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Doctors Are Calling It Quits Under Stress of the Pandemic

Source: The New York Times
Thousands of medical practices are closing, as doctors and nurses decide to retire early or shift to less intense jobs.

Dr. Kelly McGregory had to close down her private pediatric practice outside Minneapolis because of the pandemic. “It was devastating,” she said. “That was my baby.”
Dr. Kelly McGregory had to close down her private pediatric practice outside Minneapolis because of the pandemic. “It was devastating,” she said. “That was my baby.”Credit…Jenn Ackerman for The New York Times
Shidonna Raven Garden and Cook
Reed Abelson

By Reed Abelson

  • Published Nov. 15, 2020Updated Nov. 25, 2020

Two years ago, Dr. Kelly McGregory opened her own pediatric practice just outside Minneapolis, where she could spend as much time as she wanted with patients and parents could get all of their questions answered.

But just as her practice was beginning to thrive, the coronavirus hit the United States and began spreading across the country.

“As an independent practice with no real connection to a big health system, it was awful,” Dr. McGregory said. At one point, she had only three surgical masks left and worried that she could no longer safely treat patients.

Families were also staying away, concerned about catching the virus. “I did some telemedicine, but it wasn’t enough volume to really replace what I was doing in the clinic,” she said.

After her husband found a new job in a different state, Dr. McGregory, 49, made the difficult decision to close her practice in August. “It was devastating,” she said. “That was my baby.”

Many other doctors are also calling it quits. Thousands of medical practices have closed during the pandemic, according to a July survey of 3,500 doctors by the Physicians Foundation, a nonprofit group. About 8 percent of the doctors reported closing their offices in recent months, which the foundation estimated could equal some 16,000 practices. Another 4 percent said they planned to shutter within the next year.

Other doctors and nurses are retiring early or leaving their jobs. Some worry about their own health because of age or a medical condition that puts them at high risk. Others stopped practicing during the worst of the outbreaks and don’t have the energy to start again. Some simply need a break from the toll that the pandemic has taken among their ranks and their patients.

Another analysis, from the Larry A. Green Center with the Primary Care Collaborative, a nonprofit group, found similar patterns. Nearly a fifth of primary care clinicians surveyed in September say someone in their practice plans to retire early or has already retired because of Covid-19, and 15 percent say someone has left or plans to leave the practice.

The clinicians also painted a grim picture of their lives, as the pandemic enters a newly robust phase with record case counts in the United States. About half already said their mental exhaustion was at an all-time high. Many worried about keeping their doors open: about 7 percent said they were not sure they could remain open past December without financial help.

For some, family obligations left them no choice.

“Honestly, if it hadn’t been for the pandemic, I would have still been working because it was not my plan to retire at that point,” said Dr. Joan Benca, 65, who worked as an anesthesiologist in Madison, Wis.

But her daughter and son-in-law hold administrative positions in a hospital intensive care unit, treating the sickest Covid patients, and they have two small children. When cases climbed in the spring, their day care center closed, and Dr. Benca’s daughter desperately needed someone she trusted to look after the children.

“It wasn’t the way I wanted to end my career,” Dr. Benca said. “I think for most of us, we would say, you would fall on your sword for your family but not for your job,” she said, adding that she knows other female colleagues who have stayed home to care for children or older relatives.

“It was not my plan to retire,” said Dr. Joan Benca of Madison, Wis.
“It was not my plan to retire,” said Dr. Joan Benca of Madison, Wis.Credit…Lauren Justice for The New York Times
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Dr. Michael Peck, 66, an anesthesiologist in Rockville, Md., decided to leave after working in April in the hospital’s intensive care unit, intubating critically ill patients, and worrying about his own health. “When the day was over, I just said, ‘I think I’m done’ — I want to live my life, and I don’t want to get ill,” said Dr. Peck, who had already been cutting back his hours.The Coronavirus Outbreak ›

He is now spending a few hours a day as the chief medical officer for a start-up.

Still, most practices have proved resilient. The Paycheck Protection Program — authorized by Congress to help businesses, including medical practices, with the economic fallout of the pandemic — helped many doctors remain afloat. That money “kind of made me solid,” said Dr. Ripley Hollister, a family physician in Colorado Springs who serves as chairman of the research committee for the Physicians Foundation. The volume now “is really coming back,” he said.

But, depending on the future course of the pandemic, Dr. Lisa Bielamowicz, a co-founder of Gist Healthcare, a consulting firm, predicts “another wave of financial stress hitting practices.” Many doctors’ groups will seek a buyer, whether a hospital, an insurance company or a private equity firm that plans to roll up practices into a larger business.

One doctor, who asked not to be identified because the discussions are confidential, said she and her partner had already been talking with the nearby hospital nearby about buying their pediatric practice before the pandemic arrived in the United States.

Although federal aid has helped, patient visits are still 15 percent below normal, she said, and they are continually worried about making payroll and having enough doctors and staff to see patients. As the number of virus cases balloons in the Midwest, her employees must deal with increasingly agitated parents.

“They’re yelling and cussing at my staff,” she said. Working for a telemedicine firm might be an alternative, she added. “It’s a hard job to begin with, to own your own business,” she said.

The coronavirus crisis has amplified problems that doctors were already facing, whether they own their practice or are employed. “A lot of physicians were hanging on by a thread from burnout before the pandemic even started,” said Dr. Susan R. Bailey, the president of the American Medical Association.

In particular, smaller practices continue to have difficulty finding sufficient personal protective equipment, like gloves and masks. “The big hospitals and health care systems have pretty well-established systems of P.P.E.,” she said, but smaller outfits might not have a reliable source. “I was literally on eBay looking for masks,” she said. The cost of these supplies has also become a significant financial issue for some practices.

Doctors are also stressed by the never-ending need to keep safe. “There is a hunker-down mentality now,” Dr. Bailey said. She is concerned that some doctors will develop PTSD from the chronic stress of caring for patients during the pandemic.

Even those who are not responsible for running their own practices are leaving. Courtney Barry, 40, a family nurse practitioner at a rural health clinic in Soledad, Calif., watched the cases of coronavirus finally ebb in her area, only to see wildfires break out. Many of her patients are farmworkers and work outside, and they became ill from the smoke.

In 14 years as a nurse, Ms. Barry has never experienced anything “like this that is just such a high level of stress and just keeps going,” she said, adding, “The other hard part is there’s no end in sight.”

She tried working fewer days but decided eventually that she would stop altogether for several months beginning in early December. Ms. Barry hasn’t figured out what’s next for her.

“My intention is to stay in medicine, although I would not be totally opposed to doing something in a totally different area, which is something that I would not have said in the past,” she said.

And patients have indeed felt the effects. The pandemic has developed into “a really huge disruption,” said Dr. Hollister, the family physician, who thinks closed practices are likely to result in “a significant impairment to patients’ access to medical care.” In his community, where both specialists and primary care doctors are leaving, he is tending to more patients who no longer have a doctor.

It is an issue that Dr. McGregory, who took a job at the University of Wisconsin School of Medicine and Public Health in Madison, worries about. There were some families in her practice whom she could not convince to find another pediatrician immediately. She said they “are waiting, which I discouraged, because I think every child should have a medical home.”

When is the last time you have seen a doctor? How has the pandemic? Why? Why not?

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COVID-19 vaccine stirs rare hesitation in nearly virus-free Singapore

By Chen LinAradhana Aravindan
Source: Reuters

SINGAPORE (Reuters) – As Singapore prepares to roll out COVID-19 vaccinations its striking success in controlling the virus is making some question whether they should take the jabs.FILE PHOTO: The first shipment of coronavirus disease (COVID-19) vaccine arrives in Singapore December 21, 2020. Betty Chua/Ministry of Communications and Informations via REUTERS

In a city-state where compliance with the authorities is generally high, some Singaporeans fear potential side effects – even if minimal – are not worth the risk when daily cases are almost zero and fatalities are among the world’s lowest.

“Singapore is doing pretty well,” said Aishwarya Kris, who is in her 40s and does not want a shot.

“I doubt the vaccine will help at all.”

A poll by local newspaper The Straits Times in early December found that 48% of respondents said they will get a vaccine when it is available and 34% will wait six to 12 months.

But the government is keen to open more of the economy with the help of the vaccine in a country dependent on travel and trade and preparing to host the World Economic Forum’s annual gathering next year.

“Singapore is a victim of its own success,” said Leong Hoe Nam, an infectious diseases expert at the city’s Mount Elizabeth Hospital.

To show the vaccine is safe, Prime Minister Lee Hsien Loong, 68, said he and his colleagues would be among the early recipients of the shots. They will be free, voluntary and given first to healthcare workers and the elderly.

The first shipment of the Pfizer-BioNTech vaccine arrived this week and Singapore expects to have enough vaccines for all 5.7 million people by the third quarter of 2021.

The first vaccines will be given to priority groups such as health workers in the next month or two, but it will be some time before its offered to the broader population, said Lawrence Wong, a minister who co-heads Singapore’s virus taskforce.

“The roll-out to the Singapore population will also take place over several months, depending on factors such as the supply and delivery schedules of the vaccines,” he said.


Many Singaporeans said they are ready to take the shots — not just to ward off infection but in hopes they can travel again. For others, it’s a civic duty.

“I am the one in the family that goes out daily to work, so it’s the responsible thing to do,” said Jeff Tan, a 39-year-old photographer.

Singapore acted swiftly after the first cases of the virus were reported and although it was blindsided by tens of thousands of cases in migrant workers dormitories, it has brought infections right down again.

Singaporeans are generally accepting of vaccines, with a near 90% uptake of major childhood jabs, said Hsu Li Yang at Saw Swee Hock School of Public Health at National University of Singapore.

But there is concern about a new vaccine that uses novel technology and has had a rapid development and approval. Typically, vaccine acceptance takes time, he said.

Even three nurses told Reuters under the condition of anonymity that they would prefer not to take the vaccine.

Singapore’s drug regulator said it granted approval after data submitted by Pfizer-BioNTech was assessed to demonstrate the vaccine meets the required safety, efficacy and quality standards, and that the benefits outweigh the known risks.

Pfizer’s vaccine has been linked with a few cases of severe allergic reactions as it has been rolled out in the UK and the United States. But it has not turned up any serious long-term side effects in clinical trials.

John Han, a sales manager, said he wanted to wait for 80% of the population to take the vaccine without side effects.

“If there is a choice given, I might not take it. I don’t mind to put on the mask, be safe, avoid crowded places,” said Han, 40.

Reporting by Chen Lin and Aradhana Aravindan in Singapore; Editing by Michael Perry

Why do you think people across the world are hesitant to take the COVID vaccination? Have you taken the vaccine? Why? Why not?

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DePaul Hospital’s Closing Presents a Unique Opportunity for Hampton Roads

Posted on January 29, 2021 by sherlockj

De Paul Medical Center Jan. 29, 2021. Photo Credit: James C. Sherlock
Shidonna Raven Garden and Cook

by James C. Sherlock
Source: Beacon Rebellion

Not too long ago, before the decline of the malls and COVID, the healthcare community coined what they called the Nordstrom Rule.

The meaning was that if you wished to optimize profits in your healthcare business, build it close to a Nordstrom. The theory was that Nordstrom had already done the market research to identify concentrations of wealthy customers.

I wrote yesterday about the Sisters of Charity and Bon Secours, Catholic charities both. The Sisters were not in it to serve wealthy patients. They purposely located their hospitals among the poor. So 19th and 20th century of them.

Sentara, a more sophisticated public charity, avoids locations close to the poor.

In 1991, Sentara purchased the Humana Bayside Hospital in Virginia Beach, renaming it Sentara Bayside Hospital. That cleansed Virginia Beach of a competitor. But Bayside served Virginia Beach’s largest concentration of economically disadvantaged minorities. So Sentara closed it at the first opportunity.

The Virginia Department of Health brokered the closing of Bayside in 2008 under the cover of the Certificate of Public Need (COPN) process that fatally wounded DePaul, allowing Sentara to relocate the Bayside beds to the new Sentara Princess Anne, far from the minority citizens of Bayside.

The closest hospital for many residents served by Bayside was then, you guessed it, DePaul. No longer.

More about that legendary and devastatingly unfair and anticompetitive COPN decision next time.

Today we’ll talk about the gleaming cornerstone of Sentara’s Hampton Roads monopoly, Norfolk General Hospital, and until now its only competitor in Norfolk and Virginia Beach, Bon Secours DePaul Hospital, which announced this week it was closing as an inpatient hospital and emergency room.

Sentara is now unopposed in the hospital markets of Virginia’s two largest cities. I hope the sommeliers at Sentara headquarters in Norfolk were prepared for the surge in demand.

DePaul Hospital 

If you drive near DePaul hospital, either you live there or DePaul is likely your destination.

The surrounding area is mostly low cost and assisted cost apartments, very small but neat working class houses and low end strip malls. Granby High School is there, as are a few churches and a synagogue, but those do not define the area. Economically disadvantaged families and DePaul Hospital do.

It is easy to see, if you know the history of the area, what the Sisters of Charity saw at the end of the Great Depression with the coming of WW II.

They saw the mass migration of tens of thousands of people, their personal fortunes ravaged by the Depression, moving to Norfolk seeking work in the expanding shipyards, naval bases and port. They built their new DePaul hospital to serve those workers where they were settling. DePaul opened in 1944 in a section of the city then about half white and half black between the Elizabeth River and Norfolk Naval Base.

Most patients of the new DePaul in 1944 could not pay, or could only pay a little if they had found those jobs, but that is what today we would call a feature not a bug to the Sisters. There was no Medicaid, no Medicare. Just the Sisters, their mission and the Catholic church that funded their efforts.

DePaul has failed for a number of reasons including in no particular order:

  • It was built to handle 600 inpatients and thus has an enormous infrastructure. A precipitous decline in inpatients crushed revenue, but did not reduce upkeep costs;
  • There has been a sharp decline of the Catholic donations that helped fund their work;
  • Underfunded Medicare and Medicaid programs, by policy, underpay for services. That triggers  providers of all types to seek payer mixes that feature as many privately insured patients as possible (the Nordstrom Rule);
  • Physicians desire to work and practice in state-of-the-practice facilities, which DePaul, a money-loser for many years, found it difficult to fully fund;
  • Rapid development of outpatient procedures, offset partially by the Commonwealth’s near banning through COPN of outpatient surgery centers not run by a hospital, that are less financially rewarding than the inpatient procedures they replaced;
  • The costs of medical technology –– including those constantly beeping machines and million-dollar robotic surgical assistants — are rising rapidly.
  • In Virginia, the Certificate of Public Need (COPN) program picks winners and losers. By official decision in 2008, the COPN process led by Virginia’s Health Commissioner rejected Bon Secours/DePaul bids to build hospitals in Virginia Beach and Suffolk necessary to secure their financial future in favor of virtually identical bids by Sentara. Game over — it just took 12 years to fully play out;
  • Those of us who live in this area watched the painfully long coup de grace. With Bon Secours fatally wounded by the 2008 COPN decision, Sentara moved to finish it off. It lured away Bon Secours physicians. It bought more physicians’ practices. Bon Secours built a cancer center at DePaul. Sentara moved to build a bigger one at Sentara Leigh campus in Norfolk, closer to the mother load of regional cancer patients in Virginia’s largest city, Virginia Beach.

It worked. DePaul as a hospital and emergency center is dead. COPN and Sentara together (which is perhaps an unnecessary qualifier) have a kill. The physicians practices that DePaul leaves behind in Norfolk have nowhere else to go but Sentara for hospital privileges.

Stuffing and mounting DePaul on the wall is the only thing that will escape them.

Norfolk General

The cornerstone of the Sentara empire, Norfolk General Hospital, in direct contrast to DePaul is located in the exact center of the money and power in Norfolk. A drive from DePaul to Norfolk General is a ride through nearly every level of economic success, starting among the poorest citizens and arriving at the doorsteps of Norfolk’s wealthiest and most powerful people.

Norfolk General’s gleaming towers overlook the Elizabeth River, the mansions of the Hague and Ghent, the Chrysler Museum, the Harrison Opera House — you get the idea.

I wager that few who live in that area could find DePaul Hospital on a map. The right people are not interested in such places. DePaul would certainly not make for proper conversation at Ghent cocktail parties. They are only woke to a point that the consequences do not reach their doors.

And yes, Nordstrom located its Norfolk emporium near Norfolk General Hospital 20 years ago. In this case, flipping the old saying, Sentara had already done the market research for Nordstrom.

An Opportunity

I am going to try to postpone the Sentara celebration by offering for consideration a use for the massive DePaul infrastructure.

I strongly recommend the sale or gift of the DePaul complex to either Mayo Clinic or Cleveland Clinic to serve as their mid-Atlantic campus.

A campus of a world-class health system will serve patients near DePaul but not depend upon the cash flows they generate. Such a facility, like every other Mayo and Cleveland Clinic campus, will be a huge draw for medical tourism. The property is just off I-64 and very close to the airport. The new tunnel will make access much quicker from the west.

Mayo and or/Cleveland Clinic may very well find this appealing if it is marketed and incentivized properly. It is what they do, and neither has a mid-Atlantic campus.

There are at least four distinct benefits to such a course of action for the Commonwealth and Hampton Roads:

  • It will serve both the people and the medical practitioners of Hampton Roads by raising the level of medical care here;
  • It will restore competition in the hospital industry in Hampton Roads;
  • It will revitalize the economy of Norfolk and South Hampton Roads; and
  • Sentara will hate it.

I hope the Governor, Virginia’s Health Commissioner (final decision authority on COPN), Norfolk’s Mayor and City Council and every politically-connected individual and interest group in Hampton Roads will get behind this effort.

They certainly owe us one.

We have seen the decline of patient center care and the rise of medical fraud in the pursuit of profit. What are your thoughts on DePaul Hospital closing? What do you think should happen? What is the economic impact of rising health care cost, medical fraud and declining health care outcomes on a community?

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India Has Plenty of Coronavirus Vaccines But Few Takers

By Bibhudatta Pradhan and Sudhi Ranjan Sen
January 26, 2021, 4:00 PM EST
Source: Bloomberg

  •  Doctors shun early-stage vaccine, ignore government pleas
  •  India may fall short of plan to vaccinate 300 million by July
A nurse administers a shot of the Covishield vaccine in Mumbai, on Jan. 16.
A nurse administers a shot of the Covishield vaccine in Mumbai, on Jan. 16. Photographer: Dhiraj Singh/Bloomberg
Shidonna Raven Garden and Cook

Most of the world is struggling to secure enough vaccines to inoculate their populations. India has the opposite problem: Plenty of shots, but a shortage of people willing to take them.

As India rolls out one of the world’s biggest inoculation programs, some health-care and other frontline workers are hesitating because of safety concerns over a vaccine that has yet to complete phase III trials. As of Monday, only about 56% of people eligible to get the shot have stepped forward in a nation with the world’s second-worst Covid-19 outbreak.

Unless the inoculation rate significantly increases, India will fall far short of its target of inoculating 300 million people — or about a quarter of the population — by July. That will setback global efforts to contain the virus and snuff out optimism that a recovery is taking root in an economy set for its biggest annual contraction in records going back to 1952.

“At least 40% of doctors here are unsure and want to wait,” said Vinod Kumar, a resident doctor at the All India Institute of Medical Sciences of Patna, in the eastern state of Bihar. “Carrying out a vaccine trial on us when India is short of doctors, health-care workers doesn’t make sense.”

While vaccine hesitancy has surfaced in places like Japan and Brazil, and China’s candidates have also faced questions over data, the scale of the problem in India is by far the biggest. The major difficulties facing places like the U.S. and Europe are mostly due to scarce supplies rather than vaccine acceptance, and some countries are turning to New Delhi for help: India says it can produce 500 million shots per month for export, and countries such as the U.K., Belgium and Saudi Arabia have sought to buy them.

India’s domestic vaccine program administers one of two shots: the AstraZeneca Plc vaccine, manufactured by the Serum Institute of India Ltd., or the Covaxin shot developed by Bharat Biotech International Ltd., a private company based in Hyderabad. India’s approval of the Bharat Biotech shot, which was developed with government-backed research groups, was met with widespread criticism from scientists because of the lack of complete data.

“Many in our institute aren’t comfortable with Covaxin because we don’t know how effective it is,” said Adarsh Pratap Singh, a member of the Resident Doctors Association at the All India Institute of Medical Sciences in New Delhi. “To build trust among people the government must come out with the data, evidence of the trials, and encourage free and fair discussions.”

Both the company and the government have defended the shot. Krishna Ella, Bharat Biotech’s chairman, said earlier this month that the company carried out “200% honest clinical trials” and had a track record of producing 16 safe and effective vaccines. “Indian scientists want to bash on other Indian scientists,” he said while dismissing criticisms in a virtual press briefing on Jan. 4. A spokesperson for Bharat Biotech didn’t immediately respond to a request for comment.

The government, meanwhile, has urged health-care workers to get vaccinated. Health Minister Harsh Vardhan has sent tweets imploring “#CoronaWarriors” to take the shot, while dispelling rumors that the vaccine could cause infertility. A federal health ministry spokesperson wasn’t immediately available to comment.

“Vaccine hesitancy among health workers should end — I am pleading on behalf of the government, that please adopt it, because no one knows how this pandemic will take shape in the future,” said V. K. Paul, a member of the planning body Niti Aayog, noting that he’s taken the Covaxin shot without any adverse effects.

A Bitter Vaccine History Means Hurdles for Japan’s Covid Fight

“These two vaccines are safe,” he said. “We have a system to track it and if there is an unusual signal, it will be responded to the way it should be.”

Initial apprehension and doubt at the start of any vaccine rollout is normal, said Preeti Sudan, former secretary at the federal ministry of health and family welfare. India was successful in its polio immunization program, she noted, after launching a massive campaign involving children, mothers and opinion leaders to help dispel vaccine fears.

Low Vaccination Rates

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As of Monday, India distributed about 2 million shots nationwide. In Madhya Pradesh, the largest state in central India, about 75% of enrolled people turned up for vaccination on Jan. 21, while two days later in Bihar the rate was much lower at 51.6%. On Jan. 19, about 55% of those eligible were vaccinated in Rajasthan and 54% in the southern state of Tamil Nadu, according to state government data.

While the hesitation relates to both vaccines, people are most wary about Bharat Biotech’s Covaxin. In Tamil Nadu, for example, only 23.5% of those allocated Covaxin received the shots on Jan. 19, compared with 56% for the Serum Institute’s Covishield, the data show.

Nirmalya Mohapatra, a doctor at Ram Manohar Lohia Hospital in New Delhi, plans to “wait and watch” for more clarity before getting vaccinated with Bharat Biotech’s shot. If given a choice now, he would opt for Covishield, as its efficacy data was reviewed by leading medical journals.

“Covaxin could turn out to be a better vaccine in the future,” said Mohapatra, who is also vice president of the resident doctors’ association at the hospital. “But for now there is some apprehension because of the lack of a complete trial.”

— With assistance by Ganesh Nagarajan

Actually vaccination hesitation is also high in the U.S. although there are efforts to combat the hesitancy. We are uncertain as of yet the hesitancy rate in Great Britain. In fact, in the U.S. and in India the hesitation is very similar: health care professionals and the population at large are also hesitant with many wanting to at least wait until there is more information. The typically clinical trial for a new medicine last about 7 – 8 years in the U.S.? What is the global risk of being wrong about the COVID vaccine? Is rushing a COVID vaccine the only means of addressing the pandemic? What are alternative health and economic solutions

Share your comments with the community by posting them below. Share the wealth of health with your friends and family by sharing this article with 3 people today. As always you are the best part of what we do. Keep sharing!

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47% of Americans Still Hesitant to Get COVID-19 Vaccine, New Poll Says

Published: Jan 22, 2021 By Gail Dutton
Source: Biospace

Vaccine Hesitancy
Source: Biospace
Shidonna Raven Garden and Cook

Americans are still hesitant to be vaccinated against COVID-19, according to just-released research from Invisibly.

The online survey of 5,537 Americans conducted between December 4 and 14, 2020 shows Americans nearly equally divided on their willingness to receive COVID-19 vaccines. Only 53% said they were willing to get the vaccine.

“That’s a shockingly low number, but it corresponds well with what JAMA has reported,” Don Vaughn, Ph.D., a neuroscientist and VP Data & Insights at Invisibly, which conducted the survey, told BioSpace.

The Invisibly poll found that willingness to be vaccinated is tightly linked to trustworthiness. Of those who trust the vaccines to be safe and effective, 81% said they are willing to be vaccinated. Of those who considered the vaccine very untrustworthy, 80% said they were very unlikely to be vaccinated.

Notably, trust in the vaccine and willingness to be vaccinated correlated to race and age, with Caucasian people and those age 55 and older saying they are most likely to take the vaccine. The survey found no other significant correlations among income, education, gender or other demographics.

Those age 55 and older are the group most willing to take the vaccine (67%) but even among this group, 33% said they were unwilling to get the COVID-19 vaccine. The second most likely group to be vaccinated is aged 18-24 (58%), followed by those 45-54 (50%). Only 47% of respondents between ages 25 and 44 said they are likely to receive the COVID-19 vaccine.

“We’re seeing numbers now from California, reported in the Los Angeles Times, that 50% of front line healthcare workers (in Riverside County)  and 20-40% of Los Angeles County’s frontline workers refused to take the vaccine,” Vaughn said. “We presume they’re more medically educated, so…” hesitation among those outside of healthcare is less surprising.

Perhaps not surprisingly, people of color are most distrustful of the vaccine and thus the least likely to be vaccinated despite a higher incidence of COVID-19 in their communities. Of those not willing to be vaccinated:

  • 53% are Black
  • 50% are Latinx
  • 48% are of other ethnicities
  • 38% are White

Lisa Cooper, M.D., director of the Johns Hopkins Center for Health Equity and a former MacArthur “genius” fellow for her work in health disparities, explained the concern on NPR.

“In the Black community, there is skepticism that relates to historical experiences, and mistrust based on the discrimination that Black Americans face in the health care system and in the rest of society. It’s really well-founded,” Cooper said.

The overwhelming reason for this reluctance appears to be distrust of these vaccines (44%). Reports indicate that people are confused by medical terms and don’t understand how a safe vaccine was developed without cutting corners.

Vaughn has an additional explanation.

“A lot of people want to wait a bit,” Vaughn said.

An ABC poll confirmed it, with 44% of those respondents preferring to wait to see how those receiving the initial vaccines fared before rolling up their own sleeves.

In the Invisibly poll, most respondents said they will return to pre-pandemic activities only when officials say it is safe, while 23% said they would resume normal activities after most people are vaccinated. Until then, 75% said they plan to continue wearing a mask and social distancing. Notably, 25% said there are unlikely to wear a mask after vaccination.

Also, 47% of respondents think children should be required to be vaccinated against COVID-19 before returning to in-person learning. Given the low incidence of COVID-19 among children, 30% said vaccination should not be required for children and 23% were unsure.

According to the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report for January 13“Reported incidence and positive test results among children aged 0–10 years were consistently lower than those in older age groups.” Of the nearly 2.9 million laboratory-confirmed cases of COVID-19 in people younger than age 24 since the outbreak began, about 16% occurred in children aged 14-17; nearly 8% in those 11-13 years old; 11% in those 5-10 years old; and slightly more than 7% in those age 4 or younger.

Larry Corey, professor of medicine, Johns Hopkins Medical School, showed Kaplan-Meier curves concurrent with vaccine roll out that showed differences in the infection rate between vaccinated and unvaccinated individuals for both the Pfizer and Moderna vaccines.

The key to increasing vaccination rates begins with clear communication that translates the medical jargon into everyday language, followed by strategies that deliver ample quantities to vaccine where they are needed and clear guidance as to who is eligible to received the vaccines at given points in time.

For example, Washington state just entered Phase Ib of its vaccination plan and launched an online questionnaire  ( to help people know when and how to get vaccinated.

There’s still some confusion, though. One of the Phase Ib criteria includes people age 50 and older who live in multigenerational households. The definition of “multigenerational” in this context raises questions. The Washington State Department of Health defines it as two or more generations living together, although it’s often defined as three or more generations living together or grandparents caring for grandchildren. By way for example, the Washington State Department of Health says, “Think of a person over 50 who cannot live independently and receives long-term care from a caregiver, lives with someone who works outside the home, or lives with and cares for a grandchild.” Additional guidance is expected.

Regardless, throughout all 50 states and U.S. territories, people are queuing for vaccinations. Now that nearly 17 million doses of the vaccine have been administered, Vaughn said Invisibly plans to conduct another poll “in about a month,” to see whether attitudes have changed.

Indeed many healthcare workers are hesitant mainly siting the politicization of COVID 19. While other like a Jamaican doctor who died of COVID 19 complications sited poor health care treatment. Will you take the vaccine? Why? Why not? Why do you think people remain hesitant?

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Merck ends COVID-19 vaccine program, cites inferior immune responses

Merck said it will focus COVID-19 research and manufacturing efforts on two investigational medicines

Source: Fox Business

Drugmaker Merck & Co on Monday said it will end development of its two COVID-19 vaccines, and will focus pandemic research on treatments, with initial efficacy data on an experimental oral antiviral expected by the end of March.

Merck said in a statement it will record a pretax discontinuation charge in the fourth quarter for vaccine candidate V591, which it acquired with the purchase of Austrian vaccine maker Themis Bioscience, and V590, developed with nonprofit research organization IAVI.

In early trials, both vaccines generated immune responses that were inferior to those seen in people who had recovered from COVID-19 as well as those reported for other COVID-19 vaccines, the company said.


Merck was late to join the race to develop a vaccine to protect against the coronavirus, which has so far killed more than 2 million people and continues to surge in many parts of the world including the United States.

U.S. regulators in December authorized COVID-19 vaccines from Moderna Inc and partners Pfizer Inc and BioNTech SE, and tens of millions of doses of both have so far been administered globally. Rivals Johnson & Johnson, AstraZeneca Plc and others are also racing to develop safe and effective vaccines to protect against the virus.

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Source: Fox Business

Merck said it will focus COVID-19 research and manufacturing efforts on two investigational medicines: MK-7110 and MK-4482, which it now calls molnupiravir.

Molnupiravir, which is being developed in collaboration with Ridgeback Bio, is an oral antiviral being studied in both hospital and outpatient settings. Merck said a phase 2/3 trial of the drug is set to finish in May, but initial efficacy results are due in the first quarter and will be made public if clinically meaningful.

Merck said results from a phase 3 study of MK-7110, an immune modulator being studied as a treatment for patients hospitalized with severe COVID-19, are expected in the first quarter. In December, the company announced a deal to supply MK-7110 to the U.S. government for up to about $356 million. . (Reporting By Deena Beasley Editing by Shri Navaratnam)

What are your thoughts on the Merck COVID drug? Why? Why not?

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Faculty voice: Advocating for human bodies

Dec. 8, 2020
Source: MSU (Michigan State University) Today

Monir Moniruzzaman
Source: MSU (Michigan State University) Today
Shidonna Raven Garden and Cook

Monir Moniruzzaman is an associate professor in the Department of Anthropology in the College of Social Science. His research examines human organ trafficking within the black market, and how to combat this human rights violation. This story is repurposed from the College of Social Science website It was a lifelong goal of mine to become an anthropologist. My bachelor’s and master’s degrees are also in anthropology. When I was a master’s student, I read an article about the global market of human organ trafficking, which is the buying and selling of human body parts on the black market. Before I read that article, I had never thought that such kind of dehumanization and exploitation could happen in human history. I couldn’t believe it. So, I decided to do my Ph.D. in medical anthropology, and write my dissertation on human organ trafficking. I’ve been doing this work for nearly two decades, and I’ve established myself as one of the experts in this field.

As a Ph.D. student, I went to Bangladesh and conducted yearlong ethnographic fieldwork to investigate the illicit trade in human organs, including kidneys, livers and corneas. Before doing my fieldwork, I found that a handful of research came out about the recipients of these organs, most of whom lived in the West. But I wanted to look at the other side of the story — people who are selling their body parts. Who they are, what is the process of selling an organ and how they are living in their damaged bodies. I was drawn into that.

For the first four months, I couldn’t find anyone to talk to. Not even doctors or recipients involved in the trade would disclose who sold them the organs. The sellers were extremely hidden. 

I tried talking to four organ brokers, which was very risky. I was being followed, and I couldn’t go outside after dark. It was a frightening experience. However, with one broker’s help, I was able to interview 33 kidney sellers who sold their kidneys on the black market. These are live people, not cadavers. I learned from them what kind of deception, manipulation, coercion and breach of consent led them to make such a decision.

The brokers basically entrap them, promising them a large amount of money (which they never get in the end),  and lure them in with a story about the “sleeping kidney.” This is a common lie told by brokers, that one kidney sleeps while the other one works, so in the operating room, the doctor can turn on the sleeping kidney and give the other one to another patient who needs one. The brokers present it as a win-win, no-risk situation and a noble way to help other people.

The kidney was the first organ that doctors started performing because the human body has two. That’s why kidneys became the dominant organ we can see in the black market. Recently, however, I published an article about liver trading, as a lobe of liver can be cut off and be transplanted into another body. For that article, I talked to two liver sellers.

They are both young people, still in their twenties. One didn’t know what “liver” meant in English, nor its function in the body. The operation took 20 hours, and he doesn’t have enough money to pay off his post-operative care, and his body doesn’t allow him to do any physically demanding jobs. So, he’s living much worse than before.

I also found that there are cornea sales. I talked to one woman who wanted to sell her cornea because she says she doesn’t need two eyes to see the world. She’s a single mother and works as a housemaid, so she wants to sell a part of her eye to get by. 

I believe that academia is not just for knowledge production: We need to translate our work to enact meaningful changes. For example, I am a member of a task force on organ transplantation at the World Health Organization. We monitor the situation and try to combat this practice worldwide. I was invited by the Vatican and we crafted a resolution that was signed by Pope Francis and distributed around the world. I also gave a talk to the U.S. Congress Human Rights Commission and U.S. Senate Foreign Relation Committee. It’s challenging to curb such an egregious human rights violation. It’s not going to happen overnight, but persistent work can improve the situation.

The Universal Declaration of Human Rights states that all humans on this planet are entitled to certain necessities to live, such as food, water, shelter… We have made some progress towards political rights, but if you look at economic rights, we have failed completely. Most people in the world live in poverty and 10% of world populations live on less than $2 a day or in constant hunger. This has some tragic consequences and that led to human organ trafficking around the world.

We cannot live in a world where human bodies are bought and sold on the market place. It’s dehumanizing, like slavery. As economic inequality increases at an unprecedented level, including in the United States, we cannot create a world where certain populations need to sell their body parts for their physical survival. The poor have every right to keep their body parts intact. In this context, we must think of human rights as bodily rights as well.

Media Contacts

Liz Schondelmayer

The reality of the situation is that not everyone sales their organs voluntarily some organs are stolen and others agree to sell their organs, sharing horror stories of waking up in a tub of ice. While others who do decide to sale their organs wake up to everyone missing and no pay. In some cases perfectly health organs are stolen out of patients bodies in the midst of medical fraud. What should be done to address this market and fraud? Why? Why not?

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‘Must raise voice against forced organ harvesting’

Rasika Bhale MUMBAI
NOVEMBER 04, 2019 01:35 IST
UPDATED: NOVEMBER 04, 2019 01:35 IST

Dr. Torsten Trey at the Mother Teresa Memorial Awards for Social Justice in Mumbai on Sunday.  

Winner of social justice award asks world to take a stand

An organisation that has been fearlessly highlighting the forced organ harvesting in China has been conferred with this year’s Mother Teresa Memorial Awards for Social Justice. The award was presented to Dr. Torsten Trey, founder, Doctors Against Forced Organ Harvesting (DAFOH), in Mumbai on Sunday.

Other winners of the award included Nobel Laureate Kailash Satyarthi, founder of the Bachpan Bachao Andolan; Hasina Khabhih, founder of a non-profit organisation called Impulse; and Rob Williams, CEO of an NGO called War Child, U.K.

DAFOH has been working to create awareness on organ trafficking, primarily about mass killings for organ harvesting. Founded in 2006, DAFOH is a network of independent doctors across the globe. It has been raising its voice against the brutal practice of forced organ harvesting in China, which targets a religious minority called Falun Gong. The community follows the teachings of Master Li Hongzhi, who emphasised on meditation and self-cultivation for spiritual perfection.

‘Tortured minority’

“The Chinese government has been involved in mass persecution of the members of Falun Gong for over two decades. It has deemed them as a superstitious foreign-driven dangerous group of people and sent them to labour camps where they are starved, tortured, brainwashed and made targets of organ harvesting,” Dr. Trey told The Hindu.

Speaking about the origin of DAFOH, he said, “It was in 2006 that I came across the organ trafficking in the Falun Gong community. It was horrible. I was shaken and felt the need to do something. It was then that I came up with DAFOH. I received tremendous support from the medical community.”

DAFOH has a strong network of doctors in Taiwan from where it garners statistical information on forced organ harvesting in China. “The government says that around 10,000-15,000 organ transplants occur every year. However, according to a team of on-field researchers, the number is as high as 60,000. Meanwhile, the estimate for legal organ donations in the country is as less as 130 in six years,” he said.

‘Raise a voice’

Dr. Trey believes that people across the world should raise a voice against this. “It should concern you as a citizen of the world. If we just sit and watch it happen, saying it’s not my country, we are all being complicit in the crime. We need a shift in our thinking. We should discuss it and create awareness to bring about a change.”

A letter from the Editor

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We have been keeping you up-to-date with information on the developments in India and the world that have a bearing on our health and wellbeing, our lives and livelihoods, during these difficult times. To enable wide dissemination of news that is in public interest, we have increased the number of articles that can be read free, and extended free trial periods. However, we have a request for those who can afford to subscribe: please do. As we fight disinformation and misinformation, and keep apace with the happenings, we need to commit greater resources to news gathering operations. We promise to deliver quality journalism that stays away from vested interest and political propaganda.

From diseased to transgenders there are several people with interest in organs. In the midst of a pandemic where many people’s loved one have died in the hospital alone, gives organ harvesting, theft and over all black market a close look. How can minority communities be protected? How does organ harvesting happen right here in the United States?

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COVID-19 Health Care Workers at High Risk for Mental Health Issues


Shidonna Raven Garden and Cook

January 14, 2021
Killian Meara
Source: Contagion Live

Physician heal thyself comes from the Bible. Specifically, it can be found in Luke 4:23 where Jesus quotes a common Jewish phrase of the time, saying, “Ye will surely say unto me this proverb, ‘Physician, heal thyself’.” (KJV).

Frontline workers are a critical aspect to a community’s ability to manage crises and disasters.

Source: Contagion Live
Shidonna Raven Garden and Cook

A recent study investigating the mental health of frontline health care workers has found that more than half of doctors, nurses and emergency responders that are involved in the care of the coronavirus disease 2019 (COVID-19) are potentially at risk for one or more problems like depression, insomnia, anxiety and acute traumatic stress. Findings suggested that the rates of mental health conditions were comparable to rates that have been observed after natural disasters.

The study was conducted by investigators from the University of Utah Health, in collaboration with the University of Arkansas for Medical Sciences; University of Colorado, Colorado Springs; Central Arkansas VA Health Care System; Salt Lake City VA Healthcare System; as well as the National Institute for Human Resilience and was published in the Journal of Psychiatric Research.

“What health care workers are experiencing is akin to domestic combat,” Andrew J. Smith, a corresponding author on the study said. “Although the majority of health care professionals and emergency responders aren’t necessarily going to develop PTSD, they are working under severe duress, day after day, with a lot of unknowns. Some will be susceptible to a host of stress-related mental health consequences. By studying both resilient and pathological trajectories, we can build a scaffold for constructing evidence-based interventions for both individuals and public health systems.”

Investigators collected surveys from 571 health care workers, which included 473 emergency responders and 98 hospital staff. The findings showed that 56% of the participants screened positive for one or more mental health disorders, with the prevalence of each ranging from 15% to 30%.

At the top of the list was insomnia, depression and problematic alcohol use. 36% of the health care workers reported risky alcohol use, with those in direct patient care or supervisory positions at the greatest risk. The authors suggested that offering preventative education on alcohol abuse treatment was a vital aspect needing implementation.

“This pandemic, as horrific as it is, offers us the opportunity to better understand the extraordinary mental stress and strains that health care providers are dealing with right now,” Smith said. “With that understanding, perhaps we can develop ways to mitigate these problems and help health care workers and emergency responders better cope with these sorts of challenges in the future.”

The ‘mental health’ industry historically is unrecognized as a legitimate branch of medicine in the health care industry. The diagnosis are made by and based on subjective votes rather than science. The medications the use to justify their ‘branch of medicine’ is admitted not to cure the disease the are prescribe to treat. What are your thoughts on this article? What are your thoughts on medicating health care professionals who have been on the front line of the pandemic? Why or why not?

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Vaccine rollout hits snag as health workers balk at shots

January 8, 2021
Source: Associate Press

Source: Associate Press, Jae C. Hong
Shidonna Raven Garden and Cook

In this Jan. 7, 2021, file photo, a nurse puts on protective gear in a COVID-19 unit in California. The nation’s biggest immunization rollout in history is facing pushback from an unlikely source: health care workers who witnessed COVID-19′s devastation firsthand but are refusing shots in surprising numbers. (AP Photo/Jae C. Hong, File)

The desperately awaited vaccination drive against the coronavirus in the U.S. is running into resistance from an unlikely quarter: Surprising numbers of health care workers who have seen firsthand the death and misery inflicted by COVID-19 are refusing shots.

It is happening in nursing homes and, to a lesser degree, in hospitals, with employees expressing what experts say are unfounded fears of side effects from vaccines that were developed at record speed. More than three weeks into the campaign, some places are seeing as much as 80% of the staff holding back.

“I don’t think anyone wants to be a guinea pig,” said Dr. Stephen Noble, a 42-year-old cardiothoracic surgeon in Portland, Oregon, who is postponing getting vaccinated. “At the end of the day, as a man of science, I just want to see what the data show. And give me the full data.

Alarmed by the phenomenon, some administrators have dangled everything from free breakfasts at Waffle House to a raffle for a car to get employees to roll up their sleeves. Some states have threatened to let other people cut ahead of health care workers in the line for shots.

“It’s far too low. It’s alarmingly low,” said Neil Pruitt, CEO of PruittHealth, which runs about 100 long-term care homes in the South, where fewer than 3 in 10 workers offered the vaccine so far have accepted it.

Many medical facilities from Florida to Washington state have boasted of near-universal acceptance of the shots, and workers have proudly plastered pictures of themselves on social media receiving the vaccine. Elsewhere, though, the drive has stumbled.

While the federal government has released no data on how many people offered the vaccines have taken them, glimpses of resistance have emerged around the country.

In Illinois, a big divide has opened at state-run veterans homes between residents and staff. The discrepancy was worst at the veterans home in Manteno, where 90% of residents were vaccinated but only 18% of the staff members.

In rural Ashland, Alabama, about 90 of some 200 workers at Clay County Hospital have yet to agree to get vaccinated, even with the place so overrun with COVID-19 patients that oxygen is running low and beds have been added to the intensive care unit, divided by plastic sheeting.

The pushback comes amid the most lethal phase in the outbreak yet, with the death toll at more than 350,000, and it could hinder the government’s effort to vaccinate somewhere between 70% and 85% of the U.S. population to achieve “herd immunity.

Administrators and public health officials have expressed hope that more health workers will opt to be vaccinated as they see their colleagues take the shots without problems.

Oregon doctor Noble said he will wait until April or May to get the shots. He said it is vital for public health authorities not to overstate what they know about the vaccines. That is particularly important, he said, for Black people like him who are distrustful of government medical guidance because of past failures and abuses, such as the infamous Tuskegee experiment.

Medical journals have published extensive data on the vaccines, and the Food and Drug Administration has made its analysis public. But misinformation about the shots has spread wildly online, including falsehoods that they cause fertility problems.

Stormy Tatom, 30, a hospital ICU nurse in Beaumont, Texas, said she decided against getting vaccinated for now “because of the unknown long-term side effects.”

“I would say at least half of my coworkers feel the same way,” Tatom said.

There have been no signs of widespread severe side effects from the vaccines, and scientists say the drugs have been rigorously tested on tens of thousands and vetted by independent experts.

States have begun turning up the pressure. South Carolina’s governor gave health care workers until Jan. 15 to get a shot or “move to the back of the line.” Georgia’s top health official has allowed some vaccines to be diverted to other front-line workers, including firefighters and police, out of frustration with the slow uptake.

“There’s vaccine available but it’s literally sitting in freezers,” said Public Health Commissioner Dr. Kathleen Toomey. “That’s unacceptable. We have lives to save.”

Nursing homes were among the institutions given priority for the shots because the virus has cut a terrible swath through them. Long-term care residents and staff account for about 38% of the nation’s COVID-19 fatalities.

In West Virginia, only about 55% of nursing home workers agreed to the shots when they were first offered last month, according to Martin Wright, who leads the West Virginia Health Care Association.

“It’s a race against social media,” Wright said of battling falsehoods about the vaccines.

Ohio Gov. Mike DeWine said only 40% of the state’s nursing home workers have gotten shots. North Carolina’s top public health official estimated more than half were refusing the vaccine there.

SavaSeniorCare has offered cash to the 169 long-term care homes in its 20-state network to pay for gift cards, socially distanced parties or other incentives. But so far, data from about a third of its homes shows that 55% of workers have refused the vaccine.

CVS and Walgreens, which have been contracted by a majority of U.S. nursing homes to administer COVID-19 vaccinations, have not released specifics on the acceptance rate. CVS said that residents have agreed to be immunized at an “encouragingly high” rate but that “initial uptake among staff is low,” partly because of efforts to stagger when employees receive their shots.

Some facilities have vaccinated workers in stages so that the staff is not sidelined all at once if they suffer minor side effects, which can include fever and aches.

The hesitation isn’t surprising, given the mixed message from political leaders and misinformation online, said Dr. Wilbur Chen, a professor at the University of Maryland who specializes in the science of vaccines.

He noted that health care workers represent a broad range of jobs and backgrounds and said they are not necessarily more informed than the general public.

“They don’t know what to believe either,” Chen said. But he said he expects the hesitancy to subside as more people are vaccinated and public health officials get their message across.

Some places have already seen turnarounds, such as Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana.

“The biggest thing that helped us to gain confidence in our staff was watching other staff members get vaccinated, be OK, walk out of the room, you know, not grow a third ear, and so that really is like an avalanche,” said Dr. Catherine O’Neal, chief medical officer. “The first few hundred that we had created another 300 that wanted the vaccine.”


Contributing to this report were Associated Press writers Jake Bleiberg in Dallas; Heather Hollingsworth in Mission, Kansas; Janet McConnaughey in New Orleans; Candice Choi in New York; Kelli Kennedy in Fort Lauderdale, Florida; Jay Reeves in Birmingham, Alabama; Brian Witte in Annapolis, Maryland; Jeffrey Collins in Columbia, South Carolina; John Seewer in Toledo, Ohio; Melinda Deslatte in Baton Rouge, Louisiana; and Bryan Anderson in Raleigh, North Carolina.

Why are so many medical professionals one of the main communities hesitant to take a vaccine created within their own industry? Some say it was politicized? Others say it has not been adequately tested? What do you say?

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