. The flat blue line represented the remaining 90 counties, which had no mask mandates in place.

“All of the improvement in case development comes from those counties wearing masks,” Norman said.

The results are clear, Norman claimed. The red line shows reduction. The blue line is flat. Kansas’s real-life experiment showed that masks work.

It didn’t take long for people to realize something wasn’t quite right, however. The blue line and the red line were not on the same axis.

This gave the impression that counties with mask mandates in place had fewer daily cases than counties without mask mandates. This is not the case, however. In reality, counties with masks mandates have far higher daily COVID-19 cases than counties without mask mandates.

If the trends are depicted on the same axis, the blue and red lines look like this.

This is how the blue and red line look on the same axis.

Doesn’t make the same impression, does it? pic.twitter.com/1rIHjE2fcY

— Jon Miltimore (Parler: @Miltimore79) (@miltimore79)

Many Kansans were not pleased with the trickery.

Kansas Policy Institute expert Michael Austin told local media that the chart clearly gives a false impression.

“It has nothing to do about whether masks are effective or not. [It’s about] making sure Kansans can make sound conclusions from accurate information,” Austin said. “And unfortunately, the chart that was shown prior in the week strongly suggested that counties that had followed Dr. Norman’s mask order outperformed counties that did not, and that was most certainly not true.”

Twitter was less diplomatic.

COVID fraud in Kansas: @KDHE @SecNorman doctored graph and released false statement to justify mask order.@GovLauraKelly, you are going to pay the price for this.https://t.co/Nb1bOBBo27

— Dr. Milton Wolf (@MiltonWolfMD)

HOW TO LIE WITH CHARTS: KANSAS EDITION

this is literal fraud. they just used this chart to support a mask mandate.

but it shows the masked counties on a different axis with a different scale.

they are higher, not lower.

there was no good reason to do this.

it’s just lying https://t.co/ikCfTiUBlF

— el gato malo (@boriquagato)

The chart is deceptive.

Worse, Norman also failed to note that the lines were on different axes until a reporter asked if the blue line “would get below the red line” if those counties passed mask mandates, which prompted Norman to mumble about different metrics and then admit that counties without mask mandates have lower case rates.

“The trend line is what I really want to focus on,” Norman said.

The deception prompted a non-apology from the Kansas Department of Health and Environment: “Yes, the axes are labelled differently … we recognize that it was a complex graph and may not have easily been understood and easily misinterpreted.”

Dr. Norman, meanwhile, vowed to do better next time.

“I’ll learn from that and try to [be] clearer next time,” he said following criticism from lawmakers.

The episode is unfortunate because it further clouds the science and erodes trust in the medical experts individuals rely on to make informed decisions.

It’s also ironic, because the controversy overshadowed the state’s positive data, which suggests masks may be working in Kansas. The chart may have been deceptive, but the data is correct and shows a 34 percent drop in COVID cases in counties with mandates in place.

It’s quite possible that drop is linked to county orders mandating the use of masks. Then again, the order may have nothing to do with the drop. Correlation, we know, doesn’t equal causation. If it did, the surge in COVID-19 cases in California following its mask order would be “proof” that masks increase transmission rates.

But science doesn’t work that way (at least it shouldn’t), and Dr. Norman knows this.

Maybe masks are an effective way to curb transmission of the coronavirus, or maybe it’s largely ineffective or even harmful, like the Surgeon General stated back in March. The truth is we don’t yet know.

What’s clear, as I noted last week, is that the top physicians and public health experts on the planet can’t decide if face coverings help reduce the spread of COVID-19.

In light of this, it seems both reasonable and prudent that public health officials should focus less on forcing people to “mask-up” and more on developing clear and compelling research which will allow individuals to make informed and free decisions.

This, after all, is the traditional role of public health: inform people and let them choose.

Allowing individuals to choose instead of collective bodies is the proper and more effective approach, because, as the great economist Ludwig von Mises reminded us, individuals are the source of all rational decision-making.

“All rational action is in the first place individual action,” Mises wrote in Socialism: An Economic and Sociological Analysis. “Only the individual thinks. Only the individual reasons. Only the individual acts.”

Mask orders aren’t just about public health. They are a microcosm of a larger friction at work in our society: who gets to plan our lives, individuals or the collective?

Despite what many today seem to believe, society is best served by allowing individuals to plan and control their own lives.

But individuals benefit from sound and reliable information. Sadly, that is something public health officials increasingly appear incapable or unwilling to offer.

This content was originally published here.

7 summertime dental tips from Vestavia Family Dentistry and Facial Aesthetics

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Vestavia Family Dentistry
The staff at Vestavia Family and Facial Aesthetics Dentistry staff

What is it about summer and forgetting to take care of our teeth?

Is it the oppressive heat in Birmingham, Alabama or just having more time on our hands? We all seem to lapse into some bad habits concerning our dental care. Think about it – Summer is the only time we all try “Pop Rocks and Cokes”… Right?

Let’s get the summer started off right in 2019. Dr. G. Robin Pruitt, Jr. and the staff at Vestavia Family Dentistry & Facial Aesthetics gave Bham Now some useful tips to pass along to our readers for the summer. Check them out.

Front entrance of Vestavia Family Dentistry & Facial Aesthetics

Tip #1 – Drink the right beverage

It is hot out there. Birmingham has already experienced record high temperatures reaching in the mid 90s in May. This summer, stay hydrated and healthy. But think carefully when you choose your beverage – some drinks can increase your risk of tooth decay.

For example – When you are hot, you sweat. Don’t reach for a sports drink to rehydrate. Many sports drinks contain sugar as their top ingredient and can be as bad for your teeth as drinking soda. If you are going to have a sports drink, look for one that is low in sugar to prevent damage to your teeth.

The best alternative? Water. Keep your mouth moist by drinking water throughout the day. This helps wash away plaque-causing bacteria and can even improve your breath. Also, save some money by choosing tap – fluoridated tap water which strengthens your enamel, making your teeth more resistant to decay.

Tip #2 – Avoid bubbles, try tea

Photo from Milos Tea Facebook page

Simply put, drinks with bubbles – the carbonated drinks which may contain acid – can wear down your enamel. If you must drink the carbonated drinks use a straw. This reduces contact with your teeth. Finish the drink quickly, instead of sipping over a long period of time. Same concept. Less contact, less damage to your teeth.

An alternative to the bubbles. Along with water, try tea. Tea contains compounds that suppress bacteria, slowing down tooth decay and gum disease. Just remember: Don’t add sugar!

Tip #3 – Don’t chew ice

Chewing ice may cool you off on a hot summer day, but it is not good for your teeth. Use ice as something to cool your drink and not as a food. Chewing ice can leave your teeth weak and vulnerable to breaking and can cause damage to your enamel.

Tip #4 – Teeth Healthy Snacks

Whether it is packing snacks for summer day camps or on vacation. Choose teeth-healthy snacks. Fresh foods are full of vitamins and dairy products such as cheese & yogurts are full of calcium. Make sure to pack a healthy snack for days on the go!

Tip #5 – Play Sports – Protect your teeth

. Photo via Children’s of Alabama’s Instagram

Stay safe during summer activities – Wear a mouthguard during summer sports. Even though summer sports may not be high contact, your teeth can still be at risk if you take a fall. Also, don’t run at the pool – wouldn’t want to slip and fall! Be safe and protect your teeth.

Tip #6 – Pack a dental “kit” for those vacations

Don’t you hate checking into a hotel or beginning that camping trip on that summer vacation and you notice your remembered the shampoo and soap, but forgot the toothbrush, floss and mouthwash. Hop on over to the local drugstore and fully stock your travel bag with all these dental necessities for the whole family.

Tip #7 Make your summer appointment now

Stay on routine and go ahead and schedule your end-of-summer appointment – it’s a good idea to make your child’s back-to-school appointment early in the summer to avoid the August rush and help ensure you get the appointment time that works best for you.

If you have any questions about any of these tips, Dr. Pruitt and the staff at Vestavia Family Dentistry & Facial Aesthetics welcome your questions and will try to provide you answers.

Also, feel free to re-visit their New Year’s resolution list of tips story – Vestavia Family Dentistry & Facial Aesthetics recommends 5 dental resolutions for 2019.

Who says you can’t make mid-year summer dental resolutions too!

Reach them at 205-823-3223 or visit their website at:

http://www.vestaviafamilydentistry.com

Sponsored by:

The post 7 summertime dental tips from Vestavia Family Dentistry and Facial Aesthetics appeared first on Bham Now.

This content was originally published here.

DNC Illegal Immigrant: ‘I Need Health Insurance. I Deserve it, Right?’

The Democrats’ used their convention on August 19 to prod Americans to welcome ill migrants who enter the United States in search of American health care.

The video features an illegal immigrant who brought her disabled daughter into the United States for life-saving health care. Americans saved the child but cannot yet cure the spina bifida that keeps her apparently confined to a wheelchair.

Jessica Sanchez, the grown daughter, told the Democrats’ audience, “I don’t have the right ID, so I can’t get health insurance through the [Obamacare] exchange. I need health insurance. I deserve it, right?”

“Of course you do,” her mother, Sylvia, said in Spanish. “We all deserve hope, a good life, and health.”

“My mother had no choice,” said Lucy, Sylvia’s U.S.-born daughter. “There was no time to wait to save my sister. She came here looking for a miracle.”

“It breaks my heart to see how babies are separated from their families at the border,” the mother added. “That’s wrong. Those babies need to be with their families.”

“I want to go to law school,” said Jessica. “I want to help my community.”

This segment endorsing a welcome for all sick foreigners is a dramatic escalation from the Democrats’ unpopular promises to fund health care for at least 11 million resident illegal aliens, most of whom work long hours for low wages in the U.S. labor market that is flooded by illegal and legal immigrants.

The Democrats’ video extends their free-health care offer to many millions of people living outside the United States, including roughly 175 million people in Mexico and Central America.

The Democrats’ pitch to migrants is politically risky, partly because many legal-immigrant Latinos have a very ambivalent view of foreign Latinos. For example, in April, a Washington Post poll showed that Latinos were the strongest advocates for a near-total halt to legal immigration during the coronavirus epidemic and economic crash. Other polls show that white, black, and brown Americans will welcome legal migrants but also want limits to protect jobs and resources.

Any bar against foreigners getting life-saving health care is easy to write — but very painful to implement or to ensure public support. For example, foreigners can arrive as tourists, then bring their dying children to hospitals, while also offering to work low-wage jobs. Illegal immigrants get injured at construction sites, can spread epidemics, or be struck down by health problems that can be swiftly and cheaply cured by eager Americans.

But the opposite policy is also painful: Any legal approval for foreigners to use U.S. hospitals will create a global magnet for many millions of poor foreigners who are crippled or dying of cancer, heart diseases, and other ailments. For example, the 2018 caravans of Central American migrants included some who told reporters they were hoping to get treatment for cancer and heart ailments.

In practice, the U.S. quietly provides health care to at least ten million illegal migrants who are in the United States, while also erecting tough physical and legal barriers to the arrival of yet more illegal aliens. This generous healthcare policy is backed by hospital chains that gain millions of extra customers and billions in extra revenue.

President Donald Trump’s deputies also allow a modest number of foreigners to get health care after flying into the United States as tourists. The number of patients and the cost of the “Deferred Action” policy is unpublished.

In 2019, Trump’s deputies dropped a revamp of the program amid an emotional, media-magnified response by Joe Biden, hospitals, and pro-migration groups.

The Democrats used their convention to escalate the dispute.

Trump’s deputies reduce plan to curb the number of overstay illegals using US healthcare after Joe Buden accused officials of cruelly wanting to ‘unplug’ sick kids. It seems DHS/USCIS will grandfather existing patients but block future arrivals. https://t.co/snx3dTkJeD

This content was originally published here.

Association Between Universal Masking and SARS-CoV-2 Positivity Among Health Care Workers

The institutional review board of MGB approved the study and waived informed consent. Using electronic medical records, we identified HCWs providing direct and indirect patient care who were tested for SARS-CoV-2 with reverse transcriptase–polymerase chain reaction between March 1 and April 30, 2020. The primary criterion for testing HCWs in our health care system was having symptoms consistent with SARS-CoV-2 infection. Information on the job description of each HCW was obtained by linking their record to the MGB Occupational Health Services and Human Resources databases.

We identified 3 phases during the study period: a preintervention period before implementation of universal masking of HCWs (March 1-24, 2020); a transition period until implementation of universal masking of patients (March 25–April 5, 2020) plus an additional lag period to allow for manifestations of symptoms (April 6-10, 2020), as previously defined5; and an intervention period (April 11-30, 2020). Positivity rates included the first positive test result for all HCWs in the numerator and HCWs who never tested positive plus those who tested positive that day in the denominator. For each HCW, any tests subsequent to their first positive test result were excluded. Using weighted nonlinear regression, we fit the best curve for the preintervention and intervention periods (based on R2 value). The number of daily tests was used as the weight such that days with more tests had more weight in determining the curve. The overall slope of each period was calculated using linear regression to estimate the mean trend, regardless of curve shape. The change in overall slope between the preintervention and intervention periods was compared to determine any statistically significant change in mean trend, using a 2-sided α = .05. The analysis was conducted using R version 4.0 (R Foundation).

Discussion

Universal masking at MGB was associated with a significantly lower rate of SARS-CoV-2 positivity among HCWs. This association may be related to a decrease in transmission between patients and HCWs and among HCWs. The decrease in HCW infections could be confounded by other interventions inside and outside of the health care system (Figure), such as restrictions on elective procedures, social distancing measures, and increased masking in public spaces, which are limitations of this study. Despite these local and statewide measures, the case number continued to increase in Massachusetts throughout the study period,6 suggesting that the decrease in the SARS-CoV-2 positivity rate in MGB HCWs took place before the decrease in the general public. Randomized trials of universal masking of HCWs during a pandemic are likely not feasible. Nonetheless, these results support universal masking as part of a multipronged infection reduction strategy in health care settings.

Section Editor: Jody W. Zylke, MD, Deputy Editor.

Corresponding Author: Deepak L. Bhatt, MD, MPH, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115 (dlbhattmd@post.harvard.edu).

Accepted for Publication: July 1, 2020.

Published Online: July 14, 2020. doi:10.1001/jama.2020.12897

Author Contributions: Dr Bhatt had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Wang and Ferro contributed equally to this article.

Concept and design: Wang, Ferro, Hashimoto, Bhatt.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Wang, Ferro.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Wang, Zhou.

Administrative, technical, or material support: Wang, Ferro, Hashimoto.

Supervision: Hashimoto, Bhatt.

Conflict of Interest Disclosures: Dr Bhatt discloses the following relationships: advisory board: Cardax, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, Level Ex, Medscape Cardiology, PhaseBio, PLx Pharma, Regado Biosciences; board of directors: Boston VA Research Institute, Society of Cardiovascular Patient Care, TobeSoft; chair: American Heart Association Quality Oversight Committee, NCDR-ACTION Registry Steering Committee, VA CART Research and Publications Committee; data monitoring committees: Baim Institute for Clinical Research, Cleveland Clinic, Contego Medical, Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine, Population Health Research Institute; honoraria: American College of Cardiology, Baim Institute for Clinical Research, Belvoir Publications, Duke Clinical Research Institute, HMP Global, Journal of the American College of Cardiology, K2P, Level Ex, Medtelligence/ReachMD, MJH Life Sciences, Population Health Research Institute, Slack Publications, Society of Cardiovascular Patient Care, WebMD; deputy editorship: Clinical Cardiology; research funding: Abbott, Afimmune, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Cardax, Chiesi, CSL Behring, Eisai, Ethicon, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Idorsia, Ironwood, Ischemix, Lexicon, Lilly, Medtronic, Pfizer, PhaseBio, PLx Pharma, Regeneron, Roche, Sanofi Aventis, Synaptic, The Medicines Company; royalties: Elsevier; site coinvestigator: Biotronik, Boston Scientific, CSI, St Jude Medical, Svelte; trustee: American College of Cardiology; unfunded research: FlowCo, Merck, Novo Nordisk, Takeda. No other disclosures were reported.

Additional Contributions: We thank Stacey A. Duey, MT(ASCP), MCHP, Mass General Brigham, for assistance in extracting data from the Research Patient Data Registry, and Karen Hopcia, ScD, ANP-BC, Mass General Brigham, for assistance in extracting data from Occupational Health Services. No compensation was received for their roles.

This content was originally published here.

Esper eyes $2.2 billion cut to military health care – POLITICO

Roughly 9.5 million active-duty personnel, military retirees and their dependents rely on the military health system, which is the military’s sprawling government-run health care framework that operates hundreds of facilities around the world. The military health system also provides care through TRICARE, which enables military personnel and their families to obtain civilian healthcare outside of military networks.

The latest news in defense policy and politics.

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Under the proposal in the latest version of Esper’s defense-wide review, the armed services, the defense health system and officials at the Office of the Secretary of Defense for Personnel and Readiness would be tasked to find savings in their budgets to the tune of $2.2 billion for military health. Officials arrived at that number recently after months of discussions with the impacted offices during the review, said a third defense official. A fourth added that the cuts will be “conditions-based and will only be implemented to the extent that the [military health system] can continue to maintain our beneficiaries access to quality care, be it through our military health care facilities or with our civilian health care provider partners.”

However, the first two senior defense officials said the cuts are not supported by program analysis nor by warfighter requirements.

DoD Unified Medical Budget vs Veteran Medical Care Costs (in Billions) | President’s Budget Historical Data

The department’s effort to overhaul the military health system have recently come under scrutiny, as lawmakers pressed the Pentagon on whether the pandemic would affect those plans.

“A lot of the decisions were made in dark, smoky rooms, and it was driven by arbitrary numbers of cuts,” said one senior defense official with knowledge of the process. “They wanted to book the savings to be able to report it.”

“It imperils the ability to support our combat forces overseas,” added a second senior official, who argued that Esper’s moves are weakening the ability to protect the health of active-duty troops in military theaters abroad. “They’re actively pushing very skilled medical people out the door.”

However, a Pentagon spokesperson said the system will “continually assesses how it can most effectively align its assets in support of the National Defense Strategy.

“The MHS will not waver from its mission to provide a ready medical force and a medically ready force,” said Pentagon spokesperson Lisa Lawrence. “Any potential changes to the health system will only be pursued in a manner that ensures its ability to continue to support the Department’s operational requirements and to maintain our beneficiaries access to quality health care.”

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Esper rolled out the results of the first iteration of the defense-wide review in February, revealing $5.7 billion in cost savings that he said would be put toward preparing the Pentagon to better compete with Russia and China, including research into hypersonic weapons, artificial intelligence, missile defense and more.

But the proposed health cuts, in the second iteration of the defense-wide review, would degrade military hospitals to the point that they will no longer be able to sustain the current training pipeline for the military’s medical force, potentially necessitating something akin to a draft of civilian medical workers into the military, the two defense officials said.

The second official noted the challenge in finding outside doctors given longstanding complaints from some U.S. hospitals and researchers that there aren’t enough physicians to serve civilians.

“How’s a ‘draft’ even going to work?” the official said “The U.S. is dealing with a doctor shortage.”

As a result, the proposed reductions would hurt combat medical capability without actually saving money, the officials argued. The Pentagon is already significantly overspending on private sector care and TRICARE because patients are being pushed out of undermanned military health facilities to the private health care network, they said. The cuts also would follow nearly a decade of the Pentagon holding military health spending flat, even as spending on care for veterans and civilians has ballooned.

The officials blamed the Pentagon’s Cost Assessment and Program Evaluation office, or CAPE, under the leadership of John Whitley, who has been acting director since August 2019, for the cuts. CAPE conducts analysis and provides advice to the secretary of defense on potential cuts to the defense budget.

During Whitley’s confirmation hearing to be the permanent CAPE director last week, Sen. Doug Jones (D-Ala.) pressed him on the health cuts.

“Folks in my state have expressed some concern and opposition to some of the policies, which allow only active-duty service members to visit military treatment facilities,” Jones said. “What do I tell those folks?”

“The department does have work to do on expanding choice and access to beneficiaries,” Whitley responded. “Sometimes that’s in an MTF, sometimes that’s in the civilian health care setting.”

Whitley has specifically tried to eliminate the Murtha Cancer Center as an unnecessary expense, said one senior official.

Last fall, Whitley and CAPE also sought to close the Uniformed Services University of the Health Sciences, which prepares graduates for the medical corps, as part of the defense-wide review, the people said. Although at the time Esper denied the proposal, CAPE is now seeking major cuts to USU as part of the $2.2 billion. The reductions include eliminating all basic research dollars for combat casualty care, infectious disease and military medicine for USU, as well as slicing operational funds.

“What’s been proposed would be devastating, and it’s coming right out of Whitley’s shop,” said the senior official. “Instead of a clean execution, USU would be bled to death.”

The officials pointed out that USU has contributed to the Covid-19 response in recent months by graduating 230 medical officers and Nurse Corps officers early from the class of 2020 School of Medicine, leading and participating in research clinical trials for virus countermeasures and contributing to the Operation Warp Speed effort to develop a vaccine.

This content was originally published here.

Machine learning helps Invisalign patients find their perfect smile | CIO

Machine learning helps Invisalign patients find their perfect smile

Align Technology’s mobile app helps Invisalign wearers stay on schedule, while machine learning and other features help lure prospective consumers to try the orthodontic device.

The mobile computing trend requires enterprises to meet consumers’ expectations for accessing information and completing tasks from a smartphone. But there’s a converse to that arrangement: Mobile has also become the go-to digital platform companies use to market their goods and services.

Align Technology, which offers the Invisalign orthodontic device to straighten teeth, is embracing the trend with a mobile platform that both helps patients coordinate care with their doctors and entices new customers. The My Invisalign app includes detailed content on how the Invisalign system works, as well as machine learning (ML) technology to simulate what wearers’ smiles will look like after using the medical device.

“It’s a natural extension to help doctors and patients stay in touch,” says Align Technology Chief Digital Officer Sreelakshmi Kolli, who joined the company as a software engineer in 2003 and has spent the past few years digitizing the customer experience and business operations. The development of My Invisalign also served as a pivot point for Kolli to migrate the company to agile and DevSecOps practices.

The pitch for a perfect smile

My Invisalign is a digital on-ramp for a company that has relied on pitches from enthusiastic dentists and pleased patients to help Invisalign find a home in the mouths of more than 8 million customers. An alternative to clunky metal braces, Invisalign comprises sheer plastic aligners that straighten patients’ teeth gradually over several months. Invisalign patients swear by the device, but many consumers remain on the fence about a device with a $3,000 to $5,000 price range that is rarely covered completely by insurance.

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This content was originally published here.

FDA to Henry Ford Health: You can’t use hydroxychloroquine for COVID-19

FDA denies Henry Ford Health request to use hydroxychloroquine for COVID-19 patients

Kristen Jordan Shamus
Detroit Free Press
Published 5:43 PM EDT Aug 13, 2020

Weeks after the U.S. Food and Drug Administration revoked emergency use authorization of hydroxychloroquine to treat COVID-19, saying the drug doesn’t help coronavirus patients and has potentially dangerous side effects, Henry Ford Health System filed for permission to continue using it. 

The Detroit-based health system told the Free Press this week that it sought emergency use authorization July 6 to resume treating some COVID-19 patients with the drug, which is commonly used as an anti-malarial medication and for people with autoimmune diseases like lupus. 

The request came four days after Henry Ford published a controversial study in the International Journal of Infectious Diseases that suggested hydroxychloroquine slashed the COVID-19 death rate in half. The peer-reviewed observational study contradicted other published reports that showed the drug doesn’t help coronavirus patients and could cause heart rhythm problems in some people.

The FDA denied Henry Ford’s request this week.

More: After Fauci criticism, Henry Ford Health clams up on hydroxychloroquine study

More: Hydroxychloroquine saved coronavirus patients’ lives, Michigan study shows

“The U.S. Food and Drug Administration informed us that it would not grant our request for an emergency use authorization for hydroxychloroquine for a segment of COVID-19 patients meeting very specific criteria,” said Dr. Adnan Munkarah, Henry Ford’s executive vice president and chief clinical officer, in a statement. 

The patients who would have received the drug would have had to meet the same criteria as those who were enrolled in Henry Ford’s initial study:

Henry Ford’s study was widely criticized because it was observational, retrospective and not randomized or controlled. Additionally, the health system used hydroxychloroquine in combination with dexamethasone, a steroid, which has been known to improve outcomes for people with COVID-19.

Hope, and conflicting research

Early in the pandemic, hydroxychloroquine looked like it could be a promising treatment for COVID-19, but use of the drug quickly became political.

A French study published March 20 suggested the drug helped people with coronavirus, reporting it “is significantly associated with viral load reduction/disappearance in patients with COVID-19.” Positive outcomes, it noted, were improved when used in combination with the antibiotic azithromycin. 

The next day, President Donald Trump tweeted that hydroxychloroquine and azithromycin “have a real chance to be one of the biggest game changers in the history of medicine.”

Encouraged by those preliminary findings, researchers around the world began to launch their own investigations of the drug, and the FDA issued an emergency use authorization March 28 to allow doctors to begin treating patients with it in hospitalized settings outside clinical trials. 

Henry Ford Health System was among many nationally and across the state to begin using hydroxychloroquine in that way. Michigan Medicine, the Detroit Medical Center and McLaren Health Care also used it.

In early April, both Michigan Medicine and Henry Ford announced they would enroll patients in studies testing the effectiveness of hydroxychloroquine for the treatment of coronavirus. Henry Ford’s study was a retrospective analysis of 2,541 patients hospitalized between March 10 and May 2, 2020 across its six hospitals.

In the weeks that followed, more research suggested that the drug might not help coronavirus patients and could cause some harm. 

An April 23 preliminary review of 368 novel coronavirus patients at U.S. Veterans Health Administration hospitals suggested that the use of hydroxychloroquine — with or without azithromycin — did not reduce the likelihood of needing a mechanical ventilator and it may actually have made patients more likely to die.  

And a review of the initial French study found it was flawed and overstated the benefits of hydroxychloroquine treatment. The review also showed that patients who had bad outcomes after using the drug were dropped from the study, skewing the results. 

Still, Trump continued to publicly praise the drug’s effectiveness, and spoke at White House Coronavirus Task Force news conferences about how he was taking it himself with hopes it would prevent him from contracting the virus.  

With evidence mounting, the FDA issued a warning in late April, urging caution about using hydroxychloroquine in COVID-19 patients. 

“Hydroxychloroquine and chloroquine have not been shown to be safe and effective for treating or preventing COVID-19,” it said. “They are being studied in clinical trials.”

The drugs, it warned, “can cause abnormal heart rhythms such as QT interval prolongation and a dangerously rapid heart rate called ventricular tachycardia. … Patients who also have other health issues such as heart and kidney disease are likely to be at increased risk of these heart problems when receiving these medicines.”

But the federal agency didn’t revoke emergency use authorization of hydroxychloroquine until June 15, writing: “In light of ongoing serious cardiac adverse events and other potential serious side effects, the known and potential benefits of chloroquine and hydroxychloroquine no longer outweigh the known and potential risks for the authorized use.”

The World Health Organization announced June 17 that it would stop testing hydroxychloroquine in coronavirus patients through its Solidarity Trial. The National Institutes of Health halted its hydroxychloroquine study a few days later.

The FDA’s Adverse Events Reporting System logged 9,363 reports of bad reactions to hydroxychloroquine and related medications just in the first eight months of this year. Of them, 8,936 were classified as serious reactions in which 402 people died.

Comparatively, in all of 2019, there were 8,059 reports of adverse reactions to the drug, and 6,982 were considered serious; 146 people died. 

The politics of hydroxychloroquine

When Henry Ford Health System published its hydroxychloroquine study in early July showing success in the treatment of COVID-19 — cutting the mortality rate from 26% among those who did not receive the medicine to 13% among those who did — it was met with skepticism by many in the medical community.

Among the critics was Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, who called the study “flawed” in his testimony in late July at a congressional hearing on the federal government’s efforts to control the pandemic.

Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, testifies before a House Subcommittee on the Coronavirus Crisis hearing on a national plan to contain the COVID-19 pandemic, on Capitol Hill in Washington, DC, July 31, 2020.
KEVIN DIETSCH, Pool/AFP via Getty Images

Patients in the Henry Ford study, Fauci said, were given corticosteroids, which are known to be of a benefit to people with COVID-19. And it wasn’t randomized or placebo-controlled, the gold standard for medical studies. 

Yet, Henry Ford’s hydroxychloroquine research was hailed by the president as proof that the drug he touted from the beginning of the COVID-19 crisis works. 

Trump took to Twitter on July 6 — the same day Henry Ford asked the FDA for authorization to resume using hydroxychloroquine in COVID-19 patients — alleging Democrats disparaged the drug for political reasons.

The next day, Dr. Steven Kalkanis, Henry Ford Health System’s chief academic officer and senior vice president, told the Free Press that medicine shouldn’t be political. 

Dr. Steven Kalkanis, CEO of the Henry Ford Medical Group and chief of clinical academics for the Henry Ford Health System.
Henry Ford Health System

“We’re scientists, not politicians,” Kalkanis said. “We’ve never had a preconceived agenda with this study or any study regarding hydroxychloroquine. We simply wanted to use the resources and the opportunity of COVID, given that Detroit was such a hard-hit region, to find out which treatments worked and which treatment didn’t.

“So early on, we embarked on several different studies, and we wanted to let the data lead us to what is appropriate for patients. We stand behind the results of our study. We found that, you know, among 2,500 patients, the use of hydroxychloroquine cut the death rate in half.”

Last week, Henry Ford issued an open letter about its study, saying, “the political climate that has persisted has made any objective discussion about this drug impossible.”

The health system said in the letter that it will no longer comment outside the medical community on the use of hydroxychloroquine to treat novel coronavirus. 

“We are deeply saddened by this turn of events,” said the letter, signed by both Munkarah and Kalkanis.

Dr. Adnan Munkarah, Henry Ford Health System’s executive vice president and chief clinical officer.
Ray Manning/Henry Ford Health System

“Like all observational research, these studies are very difficult to analyze and can never completely account for the biases inherent in how doctors make different decisions to treat different patients. Furthermore, it is not unusual that results from such studies vary in different populations and at different times, and no one study can ever be considered all by itself.”

Trump has continued to support the use of hydroxychloroquine, saying in a July 28 White House news briefing that he believes in its benefit and that “many doctors think it is extremely successful.”

“I took it for a 14-day period, and I’m here. Right?” he said. “I’m here. I happen to think it’s — it works in the early stages. I think front-line medical people believe that, too — some, many. And so we’ll take a look at it. … It’s safe. It doesn’t cause problems. I had no problem. I had absolutely no problem, felt no different. Didn’t feel good, bad, or indifferent.”

Henry Ford is continuing with another research study of hydroxychloroquine that was announced in April in conjunction with Detroit Mayor Mike Duggan. Called the WHIP COVID-19 study, it’s the first large-scale U.S. study to investigate whether using the drug can prevent coronavirus among 3,000 health care workers and first responders.

“The decision does not impact the ongoing WHIP COVID-19 study, a randomized, double-blind investigation of hydroxychloroquine as a preventive treatment,” Munkarah said. 

The outcome of that research has yet to be published.

Contact Kristen Jordan Shamus: 313-222-5997 or kshamus@freepress.com. Follow her on Twitter @kristenshamus. 

This content was originally published here.

Europe’s Top Health Officials Say Masks Aren’t Helpful in Beating COVID-19 – Foundation for Economic Education

That’s less than one-third of the number of Danes who die from pneumonia or influenza in a given year.

Despite this success, Danish leaders recently found themselves on the defensive. The reason is that Danes aren’t wearing face masks, and local authorities for the most part aren’t even recommending them.

This prompted Berlingske, the country’s oldest newspaper, to complain that Danes had positioned themselves “to the right of Trump.”

“The whole world is wearing face masks, even Donald Trump,” Berlingske pointed out.

This apparently did not sit well with Danish health officials. They responded by noting there is little conclusive evidence that face masks are an effective way to limit the spread of respiratory viruses.

“All these countries recommending face masks haven’t made their decisions based on new studies,” said Henning Bundgaard, chief physician at Denmark’s Rigshospitale, according to Bloomberg News. (Denmark has since updated its guidelines to encourage, but not require, the use of masks on public transit where social distancing may not be possible.)  

Denmark is not alone.

Despite a global stampede of mask-wearing, data show that 80-90 percent of people in Finland and Holland say they “never” wear masks when they go out, a sharp contrast to the 80-90 percent of people in Spain and Italy who say they “always” wear masks when they go out.

Dutch public health officials recently explained why they’re not recommending masks.

“From a medical point of view, there is no evidence of a medical effect of wearing face masks, so we decided not to impose a national obligation,” said Medical Care Minister Tamara van Ark.

Others, echoing statements similar to the US Surgeon General from early March, said masks could make individuals sicker and exacerbate the spread of the virus.

“Face masks in public places are not necessary, based on all the current evidence,” said Coen Berends, spokesman for the National Institute for Public Health and the Environment. “There is no benefit and there may even be negative impact.”

In Sweden, where COVID-19 deaths have slowed to a crawl, public health officials say they see “no point” in requiring individuals to wear masks.

“With numbers diminishing very quickly in Sweden, we see no point in wearing a face mask in Sweden, not even on public transport,” said Anders Tegnell, Sweden’s top infectious disease expert.

What’s Going on With Masks?

The top immunologists and epidemiologists in the world can’t decide if masks are helpful in reducing the spread of COVID-19. Indeed, we’ve seen organizations like the World Health Organization and the CDC go back and forth in their recommendations.

CDC does not currently recommend the use of facemasks to help prevent novel #coronavirus. Take everyday preventive actions, like staying home when you are sick and washing hands with soap and water, to help slow the spread of respiratory illness. #COVID19 https://t.co/uArGZTJhXj pic.twitter.com/yzWTSgt2IV

— CDC (@CDCgov)

For the average person, it’s confusing and frustrating. It’s also a bit frightening, considering that we’ve seen people denounced in public for not wearing a mask while picking up a bag of groceries.

Opening day at Trader Joe’s in North Hollywood, Ca.

Karen is mad she was mask shamed… pic.twitter.com/pF3Zgj3w2E

— Rex Chapman🏇🏼 (@RexChapman)

The truth is masks have become the new wedge issue, the latest phase of the culture war. Mask opponents tend to see mask wearers as “fraidy cats” or virtue-signalling “sheeple” who willfully ignore basic science. Mask supporters, on the other hand, often see people who refuse to wear masks as selfish Trumpkins … who willfully ignore basic science.

There’s not a lot of middle ground to be found and there’s no easy way to sit this one out. We all have to go outside, so at some point we all are required to don the mask or not.

It’s clear from the data that despite the impression of Americans as selfish rebel cowboys who won’t wear a mask to protect others, Americans are wearing masks far more than many people in European countries.

Polls show Americans are wearing masks at record levels, though a political divide remains: 98 percent of Democrats report wearing masks in public compared to 66 percent of Republicans and 85 percent of Independents. (These numbers, no doubt, are to some extent the product of mask requirements in cities and states.)

Whether one is pro-mask or anti-mask, the fact of the matter is that face coverings have become politicized to an unhealthy degree, which stands to only further pollute the science.

Last month, for example, researchers at Minnesota’s Center for Infectious Disease Research and Policy responded to demands they remove an article that found mask requirements were “not based on sound data.”

The school, to its credit, did not remove the article, but instead opted to address the objections critics of their research had raised.

First, Do No Harm

The ethics of medicine go back millennia. 

The Hippocratic Oath famously calls on medical practitioners to “first, do no harm.” (Those words didn’t actually appear in the original oath; they developed as a form of shorthand.)

There is a similar principle in the realm of public health: the Principle of Effectiveness.

Public health officials say the idea makes it clear that public health organizations have a responsibility to not harm the people they are assigned to protect.

“If a community is at risk, the government may have a duty to recommend interventions, as long as those interventions will cause no harm, or are the least harmful option,” wrote Claire J. Horwell Professor of Geohealth at Durham University and Fiona McDonald, Co-Director of the Australian Centre for Health Law Research at Queensland University of Technology. “If an agency follows the principle of effectiveness, it will only recommend an intervention that they know to be effective.”

The problem with mask mandates is that public health officials are not merely recommending a precaution that may or may not be effective.

They are using force to make people submit to a state order that could ultimately make individuals or entire populations sicker, according to world-leading public health officials.

That is not just a violation of the Effectiveness Principle. It’s a violation of a basic personal freedom.

Mask advocates might mean well, but they overlook a basic reality: humans spontaneously alter behavior during pandemics. Scientific evidence shows that American workplaces and consumers changed the patterns of their travel before lockdown orders were issued.

As I’ve previously noted, this should come as no surprise: Humans are intelligent, instinctive, and self-preserving mammals who generally seek to avoid high-risk behavior. The natural law of spontaneous order shows that people naturally take actions of self-protection by constantly analyzing risk.

Instead of ordering people to “mask-up” under penalty of fines or jail time, scientists and public health officials should get back to playing their most important role: developing sound research on which people can freely make informed decisions.

See the World Health Organization’s Latest Guidelines on Masks and COVID-19

Editor’s note: This story was updated to reflect Denmark’s recent update on mask guidelines. 

This content was originally published here.

Health Officials Justify Mask Mandates For Political Reasons, Not Science

As the mayor of a small town in the Midwest with a population of less than 5,000 residents, I’ve been invited to attend numerous teleconferenced COVID-19 updates throughout the pandemic provided by local health officials. Because I read disease data and news daily and because my state and local area have had relatively few COVID-19 cases, I previously chose not to participate.

Recently, however, I received an email from our local city and county health officials announcing an online meeting because they were “seeing trends that are concerning.” Because I hadn’t seen anything in recently released COVID-19 data indicating a concerning trend, I made plans to attend.

The problems began early. The time stamp on the email read 12:35 p.m. yet the two calls advertised were to occur at 2:00 p.m. and 4:00 p.m. that same day. Had I another scheduled meeting or been otherwise unavailable, I would have missed hearing the “concerning” information.

The start of the call involved health officials calling out the city and state officials by name who “would not” wear masks — a situation they believed impeded their efforts to encourage citizens to wear masks. Later on the call, these same persons also complained, in a very partisan way, about President Trump’s order for hospitals to send COVID-19 data directly to the U.S. Department of Health and Human Services instead of the Centers for Disease Control (CDC).

Meeting participants were finally told that COVID-19 hospitalizations were increasing and this data was concerning. We were also told that hospitals (who self-report their statistics and are provided federal funds to assist COVID-19 patients) appeared to have ample beds, but staffing these beds was a concern, so they wanted to “sound a caution.” Minutes later, however, in an off-handed manner, everyone was informed that health officials had yet to contact local hospitals to obtain staffing information.

One city official asked how city and county health administrators could help get other local and state officials “on board” with mask-wearing because the elected officials in their town were getting “beat up” by the public when considering mask mandates. We were told that “this is about the economy and saving businesses,” and that if we didn’t want another economic shutdown, we should be encouraging mask usage because “people won’t go into businesses if they feel uncomfortable.”

As the meeting ended, I realized that for the entirety of the call I’d not heard one shred of medical or epidemiological evidence to justify a need for citizens to wear masks. I heard only copycat reasoning and talking points such as, “All communities need to be on the same page,” and “If one city mandates masks, people will just go to another city, negatively impacting that city.”

When I couldn’t get the discussion out of my head, searched the phrase “preventing economic shut down by wearing masks.” Low and behold, a CNN article titled, “Want To Prevent Another Shutdown, Save 33,000 Lives and Protect Yourself? Wear A Face Mask Doctors Say,” popped into view.

When I followed the first link provided in the story to the CDC page on COVID-19 called, “How To Protect Yourself & Others,” the information provided about viral spread says, “The virus is thought to spread mainly from person-to-person.” From that page, another link generates a page called “How COVID-19 Spreads.” We’re told at the top of that page:

COVID-19 is thought to spread mainly through close contact from person-to-person. Some people without symptoms may be able to spread the virus. We are still learning about how the virus spreads and the severity of the illness it causes.

When I clicked “cloth face covering” at the bottom of that page, I was taken to another CDC page, “Use of Cloth Face Coverings to Help Slow the Spread of COVID-19.” At the bottom of that page was highlighted text reading, “CDC calls on Americans to wear masks to prevent COVID-19 spread.”

This last link was a CDC press release dated July 14 in which three articles were referenced — a study of two salon owners in Missouri, a CDC Morbidity and Mortality Weekly Report (MMW), and a Journal of the American Medical Association article, about which was written, “the latest science and affirms that cloth face coverings are a critical tool in the fight against COVID-19 that could reduce the spread of the disease, particularly when used universally within communities.” I, however, did not come to the CDC’s conclusion after reading the editorial.

The study authors say the positive face mask outcome associated with the JAMA hospital study could have been influenced by many different factors. It also says a study on mask-wearing is extremely hard to perform with a virus like SARS-COV-2. Other studies — here and here — involved modeling, a form of science that has not been successful in projecting COVID disease levels. Yet while there is very little good data on cloth mask-wearing, the authors go on to say:

In the absence of such data, it has been persuasively argued the precautionary principle be applied to promote community masking because there is little to lose and potentially much to be gained. In this regard, the report by Wang et al provides practical, timely, and compelling evidence that community-wide face covering is another means to help control the national COVID-19 crisis.

Even more emphatically, the conclusion reads:

At this critical juncture when COVID-19 is resurging, broad adoption of cloth face coverings is a civic duty, a small sacrifice reliant on a highly effective low-tech solution that can help turn the tide favorably in national and global efforts against COVID-19.

In reality, the MMW report is nothing more than a “how-to” guide to persuade the public to wear masks. It ends with the following paragraph:

Based on behavioral associations, messages should be targeted to reach populations not wearing cloth face coverings to promote a positive attitude toward cloth face-covering use, encourage social networks to be supportive of cloth face-covering use, describe positive health outcomes expected from wearing a cloth face covering, and help persons feel confident in their ability to obtain and wear cloth face coverings consistently and correctly.

During the call with city and county health officials, no government official asked what state-collected COVID-19 epidemiological data justified potential mask mandates, and none was ever provided. No one asked about the number of hospital beds available, how a case was determined, where the national and state COVID-19 death rates stand, the demographics of positive case spikes, or anything else that might help elected officials weigh the cost of a government mandate against appropriate scientific or medical data regarding the disease.

Yes, a face mask might help slow COVID-19 transmission — but it might not. Face masks are now known to cause numerous side effects and skin disorders. Furthermore, they can’t be worn by everyone and when worn incorrectly can even cause disease.

Besides, it should not so easily be forgotten that the CDC and World Health Organization, the U.S. surgeon general, and even Dr. Anthony Fauci claimed there was no reason to wear a mask as coronavirus cases rapidly escalated, yet now, as U.S. death rates are largely falling and doctors are finding more and more ways to treat the disease, these same sources are claiming we must all wear masks.

As a public official sworn to support and defend the Constitution of the United States which, above all, was instituted to protect the individual rights of those who elected me, this is frightening. If public officials are being given only the information I was provided during this meeting and do not conduct their own research, citizens will have personal choices taken from them in the name of social conditioning, not proven scientific data.

When public officials concentrate their resources more on forwarding an agenda than championing individual rights and liberties, our republic is lost.

The author requested anonymity to avoid retribution from government officials.

This content was originally published here.

Beirut explosion: Health Ministry says there are more than 73 dead and 2,750 wounded – live updates

This story is developing

The death toll from the explosions in Beirut has climbed to 73, according to the Lebanese Health Ministry.


This church in Beirut was televising mass when the explosion took place.

OMG. Due to covid19, they televised this mass so that believers could join in from home. Then the #Beirut explosion took place. Horrible.@akhbar pic.twitter.com/lEqZ95mUHP

— Jenan Moussa (@jenanmoussa) August 4, 2020


U.S. embassy in Beirut issues statement:

Event:  We are closely following reports of an explosion at or near the Port of Beirut on August 4.

We encourage citizens in the affected area(s) to monitor local news, follow the emergency instructions provided by local authorities, enroll in the Smart Traveler Enrollment Program at step.state.gov to receive important emergency information, and follow us on Twitter and Facebook for additional updates.  There are reports of toxic gases released in the explosion so all in the area should stay indoors and wear masks if available.

We urge U.S. citizens in the affected areas who are safe to contact their loved ones directly and/or update their status on social media.  If you are in the affected area and need immediate emergency services, please contact local authorities; police can be contacted at 112, civil defense at 125, and the Lebanese Red Cross at 140.  We urge U.S. citizens to avoid the affected areas/shelter in place and follow the directions of local authorities.  The welfare and safety of U.S. citizens abroad is one of the highest priorities of the Department of State.  We will continue to provide information to U.S. citizens in the area through Alerts, our Embassy website, and travel.state.gov.  U.S. citizens with verifiable emergencies may contact BeirutACS@state.gov.

Actions to Take:

  • Avoid the area of the incident if possible
  • Review your personal security plans
  • Have travel documents up to date and easily accessible

Assistance:

  • U.S. Department of State – Consular Affairs
    +1-888-407-4747 or +1-202-501-4444

For further detailed information regarding travel and security in Lebanon:


BREAKING: Dozens feared killed, hundreds wounded in Beirut explosions: witnesses (via The Daily Star Lebanon)

Lebanon’s Health Minister says a very high number of injuries and large damage from the Beirut explosion.

There will be many examples of this from Beirut – of parents and loved ones shielding their children and each other, like this father. A friend told me how her mother saved her young son, protecting him from the glass.

There will also be those unable to. pic.twitter.com/rt04xISWdU

— Joseph Willits (@josephwillits) August 4, 2020

Several huge explosions rocked Beirut, Lebanon Thursday, but what actually caused the massive detention, that was followed by a billowing cloud of smoke is still not known.

The explosions appeared to be consecutive with one large explosion occurring before a secondary took place, according to reporters and eye witnesses in the region. The explosions were so forceful near the port in Beirut that it sent waves of water pushing back from the center of the detention.

Fireworks explosion?! I felt like I’m dying, I still can’t believe it #Lebanon #Beirut pic.twitter.com/EMTS470FOH

— Ahmad M. Yassine | أحمد م. ياسين (@Lobnene_Blog) August 4, 2020

U.S. Intelligence and State Department officials could not be immediately reached for comment and this story is developing. It will be updated when a response is available.

A massive explosion shook Lebanon’s capital Beirut wounding a number people and causing widespread damage. The blast appeared to be centered around Beirut’s port and shattered windows miles away. https://t.co/ekrRYo2Ns1

— The Associated Press (@AP) August 4, 2020

BREAKING: Reports of Explosion in Beirut #Lebanon in Port area.

Video by LATimes correspondent: pic.twitter.com/gBGKAO5PTj

— Joyce Karam (@Joyce_Karam) August 4, 2020

Numerous social media posts on Twitter and Instagram captured the large explosion, which could be seen from miles away.

Here’s the Beirut explosion captured from a boat. pic.twitter.com/DUB7cev6jD

— Ian Miles Cheong (@stillgray) August 4, 2020

Another view of the Beirut explosion from (another) boat. pic.twitter.com/xHvDZxExfP

— Ian Miles Cheong (@stillgray) August 4, 2020

The post Beirut explosion: Health Ministry says there are more than 73 dead and 2,750 wounded – live updates appeared first on Sara A. Carter.

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Artist Draws Wholesome Watercolor Comics Where A Cat Is Giving Out Mental Health Advice (20 Pics)

Artist Hector Janse van Rensburg aka ‘S**tty Watercolour’ aka ‘Swatercolour’ is making us happier and our lives more wholesome with his comics that feel like miniature hugs and feature a meowtivational cat. The UK-based painter has become a global phenomenon and is now known as the world’s favorite self-deprecating artist.

“The comics that came before this series were less optimistic, and this series is a bit like a response to that. They sometimes approach difficult issues like mental health, but the aim of the comics is not to solve the issues but to show a different perspective on them. That new perspective often comes from the cat, who is based on my cat Ona who passed away a few years ago,” Hector told Bored Panda about his newest work.

We’ve collected some of Hector’s best work featuring the lovely cat, so scroll down, upvote your fave comics, and read on for our full interview with the painter about his art, as well as for his advice when drawing “happy little wobbly blobs of color.”

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“Before I started painting online about 8 years ago, I had never had any interest in art and now it looks like that’s where my life is going,” Hector said. “Ostensibly, that just means I’m sitting at my desk with a brush more often than a keyboard, but it is a whole different type of challenge to think of things about human nature that I want to communicate in my paintings.”

He added: “One part of that is that it’s like I’m living through my art, which can be difficult.”

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We wanted to find out how the painter manages to stay passionate about art. However, Hector told us that passion might be the wrong thing to focus on. Instead, the key is discipline.

“I think if you rely on some feeling of passion to motivate you then you will have a hard time. I’ve been doing a comic every day recently and I tend to wake up, think of an idea, and then have it painted by lunchtime,” he revealed a bit about his disciplined schedule.

“The schedule around my painting process is quite robotic by now, and I think doing it that way opens up a clear space where you can be more creatively free. If I didn’t have a schedule and instead waited around for inspiration that was good enough to motivate me to paint, then I probably wouldn’t be as productive.”

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Hector said that the ideas for his comics come from negative thoughts that he can turn into more positive ones.

“So I think about the ways in which people can feel bad and how you might approach them as a friend would. I don’t think I find it too difficult to think of ideas which is probably a testament to how nice my cat was,” he complimented his cat Ona for being a fantastic feline.

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Bored Panda also wanted to hear what advice Hector would give other potential artists who are dabbling with watercolor paintings. He said that a lot depends on each individual artist’s end-goal: there are two paths that they can take.

“For me, it’s that the niceness and technical ability of a painting are different things and you can aim at either,” he said.

“It’s perfectly possible to make happy little wobbly blobs of color and people will enjoy them if the message is good and sincere. There’s probably a boundary of neatness that you should stay within but messiness is cool too. Also, most of my pictures look very bad at first, and then it’s only after a while that they come together. I think that’s because a few wobbly blobs on their own look like an accident, but a finished painting of wobbly blobs looks purposeful.”

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Hector, who has a Philosophy, Politics, and Economics degree from the University of York, has been experimenting with watercolors since December 2011. He revisited an old watercolor set when he felt bored and depressed. Originally, he started uploading his illustrations on Reddit in 2012, then he spread his gaze wider and moved on to Tumblr and Twitter.

The cartoonist admits that he’s inspired by Sir Quentin Blake who illustrated the children’s books written by beloved author Roald Dahl. So if you felt that you found his art style oddly familiar and felt nostalgia for your childhood when looking at Hector’s drawings, this is why!

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This content was originally published here.

Whitmer signs order calling racism a public health crisis

Whitmer signs order calling racism a public health crisis

Beth LeBlanc
The Detroit News
Published 3:15 PM EDT Aug 5, 2020

Gov. Gretchen Whitmer signed Wednesday an order declaring racism a public health crisis and creating the Black Leadership Advisory Council to “elevate Black voices.”

The executive directive asks the Michigan Department of Health and Human Services to have all state employees undergo implicit bias training for employees and “make health equity a major goal.”

Gov. Gretchen Whitmer addresses the state during a speech in Lansing, Mich., Wednesday, Aug. 5, 2020.
Michigan Office of the Governor via AP

People applying to the leadership council must do so by Aug. 19. 

“We must confront systemic racism head on so we can create a more equitable and just Michigan,” Whitmer said in a statement. “This is not about one party or person. I hope we can continue to work towards building a more inclusive and unbiased state that works for everyone.” 

Early in the virus’ path through Michigan, the virus has hurt the Black community more than other communities, and the trend has held true through the summer. 

African-American individuals have made up about 27% of the confirmed cases in Michigan and 39% of the deaths, despite making up 14% of the state’s population, according to state data. 

In April, Whitmer appointed the Michigan Coronavirus Task Force on Racial Disparities chaired by Lt. Gov. Garlin Gilchrist to study the issue of racial disparity. 

While the virus has been challenging for all state residents, “they have been especially tough for Black and Brown people who for generations have battled the harms caused by a system steeped in persistent inequalities,” Gilchrist said.

“These are the same inequities that have motivated so many Americans of every background to confront the legacy of systemic racism that has been a stain on our state and nation from the beginning,” he said.

Whitmer’s Wednesday executive order would task the council with reviewing state laws that perpetuate inequities, promoting legislation seeking “to remedy structural inequities,” providing advice to community groups seeking to benefit the Black community and promoting cultural arts in the African-American community. 

The task force will consist of 16 members and will fall under the Michigan Department of Labor and Economic Opportunity. 

“We are blessed to have a governor who is willing to hear us, march with us and use her office to build a better, more equal world.” Flint Mayor Sheldon Neeley said. 

Whitmer’s separate directive to the state health department requires it to review data and find ways to advocate for communities of color. Data on health disparities among Black people should be analyzed and made available.

The directive requires all existing state employees to complete implicit bias training and new hires to do so within 60 days. 

The department will use an Equity Impact Assessment tool to guide state officials through the potential implications their decisions may have on minorities, according to Whitmer’s office. 

The governor’s remarks come a day after the state of Michigan upped its tally of confirmed cases to 84,050 and its count of deaths related to the virus to 6,220. Hospitalizations linked to the virus have remained relatively low despite upward trends in cases since June. 

“Overall we are seeing a plateau in cases after a slight uptick in June and July,” Khaldun said. 

The Detroit, Grand Rapids and Kalamazoo regions have a little more than 40 cases per million people per day, the Jackson and Upper Peninsula regions about 35 cases per million people per day and the Saginaw and Lansing regions have just under 30 cases per million people per day, the chief medical executive said.  

All of those regions, with the exception of Lansing, have seen decreasing daily case averages over the last weeks, Khaldun said. 

The Traverse City region, which recently came under stricter rules by Whitmer, is averaging about 10 cases per million people per day, she said. 

The state considers daily case incidences that rise above 20 cases per million people per day to be cause for concern, while a safer level is one that stays below 10 cases per million people per day. 

“These are all good signs and we will continue to monitor these metrics,” Khaldun said. But “these plateauing trends are not reason to let our guard down.”

eleblanc@detroitnews.com

This content was originally published here.

Canadian Man Accused Of Unauthorized Horse Dentistry: ‘A Display of Lawless Bravado’

A Canadian man is facing a lifetime ban on practicing veterinary medicine after accusations he’s been performing unauthorized horse dentistry.

The Manitoba Veterinary Medical Association (MVMA) is seeking a permanent injunction against Kelvin Brent Asham, accused of treating horses—including giving one horse a sedative—without veterinary certification.

An investigator described Asham’s actions as “a display of lawless bravado,” according to court documents.

The MVMA says it’s been trying to stop Asham for the past three years: It first became aware of his activities in 2015, when a complaint was filed about a 16-year-old gelding he had treated. Asham sedated the horse, filed down its teeth—a process known as “floating”—pulled one tooth and tried to extract another.

horse teeth dentist
The sharp edges of horses’ teeth occasionally needs to be filed down to save the horse from pain when eating or holding a bit in its mouth. The term “floating” comes from the file used in the process, known as a “float.”
Anna Elizabeth/Getty

Leon Flannigan, an animal protection officer in Manitoba, investigated the claims and determined the horse had suffered “irreparable damage.” In an affidavit, Flannigan said he’d met with Asham in 2016 at a Tim Horton’s donut shop in Selkirk. Asham allegedly told Flannigan he’d been floating horse teeth since 1996 and had performed the procedure on four other horses owned by the same person as the gelding.

Asham also told Flannigan that most vets float teeth improperly, and that he had different tools than vets use. “Off the record, I do thousands of horses,” Asham allegedly told Flannigan. “I do a good job. I am willing to fight this in court.”

This incident caused the MVMA to send Asham a cease-and-desist letter in 2017, as he is not a licensed veterinarian.

But last year, the MVMA found out that Asham was still working as a equine dentist and was recommended on Facebook. The MVMA hired private investigator Russ Waugh to go undercover and try to hire Asham.

According to Waugh’s affidavit, Asham told him the horse Waugh brought in could be treated for $200 CAD (about $150), the average price for floating teeth. After the investigation, the MVMA filed suit against Asham, asking a judge to ban Asham from acting as a vet.

“By engaging in the unauthorized practice of veterinary medicine, the respondent effectively declares himself to be outside the law,” writes Robert Dawson, an attorney for the association.

This isn’t Asham’s first run-in with the law: In December 2001, the then-37-year-old was arrested after admitting to carrying 10 one-kilogram bricks of cocaine in his truck. Asham and Barry Vaughan Hancock, who was also in the truck when it was pulled over, were each charged with possession of cocaine for the purposes of trafficking.

At the time, Hancock was an equine dentist.

This content was originally published here.

Texas attorney general says local health authorities cannot “indiscriminately” shut down schools

After Texas ordered schools to reopen their classrooms this fall, county and city public health officials began to push back.
After Texas ordered schools to reopen their classrooms this fall, county and city public health officials began to push back.
Miguel Gutierrez Jr./The Texas Tribune

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Local health officials do not have the authority to shut down all schools in their vicinity while COVID-19 cases rise, Texas Attorney General Ken Paxton said in nonbinding guidance Tuesday that contradicts what the Texas Education Agency has told school officials.

Shortly after Paxton’s announcement, the Texas Education Agency updated its guidance to say it will not fund school districts that keep classrooms closed because of a local health mandate, citing the attorney general’s letter. Districts can receive state funding if they obtain TEA’s permission to stay closed, as allowed for up to eight weeks with some restrictions.

The change represents an about-face for the agency, which previously said it would fund districts that remained closed under a mandate. It will impact schools in at least 16 local authorities, many in the most populous counties, that have issued school closure mandates in the past month.

Dallas County Judge Clay Jenkins, whose county is among those with a mandate to close schools, said local officials will continue to make decisions to keep students safe “regardless of what opinion General Paxton comes up with.”

“The only way that it would really screw things up is if Abbott tried to take away the control from the local groups,” Jenkins said.

The guidance is non-binding, but local health authorities could face lawsuits especially now that Paxton has weighed in. Paxton’s office declined to comment on whether it would sue local health officials that don’t retract mandates, saying it could not comment on hypothetical or potential litigation.

After Texas ordered schools to reopen their classrooms this fall, county and city public health officials began to push back, ordering all public and private schools in their areas to stay closed through August and in some cases September.

The officials cited a state law giving health officials authority to control communicable diseases. But Paxton said in the letter that “nothing in the law gives health authorities the power to indiscriminately close schools — public or private — as these local orders claim to do. … It does not allow health authorities to issue blanket quarantine orders that are inconsistent with the law.”

The governor’s executive order allowing all school districts to operate overrules local mandates to close, Paxton said. Local health officials have some authority to order schools closed if people in it are infected by COVID-19, but not as a preventive measure.

Earlier this month, Texas revised its statewide order that schools open classrooms to give officials more local flexibility on how long to continue with entirely remote education, especially in areas where the virus is spreading quickly.

The TEA’s previous guidance says that schools could ban in-person classes if ordered to do so “by an entity authorized to issue an order under state law.” And the agency confirmed to The Texas Tribune earlier this month that school districts under such mandates would not lose state funding if they closed classrooms. But it was confusing to education officials and school communities exactly which entities were allowed to issue orders, and when state guidance trumped local law.

Gov. Greg Abbott‘s office did not respond to a request to clarify this earlier this month.

The confusion resulted in anger and panic in some communities that wanted their schools to reopen. Families protested outside the Tarrant County administration building Monday demanding that officials allow their schools to hold in-person classes before Sept. 28, according to The Dallas Morning News.

Paxton said religious private schools were exempt from following the order in guidance released earlier this month.

Stacy Fernández contributed to this report.

This content was originally published here.

Phil Murphy to Slap 2.5% Tax on Health Insurance Premiums in New Jersey – Shore News Network

TRENTON, NJ – A new bill in Trenton has been passed and is headed for Governor Phil Murphy’s desk that includes a 2.5% tax on health insurance for everyone in New Jersey.  That money will be put in a health insurance affordability fund to provide health insurance for illegal aliens and to support the NJ FamilyCareAdvantage program.

The bill requires entities to pay an annual assessment that is 2.5% of the entity’s net written premiums as defined by the bill.

The bill requires the commissioner to calculate and issue to the health provider a certified assessment that is 2.5% of the entity’s net written premiums. The bill requires entities to pay the assessment issued by the commissioner to the State Treasurer no later than May 1 of each year, as prescribed by the commissioner.

The bill reads:

The bill provides that if the commissioner determines that the amount of the assessment will reduce the State’s total revenue, the commissioner may reduce the assessment. The bill establishes in the Department of the Treasury a nonlapsing revolving fund to be known as the “Health Insurance Affordability Fund.” This fund is to be the repository for all monies collected pursuant to the bill. As directed by the commissioner, in consultation with the Commissioners of the Department of Human Services and the Department of Health, the monies in the fund are to be used only for the purposes of increasing affordability in the individual market and providing greater access to health insurance to the uninsured, including minors, with a primary focus on households with an income below 400 percent of the federal poverty level, expanding eligibility, or modifying the definition of affordability in the individual market, through subsidies, reinsurance, tax policies, outreach and enrollment efforts, buy-in programs, such as the NJ FamilyCare Advantage 2 Program, or any other efforts that can increase affordability for individual policyholders or that can reduce racial disparities in coverage for the uninsured. The bill provides that a report currently required to be issued by the Commissioner of Banking and Insurance by June 1, 2022 shall also set forth the impacts of the measures taken pursuant to the bill on affordability and reductions in racial disparities in health insurance coverage, including impacts by income level, race, and immigration status. The report shall make recommendations to increase affordability and reduce the uninsured rate in New Jersey, as appropriate, based on the data available to the department. The bill also requires that the assessments collected pursuant to the bill be used only for the purposes contained in the bill, with certain provisions to ensure the assessments are used for those purposes in future fiscal years.

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Important Studies on Opioid Prescribing: Implications for Dentistry – TeethRemoval.com

Recently on this site several articles have appeared discussing opioid prescribing after wisdom teeth removal see for example the posts Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal? and Opioid Prescriptions From Dental Clinicians for Young Adults and Subsequent Opioid Use and Abuse. Very recently several interesting studies regarding opioid prescribing have published.

The first study is titled “Trends in Opioid Prescribing for Adolescents and Young Adults in Ambulatory Care Settings” written by Hudgins et al. appearing in Pediatrics in June 2019 (vol.143, no. 6, e20181578). The article explored opioid prescribing for adolescents (ages 13 to 17) and young adults (ages 18 to 22) receiving care in emergency departments and outpatient clinics. Data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) and National Ambulatory Medical Care Survey (NAMCS) over the time period from January 1, 2005, to December 31, 2015 was used. It was found the most common conditions associated with opioid prescribing among adolescents visiting emergency departments was dental disorders (59.7%), clavicle fractures (47%) and ankle fractures (38.1%) and among young adults visiting emergency departments was dental disorders (57.9%), low back pain (38%), and neck sprain (34.8%). Thus in both cases when someone ages 13 to 22 goes to an emergency department because of a dental disorder they are nearly 60% likely to leave with an opioid prescription. Studies suggest that adolescents and young adults are the most likely to misuse and abuse opioid medications. Thus the authors imply it is possible that many of these opioids being prescribed for dental disorders are being used for non medical use.

An accompanying commentatory of the article by Hudgins also provides additional insights into the article titled “Opioids and the Urgent Need to Focus on the Health Care of Young Adults” written by Callahan also appearing in Pediatrics in June 2019 (vol. 143, no. 6, e20190835). Callahan says that research looking at young adults is often not available as they often get grouped into adolescents in studies. Callahan states:

“Efforts to improve research and health care for young adults are further hindered by (1) the lack of a consensus definition of young adulthood, (2) the false perception that young adults are healthy, (3) fragmented health insurance coverage during young adulthood, and (4) little organized advocacy on behalf of young adults.”

Callahan thus calls for more research tailored to young adults. Young adults are of course a target demographic for wisdom teeth surgery.

The second study is titled “Comparison of Opioid Prescribing by Dentists in the United States and England” written by Suda et al. appearing in JAMA Network Open in 2019 (vol. 2, no. 5,e194303). The article explored opioid prescribing differences by dentists in the United States of America and England. The authors looked at data from IQVIA LRx in the U.S. and the NHS Digital Prescription Cost Analysis in England. The authors found in 2016 dentists prescribed more than 11,440,198 opioid prescriptions in the U.S. and 28,082 opioid prescriptions in England. Dental prescriptions for opioids were 37 times greater in the US than in England. In the U.S. various opioids were prescribed including hydrocodone-based opioids (62.3% of time), codeine (23.2% of the time), oxycodone (9.1% of the time), and tramadol (4.8% of the time) whereas in England only the codeine derivative dihydrocodeine was prescribed. The authors state:

“The significantly higher opioid prescribing occurs despite similar patterns of receiving dental care by children and adults, no difference in oral health quality indicators, including untreated dental caries and edentulousness, and no evidence of significant differences in patterns of dental disease or treatment between the 2 countries.”

The authors in the article by Suda point out that the patients included in the study from England were limited to receiving medications from the U.K.’s National Health Service. However they feel that their study shows that U.S. dentists prescribe too many opioids and this practice is contributing to the opioid epidemic in the U.S.

In both studies above it seems that the authors feel that patients in the U.S. are receiving too many opioids for dental related issues and that other medications that can provide pain relief should be given. When opioids are given they should be prescribed in the shortest duration necessary to deal with the expected amount of pain the patient is dealing with. However, a limitation of both studies is the authors were unable to assess the appropriateness of the opioid prescriptions given.

This content was originally published here.

The Democrats’ Baffling Silence as Millions of Americans Lose Their Health Insurance

One of the many things that made the United States uniquely vulnerable to the coronavirus pandemic is the relationship between health care and employment in this country. About half of all Americans have employer-provided insurance; if you don’t, you are left to a mass of overlapping state and federal programs, though depending on where you live, you might find none of them overlap with you. It has been clear from the start that this patchwork health care nonsystem would cause unique problems fighting the coronavirus, and people are undoubtedly dead directly because of these problems. Months into the pandemic, the twin crises of Covid-19 and gaps in insurance are compounding each other: A new report from Families USA suggests that more than five million people have lost their insurance already; another report, from the Urban Institute, predicts another 10 million will lose their coverage by the end of the year.

It is easy to look at any issue plaguing America, from the coronavirus and health care to crumbling schools or roads, and say that the Republicans are standing in the way of progress, which they are. But there’s another dynamic at play with health care. It plainly doesn’t matter very much to our leaders—whether it’s Nancy Pelosi or Donald Trump—whether people have insurance and whether they get health care. Once a government gets used to a situation where tens of millions of people don’t have health insurance, which has always been the case in the U.S., how do we get our leaders to care when another five or 10 million are added to that number? Once you have accepted that some people don’t get to have health care, as if they’re just part of the scenery, why would another five million people at risk of financial ruin or death spur action?

The Trump administration’s response to the health insurance crisis has been predictably nonexistent. The Los Angeles Times noted Tuesday that the Trump administration has not made any sort of push to stem the loss of health insurance, with no effort to encourage people to sign up for Affordable Care Act marketplace coverage, for example. Larry Levitt, executive vice president of the Kaiser Family Foundation, told the paper that this is because the ACA is such a “political football,” adding, “what you’d normally think would be good government simply isn’t happening.” Expecting Republicans to practice good government is like expecting a dog to practice good hygiene.

On the Democratic side, there has been a range of proposals, but none that have been advocated for very forcefully. The Heroes Act, a $3 trillion stimulus bill passed by the House that was never intended to survive whole in the Senate, would fully subsidize Cobra, the program that allows laid-off workers to keep their employer-provided insurance. This usually comes at a laughably unaffordable cost, as employees must pay both their portion and the employer’s portion of the premium, but the Democratic bill would pay insurers to make it free for ex-employees instead. The left-wing criticism of this is that it provides a huge giveaway to insurers, who charge far more than they need to in premiums to rake in massive profits, instead of expanding government health insurance to laid-off people. (And, of course, many employer-sponsored insurance plans are too expensive for people to use even if their premiums are paid, because of high deductibles and co-insurance.)

That’s all true, but put that aside for a moment and think strategically. Even if making Cobra free for ex-workers were the best possible thing Democrats could get out of the Senate, why roll it into this bill that will never pass? Minimizing the loss of health insurance is among the most urgent tasks of this pandemic, along with controlling the spread of disease, providing economic relief, and preventing a wave of evictions. (Not on the list: getting bailout funds to lobbyists.)

If the Democrats wanted to run on health care against Trump, which worked in 2018 and which Joe Biden has shown an interest in doing despite struggling to articulate basic facts about his health care plan, this would be a perfect time to introduce a bluff-calling bill. Expanding Cobra is the barest minimum the government could do to provide health insurance in this crisis; Republicans don’t even have a counterproposal, because they fundamentally do not want more people to have health insurance. Expanding Cobra is such a centrist, even right-wing idea that Republican strategists write in their memos that Republicans should do it, because the alternative is expanding Medicaid, which is increasingly popular. And we can’t have that.

The Democrats could cut and paste the Cobra segment of the Heroes Act, introduce a stand-alone bill, call it the Health Access Protection Act or something suitably Third Way–ish, and dare the Republicans to vote against keeping laid-off workers on their health insurance—if, that is, they really believed in and wanted this solution to happen. There’s plenty of money for ads on the Democratic side, still. You could argue that splitting off any one part of the bill would damage the chances for success on the overall bill, or you could see the Democrats’ inability to capitalize on the fact that more than five million people have lost their health insurance as further evidence that they do not understand what a crisis American health care was already in long before the first Covid-19 case.

The lack of urgency that has characterized the federal response to this crisis—in 10 days, the expanded unemployment benefits expire, and we have no idea whether anything will be done to extend them—is simply a continuation of how the government has tolerated the obvious failures of the system up to this point. People without health insurance, like those with insurance, have bodies that break down, stop working, throw out weird symptoms and lumps and fluids, produce anxiety or depression. When these things happen to uninsured people, they often end up going to the emergency room, and rack up bills that they can’t pay, costing hospitals and the government money and often ruining their lives.

A person without health insurance can still catch the coronavirus, infect others, and get dangerously or fatally sick, without knowing that they are supposed to be able to go to the doctor about that for free: The Department of Health and Human Services reported last week that it has paid out far fewer claims for Covid-19 testing and treatment for the uninsured than it expected. Everything about the health care system is complicated, hostile, and potentially ruinous for people without health insurance, so it’s not surprising if a lot of people couldn’t shake that experience off within a matter of weeks and months. It’s true that our health care system was not designed to handle a pandemic, but it would be more accurate to say that our system was not designed to provide health care to people en masse, whether that is regular checkups or chemotherapy.

All of this would be fixed by passing Medicare for All, which Democratic voters like and which gets favorability ratings comparable to or better than the Affordable Care Act’s. It would not pass the Senate, of course, but it would provide a club to beat Republicans with. Barring a sudden change of heart on single-payer, it would still be easy and beneficial for Democratic leadership to do anything at all to show they care about people who have lost their health insurance. Propose a bill. Hold a press conference. Take a camera and go to a hospital, a homeless shelter, or a McDonald’s and talk to uninsured people who would tell you that yes, actually, I would like it if Mitch McConnell would allow me to have health insurance. All of this would be better than nothing, as inadequate as expanding Cobra would be. But Democrats won’t do these things, because they don’t really care. Once you’ve accepted 27 million uninsured, what’s another five million lives?

This content was originally published here.

Health Service Blames ‘Error’ After Telling 600,000 Healthy People They’d Had COVID-19

More than 600,000 military-connected Americans affiliated with the Tricare health plan were told in error Friday that they had been diagnosed with COVD-19.

The individuals and families were in the military health system’s East Region, according to Military.com.

The foul-up began when beneficiaries received an email that began with some very jarring news.

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“As a survivor of COVID-19, it’s safe to donate whole blood or blood plasma, and your donation could help other COVID-19 patients,” the email stated.

The email then went on to explain itself.

“Your plasma likely has antibodies (or proteins) present that might help fight the coronavirus infection. Currently, there is no cure for COVID-19. However, there is information that suggests plasma from COVID-19 survivors, like you, might help some patients recover more quickly from COVID-19,” it said.

A few hours later, Humana Military, which manages Tricare across 31 states and the District of Columbia, tried to calm the waters it had roiled.

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“In an attempt to educate beneficiaries who live close to convalescent plasma donation centers about collection opportunities, you received an email incorrectly suggesting you were a COVID-19 survivor. You have not been identified as a COVID-19 survivor and we apologize for the error and any confusion it may have caused,” Humana’s email said.

According to Military Times, Marvin Hill, Humana’s corporate communications lead, said the company apologized “for the confusion caused by the original message.”

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The initial, potentially panic-inducing message went to some of those living near a plasma collection facility and was not based “on any medical information or diagnosis,” Hill said.

Plasma from individuals who have had COVID-19, which is called “convalescent plasma,” can be used as a possible treatment for the disease.

“As a part of an effort to educate military beneficiaries about convalescent plasma donation opportunities, Humana was asked to assist our partner, the Defense Health Agency. Language used in email messages to approximately 600k beneficiaries gave the impression that we were attempting to reach only people who had tested positive for COVID-19. We quickly followed the initial email with a clear and accurate second message acknowledging this. We apologize,” Hill said in a statement, Military Times reported.

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Have you recovered from #COVID19 and live near @FtBraggNC? Your plasma could help save a life. The @WomackAMC is holding blood drives July 27-31.

Donors are needed to fuel a study about the effectiveness of convalescent plasma.

“Our goal is to encourage all personnel who have fully recovered from COVID-19 to donate their convalescent plasma as a way to help their friends, family, or colleagues who may be suffering from the disease now or who may contract the disease in the future. The need is now,” Army Col. Audra Taylor, chief of the Armed Services Blood Program, told Military Times.

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The U.S. Food and Drug Administration approved convalescent plasma as an investigational therapy in March for those hospitalized with the illness, and more than 35,000 patients in the U.S. have received it.

To date, there have been “encouraging reports and a lot of mechanistic reasoning that in fact convalescent plasma may be helpful,” said Dr. Janet Woodcock, director of the Center for Drug Evaluation and Research at the Food and Drug Administration, according to Military Times.

“These studies are being done as we speak … we need donors. Blood drives are ongoing, and the U.S. government will be trying to accelerate these drives for convalescent plasma,” Woodcock said.

We are committed to truth and accuracy in all of our journalism. Read our editorial standards.

This content was originally published here.

Updated Sedation Guidelines in Dentistry for Children – TeethRemoval.com

Recently new guidelines have been issued regarding the use of sedation for dental procedures performed on children. In the past on this site some scrutiny has been placed on sedation provided to children during dental procedures because of many deaths that have occurred, see for example What to Ask the Dentist Before Children Have Sedation and Pediatric Dental Death in Cambridge, Ontario, Canada Spurs Comments on Dental Anesthesia. In the June 2019 edition (vol. 143, no. 6) of Pediatrics in an article titled Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures written by Coté and Wilson updated guidelines for the use of sedation in dentistry is provided. These guidelines were updated for the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) for the first time in three years. These recommendations apply to all of those whom are providing deep sedation or general anesthesia in an office environment to children even if the state board does not mandate such a recommendation.

What has changed in these recommendations has been intensely contested when it comes to giving sedation to those undergoing wisdom teeth removal. The guidelines in the 2019 edition of Pediatrics call for two trained personnel to be present when deep sedation or general anesthesia is given to a child at a dental facility. The previous guidelines called for one trained person to be present when deep sedation or general anesthesia is given to a child at a dental facility. Specifically the June 2019 guidelines state:

“During deep sedation and/or general anesthesia of a pediatric patient in a dental facility, there must be at least 2 individuals present with the patient throughout the procedure. These 2 individuals must have appropriate training and up-to-date certification in patient rescue… including drug administration and PALS [ pediatric advanced life support] or Advanced Pediatric Life Support (APLS). One of these 2 must be an independent observer who is independent of performing or assisting with the dental procedure. This individual’s sole responsibility is to administer drugs and constantly observe the patient’s vital signs, depth of sedation, airway patency, and adequacy of ventilation.”

The guidelines call that the independent observer must one of: a certified registered nurse anesthetist, a physician anesthesiologist, an oral surgeon, or a dentist anesthesiologist. The independent observer must be trained in PALS or APLS and capable of managing any airway, ventilatory, or cardiovascular emergency resulting from deep sedation or general anesthesia given to the child. The person performing the dental procedure must be trained in PALS or APLS and be able to provide assistance to the independent observer if a child experiences any adverse events while sedated.

It is reported that the guidelines developed rely mostly on medical data because data for sedation in dental offices is not as readily available. Steps are being taken to incorporate more data regarding dental sedation into new guidelines. The reason for the updated guidelines is to increase safety for children having dental procedures in dental offices.

It is not clear how the American Association of Oral and Maxillofacial Surgeons may react to these June 2019 guidelines. They have long argued that their care model of having an oral and maxillofacial surgeon administer the sedation and perform the dental surgery is safe and cost effective (as seen in a recent May 2019 tweet below). Even so other physician organizations in the past have questioned their care model and it has long been suggested on this site that it may be safer to have oral surgery performed at a hospital if you are receiving sedation or anesthesia, see for example Anesthesia in the Oral and Maxillofacial Surgeons Office.

Oral and maxillofacial surgery anesthesia teams have the extensive training and experience needed to assist patients with pain and anxiety during procedures. https://t.co/sN9C5LCVHo #oralsurgery #myoms pic.twitter.com/fDhR3Jiz2d

— AAOMS (@aaoms)

Additional Source:

This content was originally published here.

Our November Practice of the Month — Zammitti & Gidaly Orthodontics

mysocialpractice.com

Congratulations to our November Practice of the Month — Zammitti & Gidaly Orthodontics!

This month we’d like to spotlight an absolute social media powerhouse practice, Zammitti & Gidaly Orthodontics! They’re using social media dental marketing to reach new audiences, strengthen relationships with current patients, and stand out in their community.

They also impressed us with their phenomenal reviews presence, with over 350 positive patient reviews across Facebook and Google.

We reached out to Michelle Camp, patient care and marketing coordinator of the practice, for some insight on how social media is growing their business and what’s been working for them. Take something from what their team has learned to apply in your own social media strategy!

Ready for a quick demo of our reviews service? Fill out the form below.

Q&A With Michelle Camp, Marketing Coordinator

(Responses edited for length and clarity.)

What has been the biggest surprise of social media marketing for you?

The biggest surprise of using social media in our practice is how fun and exciting it is creating the posts. Our staff has really loved getting involved in taking pictures, sharing their fun facts or just listening to our silly post ideas. Taking pictures of the staff and patients is a fun and quick way to break up the day/week and add some excitement to our patient’s visits.

Which of your team’s social media efforts have shown to be most effective?

The social media tool or tactic that has been most successful has been our “Fun Fact Friday”–where each staff member shares a little fact about themselves that our patients may not otherwise know. People love getting to know our staff and doctors through these posts. Our patients look forward to this post in particular because it is fun to see everyone’s unique answers while also thinking about what their answer would be for each week’s fun fact.

What has been the biggest challenge of using social media in your practice?

The biggest challenge of social media marketing has been staying fresh and current. We have a large multi-doctor, multi-location practice and it can be difficult to make sure all employees/doctors/locations are included while being sure we are not posting the same thing each week. My Social Practice has helped us with this challenge by providing interesting new content ideas.

What has been the biggest benefit to your patients since you started using social media?

The number one benefit of our social media for our patients is that it helps patients to develop a more intimate relationship with our practice. With our daily posts our patients get a little glimpse behind the scenes while also getting to know our employees and doctors more. Our patients can see that we are a family that works hard while having fun too.

What has been the biggest benefit to your practice since you started using social media?

The #1 benefit social media has brought to our practice is the ability to always stay on people’s minds. Everyone is scrolling through Facebook and Instagram at some point throughout the day. When they scroll past our posts it helps people to think about us when they otherwise wouldn’t. If they are current patients it may be a reminder to tell a friend about our office. If they are not patients yet it may be that extra reminder to call our office to schedule a consultation. Social Media brings our practice into people’s homes and into their everyday conversations.

What kind of feedback have you gotten from patients about your social media?

Luckily, the feedback we have received from our patients about our social media efforts has been positive. We have had parents of patients and older patients themselves tell us how much they enjoy our posts. I personally have been able to use this feedback to get to know our patients more, asking them what they dressed up as for Halloween or what their least favorite food is.

What do you do in your office to promote your social media presence?

Right now our employees promote our social media presence in a low-key, laid-back manner. It may be as simple as mentioning a recent post or telling a patient to look for an upcoming post. Of course, taking pictures of patients and telling them to look for their photo on our social media is a great way to promote also! We don’t ever want a patient or parent to feel pressured or uncomfortable so something as simple as “check us out on Facebook/Instagram” has done the trick so far.

What advice would you have for a dental practice just starting to build their social media presence?

For a dental practice just starting out on social media I would tell them to stay true to their values and beliefs. Social media is an amazing platform that can reach a lot of people, it is important that what is being displayed on your practice’s social media is a great representation of who you are and what you believe in. Put your best qualities out there and let social media be another marketing platform that keeps you on people’s minds.

Which My Social Practice product or service has been the most help to you?

My Social Practice’s Engagement Boxes have been the biggest help for our practice. Each engagement box has included a great variety of fun and interesting tools/props/ideas to help our posts stay fun and fresh. Each engagement box has been filled with fun props along with well-made signs and ideas for each post. We have always been impressed with the content delivered within each box!

Thank you for sharing, Michelle! Your team really understands how social media grows dental practices, and we’ve loved watching your online presence grow!

Dental social media marketing is about growing practices through increasing your reach, enhancing your local reputation, and building relationships with patients and potential patients. My Social Practice has remained laser-focused on these key objectives for over a decade as we’ve built the perfect dental social media solution.

Even if you have no social media experience and no time to learn, My Social Practice can do all the heavy lifting for you—growing your practice while you focus on serving your patients.

and we’d love to show you step-by-step how we can make your practice shine online!

Ready for a quick demo of our social media service? Fill out the form below.

The post Our November Practice of the Month — Zammitti & Gidaly Orthodontics appeared first on My Social Practice – Social Media Marketing for Dental & Dental Specialty Practices.

This content was originally published here.

EXPLOSIVE – About All These “New” Positive COVID Cases – State Health Departments Manipulating Data, Changing Definitions.. | The Last Refuge

This is very interesting.  The document described in the video below is available HERE.  Research into state health regulations by Fog City Midge shows that new guidance for the definition of COVID-19 positive infections is likely the biggest background cause in a dramatic upswing in positive test results.  WATCH:

This revelation would explain exactly why those who construct the reporting systems are pushing so hard for contact tracing.  According to the new guidance anyone who comes into contact with a person who tests positive is now also considered positive. [pdf link]

Nice convenient way to inflate the infection rate.  The verified source is Here

In order to support the most important political objectives of the DNC writ large in the 2020 election, COVID-19 hype is essential:

♦Without COVID-19 panic Democrats cannot easily achieve ‘mail-in’ voting; which they desperately need in key battleground states in order to control the outcome.

♦Without COVID-19 panic Democrats cannot shut down rallies and political campaigning efforts of President Trump; which they desperate need to do in key battleground states.

♦Without COVID-19 panic Democrats cannot block the campaign contrast between an energetic President Trump and a physically tenuous, mentally compromised, challenger.

♦Without COVID-19 panic Democrats do not have an excuse for cancelling the DNC convention in Milwaukee; thereby blocking Team Bernie Sanders from visible opposition while protecting candidate gibberish from himself.

♦Without COVID-19 panic Democrats do not have a mechanism to keep voters isolated from each-other; limiting communication and national debate adverse to their interests.  COVID-19 panic pushes the national conversation into the digital space where Big Tech controls every element of the conversation.

♦Without COVID-19 panic Democrats cannot keep their Blue state economies easily shut-down and continue to block U.S. economic growth.  All thriving economies are against the political interests of Democrats.

♦Without COVID-19 panic Democrats cannot easily keep club candidate Joe Biden sealed in the basement; where the electorate is not exposed to visible signs of his dementia.

♦Without COVID-19 panic it becomes more difficult for Big Tech to censor voices that would outline the fraud and scheme.  With COVID-19 panic they have a better method and an excuse.

♦Without COVID-19 panic Democrats cannot advance, influence, or organize their preferred presidential debate format, a ‘virtual presidential debate’ series.

[Comrade Gretchen Whitmer knows this plan, hence she cancelled the Michigan venue]

All of these, and more, strategic outcomes are based on the manufactured weaponization of the COVID-19 virus to achieve a larger political objective.  There is ZERO benefit to anyone other than Democrats for the overwhelming hype surrounding COVID-19.

It is not coincidental that all corporate media are all-in to facilitate the demanded fear that Democrats need in order to achieve their objectives.  Thus there is an alignment of all big government institutions and multinationals to support the same.

Nothing is coincidental. Everything is political.

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This content was originally published here.

NM Restaurant Association ‘devastated’ by governor’s latest public health order

Under Governor Michelle Lujan Grisham’s new public health order, restaurants will have to stop indoor dining on Monday.

“Restaurants didn’t do this to New Mexicans. New Mexicans did this to restaurants,” she said when making the announcement during a virtual news conference on Thursday.

Outdoor and patio dining at 50% capacity, along with carry out are still allowed.

“Right now, it’s over 100 degrees outside so outdoor dining doesn’t really help us much,” said Wight.

Restaurants were closed for more than two months before being allowed to resume indoor dining at 50% capacity on June 1.

“It’s going to be harder to come back from this closure then it was the last closure,” said Wight. “Last time we had PPP money, we had ways to get open, we had some savings left. We have no more savings. Our inventory – we’ve got fresh inventory right now we’ve got to get through and three days is not enough. So what are we going to do, right? We’re all just throwing our hands up saying, ‘What can we do?’”

She doesn’t have the latest number but estimates New Mexico will lose 20% of its restaurants – or 700 restaurants – with the new regulations in place.

Wight says the association is also considering a legal challenge and is planning a protest on Monday.

KOB 4 reached out to the governor’s office for a response. Press Secretary Nora Meyers Sackett said in a statement: 

It’s not accurate to say the group was not consulted before the decision. The governor has been very clear that if New Mexico’s COVID-19 cases continued to trend upwards, the state would need to retract some of the reopening measures we had been able to enact, including indoor dining. As the governor and Dr. Scrase noted yesterday, a high percentage of the state’s workplace rapid responses have been to restaurants. The governor was also very clear yesterday that this is not meant to “punish” restaurants, but it is an unavoidable consequence of New Mexicans continuing to conduct themselves in a way that continues to spread COVID-19 throughout the state. Everyone is suffering the effects of this deadly virus, and we have to do everything we can to slow the spread of it. Restaurant owners are prominent members of their communities and must, like all of us, do everything they can to save lives.
 

This content was originally published here.

Dental House NYC: Dentistry with a Pampering Spa Twist – Beauty News NYC – The First Online Beauty Magazine

Start 2019 with a dental re-boot. There’s nothing typical about the newly opened Dental House apart from its efficiency and professionalism. Located on the NE corner of 13th Street and Seventh Avenue in Greenwich Village, it’s an art-filled, airy, modern neighborhood dental practice – where things are carried out with more thought and pampering than your typical dental practice. For example, your lips are slathered with a softening, aromatic Rose Salve for your comfort, you’ll savor dark chocolate treats, sunglasses to cut any machine glare, and glasses of water to stay hydrated. Here you can enjoy all of the typical dental office treatments: x-rays, cleanings, whitening treatments, and more.

If you’ve ever hoped for a dental visit that would be soothing and reassuring while offering a full suite of typical services, then Dental House is indeed your dream dental office. Dr. Sonya Krasilnikov is well-experienced, charming, and able to thoroughly explain every aspect of your necessary treatments. You may have just found your favorite new dentist! Her partner, Dr. Irina Sinensky, is equally awesome.

Check out the Dental House website, and schedule and appointment to check off those health-oriented New Year’s resolutions:

You’ll leave Dental House with a Theo Dark Chocolate bar. Dark chocolate is a healthy snack option for dental care because cocoa beans contain beneficial ingredients that disrupt plaque formation and strengthen enamel. The less sugar in the chocolate, the better the chocolate is for you. Enjoy!

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This content was originally published here.

‘It’s absolutely horrifying’: Coronavirus expert warns of dire health crisis amid Texas surge – Houston Chronicle

Dr. Peter Hotez and his science partner, Dr. Maria Elena Bottazzi, in their vaccine lab at Texas Children’s Hospital Center for Vaccine Development – Baylor College of Medicine, in February 2020.

Dr. Peter Hotez and his science partner, Dr. Maria Elena Bottazzi, in their vaccine lab at Texas Children’s Hospital Center for Vaccine Development – Baylor College of Medicine, in February 2020.

Photo: Mark Mulligan, Houston Chronicle / Staff Photographer

Dr. Peter Hotez and his science partner, Dr. Maria Elena Bottazzi, in their vaccine lab at Texas Children’s Hospital Center for Vaccine Development – Baylor College of Medicine, in February 2020.

Dr. Peter Hotez and his science partner, Dr. Maria Elena Bottazzi, in their vaccine lab at Texas Children’s Hospital Center for Vaccine Development – Baylor College of Medicine, in February 2020.

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Houston and Texas must take significant action before the weekend arrives to fight the spread of COVID-19, warns Houston’s internationally-renowned infectious disease expert, Dr. Peter Hotez.

Throughout the COVID-19 pandemic, Hotez has lent his expertise on Texas’ response to the deadly coronavirus. He serves as dean of the National School of Tropical Medicine at Baylor College of Medicine and is currently developing a vaccine for COVID-19.

On Tuesday, Texas saw 5,489 new confirmed cases of COVID-19. In an interview with Chron.com on Wednesday, Hotez called that uptick “horrifying.”

TRIPLING THE CASES: Houston Methodist hospitals see triple the number of COVID-19 patients in expanding pandemic

Question: Now that Texas has hit 5,489 new COVID-19 cases yesterday, what are your thoughts about Houston becoming the next epicenter of the pandemic?

Hotez:  “It’s absolutely horrifying. I’m terribly upset about what I see happening. There were some predictive models out of Pennsylvania that actually showed this. This is why I didn’t want Texas to open up as early it did. “

Question:  What are your thoughts about the possibility of a second shutdown? What do you think should be done?

Hotez: “We have to implement a significant level of social distancing. Now, we have no choice.  We have to take action before the weekend.  At the minimum, we must focus on the metropolitan areas–Houston, San Antonio and Austin.  We are already reaching a dire health crisis in Houston, and it will only get worse.”

NEW COVID-19 RULES: Abbott orders new COVID-19 rules for Texas child care centers after prior restrictions dropped

Question: Do you think after yesterday’s high numbers that Houston should actually be at a red alert on coronavirus threat level?

Hotez: “I think we should be red alert for coronavirus threat level. We need to head in that direction.  Six months into this epidemic, and we’re basically to square one.”

Question: During a U.S. House Energy and Commerce committee meeting yesterday,  Rep. Pete Olson (R-Sugar Land) warned that the current trajectory in Houston has the city on pace to be one of the worst affected cities in the U.S. comparing it to Brazil. Olson even called it, “damn scary.” Thoughts on this?

Hotez:  “I think the congressman has been reading my social media page. That unfortunately is the situation we may be in, unless we do something. The default plan if we don’t do anything is that the cases rise until we reach herd immunity.  Those numbers would continue to rise vertically.”

Question: What is your message to Texans and all Americans about the COVID-19 surge?

Hotez: “Nationally, this is one of the biggest public health failings in the history of the U.S. We have a vaccine that we are hoping to advance this time next year.  This pandemic is not getting better on its own. This is a public health crisis that we share with Dallas, Austin, and San Antonio. We need to make an urgent plan to take action before the weekend.”

alison.medley@chron.com

This content was originally published here.

Early findings grim on the health of Flint kids after water crisis – 60 Minutes – CBS News

You may remember the pictures from the water crisis six years ago in Flint, Michigan. Hundreds of angry residents holding up bottles of rust-colored water and demanding answers. Months of protests were waved off by officials who denied anything was wrong. The turning point came when a local pediatrician found conclusive proof that the children of Flint were being exposed to high levels of lead in their water and prompted the state to declare an emergency. Now, that same doctor is working to solve a mystery that still worries parents in Flint: what lasting damage did the water do to their kids? As we first reported in March, her initial findings were worse than she feared. But we begin with the legacy of Flint’s water crisis.

Once a week, hundreds of cars line up for bottled water at the Greater Holy Temple Church of God in Flint.

Sandra Jones is in command. She is a pastor’s wife with the voice of a four-star general. Jones keeps the cars moving and the water coming. Each family is allowed four cases of water. On this day, they gave away 36,000 bottles.

Sharyn Alfonsi: It just strikes me. It’s been five years and you’re still doing this.

Sandra Jones: Five years. And– and the thing about it is it’s not lightening up. I could see it if it was lightening up. But it isn’t.

It is not. The state stopped giving away bottled water two years ago because it said the water is safe. Sandra Jones relies on donations of water.

Sharyn Alfonsi: What’s it been like?

Larry Marshall: It’s been kinda hard…

Larry Marshall was second in line. The widowed father of four got here at 5 a.m. He’s been waiting five hours for water.

Larry Marshall: Water should be a basic necessity that — we shouldn’t have to wait or stand in line for, you know. This is not a third world country. But we’re living like one.

Marshall, like many in Flint, still refuses to drink tap water.

Sharyn Alfonsi: And if they come to you the city or the state and they say, “You’re drinking water’s safe. Are you gonna believe them?
Larry Marshall: No. They lie so much and we know they lie, and I– when they say something, it’s like– talking to the wind, you know. I don’t believe nothing they say. None of the politicians, none of them.

Flint, once a prosperous hub of the American auto industry was nearly bankrupt back in 2014. Officials hoped to save money by switching the city water source from the Great Lakes to the Flint River.

Almost immediately, residents began noticing something wasn’t right. The water was rust colored and many people had rashes.

But Michigan’s department of environmental quality and the city insisted the water in Flint is safe. Later, a state investigation found those officials hid the fact that the river water was not treated with chemicals that would prevent the pipes from corroding. So, for months the water ate away at Flint’s old pipes, releasing lead into residents’ tap water.

Dr. Mona Hanna-Attisha: They were poisoned. I mean they were poisoned by this water.  They were all exposed to toxic water.

Dr. Mona Hanna-Attisha is a pediatrician in Flint, who her patients call “Dr. Mona.”

Dr. Mona is a bit of a superhero herself here because she was the first to link the water to high levels of lead in the children of Flint.

Dr. Mona Hanna-Attisha: So within a few months of– of being on this water, General Motors, which was born in Flint, and still has plants in Flint, noticed that this water, our drinking water, was corroding their engine parts. Let’s pause. Like, the drinking (LAUGH) water was corroding engine parts. So they were allowed to go back to Great Lakes water.

Sharyn Alfonsi: Didn’t anybody at that point say, “If it’s corroding an engine, maybe this shouldn’t be going into our bodies, into our kids?”

Dr. Mona Hanna-Attisha: I mean that should have been like fire alarm bells. Like, red flags.

Sharyn Alfonsi: So what did it take before your– it– your eyes opened about this?

Dr. Mona Hanna-Attisha: Yeah. It– it– it was the word lead.

Sharyn Alfonsi: Because the word lead, when you’re a physician or a pediatrician signals what in your brain?

Dr. Mona Hanna-Attisha: There is no safe level of lead. We’re never supposed to expose a population or a child to lead. Because we can’t do much about it. It is an irreversible neurotoxin. It attacks the core of what it means to be you, and impacts cognition– how children think. Actually drops IQ levels. It impacts behavior, leading to things like developmental delays. And it has these life-altering consequences.

In 2015, Dr. Mona and a colleague started digging through blood test records of 1,700 Flint children.   Including the kids she sees at the Hurley Children’s Clinic.

The non-profit clinic serves most of Flint’s kids. The city is 53% black and has one of the highest poverty rates in the country.

Dr. Mona Hanna-Attisha: So we looked at the children’s blood lead levels before the water switch. And we compared them to the children’s blood lead levels after the water switch. And in the areas where the water lead levels were the highest, in those parts of the city, we saw the greatest increase in children’s lead levels.

Armed with the first medical evidence that kids were being exposed to lead from the water, Dr. Mona did something controversial. She quickly held a press conference to share the blood test study, before other doctors reviewed her work.

Dr. Mona Hanna-Attisha:  So it was a bit of an academic no-no. Kind of a form of academic disobedience. But I l–

Sharyn Alfonsi: And you knew that?

Dr. Mona Hanna-Attisha: I– I knew that. But, like, but there was no choice– there was no way I was going to wait to have this this research vetted.

Two weeks later, Michigan Governor Rick Snyder ordered the water switched back to the Great Lakes and declared a state of emergency.

Rick Snyder at State of the State: I say tonight as I have before I am sorry and I will fix it.

But the damage was done. Dr. Mona estimates 14,000 kids in Flint under the age of six may have been exposed to lead in their water.

Dr. Mona Hanna-Attisha: I never should have had to do the research that literally used the blood of our children as detectors of environmental contamination.

Three years after the crisis began, the percentage of third graders in Flint who passed Michigan’s standardized literacy test dropped from 41% to 10%.

Kenyatta Dotson: I’m very concerned about my children. And not only my children, but I’m concerned about the children of Flint.

Kenyatta Dotson is still fearful of the water, even though the state is spending more than $300 million to fix the water system.

The city promised to replace all 12,000 supply lines that may have been contaminated with lead by last fall. Now, they say the work won’t be done until summer. 

Dotson says she and her daughters will continue to use bottled water for cooking and brushing their teeth.

Kenyatta Dotson: I need time to come back to a place where I feel whole again.

Sharyn Alfonsi: You don’t feel whole right now?

Kenyatta Dotson: Oh no.

Sharyn Alfonsi: Would this have happened in a rich, white suburb?

Kenyatta Dotson:  Maybe it would’ve happened in– in a rich, white suburb. Would it have continued for as long as it has? I don’t believe so.

We found many parents in Flint still bathe their young children with bottled water — first warmed on the stove then brought to the tub.

Dr. Mona Hanna-Attisha: When I’m in clinic– almost every day– a mom asks me, “Is my kid gonna be okay”? So that’s a number one kind of anxiety and– and concern right now–

Sharyn Alfonsi: How do you answer that?

Dr. Mona Hanna-Attisha: Oh, I– I sit down. I sometimes hold their hand. And I reassure my patients and their parents just as I would before the crisis… to keep doing everything that you’re supposed to be doing to promote your children’s development.

In January of 2019, she launched the Flint registry, the first comprehensive look at the thousands of kids exposed to lead in Flint. The goal of the federal and state-funded program is to track the health of those kids and get them the help they need.

The registry refers hundreds of kids to specialists who conduct 8 hours of neuro-psychological assessments of their behavior and development.

Dr. Mona shared her preliminary findings with 60 Minutes.

Before the crisis, about 15% of the kids in Flint required special education services. But of the 174 children who went through the extensive neuro-exams, specialists determined that 80% will require help for a language, learning or intellectual disorder.

Sharyn Alfonsi: What are you gonna do?

Dr. Mona Hanna-Attisha: So there’s not much we can do. So there’s no magic pill. There’s no antidote.  There’s no cure. We can’t take away this exposure. But incredible science has taught us that there’s a lot we can do to promote the health and development of children and that’s exactly what we’re doing.

Through the registry, already 2,000 Flint children who were exposed to lead have been connected to services such as speech and occupational therapy, which some may need for the rest of their lives.

Dr. Mona Hanna-Attisha: But we also realized that our research, our science, this data and facts was also an underestimation of the exposure.

Sharyn Alfonsi: Why underestimated?

Dr. Mona Hanna-Attisha: Because we were looking at blood lead data done as part of these surveillance programs, which are done at the ages of 1 and 2. Lead in water impacts a younger age group. It impacts the unborn.

To determine that impact, Dr. Mona turned to a novel technique developed by Dr. Manish Arora at New York’s Mount Sinai Hospital. He examines baby teeth. Baby teeth begin to grow in utero.
Dr. Manish Arora: And just like growth rings in trees, every day a tooth forms a ring. And anything that we’re exposed to in our diet, what we eat, what we breathe, what we drink gets trapped in those growth rings.

A laser cuts through the tooth to analyze whether lead is embedded in the growth rings of teeth. Dr. Mona has sent teeth from 49 Flint kids to be analyzed. This was a scan on the tooth of a child who was 6 months old when the water source switched in Flint.

Dr. Manish Arora: As we hit that six month mark where the–

Sharyn Alfonsi: Oh, my gosh–

Dr. Manish Arora: –water– the water supply was change, you can see how–

Sharyn Alfonsi: Look at that.

Dr. Manish Arora: You can see how the lead levels go up and then they just keep– keep going up as more and more lead’s entering the body.

Sharyn Alfonsi: It shoots straight up.

Dr. Manish Arora: Exactly.

Sharyn Alfonsi: Wow.

For the first time, researchers can pinpoint to the day, even before birth, when a child was exposed to lead from the water and at what levels. Those early years are a critical time for brain development.

As we were following Dr. Mona’s work in Flint, another American city was forced to hand out cases of water. Testing on the drinking water in Newark, New Jersey, found lead levels four times higher than the federal limit. In some places, higher than Flint. Newark officials were warned about it’s water more than two years ago.

Dr. Mona Hanna-Attisha: Newark, New Jersey is like living Flint all over again. If we cannot guarantee that all kids have access to safe drinking water, not just privileged kids, but all kids have access to safe drinking water. That’s just one issue. Like, who are we?

Sharyn Alfonsi: This is not isolated to Flint–

Dr. Mona Hanna-Attisha: This is– this is an everywhere story. This is an America story.

Last month, we made another visit to Flint to check in with Sandra Jones.

She was still in command despite temperatures in the single digits. Hundreds in Flint are still coming to her church parking lot for their weekly supply of water, more than five years after the crisis began.

Produced by Guy Campanile and Lucy Hatcher. Broadcast associate, Cristina Gallotto. Edited by Matt Richman.

This content was originally published here.

Health expert Zeke Emanuel says 250,000 Americans could die of COVID by end of year – CBS News

Bioethicist Dr. Zeke Emanuel is predicting that up to 250,000 Americans could die directly from the coronavirus by the end of the year. In an interview with CBS News chief Washington correspondent Major Garrett, Emanuel, who is the vice provost for Global Initiatives and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, slammed the Trump administration’s response to the pandemic as “incompetent and pretty disastrous.”

“Before the year is out, we’ll probably have, I would think, between 220,000 and 250,000 Americans who died directly from COVID, not to mention those people who are dying indirectly,” Emanuel said in this week’s episode of “The Takeout” podcast. Emanuel singled out people with heart conditions or in need of cancer treatment who may not visit the doctor due to concerns about catching the virus as factors contributing to high indirect mortality rates.

“You’ll have a huge increase in mortality because of COVID, and that is, it seems to me, to be a failure,” Emanuel said. Emanuel is also a senior fellow for the left-leaning think tank Center for American Progress, and he is also on former Vice President Joe Biden’s campaign task force to address the coronavirus.

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Highlights from this week’s episode:

Emanuel noted that several states have seen an uptick in cases in recent weeks, and that the daily death tolls are comparable to what they were at the onset of the pandemic in the U.S. in March.

“That’s not progress, that’s regression. In some ways, you can say we’ve wasted four months,” Emanuel said. He also shot down President Trump’s claim that 40 million people had been tested. Forty million tests have been administered, with some people receiving multiple tests.

“We were extremely slow to develop good testing, and we still don’t have the best testing that we should,” Emanuel said.

However, Emanuel and the Trump administration do agree on one point: Schools should be reopened safely in the fall.

“We need to open up primary and secondary schools in the fall. I think it’s really important. I think you can do it safely. But whenever I say it, I don’t mean ‘no COVID,’ I mean ‘you will get COVID and kids will get COVID,’ but you can do it in a way that tries to minimize those cases,” Emanuel said. “It’s not risk-free. Life is not risk-free. But I think it’s probably worth it.”

Emanuel bemoaned how wearing a mask has become politicized, in part because the president has largely avoided wearing a mask in public.

“I heard someone saying, ‘Oh only sissies wear masks.’ Baloney! You wear a mask because you don’t want to spread it to someone else, and you don’t want to catch it from someone else,” Emanuel said. “Will it absolutely protect you? No. Will it decrease your chance of getting COVID? Yes.”

For more of Major’s conversation with Emanuel, download “The Takeout” podcast on Art19, iTunesGooglePlaySpotify and Stitcher. New episodes are available every Friday morning. Also, you can watch “The Takeout” on CBSN Friday at 5pm, 9pm, and 12am ET and Saturday at 1pm, 9pm, and 12am ET. For a full archive of “The Takeout” episodes, visit www.takeoutpodcast.com. And you can listen to “The Takeout” on select CBS News Radio affiliates (check your local listings).  

Producers: Arden Farhi, Jamie Benson, Sara Cook and Eleanor Watson
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This content was originally published here.

Airway Perspective on AAO Obstructive Sleep Apnea and Orthodontics White Paper – Spear Education

Author’s note: The topic of the impact of tooth extraction on the airway can be very contentious. My hope is this article serves as a tool to allow collegial discourse between restorative dentists concerned with airway and the orthodontists who they look to for solutions.

Recently, I had a new patient come to see me “looking for some veneers.” She had four bicuspids removed for orthodontics in the early 1970s and was given a headgear, but routinely found it on the floor at night. Also, her tonsils and adenoids were removed when she was very young due to recurrent infections.

She complains of a lifetime of poor sleep and never feeling refreshed. She is on multiple high blood pressure medications and has reflux. Ten years ago, she was snoring so badly her husband requested a sleep study.

The study diagnosed her with snoring and apnea. The treatment was UPPP (palatal surgery) and repair of a deviated septum. She feels that she can breathe better than before the surgery, but the symptoms never cleared. She still snores and has unrefreshing sleep.

My examination revealed multiple teeth with recession, some significant. Generalized pathologic wear and erosion. The maxillary anterior teeth were retroclined with lingual facets from pathway wear. The lower anteriors were over erupted. The tongue volume appeared normal, but the oral volume was limited. Her airway, on examination, was constricted with an exaggerated protective retraction of her tongue during examination of the oropharynx.

I thought to myself, “Could the removal of four teeth and subsequent retraction of the anterior teeth be culpable in her medical and dental history?”

The OSA and orthodontics relationship is relatively new

In 2019, the American Association of Orthodontists (AAO) released its “Obstructive Sleep Apnea and Orthodontics” white paper. It was the culmination of a two-year project by a panel of sleep medicine and dental sleep experts. They were tasked to produce guidelines for the role of orthodontists in the management of obstructive sleep apnea (OSA).

In the end, the group could not develop any formal OSA guidance for orthodontists. This is interesting given that orthodontists are charged with managing the anatomy of the airway and they work with medical providers on airway anatomy issues like cleft palates and orthognathic surgery.

While it was not stated in the paper, in my opinion, the reason for the lack of specificity of recommendations comes from the nature of the science that was being evaluated. When medical colleagues review dental literature, routinely they are struck by the poor quality of the data. Dental research is typically not well funded, the numbers of participants are limited, the follow-up is short, and it lacks untreated control subjects.

Orthodontics takes years to complete and many years to determine any impact. And finally, the relationship between OSA and orthodontics is a relatively new concept that has rarely been tested in sleep laboratories. Instead, most studies on airway change look at cephalometric or CBCT volumetric alteration and infer (all be it incorrectly) that bigger is better. The conclusions of the AAO white paper are, therefore, going to be constrained by this lack of quality evidence.

Bicuspid extraction addressed

Curiously, section 12 of the AAO white paper, “Fallacies About Orthodontics in Relation to OSA,” addresses the issue of bicuspid extraction. It begins, “Conventional orthodontic treatment never has been proven to be an etiologic factor in the development of obstructive sleep apnea. When one considers the complex multifactorial nature of the disease, assigning cause to any one minor change in dentofacial morphology is not possible.”

This conclusion is true, but the key word is “proven.” There is also a lack of proof orthodontics is not a factor in the development of OSA. The disease is multifactorial but minor changes in oral volume, vertical dimension, and mandibular protrusion have been shown to change the airway and sleep apnea significantly. To argue that removal of four teeth is an unremarkable change is, at least, questionable given available data.

The paper continues, “The specific effects on the dental arches and the muscles and soft tissues of the oral cavity following orthodontic extractions can differ significantly, depending on the severity of dental crowding, the amount of protrusion of the anterior teeth and the specific mechanics used to close the extraction spaces.”

Zhiai Hu1 published a systematic review evaluating the effect of teeth extraction on the upper airway. It included only seven articles. They were divided by the reason for treatment:

The Class I bimax group all had anterior tooth retraction without boney changes. Three of the four articles showed a reduction in upper airway dimension, the last showed a reduction but not to the level of significance.

The one article on crowding differed because the orthodontic technique allowed the molars to move forward ~3mm. That created an increase in the airway dimension.

Finally, the unspecified group did not provide a discussion of the direction of movement (retractive or molar movement) and found small increases for both extraction and non-extraction groups. A conclusion that can be reached from this review is if you retract the anterior teeth, the airway size reduces and if the molars move forward, the airway improves or remains the same.

Impact of volumetric change

The white paper goes on to state, “The impact that orthodontic treatment with or without dental extractions may have on the dimensions of the upper airway also has been examined directly, first with two-dimensional cephalograms and more recently with three-dimensional CBCT imaging…

“In discussing orthodontic treatment to changes in the dimensions of the upper airway, it also is helpful to understand that an initial small or subsequently reduced or increased size does not necessarily result in a change in airway function.”

This is one of the issues medicine has with dental literature. Dental researchers rarely study the actual impact of the volumetric change. It is not enough to say the space is smaller. It needs to be quantified with sleep data. It also needs to be followed over time.

However, Christian Guilleminault highlighted a reduction in the ideal size of the upper airway can lead to abnormal breathing over time, initially with flow limitation, then with a progressive worsening toward full-blown OSA.2> Rarely would testing at the completion of orthodontics demonstrate a compromise. It is the stressful breathing night after night that compromises the airway and makes people more prone to breathing issues during sleep.

Existing evidence suggests the opposite

The AAO white paper does highlight a paper that attempts to answer the question about compromise later in life.

“One such study assessed dental extractions as a cause of OSA later in life with a large retrospective examination of dental and medical records… The study concluded that the prevalence of OSA was essentially the same in both groups, and that dental extractions were not a causative factor in OSA.”

A.J. Larsen3 reviewed insurance records for 5,500 patients between the ages of 40-70. Dental radiographs determined if the subjects were missing four bicuspids or had a full complement of teeth. They matched the two groups for age, BMI, etc. Then they reviewed their medical records to see if the subject had received a diagnosis for apnea.

The results showed that 9.56% of the non-extraction and 10.71% of the extraction group had a diagnosis of OSA. This was not significantly different. Thus, the authors’ conclusion was there was not a relationship between OSA and premolar extractions.

It is currently estimated that 80-90% of OSA patients are undiagnosed. Larsen’s paper states because the subjects all have insurance, they would expect physicians would note the symptoms and get them a sleep study and diagnosis.

There is absolutely no evidence to support that assertion and the existing evidence suggests just the opposite. From pediatricians to primary care, physicians are not diagnosing apnea effectively. The conclusion of the article should be extraction and non-extraction individuals are underdiagnosed at almost the same rate.

Orthodontic literature is not conclusive

The AAO paper goes on to state, “Overall it can be stated that existing evidence in the literature does not support the notion that arch constriction or retraction of the anterior teeth facilitated by dental extractions, and which may (or may not) be the objective of orthodontic treatment, has a detrimental effect on respiratory function.”

Once again, it is true existing evidence does not support that position because there is no quality evidence at this time, not that the relationship does not exist. This should, in my opinion, be a call for more research rather than posturing the topic as a fallacy.

Orthodontic literature is not conclusive on whether premolar extractions impact the airway. A weakness of all the studies is they are based on CBCT or cephalometric radiographic measurements and not sleep data. How a patient uses the existing airway volume is more critical than the size and that’s never measured.

Is there ever a time when I agree with an orthodontic recommendation of extractions? Absolutely. I will, however, ask my specialist:

The most important take away should be the need to intervene earlier. Attempting to direct craniofacial development may keep us from ever needing to know the answer to, “Does the extraction of four bicuspids impact the airway?”

Jeffrey Rouse, D.D.S., is a member of Spear Resident Faculty.

1. Hu Z, Yin X, Liao J, Zhou C, Yang Z, Zou S. The effect of teeth extraction for orthodontic treatment on the upper airway: a systematic review. Sleep and Breathing. 2015;19(2):441-451.

2. Guilleminault C, Huseni S, Lo L. A frequent phenotype for paediatric sleep apnoea: short lingual frenulum. ERJ Open Research. 2016;2(3):00043-02016.

3. Larsen AJ, Rindal DB, Hatch JP, et al. Evidence Supports No Relationship between Obstructive Sleep Apnea and Premolar Extraction: An Electronic Health Records Review. Journal of Clinical Sleep Medicine. 2015;11(12);1443-1448.

This content was originally published here.

Millions Have Lost Health Insurance in Pandemic-Driven Recession – The New York Times

The White House and Congress have done little to help. The Trump administration has imposed sharp cuts on the funding for outreach programs that assist people in signing up for coverage under the health law. And while House Democrats have passed legislation intended to help people to keep their health insurance, the bill is stuck in the Republican-controlled Senate.

Rather than expand access to subsidized insurance under the Affordable Care Act, Mr. Trump has promised to directly reimburse hospitals for the care of coronavirus patients who have lost their insurance. But there is little evidence that has begun.

“Helping people keep their insurance through a public health crisis surprisingly has not gotten much attention,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. “This is the first recession in which the A.C.A. is there as a safety net, but it’s an imperfect safety net.”

The Families USA study is a state-by-state examination of the effects of the pandemic on laid-off adults younger than 65, the age at which Americans become eligible for Medicare. It found that nearly half — 46 percent — of the coverage losses from the pandemic came in five states: California, Texas, Florida, New York and North Carolina.

In Texas alone, the number of uninsured jumped from about 4.3 million to nearly 4.9 million; three out of every 10 Texans are uninsured, the research found. In the 37 states that expanded Medicaid under the Affordable Care Act, 23 percent of laid-off workers became uninsured; the percentage was nearly double that — 43 percent — in the 13 states that did not expand Medicaid, which include Texas, Florida and North Carolina.

Five states have experienced increases in the number of uninsured adults that exceed 40 percent, the analysis found. In Massachusetts, the number nearly doubled, rising by 93 percent — a figure Mr. Dorn attributed to a large number of people losing employer-based coverage there. Across the country as a whole, more than one in seven adults — 16 percent — is now uninsured, the analysis found.

To generate the estimates, Mr. Dorn examined the number of laid-off workers in each state and calculated how many had become uninsured based on coverage patterns since 2014, when the central provisions of the Affordable Care Act went into effect. The underlying data for those patterns comes from work published by the Urban Institute in April.

This content was originally published here.

As Pandemic Toll Rises, Science Deniers in Louisiana Shun Masks, Comparing Health Measures to Nazi Germany

Science denial in America didn’t begin with the Trump administration, but under the leadership of President Trump, it has blossomed. From the climate crisis to the COVID-19 pandemic, this rejection of scientific authority has become a hallmark of and cultural signal among many in conservative circles. This phenomenon has been on recent display in Louisiana, where a clear anti-mask sentiment has emerged in the streets and online even as COVID-19 cases rise.
“Are you a masker or a free breather?” Pastor Tony Spell asked the crowd while speaking from the bed of a pickup truck at a July 4 “Save America” rally in Baton Rouge. At the end of March Spell gained international attention for his refusal to stop his church’s services despite Gov. John Bel Edwards’ stay-at-home order, which was issued to slow the Louisiana’s rapid rise in COVID-19 cases.
 
“It has never been about a virus — it is about destroying America,” Spell claimed, before equating a government whose public health measures restrict church gatherings and require protective face coverings in public to Germany under Hitler. A crowd of less than 200 roared in agreement at the rally that was held across from the governor’s mansion. 

Pastor Tony Spell
Pastor Tony Spell speaking at the “Save America” rally in Baton Rouge on July 4.

Attendees of a "Save America" rally in Baton Rouge on July 4
Attendees of the “Save America” rally in Baton Rouge on July 4 including one holding a fan.

On July 8, another conservative voice, Louisiana State Representative Danny McCormick, posted a video on Facebook making a similar comparison to Nazi Germany. “This isn’t about whether you want to wear a mask or you don’t want to wear a mask — this is about your right to wear a mask or not,” McCormick said. “This is about liberty. Your body is your private property … People who don’t wear a mask will be soon painted as the enemy — just as they did the Jews in Nazi Germany. Now is the time to push back before it is too late.”

 At a press conference the day after McCormick posted his video, Gov. Edwards announced that the state had lost its previous gains against the coronavirus. 

McCormick’s statements come about six months into a public health crisis that has infected 71,884 Louisiana residents and killed 3,247, as of July 9. Despite the pandemic’s accelerating and deadly spread, the complaints by McCormick, Pastor Spell, and the others joining them at a handful of protests in Baton Rouge  illustrate a pervasive disdain for science held by many associated with the Republican Party. 

Louisiana State Rep. Danny McCormick
State Representative Danny McCormick at an “End the Shutdown” protest in Baton Rouge, Louisiana, on April 25.

State Rep. Danny McCormick's talking points at an "end the shutdown" rally in Louisiana
State Representative Danny McCormick’s talking points on an index card he held while making a speech during an “End the Shutdown” rally in Baton Rouge on April 25.

A DeSmog investigation found that a number of groups behind protests against pandemic stay-home orders are also part of the climate change countermovement, a term coined by sociologist Robert Brulle. U.S. Sen. Sheldon Whitehouse (D-RI) has called this network of individuals and organizations disputing climate science the “web of denial.”

April and May rallies in Louisiana pushing to open the state followed larger rallies in Idaho, Michigan, and North Dakota. Helping tie together what Trump has called the “liberate” movement is the State Policy Network (SPN). As DeSmog has reported, SPN is “a network of state-level conservative think tanks advancing pro-corporate agendas, [and] has received money from the likes of the Koch family, the Devos family, the Mercer Family Foundation, and others.” 

Woman with a COVID-19 denial sign at an "end the shutdown" rally in Baton Rouge
Woman with a Covid-19 denial sign at an “End the Shutdown” protest in Baton Rouge, Louisiana, on April 25.

Woman with a COVID-19 denial sign targeting Bill Gates, a common target of the right wing
Woman with a Covid-19 denial sign sporting a message for Bill Gates, a common target of the right wing, at an “End the Shutdown” protest in Baton Rouge, Louisiana, on April 25.

At an April 25 “End the Shutdown” rally in Baton Rouge, rally-goers, led by Rep. McCormick, marched from the State Capitol building to the nearby lawn across from the governor’s mansion to express their anger with his handling of the crisis. In a speech, McCormick offered talking points to counter Gov. Edwards’ emergency orders meant to address the COVID-19 pandemic. The talking points mirrored a memo sent by GOP political operative Jay Connaughton to Republican State Sen. Sharon Hewitt and shared with GOP state legislators. Hewitt is one of Louisiana’s top conservative leaders. In 2018 she was named “National Legislator of the Year” by the American Legislative Exchange Council (ALEC).

Veronica Lemoa, a stay-at-home mom, at the "end the shutdown" protest on April 25 in Baton Rouge
Veronica Lemoa, a stay-at-home mother, at an “End the Shutdown” protest on April 25, 2020 in Baton Rouge, Louisiana. 

Young girl at an "Open Louisiana" event in Baton Rouge May 2
Young girl at an “Open Louisiana” event in Baton Rouge on May 2 across from the Governor’s Mansion. 

Despite President Trump’s praise for Gov. Edwards, a Democrat, for his handling of the pandemic, anti-mask protesters are equating the governor’s stay-at-home order and mask mandate with the first step to tyranny. Spell, who was arrested for defying the mask mandate, did not stop with his sharp criticism of the governor — and also had some for Trump. While he is glad the Trump administration deemed churches “essential,” in order to reopen them, Spell proclaimed that he doesn’t need the president’s permission, and warned: “If they can give you your right to go to church, then they can take from you your right to go to church.”


Pastor Tony Spell speaking on the July 4 at rally in Baton Rouge. 

At the July 4 rally, many expressed their support for Trump, and saw the upcoming presidential election as the most important in their lifetime. They labeled those who wear protective face coverings “sheep.” Out of the less than 200 rally-goers, I saw only two people with face masks. One was worn by a man that had the words “Dixie Beer” painted on it, which was expressing his disdain over the decision by the owner of the New Orleans beer company to change the beer’s name in response to anti-racism demonstrations. The other mask I noticed at the rally was worn on a woman’s arm. 

The only man wearing a face mask at a "save America" rally on July 4
The only man wearing a mask on his face at a “Save America” rally in Baton Rouge on July 4. He expressed his displeasure that the owner of Dixie Beer is changing the New Orleans beer’s name. 

Woman with a mask on her arm at the "save America" July 4 rally
Woman wearing a face mask on her arm at the “Save America” rally in Baton Rouge on July 4. 

In an April 1 op-ed in Newsweek, Rochester Institute of Technology philosophy professor Lawrence Torcello, and Pennsylvania State University climate scientist Michael E. Mann wrote: “Unfortunately, President Trump has again emerged as a leading source of disinformation. Having called COVID-19, as he previously did with climate change, a ’hoax,’ he now resorts to calling COVID-19 the ‘Chinese Virus.’ In the case of both COVID-19 and climate change, he has outsourced policy decision-making to science deniers. In both cases he is as wrong as he is xenophobic — and in both cases his predictable disinformation endangers lives.”

In February, before the first COVID-19 cases were identified in Louisiana, Gov. Edwards finally broke away from Trump on espousing climate science denial. 

Louisiana will not just accept or adapt to climate change impacts,” Edwards stated at a news conference in Baton Rouge. “Louisiana will do its part to address climate change.” In a reversal of his previous statements that questioned humans’ well-established role in driving the climate crisis, he said, “Science tells us that rising sea level will become the biggest challenge we face, threatening to overwhelm our best efforts to protect and restore our coast. Science also tells us that sea level rise is being driven by global greenhouse gas emissions.”

But Sharon Lavigne, founder of RISE St. James, a community group fighting petrochemical industry expansion in Louisiana’s Cancer Alley, doubts his sincerity. “If the governor is serious about reducing carbon emissions, he needs to pull the plug on Formosa.” Plastics giant Formosa is poised to start building a petrochemical complex in St. James Parish that has received permits to spew the emissions equivalent of 2.6 million cars. 

Petrochemical companies are one of Louisiana’s top producers of carbon dioxide, one of the globe-warming gases linked to human-caused climate change. However, the governor has not walked back his support of Formosa’s project. 

Edwards was the first governor in the country to point out that African Americans are being disproportionately impacted by the pandemic. But he has yet to address the impact which ongoing pollution from the petrochemical industry plays in the poor health of predominantly Black communities living near existing plants, or future ones, such as Formosa’s in St. James Parish.

Many U.S. leaders have failed to take to heart scientists’ warnings that half-measures to combat climate change and the COVID-19 pandemic won’t work. Meanwhile, temperatures across America are hitting new record highs, and cases of the coronavirus continue to rise exponentially, leading top U.S. infectious disease official Dr. Anthony Fauci to advise states “having a serious problem” with a surge in coronavirus cases to “seriously look at shutting down.” 

Protester across from the Louisiana Governor's Mansion on May 2
Protester across from the Governor’s Mansion in Baton Rouge on May 2 with a protest sign against Anthony Fauci, Bill Gates, and the “New World Order.”  

Protesters across from the Louisiana Governor's Mansion on May 2
Protesters across from the Governor’s Mansion in Baton Rouge on May 2.   

As with climate change, theoretical models have proven essential for anticipating what is likely to happen in the future. In the case of coronavirus, the initial spread of this virus is occurring at an exponential rate as models predicted,” Torcello and Mann pointed out in their Newsweek op-ed. “This means we can anticipate that larger sums of people will become infected in the coming weeks. We know the majority of those infected by COVID-19 will experience mild or no symptoms while remaining highly contagious, and we know that for others, COVID-19 will create the need for ventilators and other emergency medical supports that we do not yet have in sufficient supply. It is worth emphasizing: The fact that most people will experience mild symptoms is irrelevant to a crisis, like COVID-19, which is grounded in the math of large numbers.”

In his 1995 book The Demon-Haunted World, astronomer and science writer Carl Sagan presaged, with trepidation, an America wherein “our critical faculties in decline, unable to distinguish between what feels good and what’s true, we slide, almost without noticing, back into superstition and darkness…a kind of celebration of ignorance.”

After viewing some of my photos from the recent “Save America” rally, Mann wrote in an email: “These people, sadly, are the purest embodiment of Sagan’s chilling prophecy.”

Protester across from the Governor’s Mansion on May 2 with a protest sign that is a variation of the Gandsen Flag. 
Protester across from the Governor’s Mansion on May 2 with a protest sign that is a variation of the Gandsen Flag. 

Trump supporters at a rally across from the Governor’s Mansion on July 4.
Trump supporters at a rally across from the Governor’s Mansion on July 4.

Protesters at an “End the Shutdown" event in Baton Rouge on April 25 march from the Capital Building to the Governor’s Mansion nearby. 
Protesters at an “End the Shutdown” event in Baton Rouge on April 25 march from the Capital Building to the Governor’s Mansion nearby. 

Main image: Woman holding an anti-mask sign at a July 4 “Save America” rally in Baton Rouge. Credit: All photos and video by Julie Dermansky for DeSmog

This content was originally published here.

Dr. Scott Atlas disputes COVID-19 fear mongering tactics from our health officials –

Dr. Scott Atlas disputes COVID-19 fear mongering tactics from our health officials

SAN DIEGO (KUSI) – As coronavirus cases continue to increase across the United States, health officials and Democrat politicians seem to be using that statistic to fear monger and justify closure orders.

Dr. Scott Atlas of the Hoover Institute, discussed why we don’t need to be scared of the increase spread of coronavirus on Good Morning San Diego with KUSI’s Paul Rudy.

Atlas said that he has done more than a superficial analysis of the numbers, and after analyzing them, he doesn’t get scared.

Explaining, “When you look all over at the states who are seeing a lot of new cases, you have to look at who is getting infected because we should know by now, that the goal is not to eliminate all cases, that’s not rational, it’s not necessary, if we just protect the people who are going to have serious complications. We look at the cases, yes there’s a lot more cases, by the way they do not correlate in a time sense to any kind of reopening of states. If you look at the timing, that’s just a misstatement, a false narrative. The reality is they may correlate to the new protests and massive demonstrations, but it’s safe to say the majority of new cases are among younger, healthier people.”

Furthermore, Dr. Atlas emphasized the fact that the death rates are not going up, despite the increase in cases. “And that’s what really counts, are we getting people who are really sick and dying, and we’re not, and when we look at the hospitalizations, yes, hospitals are more crowded, but that’s mainly due to the re-installation of medical care for non COVID-19 patients.”

Dr. Atlas used Texas of an example saying, “90+% of ICU beds are occupied, but only 15% are COVID patients. 85% of the occupied beds are not COVID patients. I think we have to look at the data and be aware that it doesn’t matter if younger, healthier people get infected, I don’t know how often that has to be said, they have nearly zero risk of a problem from this. The only thing that counts are the older, more vulnerable people getting infected. And there’s no evidence that they really are.”

Dr. Atlas then pointed out the hospitalization length of stay is about half of what it once was.

This content was originally published here.

China Never Reported Existence of Coronavirus to World Health Organization

Contrary to claims from both Chinese officials and the World Health Organization, China did not report the existence of the coronavirus in late 2019, according to a WHO timeline tracking the spread of the virus. Rather, international health officials discovered the virus through information posted to a U.S. website.

The quiet admission from the international health organization, which posted an “updated” timeline to its website this week, flies in the face of claims from some of its top officials, including WHO director general Tedros Adhanom, who maintained for months that China had informed his organization about the emerging sickness.

China and its allies at the WHO insisted in multiple interviews and press conferences that China came to the health organization with information about the virus. This is now known to be false. The WHO’s backtracking lends credibility to a recent congressional investigation that determined China concealed information about the virus and did not initially inform the WHO, as it was required to do.

The WHO’s updated timeline, posted online this week, now states that officials first learned about the virus on Dec. 31, 2019, through information posted on a U.S. website by doctors working in Wuhan, where the virus first emerged. This contradicts the agency’s initial timeline, which said that China first presented this information at that date.

That initial timeline stated that the “Wuhan Municipal Health Commission, China, reported a cluster of cases of pneumonia in Wuhan, Hubei Province” on Dec. 31.

These claims were carried in numerous American media outlets that relied on the WHO’s inaccurate timeline, including CNN and Axios.

Chinese officials and state-controlled media also claimed for months that the communist regime informed the WHO on or around Dec. 31. In recent days, however, Chinese officials have dropped that talking point.

Rep. Michael McCaul (Texas), lead Republican on the House Foreign Affairs Committee and a member of Congress’s China Task Force, was one of the first lawmakers to expose China’s lies about reporting the virus. An interim congressional report on the virus’s origins published last month first disclosed the fact that the WHO found out about the virus from online postings, not China.

“I’m glad to see the WHO and the Chinese Communist Party have both read my interim report on the origins of the pandemic and are finally admitting to the world the truth—the CCP never reported the virus outbreak to the WHO in violation of WHO regulation,” McCaul told the Washington Free Beacon in a statement. “The question now is whether the CCP will continue their false propaganda campaign that continues to claim they warned the world, or whether they will come clean and begin to work with the world health community to get to the bottom of this deadly pandemic.”

McCaul’s report makes clear that WHO director general Adhanom parroted China’s claim about self-reporting the virus.

“Director General Tedros actively engaged in an effort to defend the CCP’s leadership from criticism, negatively impacting the world’s understanding of the virus and hampering the global response effort,” the report concluded.

The WHO’s initial timeline “leaves out the fact that the WHO China Country Office was ‘informed’ by the WHO headquarters in Geneva—not PRC health authorities,” according to McCaul’s findings, which are now verified by the WHO’s revised timeline.

While initial reports of the virus did in fact originate in Wuhan, WHO officials in its headquarters found the information on an American early-warning site.

“Director General Tedros’s comments seem to suggest that Wuhan or the PRC informed the WHO of the outbreak, which is untrue,” according to the congressional report.

This content was originally published here.

Here’s What I Can Tell You About My Health – The Rush Limbaugh Show

RUSH: I’ve got a bunch of emails from you people. You’re not complaining. I understand you’re not complaining. You’re genuinely, heartfelt curious. You’re pointing out that I have not given you a health update in longer than you can remember. And you’re right, I haven’t. And I told you that it was going to be this way. I told you that A, I didn’t want to burden anybody with that. That is not why you’re here.

Number two, no matter how you do it, it’s gonna sound like a complaint, and I just don’t complain. And number three, I have — as have you, I have seen people, public figures who get cancer, who then live it publicly, and it’s somehow — I don’t know. It’s just over the top to me. And then sometimes they make the mistake of saying, “Hey, I just saw the doctors and, man, I’m cancer free,” and then six weeks later… so I have vowed that’s not gonna happen. I’m not gonna in any way perform here or host this program as an ongoing cancer patient with weekly, daily reports, because, as I’ve said, there are good days, bad days; there are good weeks, bad weeks.

Here’s what I can tell you. The last treatment that I had, which is an infusion, was 10 days ago. And today is the first day I feel like being alive after that infusion. You’ve heard me, I say I feel normal, meaning I feel like I’m not taking any medicine. Now, the last infusion, that happened after five days. This one it has taken 10 days to reach this level, which only stands to reason because this infusion was the second one.

So there now are two doses of this treatment medication running throughout the deep, dark crevices of my body and my system. So the more you add to it, the more impact that it’s gonna have. And I actually am very lucky. I am not suffering any of the typical or the worst side effects that you hear about. For example, no nausea, no gastric or gastrointestinal distress at all. The primary side effect I have is a debilitating fatigue. I can’t even describe it because it’s so much more than being tired.

Everything has a rotten taste. Everything has a rotten smell. I surround myself with key lime scented candles and lavender and lemon candles just to get the rotten sense of smell at bay. And, of course, that bleeds over to sense of taste, which does nothing for the appetite, obviously. So I’m forcing myself to eat a bunch of stuff that literally tastes like horrible stuff. But these are the things you have to do and I don’t want to tell you this kind of stuff every day.

As far as overall how it is going, every day I wake up, I thank God I did. And that’s pretty much it. So I’m not trying to hide anything, and I’m not trying to shield you from anything. I’m actually simply trying to take what I’ve learned in this process and understand that it changes frequently and constantly, that nothing is guaranteed. And so you take every day as it comes, when you get a good one, you rejoice. When you get a good one you try to maximize it, make the most out of it as you can. When you get a bad day, you try to limit it, you live through it, you don’t complain about it.

This content was originally published here.

Straighten Out Your Orthodontics Billing

Managing billing at your orthodontics practice can take up as much time as you spend with your patients. If your current payment software doesn’t integrate with other platforms like QuickBooks Online, you could be spending hours reconciling payments.

Integrated technology cuts through the red tape for orthodontic payment processing. Integrated payments means that your billing, credit card processing, customer management, and business analytics are all in one place. In this blog, we’ll explore how you can straighten out your orthodontics billing and save money with integrated technology.

Use ACH to Save on Fees

ACH, or “automated clearinghouse,” payments are great for invoicing patients. ACH payments are a secure, low-cost option, especially if you send invoices through a virtual terminal.

ACH costs less than $1 per transaction to providers, unlike credit cards that vary in percentages, usually between 3-4% per transaction. Those savings add up, especially if you’re billing a patient for a high-cost procedure. Once you send a patient an invoice, they can enter their bank account information and complete the payment. Patients can also set up autopay for recurring invoices so you don’t have to worry about late payments. You’ll get paid faster and at a much lower cost.

Use Practice Management Software to Track Your Payer Mix

Your payer mix is crucial to your practice’s cash flow. A payer mix is the total distribution of how your patients pay for their care. They can pay through private insurance, government-funded options, or completely out of their own pocket. Having a good balance between the three creates a steady cash flow for your practice. For instance, if your payer mix leans towards federal insurance programs like Medicaid, changes in regulations can upset your cash flow and revenue.

You can track your payer mix through practice management software like OrthoTrac. You can even check the status of insurance claims and reimbursement so you get paid faster. To stay competitive, you should assess your payer mix and make adjustments as necessary, like accepting more forms of insurance. And to work even more efficiently, choose a payment processor like Fattmerchant that integrates seamlessly with OrthoTrac and other practice management software.

Sync Your Data to End Reconciliation

Integrated technology means you don’t have to stop using the tools you already love, like QuickBooks Online. Integrated technology will work with other tools to create a seamless experience. You can manage patients, their insurance information, payments, and outstanding invoices all without needing to log into separate tools.

Fattmerchant integrates with practice management software like OrthoTrac and DentalXchange, plus 200 other applications and platforms. You can manage the most vital aspects of your orthodontic practice’s billing from one platform. Plus, with our 2-way sync with QuickBooks Online, your data is automatically transferred between the two platforms, making reconciling a thing of the past.

See how integrated payment technology can help your orthodontics practice.

The post Straighten Out Your Orthodontics Billing appeared first on Fattmerchant.

This content was originally published here.

Bumpy’s owner arrested over health code violation in Schenectady

SCHENECTADY — The owner of a city soft ice cream stand has been arrested for allegedly keeping the business open despite a Schenectady County Department of Health order.

David Elmendorf, 35, the owner of Bumpy’s Polar Freeze on State Street, was arrested by city police on Wednesday on a charge of obstructing government administration, County Attorney Christopher Gardner said. He was released without bail pending a future City Court appearance.

Gardner said that Elmendorf also faces two citations under Public Health Law for operating without Health Department authorization since May 9, and for not properly securing a kitchen sink spray nozzle that was first brought to his attention as a code violation last fall. For each of those two charges, Gardner said Elmendorf could be fined up to $1,000 per day.

The Bumpy’s property has been posted with a Department of Health violation notice, Gardner said, and Elmendorf has removed it and continued to operate the business.

“[County Public Health] has been on his property several times and he has been uncooperative,” Gardner said on Thursday. “He just does not seem to want to obey the law.”

Gardner said the spray nozzle violation could have been settled with a small repair and a $100 fine, but the situation escalated this spring when an inspector returned and the spray nozzle issue had not been addressed and the fine hadn’t been paid. That led to the orders to close the business — the orders Elmendorf is accused of ignoring.

“His behavior is one of obstruction, non-cooperation and not obeying rule of law,” Gardner said.

Bumpy’s is located at 2013 State St., next door to the county Department of Motor Vehicles office, and has been in business for decades. Elmendorf, a former Schenectady County corrections officer, has operated it since 2012.

David Byrne and his wife ran Bumpy’s from 1996 until 2012, when they leased it to Elmendorf, and have since moved to Florida. Byrne said on Thursday that Elmendorf has never made good on a plan to buy the business and he continues to operate there even though the lease has expired.

“We have not been paid since February,” Byrne said. “We want to evict him and have sent him an eviction notice to come into eviction court, but we haven’t got into court [because of the pandemic.] We can’t physically remove him because we don’t have a court order. He doesn’t communicate with us. It’s very difficult.”

The arrest isn’t Elmendorf’s first brush with municipal code violations. In 2017, after a parking lot that customers had used was fenced off as part of the county DMV construction next door, Elmendorf was cited for not getting a permit before tearing down the car wash on the other side of Bumpy’s, which he owned, to create new parking.

Elmendorf would not respond to a request for comment Thursday. “We are not taking any questions at all,” said a man who answered the phone at Bumpy’s and identified himself as an employee.

Reach staff writer Stephen Williams at 518-395-3086, [email protected] or @gazettesteve on Twitter.

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This content was originally published here.

Outcomes Data Registry for Dentistry – TeethRemoval.com

Using large amounts of data from many different dentists or surgeons is a way to improve the quality of healthcare. From such clinical data registries in healthcare
many things can be gleaned regarding information about individual surgeries or medical devices. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has recently launched OMS Quality Outcomes Registry or OMSQOR for short which is discussed on pages 7-12 of the March/April 2019 issue of AAOMS Today. The groundwork for OMSQOR actually began in 2014 and OMSQOR officially launched in January 2019. The way OMSQOR works is that treatment data from all members who participate will be collected in a national registry that will be used to help improve the quality of care and patient outcomes. Such quality data will allow for tracking surgical outcomes, complications, and possible gaps in treatment. OMSQOR will even allow an individual surgeon to compare their patients to all patients in the database to identify areas in their practice they may be lacking and improvement is needed. AAOMS is encouraging all of their members to sign up and participate.

The data registry will be used to help AAOMS be able to better advocate on behalf of oral and maxillofacial surgeons along with conduct additional research to improve outcomes. Practice patterns across the entire specialty can be tracked. This can allow for better reimbursement for services that is fair where insurance companies may be challenging them. This can also allow for better data showing how often an anesthesia death occurs by oral and maxillofacial surgeons. This is important to them because many have challenged their delivery model of having the surgeon both perform surgery and deliver anesthesia which is not how surgeries are conducted in other specialties. The data registry can allow for the frequency of particular complications after particular surgeries to be identified. Of particular interest is identifying the frequency of nerve injuries after wisdom teeth surgery. The data registry can also be used to explore medical prescription prescribing habits which is of particular interest with recent studies demonstrating possible over prescribing of opioids which are then diverted to non medical use. According to the AAOMS Today article:

“Often, anesthesia advocacy stalls because AAOMS does not know how many anesthetics OMSs safely and routinely use. With OMSQOR, relevant aggregate data can be collected and safety statistics shared with federal and state agencies as well as insurance companies.”

Currently the safety of oral and maxillofacial surgeons delivery anesthesia is measured by several morbidity and mortality studies that have been conducted over time see for exaxmple http://www.teethremoval.com/mortality_rates_in_dentistry.html along with anecdotal reports and hearing about patient death or serious injury from media reports. Included with OMSQOR, is a Dental Anesthesia Incident Reporting System (DAIRS) which is an anonymous self-reporting system used to gather and analyze
information about dental anesthesia incidents. For example if an equipment fails or a cardiac event occurs in a patient a surgeon could report this anonymously using DAIRS. All dental dental anesthesia providers are being encouraged to report to DAIRS in order to help improve patient outcomes.

Even with the advantages of OMSQOR it is true that some members may be hesitant to want to use the system. This is because it can potentially be a significant time burden involved with the initial set-up to import all the data and surgeons may frankly just not like everyone else knowing intimate details about their practice. In addition their may be concerns with patient privacy. Both patient information and surgeon information will however be de-identified in the data registry so these concerns should not be subdued. Even so it may be possible to re-identify de-identified data. For example if there is a rare complication or death that occurs and is then picked up by the news media it may be possible to piece together who the patient and doctor is. Even with the limitations it seems that if many oral and maxillofacial surgeons and dental anesthesia providers use both OMSQOR and DAIRS then patient outcomes for dental procedures including wisdom teeth surgery may improve in the future.

This content was originally published here.

Health Officials Had to Face a Pandemic. Then Came the Death Threats. – The New York Times

“There’s a big red target on their backs,” Ms. Freeman said. “They’re becoming villainized for their guidance. In normal times, they’re very trusted members of their community.”

Some critics of the public health directors have said that they believe that allowing businesses to operate is worth the risk of spreading the coronavirus, and that health directors are too cautious about reopenings. Others have cited conspiracy theories that claim that the coronavirus is a hoax; that the development of a vaccine is part of a massive effort to track citizens and monitor their movements; and that wearing a mask or cloth face covering is a practice that impedes personal freedom.

In Washington State, where rural counties are struggling with new outbreaks and trying to warn residents to take basic precautions to stem the spread of the virus, pleas from local health officials have often been answered with hostility and threats.

In Yakima County, which has more than six times as many cases per capita as the county that includes Seattle, hospitals have reached capacity and patients were being taken elsewhere for medical care. Gov. Jay Inslee warned over the weekend that “we are frankly at the breaking point,” and has said he would require Yakima residents to wear face coverings in an effort to slow the virus’s spread.

“I’ve been called a Nazi numerous times,” said Andre Fresco, the executive director of the Yakima Health District. “I’ve been told not to show up at certain businesses. I’ve been called a Communist and Gestapo. I’ve been cursed at and generally treated in a very unprofessional way. It’s very difficult.”

Updated June 22, 2020

Is it harder to exercise while wearing a mask?

A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

I’ve heard about a treatment called dexamethasone. Does it work?

The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

What is pandemic paid leave?

The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

Does asymptomatic transmission of Covid-19 happen?

So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

What’s the risk of catching coronavirus from a surface?

Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

How does blood type influence coronavirus?

A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

How many people have lost their jobs due to coronavirus in the U.S.?

The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

My state is reopening. Is it safe to go out?

States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

What are the symptoms of coronavirus?

Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

How can I protect myself while flying?

If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

What should I do if I feel sick?

If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

How do I get tested?

If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

In California, angry protesters have tracked down addresses of public health officers and gathered outside their homes, chanting and holding signs. Last week, a group called the Freedom Angels did just that in Contra Costa County, Calif., filming themselves and posting the videos on Facebook.

“We came today to protest in front of our county public health officer’s house, and some people might have issues with that, that we took it to their house,” one woman said in a video. “But I have to tell you guys, they’re coming to our houses. Their agenda is contact tracing, testing, mandatory masks and ultimately an injection that has not been tested,” she said, apparently referring to a vaccine even though none have been approved.

This content was originally published here.

Henry Ford Health study: Hydroxychloroquine lowers COVID-19 death rate

Hydroxychloroquine lowers COVID-19 death rate, Henry Ford Health study finds

Sarah Rahal and Beth LeBlanc
The Detroit News
Published 6:42 PM EDT Jul 2, 2020

A Henry Ford Health System study shows the controversial anti-malaria drug hydroxychloroquine helps lower the death rate of COVID-19 patients, the Detroit-based health system said Thursday.

Officials with the Michigan health system said the study found the drug “significantly” decreased the death rate of patients involved in the analysis.

The study analyzed 2,541 patients hospitalized among the system’s six hospitals between March 10 and May 2 and found 13% of those treated with hydroxychloroquine died while 26% of those who did not receive the drug died.

Among all patients in the study, there was an overall in-hospital mortality rate of 18%, and many who died had underlying conditions that put them at greater risk, according to Henry Ford Health System. Globally, the mortality rate for hospitalized patients is between 10% and 30%, and it’s 58% among those in the intensive care unit or on a ventilator.

An arrangement of hydroxychloroquine pills.
John Locher, AP

“As doctors and scientists, we look to the data for insight,” said Steven Kalkanis, CEO of the Henry Ford Medical Group. “And the data here is clear that there was a benefit to using the drug as a treatment for sick, hospitalized patients.”

The study, published in the International Society of Infectious Disease, found patients did not suffer heart-related side effects from the drug. 

Patients with a median age of 64 were among those analyzed, with 51% men and 56% African American. Roughly 82% of the patients began receiving hydroxychloroquine within 24 hours and 91% within 48 hours, a factor Dr. Marcus Zervos identified as a potential key to the medication’s success. 

“We attribute our findings that differ from other studies to early treatment, and part of a combination of interventions that were done in supportive care of patients, including careful cardiac monitoring,” said Zervos, division head of infectious disease for the health system who conducted the study with epidemiologist Dr. Samia Arshad. 

Other studies, Zervos noted, included different populations or were not peer-reviewed.

“Our dosing also differed from other studies not showing a benefit of the drug,” he said. “We also found that using steroids early in the infection associated with a reduction in mortality.”

But Zervos cautioned against extrapolating the results for treatment outside hospital settings and without further study. 

Lynn Sutfin, spokeswoman for the Michigan Department of Health and Human Services, respond to the study Thursday by noting “prescribers have a responsibility to apply the best standards of care and use their clinical judgment when prescribing and dispensing hydroxychloroquine or any other drugs to treat patients with legitimate medical conditions.”

Dr. Marcus Zervos identified administering steroids early in the infection as a potential key to the medication’s success.
Zoom screenshot

The study found about 20% of patients treated with a combination of hydroxychloroquine and azithromycin died and 22% who were treated with azithromycin alone compared with the 26% of patients who died after not being treated with either medication. 

Henry Ford Health has been working on multiple clinical trials of hydroxychloroquine, including one that is testing whether the drug can prevent COVID-19 infections in first responders who work with coronavirus patients. The first responder clinical trial was trumpeted by Trump administration officials early in the pandemic.

Many health care institutions, including the World Health Organization, suspended clinical trials of the drug touted by President Donald Trump after a faulty study was published in the British medical journal The Lancet on May 22. The WHO restarted the trials in June.

The study is vital, Zervos said, as medical workers prepare for a possible second wave of the virus and there is plenty of research that still needs to be conducted to solidify an effective treatment.

In this May 18, 2020 file photo, President Donald Trump tells reporters that he is taking zinc and hydroxychloroquine. Results published Wednesday, June 3, 2020, by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the COVID-19 coronavirus. The drug did not seem to cause serious harm, though – about 40% on it had side effects, mostly mild stomach problems.
Evan Vucci, AP, File

Still, use of the malaria drug became highly controversial.

Doctors at Michigan Medicine, the University of Michigan’s health system, remain steadfast in their decision not to use hydroxychloroquine on coronavirus patients, which they stopped using in mid-March after their own early tracking of the treatment found little benefit to patients with some serious side effects.

Michigan’s largest system of hospitals, Southfield-based Beaumont Health, also stopped using the decades-old anti-malarial drug as a coronavirus treatment after deciding it was ineffective. 

St. Joseph Mercy health system has also backed away from the treatment. The system has St. Joseph hospitals in Ann Arbor, Chelsea, Howell, Livonia and Pontiac, as well as the Mercy Health hospitals in Grand Rapids, Muskegon and Shelby. 

Heidi Pillen, director of pharmacy at Beaumont Health, confirmed on Thursday that the health system is not using hydroxychloroquine to treat COVID-19 patients. 

A recent United Kingdom study evaluating hydroxychloroquine in hospitalized patients with coronavirus was stopped after preliminary analysis found it didn’t have any benefit. About 26% of patients in the trial using the drug died, compared with about 24% receiving the usual care, according to the Oxford University study. 

But doctors at Detroit Medical Center’s Sinai-Grace told The Detroit News in April, when the hospital was overloaded with senior COVID patients, that they were giving the drug to anyone they could.

srahal@detroitnews.com

Twitter: @SarahRahal_

This content was originally published here.

The Oral-Systemic Connection & Our Broken Healthcare System – International Academy of Biological Dentistry and Medicine

Say Ahh, the world’s first documentary on oral health, takes a sobering look at the state of our national healthcare system. Despite being one of the wealthiest nations in the world, home to some of the most advanced medicine and technology, America is suffering from a drastic decline in the overall health of its citizens. …

This content was originally published here.

Public Health Experts Have Undermined Their Own Case for the COVID-19 Lockdowns – Reason.com

In theory, the mass protests following the alleged murder of George Floyd put public health officials who have ceaselessly inveighed against mass gatherings in a difficult position. They have called for a moratorium on most types of public activities, but particularly gathering in large crowds where increased aerosolization from loud talking and yelling could spread the COVID-19 virus to massive groups.

But when it comes to the protests against police brutality, many medical experts think there should be an exemption to the COVID-19 lockdown logic.

More than a thousand public health experts signed an open letter specifically stating that “we do not condemn these gatherings as risky for COVID-19 transmission. We support them as vital to the national public health and to the threatened health specifically of Black people in the United States.”

The letter conceded that mass protests carried the risk of spreading coronavirus, and offered some good—if naive—advice for people who are going out anyway: wear masks, stay home if sick, attempt to maintain six feet of distance from other protesters. Many protesters are wearing masks, but others are not. And while we can blame the police for forcefully corralling people into close quarters, it’s a bit rich for public health experts to endorse protesting under conditions that they know are impossible for protesters to meet.

Indeed, for the purposes of offering health care advice, the only thing that should matter to doctors is whether their harm-reduction recommendations are being followed: how big is the event, is it outdoors, are masks being worn, etc. However, the letter distinguishes police violence protesters from “white protesters resisting stay-home orders,” as if the virus could distinguish between the two types of events. While I am not a doctor, my understanding is that it cannot.

The letter led a Slate writer to claim that “Public Health Experts Say the Pandemic Is Exactly Why Protests Must Continue.” The argument here is that coronavirus is more deadly for black people because of systemic racism and that protesting systemic racism is a sort of medical intervention.

“White supremacy is a lethal public health issue that predates and contributes to COVID-19,” the letter continues.

There is much truth to this! Black people in America do have worse health outcomes, but so do low-income people of every race and ethnicity. Is it medically acceptable for a poor person to protest against lockdown-induced economic insecurity? For people who live paycheck to paycheck to protest looming evictions and foreclosures? What about people experiencing loneliness, depression, and bereavement? Again, my understanding is that the virus does not think and thus does not choose to infect us based on what we’re protesting.

Many people all over the country were prevented from properly mourning lost loved ones because policymakers and health officials limited public funerals to just 10 people. For months, public health officials urged people to stay inside and avoid gathering in large groups; at their behest, governments closed American businesses, discouraged non-essential travel, and demanded that we resist the basic human instinct to seek out companionship, all because COVID-19 could hurt us even if we were being careful, even if we were going to a funeral rather than a nightclub. All of us were asked to suffer a great deal of second-order misery for the greater good, and many of us complied with these orders because we were told that failing to slow the spread of COVID-19 would be far worse than whatever economic impact we would suffer as a result of bringing life to a complete standstill.

People who failed to follow social distancing orders have faced harsh criticism and even formal sanction for violating these public health guidelines. To take just one extreme example, New York City Mayor Bill de Blasio threatened to use law enforcement to break up a Jewish funeral.

After saying no to so many things, a significant number of public health experts have determined that massive protests of police brutality are an exception to the rules of COVID-19 mitigation. Yes, these protests are outdoors, and yes, these experts have encouraged protesters to wear masks and observe six feet of social distance. But if you watch actual footage of protests—even the ones where cops are behaving badly themselves—you will see crowds that are larger and more densely packed than the public beaches and parks that many mayors and governors have heavily restricted. Every signatory to the letter above may not have called for those restrictions, but they also didn’t take to a public forum to declare them relatively safe under certain conditions.

“For many public health experts who have spent weeks advising policymakers and the public on how to reduce their risk of getting or inadvertently spreading the coronavirus, the mass demonstrations have forced a shift in perspective,” The New York Times tells us.

But they could have easily kept the same perspective: Going out is dangerous, here’s how to best protect yourself. The added well, this cause is important, though, makes the previous guidance look rather suspect. It also makes it seem like the righteousness of the cause is somehow a mitigating factor for spreading the disease.

Examples of this new framing abound. The Times interviewed Tiffany Rodriguez, an epidemiologist “who has rarely left her home since mid-March,” but felt compelled to attend a protest in Boston because “police brutality is a public health epidemic.” NPR joined in with a headline warning readers not to consider the two crises—racism and coronavirus—separately. Another recent New York Times article began: “They are parallel plagues ravaging America: The coronavirus. And police killings of black men and women.”

Police violence, white supremacy, and systemic racism are very serious problems. They produce disparate harms for marginalized communities: politically, economically, and also from a medical standpoint. They exacerbate health inequities. But they are not epidemics in the same way that the coronavirus is an epidemic, and it’s an abuse of the English language to pretend otherwise. Police violence is a metaphorical plague. COVID-19 is a literal plague.

These differences matter. You cannot contract racism if someone coughs on you. You cannot unknowingly spread racism to a grandparent or roommate with an underlying health condition, threatening their very lives. Protesting is not a prescription for combatting police violence in the same way that penicillin is a prescription for a bacterial infection. Doctors know what sorts of treatments cure various sicknesses. They don’t know what sorts of protests, policy responses, or social phenomena will necessarily produce a less racist society, and they shouldn’t leverage their expertise in a manner that suggests they know the answers.

It’s clear that we’ve come to the point where people can no longer be expected to stay at home no matter what. Individuals should feel empowered to make choices about which activities are important enough to incur some exposure to COVID-19 and possibly spreading it to someone else, whether that activity is reopening a business, going back to work, socializing with friends, or joining a protest against police brutality. Health experts can help inform these choices. But they can’t declare there’s just one activity that’s worth the risk.

This content was originally published here.

Some in Melbourne’s COVID-19 hotspots dismiss the health risks as testing blitz gets underway – ABC News

On the streets of Broadmeadows in Melbourne’s north, there is both deep concern and general indifference to the Victorian Government’s coronavirus testing blitz, with some locals saying that not even a deadly virus would cause them to change their behaviour.

A team of 800 health workers will try to test 10,000 people a day in Melbourne’s 10 problem suburbs, with the aim to carry out about 100,000 tests in 10 days.

Broadmeadows is one of the hotspots with a worrying spike in the number of cases of COVID-19.

A child getting a test for COVID-19 with a man putting a swab in her mouth.

But while some Broadmeadows locals expressed fear and urged their fellow residents to heed health warnings, others described the virus as “rubbish”.

“I’ve been out and about, and everyone has, and I haven’t met a person that’s got it,” one man said.

He said he was still hugging and kissing people in greeting and said COVID-19 was not dangerous.

“It’s not deadly, it’s like any other virus,” he said.

“A person who’s 99 years old is dying, 100 years old is dying … they’re going to die the next day regardless, so why does it matter?

“I’m not going to stop my whole life for coronavirus, I’ve got to work, I’ve got a business to run … just like everyone else in Broadmeadows.”

A man in a black top with a beard.

Others said they were not surprised to learn that Broadmeadows was a hotspot.

“No-one listens to the rules … not staying home, hugging, kissing,” one man said.

Some urged the Government to introduce heftier fines for failing to practice social distancing.

“People think they don’t get sick, but this is not a game anymore,” one woman said, describing the behaviour of some as “stupid”.

“[They] are hugging, they’re kissing, they’re too close to each other,” she said.

But other locals said they were not worried about hugging and were not practising social distancing.

“In our community everybody does that,” one man said.

Why are some suburbs hotspots? We may never know

Deputy Chief Health Officer Annaliese van Diemen called the comments that everyone was going to get coronavirus “concerning”.

She urged people to continue to keep their distance in order “to keep this at bay in our community”.

“People need to avoid hugging each other and they need to avoid shaking hands. They need to stay 1.5 metres apart,” she told ABC News Breakfast.

“I would thoroughly disagree that everybody has it and that everybody is going to get it.”

Four health workers wearing PPE speak to a woman in a dressing gown at a coronavirus testing station on a residential street.

Dr van Diemen said the testing blitz was underway and had been going well.

“We’ve had good engagement from the community, lots of tests done yesterday,” she told ABC Radio Melbourne.

“We’re expecting that to increase over coming days.”

But we may never know why some suburbs were hotspots and others were not.

“It’s clear there was still some virus lurking around, that there [were] some transmission chains,” she said.

“With significantly increased movement, increased mixing, increased gathering sizes and frequency, those last few infections have just had the chance to take off.”

She said there was a complex set of factors at play, like, for example the fact some workforces in these hotspots had to continue to physically attend work during the lockdown.

Two men greet and embrace each other in a street.

Elsewhere, as the testing blitz got underway, people said they were unfazed to be living or working in one of Melbourne’s coronavirus hotspots.

One woman from Keilor Downs in Melbourne’s north-west said she was getting on with life and had been dismissing the concerns expressed by her relatives for her safety as “rubbish”.

“I ignore the hotspot, Keilor’s a wonderful place to live, hotspot or not,” she said.

She was unimpressed by the testing blitz.

“I reckon we’re crushing a peanut with a sledgehammer.”

In Pakenham, some said they were living life as normal, despite the virus.

“I haven’t seen anybody with COVID,” one woman said.

But Kay from Cafe Transylvania in Hallam said she was praying for people to listen.

“It’s better for everyone to do the right thing,” she said.

A woman holds a swab to her mouth as an ambulance officer watches.

Premier urges everyone to be cooperative

The first three days of Victoria’s testing blitz will focus on Keilor Downs and Broadmeadows, where health workers will aim to test half the population.

The focus will then move to other hotspot suburbs over the course of the 10-day program.

Stay up-to-date on the coronavirus outbreak

A map highlighting eight suburbs in Melbourne's north and west.

The other suburbs central to the ramped-up testing program are Maidstone, Albanvale, Sunshine West, Brunswick West, Fawkner, Reservoir as well as Hallam and Pakenham in the outer south-eastern suburbs.

A map showing Hallam and Pakenham highlighted in orange.

Victoria’s Premier Daniel Andrews said ambulances and other testing vans would be at the end of many streets to make it easy for residents to be tested.

“They will be invited to come and get a test, and they’ll only have to travel 50 metres or 100 metres in order to complete that test,” Mr Andrews said.

The blitz was announced on a day when Victoria recorded 33 more coronavirus infections and another childcare centre, Connie Benn Early Learning Centre in Fitzroy, was forced to close after a parent of a child who attended the centre tested positive to COVID-19.

Mr Andrews said he was “confident” the strategy would help contain community transmission in Victoria.

He urged everyone to be cooperative and get tested.

What you need to know about coronavirus:

This content was originally published here.

Dentists say mandating COVID-19 tests for patients before procedures will ‘shut down’ dentistry

(Creative Commons photo by Allan Foster)

When Gov. Mike Dunleavy and state health officials said elective health care procedures could restart in a phased approach, many of Alaska’s dentists were hoping to take non-emergency patients again.

But they said a state mandate largely prevents that from happening. 

State officials said they want to work with the dentists, but point to federal guidelines that dentists are at very high risk of being exposed to the virus.

Find more stories about coronavirus and the economy in Alaska.

The mandate said patients must have a negative result of a test for the coronavirus within 48 hours of a procedure that generates aerosols — tiny, floating airborne particles that can carry the virus. Aerosols are produced by many dental tools, from drills to the ultrasonic scalers used to remove plaque.

Dr. David Nielson is the president of the Alaska Board of Dental Examiners, which licenses dentists. In a meeting with the state, he told state Chief Medical Officer Dr. Anne Zink that it’s a challenge for patients to get test results within 48 hours of an appointment.

“Basically, what that means is, in your view, dentistry is just shut down indefinitely,” Nielson told Zink.

“That’s not true. That’s not what I feel at all,” Zink said.

“Well, that’s what it says to most of us,” Nielson said.

Nielson said dentists can ensure that patients are safe without testing for the virus.

“We do believe that waiting for the availability of testing to ramp up to the levels that would be necessary will jeopardize the oral health of the public,” he said.  

Nielson also said dentists are already taking steps to practice safely and could start taking more patients if they didn’t have to follow the testing mandate. 

“Based on everything that we’re doing with all our, you know, really, really intense screening protocols and all the different PPE requirements and stuff like that, that we’re basically good to go, as long as we do all of the things that we’ve already recommended,” he said.

Zink said Alaska is among the first states to reopen non-urgent health care. She says the state’s testing capacity is increasing, and that other groups affected by the mandate are working to have patients tested. 

“We are seeing numerous groups, including surgeons, stand up ways to be able to get testing available,” she said. 

The state mandate is less restrictive than what’s currently recommended by the federal Centers for Disease Control and Prevention. The CDC said all non-urgent dental appointments should be postponed. The CDC is revising the recommendation, but it’s not clear when there will be new recommendations. 

The dental board would like to replace the mandate with guidelines that require that every patient be screened, including answering questions about their travel, symptoms and contacts before an appointment, as well as to be checked for whether they have a fever before an appointment. 

Zink noted a problem with relying on screening. 

“It’s increasingly challenging to identify COVID patients,” she said. “This is an incredibly sneaky disease that appears to be most contagious in the presymptomatic or early symptomatic people with symptoms that can look almost like anything else.”

The draft framework proposed by the dental board also differs from CDC recommendations on personal protective equipment. The CDC recommends both an N95 respirator and either goggles or a full face shield. The framework said that if goggles or face shields aren’t available, dentists should understand there is a higher risk for infection and should use their professional judgment. 

Dentists working to start seeing more patients say they already take precautions against infectious diseases. 

Dr. Paul Anderson of Timbercrest Dental in Delta Junction said it would be challenging to have timely tests done for patients who live far from an urban center. 

Anderson said dentists have been working to prevent the spread of infectious diseases since at least HIV/AIDS in the 1980s. 

“We’ve been following these protocols, and it just seems odd to me that all of a sudden the government feels that it’s necessary to add all of these additional regulations,” he said. 

Anderson said screening patients — including checking their temperatures — is a significant safety measure dentists can take.

Zink said the state is open to working with the dental board to revise the mandate, or to issue a new mandate specific to dentistry. It’s not clear if the issue can be resolved before Monday, when the state will begin allowing elective procedures under the mandate. 

This content was originally published here.