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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.

G.O.P. Faces Risk From Push to Repeal Health Law During Pandemic – The New York Times

“People now see a clear and present threat when others don’t have health care,” he said. “Republicans have no response to that because their entire worldview on health care is built on an assumption that’s now out of date.”

And with Mr. Trump making dubious claims about health care — like suggesting people inject or drink bleach, and promoting an unproven malaria drug — Democrats are seeking to paint him and his party as ignorant on an important issue.

In a recent survey, Mr. Ayres asked swing-state voters how government should help workers who have recently lost insurance coverage. The poll found that 47 percent supported a major government expansion of health care, 31 percent believed the best option for laid-off workers was to go on Medicaid, and only 16 percent preferred federal subsidies for Affordable Care Act premiums.

Based on that research, and given the Republican inclination to favor a private-sector approach, Mr. White, who is president of a business-oriented coalition called the Council for Affordable Health Coverage, has called for the government to help pay for premiums under COBRA, the program that allows unemployed workers to buy into their former employers’ plan.

“Republicans must offer private market coverage solutions that are preferable to Medicaid (which is now more popular than Obamacare),” Mr. White wrote in a policy memo.

Ms. Pelosi’s bill is aimed at shoring up the Affordable Care Act, which she helped muscle through Congress during her first speakership, and reducing premiums, which are skyrocketing. Ms. Pelosi had intended to unveil the measure in early March, for the health law’s 10th anniversary, at a joint appearance with former President Barack Obama. But the event was canceled amid the mounting coronavirus threat.

The bill would expand subsidies for health care premiums under the Affordable Care Act so families would pay no more than 8.5 percent of their income for health coverage; allow the government to negotiate prices with pharmaceutical companies; provide a path for uninsured pregnant women to be covered by Medicaid for a year after giving birth; and offer incentives to those states that have not expanded Medicaid under the law to do so.

One thing it will not have, aides to Ms. Pelosi say, is a “public option” to create a government-run health insurer, an idea embraced by former Vice President Joseph R. Biden Jr., the presumptive Democratic presidential nominee. The bill being introduced by Ms. Pelosi has no chance of passing the Senate and becoming law, but it will give Democrats another talking point to use against Republicans.

The health law has already survived two court challenges. In the current Supreme Court case, 20 states, led by Texas, argue that when Congress eliminated the so-called individual mandate — the penalty for failing to obtain health insurance — lawmakers rendered the entire law unconstitutional. The Trump administration, though a defendant, supports the challenge.

The justices are expected to hear arguments in the fall, just as the presidential and congressional races are heating up. But Mr. Cole, the Republican congressman, said other issues related to the coronavirus pandemic would also be at play in November.

“If we look like we’re on top of it in September or October and we’re on the way to a vaccine, then it will break to the president’s advantage,” he said. “If we’re in the middle of a second wave, obviously not.”

This content was originally published here.

Virginia Health Dept Urges Citizens to Snitch on Churches and Gun Ranges | Dan Bongino

Virginia’s Department of Health is joining others who have encouraged their state’s citizens to snitch on each other – but only for select reasons.

As the Washington Free Beacon’s Andrew Stiles reports:

The Virginia Department of Health is encouraging citizens to lodge anonymous complaints against small businesses for violating Gov. Ralph Northam’s (D.) coronavirus-related restrictions on public gatherings.

Virginia residents can report alleged violations of Northam’s executive orders regarding the use of face masks and capacity requirements in indoor spaces via a portal on the health department’s website, a practice commonly known as “snitching.” 

The webpage gives snitchers several options regarding the “type of establishment” on which they are intending to snitch. These include “indoor gun range” and “religious service,” among others. Republican state senator Mark Obenshain expressed concern that churches and gun ranges were “specifically” singled out, noting, “there is nothing to prevent businesses from snitching on competitors, or to prevent the outright fabrication of reports.”

Meanwhile, when protesters were out in full force in the tens of thousands earlier in the month, VA’s health department merely encouraged them to wear masks and wash their hands. They also recommended social distancing, which would obviously be impossible in such an environment. “We support the right to protest, and we also want people to be safe” they said.

What do they think is going to do more to spread the virus, a dozen people at a gun range, or tens of thousands in the streets? Even if those at the gun range transmitted the virus at a higher rate, the latter would still infect more people due to sheer volume.

It is indeed the case that coronavirus cases are on the rise nationally (as you’d expect after weeks of mass protest), but not all cases are created equal. The vast majority of cases are mild and asymptomatic, and the median age of those infected is drastically lower than it was months ago (meaning most new cases are among those least likely to die of the virus).

That’s evident in Florida, where cases are exploded – but the death rate has precipitously declined because the average person infected is now only 37 years old. In March it averaged in the mid fifties.

In many states more people above the age of 100 have died of the virus than those under 40. On the day coronavirus deaths peaked, for every person aged 24 or younger that died of the virus, 319 people above the age of 85 died of it.

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.

Motivated by his son Beau, Joe Biden pledges help for veterans with burn pit health issues – CBS News

Throughout his presidential campaign, one of the most striking elements of Joe Biden‘s appeal has been his empathy. The personal tragedies he has suffered inform his interactions with voters who are also experiencing loss. And his sorrow could also guide policy decisions as commander-in-chief, offering assistance to veterans who may be suffering from service-related medical conditions — as he believes his son did. 

With a familiar quiver in his voice, Biden regularly on the campaign trail shares memories of his son Beau, who died in 2015 from glioblastoma brain cancer. A handful of times Biden detailed how he thinks his son’s cancer may have been related in part to the large, military base burn pits during his 2009 service in the Iraq War.

“He volunteered to join the National Guard at age 32 because he thought he had an obligation to go,” Biden told a Service Employees International Union convention in October. “And because of exposure to burn pits — in my view, I can’t prove it yet — he came back with Stage Four glioblastoma.”

Biden’s precise language — “in my view, I can’t prove it yet” — appears to be intentional as he lends his voice to the ongoing and somewhat controversial debate over whether the burn pits caused lasting health issues for American veterans.

“We don’t have 20 years”  

As the Iraq and Afghanistan military operations grew, so did the installations of bigger burn pits on military bases, rather than the smaller burn barrels that had previously been used. The pits were meant to dispose of everything from garbage to sensitive documents and even more hazardous materials. 

“They build as big as this auditorium,” Biden said to a CNN town hall audience in February, “It’s about 8-to-10-feet-deep and they put everything in it they want to dispose of and can’t leave behind, from flammable fuel to plastics to all range of things.”

But in the middle of a war zone, concern about the burn pits was sometimes considered secondary to other safety issues. 

“You’ve got dust storms, you have the enemy, you have all sorts of things going on that some smoke in the air doesn’t really seem like as important of an issue at the moment,” Jim Mowrer, who befriended Beau at Camp Victory in Iraq in 2009, told CBS News. Other times, Mowrer, 34, who now serves as co-chair for the Veterans for Biden committee, said he tried to filter the air by wearing a face covering.

“The concern factor became more of a concern after we came home,” Beau’s overseas boss, Command JAG Kathy Amalfitano, 59, told CBS News. Amalfitano said she remembers discussing the burn pits with Beau a few times, but added “I know our thought process was that this was part of the deployment.”

Biden is not alone in thinking burn pits impacted soldiers’ health.

Since 2014, more than 200,000 Afghanistan and Iraq War veterans have registered in the “Airborne Hazards and Open Burn Pit Registry” run by the Department of Veterans Affairs (VA), detailing exposure to service-related airborne hazards from burn pit smoke and other pollution.

And while these veteran health concerns seem widespread, the VA’s policy only recognizes “temporary” irritation from burn pit exposure. Citing a range of studies, the department states that “research does not show evidence of long-term health problems from exposure to burn pits.”

One ongoing study is by National Jewish Health and funded by the Defense Department, and is examining lung issues and has yielded “a spectrum of diseases that are related to deployment,” the study’s principal investigator Dr. Cecile Rose told CBS News last year. ” [The diseases] weren’t there before, and they are clearly there after people have returned from these arid and extreme environments.” However, Rose cautioned that findings are complicated by other possible culprits, like desert dust and diesel exhaust.

Advocates for veterans say not enough is being done to address veterans’ health claims regarding the burn pits.

From 2007 to 2018, the VA processed 11,581 disability compensation claims that had “at least one condition related to burn pit exposure,” a department spokesman told The New York Times last year. But the department only accepted 2,318 of these claims. The department said the rest did not show evidence connected to military service or the condition in the claim was not “officially diagnosed,” the Times noted. 

The VA did not respond to CBS News’ request this week for updated numbers.

“I always push back on…the VA administration folks who try to use the ‘perfect study’ as a criteria to show proof,” California Representative Raul Ruiz, a doctor and vocal burn pits critic, told CBS News. Ruiz criticized the VA’s reliance on long-term studies to validate clams. 

“We don’t have 20 years because then these veterans are going to be dying without the care they need,” Ruiz said.

A report five years ago by a Defense Department inspector general said it was “indefensible” that military personnel “were put at further risk from the potentially harmful emissions from the use of open-air burn pits.” But the Supreme Court last year rejected a victims’ lawsuit against contractors who oversaw some of the burn pits.

“If these [burn pits] had happened in the United States, the Environmental Protection Agency and Centers for Disease and Control would have this corrected immediately,” said Iraq War veteran Jeremy Daniels, adding he believes burn pits caused him to be wheelchair bound.

Modern-day “Agent Orange”?

Biden on the campaign trail invoked the healthcare struggles of Vietnam veterans exposed to the herbicide Agent Orange to explain the need to address burn pits.

“You were entitled to military compensation if you could prove that Agent Orange caused whatever the immune system damage was to you,” Biden said, accenting the word “prove” during a Veterans Day town hall in Oskaloosa, Iowa. “But you had to prove it and it’s very hard to prove.”

After reading a book on burn pits detailing Beau’s case, Biden has advocated easing this burden of proof for veterans who say the burn pits have harmed them in some way, as he first told PBS.

Biden has a plan that pushes for congressional approval to expand the list of “presumptive conditions”– meaning veterans’ health conditions would be presumed causal to the burn pits making them eligible for greater VA healthcare. He also aims to expand the claim eligibility period for toxic exposure conditions to five years after service instead of one year and increase federal research by $300 million in part to focus on toxic exposure from burn pits.

This push has intensified in recent years on Capitol Hill, and bills funding more research into burn pits have already been signed by President Trump. The recent National Defense Authorization Act also required the Department of Defense to implement a plan to phase out burn pits and disclose the locations of the still-operating pits. Enclosed incinerators are an alternative.

There were nine active military burn pits in the Middle East as of last year, according to the Defense Department’s April 2019 “Open Burn Pit Report to Congress” shared with CBS News, though some advocates think the actual number is higher. 

Some veterans expressed doubt that recent efforts will lead to more aid for veterans exposed to burn pits, given the slow-moving bureaucracy and concern over higher health care costs. And others question whether a Biden administration would act more decisively than the Obama administration, which primarily focused on long-term studies.

But Biden says that his motivation is far greater than his family’s own personal loss, and that the “only sacred” commitment the United States has is to American soldiers.

“It’s not because my son died…[he] went from very, very healthy but he lived in the bloom of those burn pits for a long time. He’s passed—it doesn’t affect him,” Biden said in Oskaloosa. “But the point is that every single veteran shouldn’t have to prove and wait until science demonstrates beyond a doubt…We just have to change the way we think a little bit.”

May 30 will mark the five-year anniversary of Beau Biden’s death.

This content was originally published here.

Enter For Your Chance to Win Invisalign For Your Child – SheKnows

When the final school bell rings and two months of unstructured free time stretch out before your kids, back-to-school season may feel like a lifetime away. But in reality, it’s just a few weeks, meaning now is the time to schedule all those late-summer doctors appointments. And if your child is one of the millions of kids in North America who will likely seek orthodontic help this year (according to the American Association of Orthodontists), you can add the orthodontist to that list.

With more than 6 million patients, parents and teens are increasingly choosing Invisalign treatment for everything from simple to complex cases. The clear aligners not only have the confidence-boosting benefit of being less noticeable, but because they are removable, they make it easier for teens to enjoy every type of food and care for teeth. They also are more convenient for teens who play instruments and safer for those who play sports. In fact, with Invisalign treatment, there are no emergency visits due to broken wires of brackets. If you want to learn more about Invisalign treatment, click here.

This summer SheKnows has partnered with the Invisalign brand to give parents a chance to win free Invisalign treatment for their child. Enter below for your chance to win. 

And once you’ve entered, follow the Invisalign brand on Instagram for more smiles. 

This post was created by SheKnows for Invisalign Brand. 

This content was originally published here.

Ontario’s health minister shopped at Toronto LCBO while awaiting COVID-19 test results | CP24.com

Ontario’s health minister says she was following the advice of medical professionals when she decided to shop at a Toronto LCBO on Wednesday afternoon while awaiting her COVID-19 test results.

Health Minister Christine Elliott and Premier Doug Ford, who have since tested negative for the virus, underwent COVID-19 testing on Wednesday after learning that the province’s education minister, Stephen Lecce, had earlier come in contact with someone who tested positive for the virus.

Ford and Elliott, who had held a joint press conference with Lecce one day earlier, decided to skip their daily briefing at Queen’s Park on Wednesday afternoon out of an abundance of caution.

Elliott also cancelled an appearance at a Brampton mobile testing site that was scheduled for 3 p.m.

Lecce released a statement shortly before 2 p.m. on Wednesday confirming that his test results had come back negative and about an hour-and-a-half later, Elliott was seen shopping at an LCBO near Dupont Street and Spadina Avenue.

A photo sent to CP24 shows Elliott, who is wearing a surgical mask, standing beside a basket and looking at the store’s VQA wine selection.

“Minister Lecce’s results came back negative before I went for testing and so while there was no real need for me to go to be tested, I had made a public commitment to do so and so that’s where I went,” Elliott told reporters at Queen’s Park on Thursday.

“I went and while I was at the assessment centre having the test, I was advised that because I had not directly been in contact with anyone with COVID that I did not need to self-isolate…That was the medical advice I was given and that is what I did and my test results came back negative of course.”

Elliott and Ford returned to Queen’s Park for their daily COVID-19 update on Thursday afternoon.

“To be clear, both Premier Ford and Minister Elliott have had no known contact with anyone who has tested positive for COVID-19, and as a result, there is no need for either of them to self-isolate,” a statement from the premier’s office read.

“They will continue to follow public health guidelines.”

Lecce’s office confirmed Thursday that he will continue to self-isolate.

“Minister Lecce is feeling well and continues to work from home. He is following the advice of his doctor by continuing to monitor for any symptoms,” a statement from the education minister’s office read.

“Out of an abundance of caution, although the exposure risk was extremely low, he will be self-isolating for the remainder of the 14 days since the time of exposure, on June 6. The Minister again would like to offer his sincere thanks to the team at UHN and everyone yesterday who sent positive thoughts and messages.”

Public health experts have cautioned that negative test results are not always an indication that a person isn’t infected with the virus, especially when tests are conducted a short time after exposure.

Those who have tested negative for the virus are still advised to monitor for symptoms as the virus has an incubation period of 14 days.

“As we outlined our testing criteria at the assessment centres… if you have signs and symptoms and you’re suspected of being a COVID case, you will get your test and then you are supposed to stay in self-isolation until you get results,” Dr. David Williams, Ontario’s chief medical officer of health, said at a news conference on Thursday.

“Other criteria, you say, ‘Well, I was in contact with a known positive.’ That is another reason to get tested and you still have to self-isolate until you get that result back, including people who say, ‘Well I’m not sure but I was in a highly risky area, I don’t know.’’”

He noted that the rules are different for people who are not experiencing symptoms of the virus and have not been in contact with a known case.

“Testing asymptomatic people… say 5,000 workers, none of them have symptoms, none of them are cases, we are not going to say all 5,000 wait for five, six days to get results back. They just continue going to work because it is asymptomatic testing,” he added.

“They have no signs and symptoms, they have no contact with a case, no possible contact with a case, and there is no evidence of an outbreak. So it is a different situation altogether.”

This content was originally published here.

Arizona coronavirus: Banner Health reaches capacity on ECMO lung machines

Arizona’s largest health system reaches capacity on ECMO lung machines as COVID-19 cases in the state continue to climb

Stephanie Innes
Arizona Republic
Published 2:24 PM EDT Jun 6, 2020
Coronavirus 2019-nCoV vials
solarseven, Getty Images/iStockphoto

Hospitalizations in Arizona of patients with suspected and confirmed COVID-19 have hit a new record and the state’s largest health system has reached capacity for patients needing external lung machines.

Arizona’s total identified cases rose to 25,451 on Saturday according to the most recent state figures. That’s an increase of 4.4%, since Friday when the state reported 24,332 identified cases and 996 deaths. 

Some experts are saying that Arizona is experiencing a spike in community spread, pointing to indicators that as of Saturday continued to show increases — the number of positive cases, the percent of positive cases and hospitalizations.

Also, ventilator and ICU bed use by patients with suspected and confirmed COVID-19 in Arizona hit record highs on Friday, the latest numbers show.

Statewide hospitalizations as of Friday jumped to 1,278 inpatients in Arizona with suspected and confirmed COVID-19, which was a record high since the state began reporting the data on April 9. It was the fifth consecutive day that hospitalizations statewide have eclipsed 1,000.

On Saturday morning, officials with Banner Health notified the Arizona centralized COVID-19 surge line that  Banner hospitals are unable to take any new patients needing ECMO — extracorporeal membrane oxygenation.

ECMO is an an external lung machine that’s used if a patient’s lungs get so damaged that they don’t work, even with the assistance of a ventilator.

The Arizona surge line is a 24/7 statewide phone line for hospitals and other providers to call when they have a COVID-19 patient who needs a level of care they can’t provide. An electronic system locates available beds and appropriate care, evenly distributing the patients so that no one system or hospital is overwhelmed by patients.

Banner Health, which is the state’s largest health system, is also nearing its usual ICU bed capacity, officials said Friday and if current trends continue is at risk of exceeding capacity. Banner Health typically has about half of Arizona’s suspected and confirmed COVID-19 hospitalized patients.

The state’s death toll on Saturday was 1,042, with 30 new deaths reported. On Friday the tally for the first time reached four figures — 1,012 total deaths —  three weeks after Gov. Doug Ducey’s stay-at-home order expired.

What we know about the known deaths, based on the state data:

Ducey said at a Thursday news conference that “we mourn every death in the state of Arizona.”

“… I’m confident that we’ve made the best and most responsible decisions possible, guided by public health, the entire way,” Ducey said.  

Saturday marked Arizona’s fifth consecutive day of high numbers of new coronavirus cases reported, with 1,119 positives reported Saturday, a record 1,579 reported on Friday, 530 on Thursday, 973 on Wednesday and 1,127 new cases reported on Tuesday.

Dr. Cara Christ, director of the Arizona Department of Health Services, said at a Thursday news conference that the increase in cases was expected given increased testing and reopening. 

“As people come back together, we know that there is going to be transmission of COVID-19,” Christ said. “We are seeing an increase in cases, and so we will continue to monitor at this time. But we have to weigh the impacts of the virus versus the impacts of what a stay-at-home order can have on long-term health as well.”

Before this week, new cases reported daily have typically been in the several hundreds. The state has reported new cases each day, typically in the several hundreds. The daily increase in case numbers also reflects a lag in obtaining results from the time a test was conducted.

Additional deaths are reported each day as well and have varied between single- and double-digit increases. The number of deaths reported each day represents the additional known deaths reported by the Health Department that day, but could have occurred weeks prior and on different days.

The date with the most deaths in a single day so far is April 30 with 26 deaths, followed by May 7 with 25 deaths and April 23 and May 8 with 24 deaths each. Next comes April 20 with 23 deaths and April 19, May 3 and May 5 with 22 deaths on each of those days, according to Friday’s data, which is likely to change in the days ahead as more deaths are identified.

Maricopa County’s confirmed case total was at 12,761 on Saturday according to state numbers. 

“We are seeing some indicators that the number of cases in Maricopa County are starting to rise,” county spokesman Ron Coleman said this week in an email. “This is in addition to an increase from increased testing.”

The number of Arizona cases likely is higher than official numbers because of limits on supplies and available tests, especially in early weeks of the pandemic. 

The percentage of positive tests per week increased from 5% a month ago to 6% three weeks ago to 9% two weeks ago, and 11% last week. The ideal trend is a decrease in percent of positives tests out of all tests. 

In addition to an increase in hospitalizations, ventilator use in Arizona by suspected and positive COVID-19 patients statewide jumped to 292 on Friday, which was the highest number reported since the state data began on April 9.

Also, ICU bed use by patients with positive and suspected COVID-19 on Friday was 391 — a record high and the 11th consecutive day that the number has been higher than 370.

The latest Arizona data

As of Saturday morning, the state reported death totals from these counties: 489 in Maricopa, 205 in Pima, 85 in Coconino, 72 in Navajo, 57 in Mohave, 49 in Apache, 41 in Pinal, 24 in Yuma, six in Yavapai, 4 in Cochise, three in Santa Cruz and three in Gila.

La Paz County officials reported two deaths and Graham County reported one death, although the state site listed them as just having fewer than three deaths. Greenlee County reported no deaths.

Of the statewide identified cases overall, 47% are men and 53% are women. But men made up a higher percentage of deaths, with 54% of the deaths men and 46% women as of Saturday.

Overall, Arizona has 354 cases and 14.49 deaths per 100,000 residents, according to state data.

The scope of the outbreak differs by county, with the highest rates in Apache, Navajo, Santa Cruz, Yuma and Coconino counties.

Of all confirmed cases, 9% are younger than 20, 42% are aged 20 to 44, 16% are aged 45 to 54, 14% are aged 55 to 64 and 17% are over 65. This aligns with the proportions of testing done for each age range.

The state Health Department website said both state and private laboratories have completed a total of  271,646 diagnostic tests for COVID-19, and 109,266 serology, or antibody, tests.

Most COVID-19 diagnostic tests come back negative, the state’s dashboard shows, with 7.2% positive. For serology tests, 3% have come back positive.

Maricopa County’s Department of Public Health provided more detailed information on a total of 12,685 cases Friday (the state reported the county case total at 12,761):

Cases rise in other counties

According to Friday’s state update, Pima County reported 2,950 identified cases. Navajo County reported 2,152 cases, while Yuma County reported 1,850; Apache County 1,692; Coconino County 1,267; Pinal County 1,067; Santa Cruz County 530; Mohave County 485; and Yavapai County 326. 

La Paz County reported 158 cases, Cochise County 122, Gila County 43, Graham County 39 and Greenlee County nine, according to state numbers.

The Navajo Nation reported a total of 5,808 cases and at least 269 confirmed deaths as of Friday. The Navajo Nation includes parts of Arizona, New Mexico and Utah.

237 cases in Arizona prisons

The Arizona Department of Corrections’ online dashboard said 237 inmates had tested positive for COVID-19 as of Friday, up from 198 one day prior. 

The cases were at these eight facilities: 75 in Florence, 97 in Yuma, 28 in Tucson, 12 in Phoenix, nine in Marana, six in Eyman, six in Perryville, two in Kingman and two in Lewis.

Four inmate deaths have been confirmed — two in Florence and two in Tucson, and three deaths are under investigation, the dashboard says.

Ninety-nine staff members have self-reported positive for the virus, and 69 have been certified as recovered, the department said. 

Both legal and nonlegal visitations have been suspended through June 13, at which point the department will reassess. Temporary video visitation will be available to approved visitors and inmates who have visitation privileges, the department announced. Inmates are eligible for one 15-minute video visit per week. CenturyLink also is giving inmates two additional 15-minute calls for free during each week visitation is restricted.

Separately, the Maricopa County Jail system as of Friday was reporting 30 inmates who had tested positive for COVID-19, county officials said. That was up from six positive inmates one week prior.

Arizona Republic reporter Alison Steinbach contributed to this article

Reach the reporter at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes

Support local journalism. Subscribe to azcentral.com today.

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44 Black Mental Health Support Resources for Anyone Who Needs Them | SELF

Black lives matter. Black bodies matter. Black mental health matters. This latest string of rampant and wanton brutality against Black people flies in the face of these indisputable truths. As a Black woman myself, I’ve spent years trying to process the violence and racism that are part and parcel of living in this country in this skin. But I’ve never had to do it during a pandemic that, of course, is decimating Black lives, health, and communities the most.

In my years as a mental health reporter and editor, I’ve been heartened to slowly see the collection of mental health resources for Black people start to grow. It’s still not where it needs to be, but there is solidarity and support out there if you need help processing what’s happening (and there’s nothing weak about needing it, either). Here’s a list of resources that may help if you’re looking for mental health support that validates and celebrates your Blackness.

It starts with people to follow on Instagram who regularly drop mental health gems, then goes into groups and organizations that do the same, followed by directories and networks for finding a Black mental health practitioner. Lastly, I’ve added a few tips to keep in mind when seeking out this kind of mental health support, especially right now.

People to follow

Alishia McCullough, L.P.C.: McCullough’s Instagram places an emphasis on Black mental wellness and self-love, along with social justice issues like fat liberation. She also posts about participating in live virtual panels on issues like living with an abuser while social distancing and having to live with toxic family during the new coronavirus crisis, so if you’re craving that kind of content, consider following along.

Bassey Ikpi: Ikpi is a mental health advocate who I first became familiar with when she appeared on The Read podcast, where she talked about her now best-selling debut essay collection, I’m Telling the Truth But I’m Lying, in which she writes about her experiences having bipolar II and anxiety. Ikpi is also the founder of the Siwe Project, a global non-profit that increases awareness around mental health in people of African descent.

Cleo Wade: The best-selling author of Heart Talk and Where to Begin: A Small Book About Your Power to Create Big Change in Our Crazy World, Wade’s poetic Instagram dispatches offer quiet meditations on life, love, spirituality, current events, relationships, and finding inner peace.

Donna Oriowo, Ph.D.: I first heard about Oriowo, a sex and relationship therapist, when a friend told me I had to listen to a recent Therapy for Black Girls podcast episode where Oriowo discussed whether Issa and Molly can repair their friendship on Insecure. Oriowo shared so much insight into Issa and Molly’s psyches that I was having lightbulb moment after lightbulb moment. And as a sex and relationship therapist, her Instagram feed destigmatizes Black sexuality and relationships specifically, which is essential.

Jennifer Mullan, Psy.D.: Mullan’s mission is, as her Instagram handle so succinctly sums up, decolonizing therapy. Check out her feed for ample conversation about how mental health (and access to related services) are impacted by trauma and systemic inequities, along with hope that healing is indeed possible.

Jessica Clemons, M.D.: Dr. Clemons is a board-certified psychiatrist who spotlights Black mental health. Her Instagram encompasses everything from mindfulness to motherhood, and her live Q + As and #askdrjess video posts really make it feel like you’re not only following her, but connecting with her, too.

Joy Haven Bradford, Ph.D.: Bradford is a psychologist who aims to make discussions about mental health more accessible for Black women, particularly by bringing pop culture into the mix. She’s also the founder of Therapy for Black Girls, a much-loved resource that includes a great Instagram feed and podcast.

Mariel Buquè, Ph.D.: Click the follow button if you could use periodic “soul check” posts asking how your soul is holding up, gentle ways to practice self-care, help sorting through your feelings, advice on building resilience, and so much more.

Morgan Harper Nichols: If you don’t already follow Nichols but like stirring art mixed with uplifting messages, you’re in for a treat. Her Instagram feed is a swirly, colorful dream of what she describes as “daily reminders through art”—reminders of how valid it is to still seek joy, and of your worth, and of the fact that “small progress is still progress.”

Nedra Glover Tawwab: In Tawwab’s Instagram bio, the licensed clinical social worker describes herself as a “boundaries expert.” That expertise is critical right now, given that safeguarding our mental health as much as possible pretty much always requires firm boundaries. Tawwab also holds weekly Q+A sessions on Instagram, so stay tuned to her feed if you have a question you’d like to submit.

Thema Bryant-Davis, Ph.D.: A licensed psychologist and ordained minister, some of Bryant-Davis’s clinical background focuses on healing trauma and working at the intersection of gender and race. If you happen to be avoiding Twitter as much as possible for the sake of your mental health, like I am, you might like that her feed is mainly a collection of her great mental health tweets that you would otherwise miss.

Brands, collectives, and organizations to follow

Balanced Black Girl: This gorgeous feed features photos and art of Black people along with summaries of their podcast episode topics, worthwhile tweets you can see without having to scroll through Twitter, and advice about trying to create a balanced life even in spite of everything we’re dealing with. Balanced Black Girl also has a great Google Doc full of more mental health and self-care resources.

Black Female Therapists: On this feed, you’ll find inspirational messages, self-care Sunday reminders, and posts highlighting various Black mental health practitioners across the country. They have also recently launched an initiative to match Black people in need with therapists who will do two to three free virtual sessions.

Black Girls Heal: This feed focuses on Black mental health surrounding self-love, relationships, and unresolved trauma, along with creating a sense of community. (Like by holding “Saturday Night Lives” on Instagram to discuss self-love.) Following along is also an easy way to keep track of the topics on the associated podcast, which shares the same name.

Black Girl in Om: This brand describes their vision as “a world where womxn of color are liberated, empowered & seen.” On their feed, you can find helpful resources like meditations, along with a lot of joyful photos of Black people, which I personally find incredibly restorative at this time.

Black Mental Wellness: Founded by a team of Black psychologists, this organization offers a ton of mental health insight through posts about everything from destigmatizing therapy, to talking about Black men’s mental health, to practicing gratitude, to coping with anxiety.

Brown Girl Self-Care: With a mission described as “Help Black women healing from trauma go from ‘every once in a while’ self-care to EVERY DAY self-care,” this feed features tons of affirmations and self-care reminders that might help you feel a little bit better. Plus, in June, they’re running a free virtual Self-Care x Sisterhood circle every Sunday.

Ethel’s Club: This social and wellness club for people of color, originally based in Brooklyn, has pivoted hard during the pandemic and now offers a digital membership club featuring virtual workouts, book clubs, wellness salons, creative workshops, artist Q+As, and more. Membership is $17 a month, or you can follow their feed for free tidbits if that’s a better option for you.

Heal Haus: This cafe and wellness space in Brooklyn has of course closed temporarily due to the pandemic. In the meantime, they’ve expanded their online offerings. Follow their Instagram to stay up to date with what they’re rolling out, like their free upcoming Circle of Care for Black Womxn on June 5.

The Hey Girl Podcast: This podcast features Alexandra Elle, who I mentioned above, in conversation with various people who inspire her. Its Instagram counterpart is a pretty and calming feed of great takeaways from various episodes, sometimes layered over candy-colored backgrounds, other times over photos of the people Elle has spoken to.

Inclusive Therapists: This community’s feed specializes in regular doses of mental health insight, a lot of which seems especially geared towards therapists. With that said, you don’t have to be a therapist to see the value in posts like this one that notes, “You are whole. The system is broken.”

The Loveland Foundation: Founded by writer, lecturer, and activist Rachel Elizabeth Cargle, The Loveland Foundation works to make mental health care more accessible for Black women and girls. They do this through multiple avenues, such as their Therapy Fund, which partners with various mental health resources to offer financial assistance to Black women and girls across the nation who are trying to access therapy. Their Instagram feed is a great mix of self-care tips and posts highlighting various Black mental health experts, along with information about panels and meditations.

The Nap Ministry: If you ever feel tempted to underestimate the pure power of just giving yourself a break, The Nap Ministry is a great reminder that, as they say, “rest is a form of resistance.” Rest also allows for grieving, which is an unfortunately necessary practice as a Black person in America, especially now. In addition to peaceful and much-needed photos of Black people at rest, there are great takedowns of how harmful grind/hustle culture can be to our health.

OmNoire: Self-described as “a social wellness club for women of color dedicated to living WELL,” this mental health resource actually just pulled off a whole virtual retreat. Follow along for affirmations, self-care tips, and images that are inspirational, grounding, or both. (Full disclosure: I went on a great OmNoire retreat a year ago.)

Saddie Baddies: Gorgeous feed, gorgeous mission. Along with posts exploring topics like respectability politics, obsessive-compulsive disorder, self-harm, and loneliness, this Instagram features beautiful photos of people of color with the goal of making “a virtual safe space for young WoC to destigmatize mental health and initiate collective healing.”

Sad Girls Club: This account is all about creating a mental health community for Gen Z and millennial women who have mental illness, along with reducing stigma and sharing information about mental health services. Scroll through the feed and you’ll see many people of color, including Black women, openly discussing mental health—a welcome sight.

Sista Afya: This Chicago-based organization focuses on supporting Black women’s mental health in a number of ways, like connecting Black women to affordable and accessible mental health practitioners and running mental health workshops. They also offer a Thrive in Therapy program for Illinois-based Black women making less than $1,500 a month. For $75 a month, members receive two therapy sessions, free admission to the monthly support groups, and more.

Transparent Black Girl: Transparent Black Girl aims to redefine the conversation around what wellness means for Black women. Their feed is a mix of relatable memes, hilarious pop culture commentary, beautiful images and art of Black people, and mental health resources for Black people. Transparent Black Guy, the brother resource to Transparent Black Girl, is also very much worth a follow, particularly given the stigma and misconceptions that often surround Black men being vulnerable about their mental health.

Directories and networks for finding a Black (or allied) therapist

Here are various directories and networks that have the goal of helping Black people find therapists who are Black, from other marginalized racial groups, or who describe themselves as inclusive. This list is not exhaustive, and some of these resources will be more expansive than others. They also do different levels of vetting the experts they include. If you find a therapist via one of these sites who seems promising, be sure to do some follow-up searches to learn more about them.

This content was originally published here.

Myant partners with Canadian expert for dentistry PPE innovation

Myant Inc., a world leader in Textile Computing, has announced a partnership with Dr Natalie Archer DDS, a recognized Canadian dental expert, to collaboratively develop a new line of personal protective equipment (PPE) designed to address the extreme risks that dental professionals face as they reopen their practices to serve their communities.

The types of PPE under development include both washable textile masks intended for support staff in dental practices, and washable textile-based respirators that meet NIOSH N95 standards for dental professionals who work in critical proximity to patients.

Risks for dental professionals

Social distancing is one of the basic ways to mitigate the spread of the coronavirus, with health officials advising people to maintain distancing of two metres with others. With governments progressively reopening their economies and allowing businesses to begin serving their communities again, the challenge of maintaining two metre distancing will become a potential source of danger for both front-line workers and for those that they serve.

“This is especially true for people working in the dental industry whose work environment is literally at the potential source of infection: the mouths and noses of their patients,” Myant said in an article on its website. “An analysis conducted by Visual Capitalist, leveraging data from the Occupational Information Network, suggests that dentists, dental hygienists, dental assistants, and dental administrative staff are among the professions and support staff at the highest risk of exposure to coronavirus. Their work requires close proximity / physical contact with others, and they are routinely exposed to potential sources of infectious diseases.”

“The public health risk is magnified when you consider the volume of patients coming in and out of a dental practice,” Myant adds. “Consider the contact tracing challenge if a single asymptomatic dental hygienist tests positive for COVID-19. That dental hygienist may work in a practice with two dentists, a billing coordinator, a receptionist, and perhaps three other dental hygienists who each see 100 patients a week (with each patient coming with a loved one in the waiting room). It is clear that dental professionals will need to be among the most vigilant in our communities when it comes to the adoption of effective PPE in order to protect themselves and society from a potential second-wave of the virus.”

Partnership to drive innovation in dental PPE

Recognizing this challenge Myant, the textile innovator that pivoted to innovation in PPE as a response to COVID-19, has partnered with one of Canada’s pre-eminent dental experts to design a line of PPE geared specifically to meet the challenges that dentists, other dental professionals and their staff will face, in the Post-COVID normal. Dr. Natalie Archer DDS was the youngest dentist ever elected to serve on the Board of the Royal College of Dental Surgeons of Ontario and served as the governing body’s Vice President between 2011 and 2012. As a recognized and trusted subject matter expert on dentistry-related topics, she is regularly asked to speak to the public in the Canadian media. Dr. Archer will be working closely with the Myant team, advising on the design and the certification process for a new line of PPE for dental professionals currently under development.

Reflecting on her motivations, Dr. Archer told Myant: “Dental professionals feel a tremendous responsibility to get back to serving their communities, but as both members and servants of the community, we must be safe and responsible for both patients and the people that treat them. Like other dental professionals, I am concerned about maintaining levels of PPE.”

“With disposable PPE I feel there will always be a concern of running out, the expense, uncertain quality, not to mention environmental concerns because of all of the waste. Also, there is a real problem with the discomfort that currently available PPE poses for dental professionals who typically work long shifts and whose work is physical. I am excited to be innovating with the team at Myant to address the real world clinical problems that we are facing now in dentistry by producing PPE that is protective, comfortable, and reusable, which will help all of us stay safe and allow us to do our jobs.”

The PPE for dental professionals will be designed and manufactured at Myant’s Toronto-based, 80,000 square foot facility which has the current capacity to produce 340,000 units of PPE a month. Plans are underway to expand that capacity to produce over one million units per month as communities across Canada and the United States start looking for ways to re-open in a safe and responsible manner.

 “This new development highlights the agility with which Myant is able to operate, rapidly integrating the domain expertise of our partners to unlock the potential behind our core textile design and commercialization capabilities,” said Myant Executive Vice President Ilaria Varoli. “Textiles are everywhere in our daily lives and we look forward to working with partners like Dr. Archer to make life better, easier, and safer for all people.”

Ilaria Varoli, EVP, Myant Inc.(c) Myant.Ilaria Varoli, EVP, Myant Inc.(c) Myant.

Further information

To stay up to date on Myant’s dental PPE developments, join the Myant PPE Dental Mailing List.

For consumers interested in purchasing non-dental PPE, please visit www.myantppe.ca.

For B2B inquiries about Myant’s non-dental PPE, please contact us at .

This content was originally published here.

How The ‘Lost Art’ Of Breathing Impacts Sleep And Stress : Shots – Health News : NPR

Breathing slowly and deeply through the nose is associated with a relaxation response, says James Nestor, author of Breath. As the diaphragm lowers, you’re allowing more air into your lungs and your body switches to a more relaxed state.

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Breathing slowly and deeply through the nose is associated with a relaxation response, says James Nestor, author of Breath. As the diaphragm lowers, you’re allowing more air into your lungs and your body switches to a more relaxed state.

Humans typically take about 25,000 breaths per day — often without a second thought. But the COVID-19 pandemic has put a new spotlight on respiratory illnesses and the breaths we so often take for granted.

Journalist James Nestor became interested in the respiratory system years ago after his doctor recommended he take a breathing class to help his recurring pneumonia and bronchitis.

While researching the science and culture of breathing for his new book, Breath: The New Science of a Lost Art, Nestor participated in a study in which his nose was completely plugged for 10 days, forcing him to breathe solely through his mouth. It was not a pleasant experience.

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Nestor says the researchers he’s talked to recommend taking time to “consciously listen to yourself and [to] feel how breath is affecting you.” He notes taking “slow and low” breaths through the nose can help relieve stress and reduce blood pressure.

“This is the way your body wants to take in air,” Nestor says. “It lowers the burden of the heart if we breathe properly and if we really engage the diaphragm.”

Interview Highlights

On why nose breathing is better than mouth breathing

The nose filters, heats and treats raw air. Most of us know that. But so many of us don’t realize — at least I didn’t realize — how [inhaling through the nose] can trigger different hormones to flood into our bodies, how it can lower our blood pressure … how it monitors heart rate … even helps store memories. So it’s this incredible organ that … orchestrates innumerable functions in our body to keep us balanced.

On how the nose has erectile tissue

The nose is more closely connected to our genitals than any other organ. It is covered in that same tissue. So when one area gets stimulated, the nose will become stimulated as well. Some people have too close of a connection where they get stimulated in the southerly regions, they will start uncontrollably sneezing. And this condition is common enough that it was given a name called honeymoon rhinitis.

James Nestor’s previous book, Deep, focused on the science behind free diving.

Julie Floersch/Riverhead Books


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James Nestor’s previous book, Deep, focused on the science behind free diving.

Another thing that is really fascinating is that erectile tissue will pulse on its own. So it will close one nostril and allow breath in through the other nostril, then that other nostril will close and allow breath in. Our bodies do this on their own. …

A lot of people who’ve studied this believe that this is the way that our bodies maintain balance, because when we breathe through our right nostril, circulation speeds up [and] the body gets hotter, cortisol levels increase, blood pressure increases. So breathing through the left will relax us more. So blood pressure will decrease, [it] lowers temperature, cools the body, reduces anxiety as well. So our bodies are naturally doing this. And when we breathe through our mouths, we’re denying our bodies the ability to do this.

On how breath affects anxiety

I talked to a neuropsychologist … and he explained to me that people with anxieties or other fear-based conditions typically will breathe way too much. So what happens when you breathe that much is you’re constantly putting yourself into a state of stress. So you’re stimulating that sympathetic side of the nervous system. And the way to change that is to breathe deeply. Because if you think about it, if you’re stressed out [and thinking] a tiger is going to come get you, [or] you’re going to get hit by a car, [you] breathe, breathe, breathe as much as you can. But by breathing slowly, that is associated with a relaxation response. So the diaphragm lowers, you’re allowing more air into your lungs and your body immediately switches to a relaxed state.

On why exhaling helps you relax

Because the exhale is a parasympathetic response. Right now, you can put your hand over your heart. If you take a very slow inhale in, you’re going to feel your heart speed up. As you exhale, you should be feeling your heart slow down. So exhaling relaxes the body. And something else happens when we take a very deep breath like this. The diaphragm lowers when we take a breath in, and that sucks a bunch of blood — a huge profusion of blood — into the thoracic cavity. As we exhale, that blood shoots back out through the body.

On the problem with taking shallow breaths

You can think about breathing as being in a boat, right? So you can take a bunch of very short, stilted strokes and you’re going to get to where you want to go. It’s going to take a while, but you’ll get there. Or you can take a few very fluid and long strokes and get there so much more efficiently. … You want to make it very easy for your body to get air, especially if this is an act that we’re doing 25,000 times a day. So, by just extending those inhales and exhales, by moving that diaphragm up and down a little more, you can have a profound effect on your blood pressure, on your mental state.

On how free divers expand their lung capacity to hold their breath for several minutes

The world record is 12 1/2 minutes. … Most divers will hold their breath for eight minutes, seven minutes, which is still incredible to me. When I first saw this, this was several years ago, I was sent out on a reporting assignment to write about a free-diving competition. You watch this person at the surface take a single breath there and completely disappear into the ocean, come back five or six minutes later. … We’ve been told that whatever we have, whatever we’re born with, is what we’re going to have for the rest of our lives, especially as far as the organs are concerned. But we can absolutely affect our lung capacity. So some of these divers have a lung capacity of 14 liters, which is about double the size for a [typical] adult male. They weren’t born this way. … They trained themselves to breathe in ways to profoundly affect their physical bodies.

Sam Briger and Joel Wolfram produced and edited this interview for broadcast. Bridget Bentz, Molly Seavy-Nesper and Deborah Franklin adapted it for the Web.

This content was originally published here.

Suddenly, Public Health Officials Say Social Justice Matters More Than Social Distance – POLITICO

“The injustice that’s evident to everyone right now needs to be addressed,” Abraar Karan, a Brigham and Women’s Hospital physician who’s exhorted coronavirus experts to use their platforms to encourage the protests, told me.

It’s a message echoed by media outlets and some of the most prominent public health experts in America, like former Centers for Disease Control and Prevention director Tom Frieden, who loudly warned against efforts to rush reopening but is now supportive of mass protests. Their claim: If we don’t address racial inequality, it’ll be that much harder to fight Covid-19. There’s also evidence that the virus doesn’t spread easily outdoors, especially if people wear masks.

The experts maintain that their messages are consistent—that they were always flexible on Americans going outside, that they want protesters to take precautions and that they’re prioritizing public health by demanding an urgent fix to systemic racism.

But their messages are also confounding to many who spent the spring strictly isolated on the advice of health officials, only to hear that the need might not be so absolute after all. It’s particularly nettlesome to conservative skeptics of the all-or-nothing approach to lockdown, who point out that many of those same public health experts—a group that tends to skew liberal—widely criticized activists who held largely outdoor protests against lockdowns in April and May, accusing demonstrators of posing a public health danger. Conservatives, who felt their own concerns about long-term economic damage or even mental health costs of lockdown were brushed aside just days or weeks ago, are increasingly asking whether these public health experts are letting their politics sway their health care recommendations.

“Their rules appear ideologically driven as people can only gather for purposes deemed important by the elite central planners,” Brian Blase, who worked on health policy for the Trump administration, told me, an echo of complaints raised by prominent conservative commentators like J.D. Vance and Tim Carney.

Conservatives also have seized on a Twitter thread by Drew Holden, a commentary writer and former GOP Hill staffer, comparing how politicians and pundits criticized earlier protests but have been silent on the new ones or even championed them.

“I think what’s lost on people is that there have been real sacrifices made during lockdown,” Holden told me. “People who couldn’t bury loved ones. Small businesses destroyed. How can a health expert look those people in the eye and say it was worth it now?”

Some members of the medical community acknowledged they’re grappling with the U-turn in public health advice, too. “It makes it clear that all along there were trade-offs between details of lockdowns and social distancing and other factors that the experts previously discounted and have now decided to reconsider and rebalance,” said Jeffrey Flier, the former dean of Harvard Medical School. Flier pointed out that the protesters were also engaging in behaviors, like loud singing in close proximity, which CDC has repeatedly suggested could be linked to spreading the virus.

“At least for me, the sudden change in views of the danger of mass gatherings has been disorienting, and I suspect it has been for many Americans,” he told me.

The shift in experts’ tone is setting up a confrontation amid the backdrop of a still-raging pandemic. Tens of thousands of new coronavirus cases continue to be diagnosed every day—and public health experts acknowledge that more will likely come from the mass gatherings, sparked by the protests over George Floyd’s death while in custody of the Minneapolis police last week.

“It is a challenge,” Howard Koh, who served as assistant secretary for health during the Obama administration, told me. Koh said he supports the protests but acknowledges that Covid-19 can be rapidly, silently spread. “We know that a low-risk area today can become a high-risk area tomorrow,” he said.

Yet many say the protests are worth the risk of a possible Covid-19 surge, including hundreds of public health workers who signed an open letter this week that sought to distinguish the new anti-racist protests “from the response to white protesters resisting stay-home orders.”

Those protests against stay-at-home orders “not only oppose public health interventions, but are also rooted in white nationalism and run contrary to respect for Black lives,” according to the letter’s nearly 1,300 signatories. “Protests against systemic racism, which fosters the disproportionate burden of COVID-19 on Black communities and also perpetuates police violence, must be supported.”

“Staying at home, social distancing, and public masking are effective at minimizing the spread of COVID-19,” the letter signers add. “However, as public health advocates, we do not condemn these gatherings as risky for COVID-19 transmission.”

Was it fair to decry conservatives’ protests about the economy while supporting these new protests? And if tens of thousands of people get sick from Covid-19 as a result of these mass gatherings against racism, is that an acceptable trade-off? Those are questions that a half-dozen coronavirus experts who said they support the protests declined to directly answer.

“I don’t know if it’s really for me to comment,” said Karan. He did add: “Addressing racism, it can’t wait. It should’ve happened before Covid. It’s happening now. Perhaps this is our time to change things.”

“Many public health experts have already severely undermined the power and influence of their prior message,” countered Flier. “We were exposed to continuous daily Covid death counts, and infections/deaths were presented as preeminent concerns compared to all other considerations—until nine days ago,” he added.

“Overnight, behaviors seen as dangerous and immoral seemingly became permissible due to a ‘greater need,’” Flier said.

The frustration from some conservatives is an outgrowth of how Covid-19 has affected the United States so far. In Blue America, the pandemic is a dire threat that’s killed tens of thousands in densely packed urban centers like New York City—and warnings from infectious-disease experts like Tony Fauci carry the weight of real-world implications. In many parts of Red America, rural states like Alaska and Wyoming still have fewer than 1,000 confirmed cases, and some residents are asking why they shuttered their economies for a virus that had little visible effect over the past three months.

Pollsters also have consistently found a partisan split on how Americans view the pandemic, with Democrats believing that the media is underplaying the risks of Covid-19 while Republicans say that the threat has been exaggerated. That attitude may change with virus numbers on the march in states like Alabama and Arkansas.

People on both sides are already trying to figure out whom to blame if coronavirus cases jump as widely expected after hundreds of thousands of Americans spilled into the streets this past week, sometimes in close proximity for hours at a time. When we discussed the possible risks of a large public gathering, protest supporters like Karan and Koh seized on police behaviors —like using pepper spray and locking up protesters in jail cells—which they noted created significant risks of their own to spread Covid-19.

“Trump will try to blame protestors for [the] spike in coronavirus cases he caused,” a spokesperson for Protect Our Care, a progressive-aligned health care group, wrote in a memo circulated to media members on Wednesday. While acknowledging the risks of mass protests, “the reality is that the spikes in cases have been happening well before the protests started—in large part because Trump allowed federal social distancing guidelines to expire, failed to adequately increase testing, and pushed governors to reopen against the advice of medical experts,” the spokesperson claimed.

Contra those claims, public health experts like Koh generally acknowledge that it’s going to be difficult to tease apart why Covid-19 cases could jump in the coming weeks, given the sheer number of Americans joining mass gatherings, states relaxing restrictions and other factors that could pose challenges for disease-tracing on a large scale.

Some experts also are cautious of condemning states for rolling back restrictions after inconclusive evidence from states that already moved to do so. For instance, a widely shared Atlantic article in April framed the decision by Georgia’s GOP governor to relax social-distancing restrictions as an “experiment in human sacrifice.” A month later, Georgia’s daily coronavirus cases have stayed relatively level and it’s not clear whether the rollback led to significant new outbreaks.

What is clear is that the only successful tactic to stop Covid-19 remains social distancing and, failing that, thoroughly wearing personal protective equipment. Yet there’s also considerable video and photo evidence of maskless protesters, sometimes closely huddled together with public officials—also sans mask—in efforts to defuse tensions, or recoiling from police attacks that forced them to remove protection.

That means a collision between the protests and coronavirus is coming, which will force decisions big and small. Will local leaders need to reimpose restrictions when cases go up? Will that advice be trusted? Or is it possible that their guidance was too draconian all along?

Some participants in the new protests—whether marching themselves or drawn in from the sidelines—say they recognize the threat they’re facing.

A Washington, D.C., man named Rahul Dubey attracted national attention for sheltering protesters from the police inside his home on Monday night. On Wednesday, he told me that he was on the way to get a coronavirus test and was planning to self-quarantine himself for two weeks—having spent hours in close proximity to dozens of maskless people.

It’s a reminder of a line often heard from medical experts: Public health should be above politics. Now some conservatives are invoking it too.

“The virus doesn’t care about the nature of a protest, no matter how deserving the cause is,” Holden said.

This content was originally published here.

Everyday Superhero: Dr. Andrew V., Cosmetic Dentistry – My Jaanuu

We asked Dr. Andrew Vo – a dentist, spin instructor and Captain in the United States Army – for his best self care tips, even when life and work throw a lot at you.

Where are you from? Huntington Beach, CA

What is your favorite part about your job?

I love to change negative experiences a patient may have had into positive ones, building a long and lasting relationship with each and every one of my patients and using my profession to truly change lives for the better.

Why did you choose cosmetic dentistry?

I originally chose cosmetic dentistry because I wanted to help people smile, to help build more confidence, and to help patients live the life that is worth living. In addition to cosmetic dentistry, I also love working on pediatric patients. I decided to go back to school this June to specialize in pediatric dentistry. When I first started my journey in dentistry, I first worked with children and I miss working with them so much. I want to learn more about treating children, become an advocate for pediatric health, and create future mission trips with a foundation of knowledge.

What does self care mean to you?

Taking care of yourself both physically and mentally in order to take care of your loved ones.

You’ve got a lot going on, how do you practice self care?

Being in the fitness community (GritCycle and Equinox) and teaching indoor cycling for these companies, I am so blessed to have met such incredible people. Everyone has challenging days, but these two communities are filled with love, positivity and joy, which helps me practice self care.

Have you always known how to practice self care? If not, how did you find your balance?

I love food, and sometimes the foods that I consume aren’t the best choices. At one time in my life, I was overweight, unmotivated and depressed. I found my balance and changed my life when I found fitness and the people that inspired me to live a better and healthier life.

Why is it important for healthcare professionals to take time for self care?

We all get busy with our jobs and often times we make up excuses not to exercise because we don’t have time or to eat healthy because it takes too long. It is never too late to change, just take one step at a time and you will eventually get there.

How long have you been cycling? What made you decide to become an instructor?

I have been cycling for the past 12 years and decided to become an instructor because I wanted to make a difference and share my story. I wasn’t always in shape and healthy. It was when I hit rock bottom and had to make a choice to either keep going down the dirt road or be proactive and commit to living my best life. It wasn’t easy, but I got there. I love teaching indoor cycling to help people realize that they are loved, that they are accepted, and that it is NEVER too late to change for the better.

Hear more from our Everyday Superheroes here and here.

This content was originally published here.

Minn. health officials urge caution after news of ICU beds filling up – StarTribune.com

Metro hospitals are running short on intensive care unit beds due to an increase in patients with COVID-19 and other medical issues, prompting health officials to call for more public adherence to social distancing to slow the spread of the infectious disease.

The Minnesota Department of Health on Friday reported a record 233 patients with COVID-19 in ICU beds, but doctors and nurses said patients with other illnesses resulted in more than 95% of those beds in the Twin Cities to be filled.

Patients with unrelated medical problems needed intensive care, along with patients recovering from surgeries — including elective procedures that resumed May 11 after they had been suspended due to the pandemic.

“We are tight,” said Dr. John Hick, an emergency physician directing Minnesota’s Statewide Healthcare Coordination Center. “Resuming elective surgeries plus an uptick in ICU cases has constricted things pretty quickly.”

At different times, Hennepin County Medical Center and North Memorial Health Hospital were diverting patients to other hospitals. Almost all heart-lung bypass machines were in use for severe COVID-19 patients and others at the University of Minnesota Medical Center and Abbott Northwestern Hospital in Minneapolis.

As planned, Children’s Minnesota took on some young adult patients to take pressure off the general hospitals.

People might think the pandemic is over because public restrictions are being scaled back, but “in the hospitals, it is not over and it is not getting back to normal,” said nurse Emily Sippola, adding that her United Hospital was opening a third COVID-specific unit ahead of schedule. “The pace is picking up.”

The pressure on hospitals comes at a crossroads in Minnesota’s response to the pandemic, which is caused by a novel coronavirus for which there is yet no vaccine. Infections and deaths are rising even as Gov. Tim Walz lifted his statewide stay-at-home order on Monday and faced pressure this week to pull back even more restrictions on businesses and churches.

Despite talks with Walz on Friday, leaders of the Catholic Archdiocese of St. Paul and Minneapolis issued no change in guidance for their churches to defy the governor’s order and hold indoor masses at one-third seating capacity starting Tuesday. President Donald Trump might have altered those talks when he threatened to supersede any state government that tried to keep churches closed any longer, although the White House didn’t cite any law giving him the right to do so.

A single-day record of 33 COVID-19 deaths was reported Friday in Minnesota — with 25 in long-term care and one in a behavioral health group home — raising the death toll to 842. Infections confirmed by diagnostic testing increased by 813 on Friday to 19,005 overall, and Dr. Deborah Birx, the White House’s coronavirus response coordinator, called out Minneapolis for having one of the nation’s highest rates of diagnostic tests being positive for COVID-19.

People can slow the spread of COVID-19 if they continue to wear masks, practice social distancing, wash hands and cover coughs, said Dr. Ruth Lynfield, state epidemiologist.

“There are those among us who will not do well with this virus and will develop severe disease, and I think we need to be very mindful of that,” she said. “It’s not high-tech. We know what to do to prevent transmission of this virus.”

While as many as 80% of people suffer mild to moderate symptoms from infection, the virus spreads so easily that it will still lead to a high number of people needing hospital care. Health officials are particularly concerned about people with underlying health problems — including asthma, diabetes, smoking, and diseases of the heart, lungs, kidneys or immune system.

Individuals with such conditions and long-term care facility residents have made up around 98% of all deaths. The state’s total number of long-term care deaths related to COVID-19 is now 688.

The University of Minnesota’s Center for Infectious Disease Research and Policy estimates that only 5% of Minnesotans have been infected so far and that this rate will increase substantially.

Hospitals working together

Part of the state response strategy is aggressive testing of symptomatic patients to identify the course of the virus and hot spots of infection before they spread further. Widespread testing is being scheduled in long-term care facilities that have confirmed cases, and testing has taken place in eight food processing plants with cases as well.

The state averaged nearly 7,000 diagnostic tests per day this week, and the state should get a boost from a new campaign of testing clinics at six National Guard Armory locations across Minnesota from Saturday through Monday, said Jan Malcolm, state health commissioner.

The state’s pandemic preparedness website as of Friday indicated that 1,045 of 1,257 available ICU beds were occupied by patients with COVID-19 or other unrelated medical conditions — and that another 1,093 beds could be readied within 72 hours.

Several hospitals are already activating those extra beds, though in some cases they are finding it difficult to find the critical care nurses to staff existing ICU beds — much less new ones, said Dr. Rahul Koranne, president of the Minnesota Hospital Association. Staffing difficulties, rather than a lack of physical bed space, caused some of the hospitals to divert patients.

Nurses in the Twin Cities reported being called in for overtime shifts for the Memorial Day weekend, which in typical years also launches a summerlong increase of car accidents and traumatic injuries. North Memorial, HCMC and Regions Hospital in St. Paul are trauma centers.

“This increased trauma volume typically persists throughout the summer season and into fall,” North Memorial said in a statement provided by spokeswoman Katy Sullivan. “To be able to provide the needed level of care for the community and honor our commitments to our healthcare partners throughout Minnesota and western Wisconsin, we need to preserve some capacity for emergency trauma care.”

An increase in surgeries might have contributed to the ICU burden, but Koranne said many didn’t fit the definition of elective. Some patients delayed the removal of tumors due to the pandemic but can no longer afford to do so.

“They are patients who have been waiting for critical time-sensitive procedures that their physician is worried might be getting worse,” Koranne said. “To call those type of procedures elective could not be further from the truth.”

Competing hospitals have long cooperated when others needed to divert patients, but that has increased with the help of the state COVID-19 coordinating center and is showing in how they are managing ICU bed shortages, hospital leaders said.

“We all have surge plans in place,” said Megan Remark, Regions president, “but more than ever before, everyone is working together and with the state to ensure that we can provide care for all patients.”

This content was originally published here.

O’Leary retires; Tsunoda to take over orthodontics practice – Wisconsin Rapids City Times

For the City Times

WISCONSIN RAPIDS – Dr. Michael O’Leary, of O’Leary Orthodontics, will retire after 42 years practicing orthodontics in the Wisconsin Rapids area.

“I extend my deepest and sincere thanks for the confidence, trust, and support shown throughout the years by my patients and the community,” Dr. Michael O’Leary said. “Superior care for my patients is of utmost importance to me. We took some time to find the right doctor and I am thrilled to announce that Dr. Kan Tsunoda joined the practice in May. I will miss all of you very much, but I know you will really like him.”

Dr. Kan Tsunoda will continue to provide orthodontic treatment under the new practice name “Rapids Orthodontics.”

“Rest assured, the familiar faces on the orthodontic support team will still be at Rapids Orthodontics to provide the same level of personalized care,” the company said in a release.

Tsunoda attended dental school at Midwestern University College of Dental Medicine-IL and completed his masters in oral biology and orthodontic specialty certificate at the University of Illinois at Chicago.

Tsunoda said he enjoys the outdoors and is excited to be a part of the community with his wife and four daughters.

For more information, call 715-421-5255 or visit www.RapidsOrthodontics.com.

Rapids Orthodontics is located at 440 Chestnut Street, Wisconsin Rapids.

This content was originally published here.

Wealthiest Hospitals Got Billions in Bailout for Struggling Health Providers – The New York Times

But it is not just another deep-pocketed investor hunting for high returns. It is the Providence Health System, one of the country’s largest and richest hospital chains. It is sitting on nearly $12 billion in cash, which it invests, Wall Street-style, in a good year generating more than $1 billion in profits.

With states restricting hospitals from performing elective surgery and other nonessential services, their revenue has shriveled. The Department of Health and Human Services has disbursed $72 billion in grants since April to hospitals and other health care providers through the bailout program, which was part of the CARES Act economic stimulus package. The department plans to eventually distribute more than $100 billion more.

Those cash piles come from a mix of sources: no-strings-attached private donations, income from investments with hedge funds and private equity firms, and any profits from treating patients. Some chains, like Providence, also run their own venture-capital firms to invest their cash in cutting-edge start-ups. The investment portfolios often generate billions of dollars in annual profits, dwarfing what the hospitals earn from serving patients.

Representatives of the American Hospital Association, a lobbying group for the country’s largest hospitals, communicated with Alex M. Azar II, the department secretary, and Eric Hargan, the deputy secretary overseeing the funds, said Tom Nickels, a lobbyist for the group. Chip Kahn, president of the Federation of American Hospitals, which lobbies on behalf of for-profit hospitals, said he, too, had frequent discussions with the agency.

One formula based allotments on how much money a hospital collected from Medicare last year. Another was based on a hospital’s revenue. While Health and Human Services also created separate pots of funding for rural hospitals and those hit especially hard by the coronavirus, the department did not take into account each hospital’s existing financial resources.

“This simple formula used the data we had on hand at that time to get relief funds to the largest number of health care facilities and providers as quickly as possible,” said Caitlin B. Oakley, a spokeswoman for the department. “While other approaches were considered, these would have taken much longer to implement.”

That pattern is repeating in the hospital rescue program.

For example, HCA Healthcare and Tenet Healthcare — publicly traded chains with billions of dollars in reserves and large credit lines from banks — together received more than $1.5 billion in federal funds.

Angela Kiska, a Cleveland Clinic spokeswoman, said the federal grants had “helped to partially offset the significant losses in operating revenue due to Covid-19, while we continue to provide care to patients in our communities.” The Cleveland Clinic sent caregivers to hospitals in Detroit and New York as they were flooded with coronavirus patients, she added.

Critics argue that hospitals with vast financial resources should not be getting federal funds. “If you accumulated $18 billion and you are a not-for-profit hospital system, what’s it for if other than a reserve for an emergency?” said Dr. Robert Berenson, a physician and a health policy analyst for the Urban Institute, a Washington research group.

Hospitals that serve poorer patients typically have thinner reserves to draw on.

Even before the coronavirus, roughly 400 hospitals in rural America were at risk of closing, said Alan Morgan, the chief executive of the National Rural Hospital Association. On average, the country’s 2,000 rural hospitals had enough cash to keep their doors open for 30 days.

At St. Claire HealthCare, the largest rural hospital system in eastern Kentucky, the number of surgeries dropped 88 percent during the pandemic — depriving the hospital of a crucial revenue source. Looking to stanch the financial damage, it furloughed employees and canceled some vendor contracts. The $3 million the hospital received from the federal government in April will cover two weeks of payroll, said Donald H. Lloyd II, the health system’s chief executive.

This content was originally published here.

‘This is not about politics’: GOP governor says wearing masks is public health issue

WASHINGTON — Ohio Republican Gov. Mike DeWine on Sunday dismissed the politicization of wearing masks in public to help contain the spread of the coronavirus, imploring Americans during the Memorial Day Weekend to understand “we are truly all in this together.”

With many states like Ohio beginning to relax stay-at-home restrictions, DeWine underscored the importance of following studies that show masks are beneficial to limiting the spread of the virus in an exclusive interview with “Meet the Press.”

“This is not about politics. This is not about whether you are liberal or conservative, left or right, Republican or Democrat,” DeWine said.

“It’s been very clear what the studies have shown, you wear the mask not to protect yourself so much as to protect others. This is one time where we are truly all in this together. What we do directly impacts others.”

DeWine made the comments in response to an emotional plea from North Dakota Gov. Doug Burgum, who last week denounced the idea that mask-wearing should be a partisan issue.

Public health experts continue to say mask usage can help stunt the spread of the virus and recommend that people wear masks where social distancing is not feasible. But the White House has sent mixed signals on the practice.

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President Trump has repeatedly bucked the practice of wearing a mask in public, reportedly telling advisers he thought doing so would send the wrong message and distract from the push to reopen the economy.

He did not wear one during a visit to an Arizona mask production facility earlier this month. And while he did wear one for part of his trip to a Ford manufacturing plant in Michigan last week, he took it off before speaking to reporters and said “I didn’t want to give the press the pleasure of seeing it.”

Vice President Pence did not wear a mask while touring the Mayo Clinic in Minnesota last month, but donned one during another tour days later in Indiana after criticism.

O’Brien: The president wears masks ‘when necessary’

Robert O’Brien, Trump’s national security adviser, told “Meet the Press” Sunday that he and many other members of White House staff wear masks during work and hope that will set an “example” for Americans looking to return to the office. And he defended the president’s conduct by arguing that if proper social-distancing measures are taken, Trump doesn’t always need to wear a mask.

“I think Gov. DeWine was spot on when he talked about office-workers wearing the masks, and mask usage is going to help us get this economy reopened,” he said.

“And we do need to get the country reopened because we can’t get left behind by China or others with respect to our economy.”

The question of how to safely reopen the American economy is weighing heavy this Memorial Day weekend, as every state across the country is beginning to move toward relaxing coronavirus-related restrictions.

There have been more than 1.6 million coronavirus cases in America including more than 97,700 deaths as of Sunday morning, according to NBC News’ count. And 38 million Americans have filed unemployment claims since March 14.

As governors like DeWine are trying to balance the public health risks of removing restrictions with the economic risks of keeping most of America shut in their homes, the Ohio governor said that he’s confident “we can do two things at once.”

“We want to continue to up that throughout the state because it is really what we need as we open up the economy. This is a risk, but it’s also a risk if we don’t open up the economy, all the downsides of not opening up the economy,” he said.

This content was originally published here.

Cranston orthodontist fears a burglary, but finds a turkey

John Hill Journal Staff Writer jghilliii

CRANSTON, R.I. — It was Columbus Day and Joseph E. Pezza and his wife had gotten back from a weekend in Nashville. The Pontiac Avenue orthodontist decided to stop by the office to check the mail and make sure everything was set for Tuesday morning.

But someone was already waiting in the office. He’d come through the office window, a fully grown wild turkey.

The waiting area was strewn with broken glass, Pezza said, and at first he thought he been the victim of a burglary. He went into his office to leave a message for the building manager and while he was wondering if he should call the police, the reason for the carnage became apparent.

“I went back into the room and all of a sudden this bird flies over my head,” Pezza said.

Pezza said he immediately headed back to his office, closed the door and waited for the building crew.

Pezza and his son Gregory are Pezza Orthodontics, located in a four-story office building off Pontiac Avenue near the interchange with Pontiac Avenue and Route 37. Birds sometimes bump into the back windows of the building, some of the office staff said, but the turkey was a first.

“It was double-pane glass, “ Pezza said, in wonder that the bird could fly high enough and fast enough to smash through the window. And survive

The maintenance crew worked to get the bird into a large bucket to get the bird out of the building, Pezza said, but it collapsed and died, possibly of shock or injuries suffered in the crash.

For now, the window is covered with a square of wood, with a felt turkey hanging from the center.

He declined to say if the incident was going to affect his plans for Thanksgiving.

This content was originally published here.

Pelosi calls for public health benefits for illegal immigrants

House Speaker Nancy Pelosi said it is “absolutely essential” that illegal immigrants also get access to health benefits amid the coronavirus pandemic.

“It’s in everyone’s interest that everyone be in the health-care loop. … it’s absolutely essential that we’re able to get benefits to everyone in our country when we’re testing, when we’re tracing, when we’re treating and the rest,” the California Democrat said during a teleconference call.

Pelosi said Democrats want to undo a provision in coronavirus legislation that prevents families with mixed immigration status from receiving stimulus payments from the Internal Revenue Service.

“We want to address the mixed-family issue,” she said during her weekly news conference Thursday, without committing to it being part of the next bill the House passes on the pandemic, according to the San Francisco Chronicle.

Responding to a question about supporting undocumented immigrants more broadly than the stimulus payments, the speaker said she was pleased that the Federal Reserve is looking at ways to extend lending programs to nonprofits, including those that work with illegal immigrants.

California has partnered with nonprofits to set up a $125 million fund to provide cash payments to undocumented immigrants in the state.

“We are well-served if we recognize that everybody in our country is part of our community and … helping to grow the economy. Most of what we are doing is to meet the needs of people, but it’s all stimulus, so we shouldn’t cut the stimulus off,” Pelosi said.

House Speaker Nancy Pelosi said a “guaranteed income” for Americans,…

On Tuesday, Pelosi pressed ahead with a sweeping package even as a host of Republican leaders express hesitation about additional spending.

She promises that the Democrat-controlled House will deliver legislation to help state and local governments through the crisis, along with additional funds for direct payments to individuals, unemployment insurance and a third installment of aid to small businesses.

Pelosi is leading the way as Democrats fashion the package, which is expected to be unveiled soon even as the House stays closed while the Senate is open.

Senate Majority Leader Mitch McConnell said earlier this week that it’s time to push “pause” on more aid legislation — even as he repeated a “red line” demand that any new package include liability protections for hospitals, health care providers and businesses.

With Post wires

This content was originally published here.

Coronavirus Map And Graphics: Track The Spread In The U.S. : Shots – Health News : NPR

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Since the first coronavirus case was confirmed in the United States on Jan. 21, more than 1 million people in the U.S. have confirmed cases of COVID-19. On April 12, the U.S. became the nation with the most deaths globally, but there are early signs that the U.S. case and death counts may be leveling off, as the growth of new cases and deaths plateaus. The pattern isn’t consistent across the country, as new hot spots emerge and others subside.

To see how quickly your state’s case count is growing, click here.

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Click here to see a global map of confirmed cases and deaths.

In response to mounting cases, state and federal authorities have emphasized a social distancing strategy, widely seen as the best available means to slow the spread of the virus. Most states have put in place measures such as closing schools and nonessential businesses and ordering citizens to stay home as much as possible.

It’s not clear how long such measures need to be in place to see a lasting effect. In Wuhan, the city in China where the virus originated, a strictly enforced lockdown and widespread testing have slowed the outbreak dramatically, enough to bring an end to the 76-day lockdown.

A large portion of U.S. cases are centered on New York City. Since March 20, New York state, Connecticut and New Jersey have accounted for about 50% of all U.S. cases. As of April 9, nearly 60% of all deaths from COVID-19 have been in these three states. While New York state appears to be reaching a plateau, as seen below, it notched between 8,000 and 10,000 new cases each day between March 31 and April 12.

To understand how one state’s outbreak compares with another’s, it’s helpful to look at not just the daily counts but the rate of change day over day. In the following chart, we display cases on a logarithmic scale, meaning that every axis line is 10 times greater than the previous one. This type of scale emphasizes the rate of change.

When case counts grow very quickly, a state’s curve trends sharply upward, as New York’s does over the first 15 days past 100 cases. Generally, this is evidence of unbridled community transmission of the disease. As new cases slow, the curve bends toward horizontal, showing that the state’s outbreak may be leveling off. This doesn’t mean the number of cases has stopped growing, but the rate of growth has slowed, which could signify that social distancing measures are having an effect.

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In some areas, there are signs of hope. The areas with the earliest outbreaks — such as California and Washington — seem to be having success at suppressing the disease. The outlook in Washington has improved to the point that the state has returned unused Army hospital beds it had received in preparation for a peak in cases.

Elsewhere, limited access to testing may make the number of cases look smaller than it really is. As testing becomes more readily available, we are likely to see the number of confirmed cases continue to grow, even if not at the pace previously seen.

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The data used here are compiled by the Center for Systems Science and Engineering at Johns Hopkins University from several sources, including the Centers for Disease Control and Prevention; the World Health Organization; national, state and local government health departments; 1point3acres; and local media reports. The JHU team automates its data uploads and regularly checks them for anomalies. State-by-state testing and hospitalization data are still being assessed for reliability. State-by-state recovery data are unavailable at this time. There may be discrepancies between what you see here and what you see on your local health department’s website.

Stephanie Adeline, Alyson Hurt, Connie Hanzhang Jin, Ruth Talbot and Thomas Wilburn contributed to this story.

This content was originally published here.

NYC health commissioner wouldn’t supply NYPD with masks

New York City’s health commissioner blew off an urgent NYPD request for 500,000 surgical masks as the coronavirus crisis mounted — telling a high-ranking police official that “I don’t give two rats’ asses about your cops,” The Post has learned.

Dr. Oxiris Barbot made the heartless remark during a brief phone conversation in late March with NYPD Chief of Department Terence Monahan, sources familiar with the matter said Wednesday.

Monahan asked Barbot for 500,000 masks but she said she could only provide 50,000, the sources said.

“I don’t give two rats’ asses about your cops,” Barbot said, according to sources.

“I need them for others.”

The conversation took place as increasing numbers of cops were calling out sick with symptoms of COVID-19 but before the department suffered its first casualties from the deadly respiratory disease, sources said.

Although surgical masks don’t necessarily prevent wearers from being infected with the coronavirus, they can prevent people from spreading it to others.

An NYPD detective died after contracting coronavirus — the first…

The NYPD has recorded 5,490 cases of coronavirus among its 55,000 cops and civilian workers, with 41 deaths, according to figures released Wednesday evening.

Patrick Lynch, president of the Police Benevolent Association, called for Barbot to be fired over her “Despicable and unforgivable” comments.

“Dr. Barbot should be forced to look in the eye of every police family who lost a hero to this virus. Look them in the eye and tell them they aren’t worth a rat’s ass,” Lynch fumed.

In the wake of Barbot’s crass rebuff of Monahan, NYPD officials learned that the Department of Health and Mental Hygiene had a large stash of masks, ventilators and other equipment stored in a New Jersey warehouse, sources said.

The department appealed to City Hall, which arranged for the NYPD to get 250,000 surgical masks, sources said.

The federal Department of Homeland Security and the Federal Emergency Management Agency also learned about the situation, leading FEMA to supply the NYPD with Tyvek suits and disinfectant, sources said.

A source who was present during a tabletop exercise at the city Office of Emergency Management headquarters in Brooklyn in March recalled witnessing a “very tense moment” when Monahan complained to Mayor de Blasio in front of Barbot about the NYPD’s need for personal protective equipment, saying, “For weeks, we haven’t gotten an answer.”

De Blasio, who was seated between Monahan and Barbot, asked her, “Oxiris what is he talking about?” the source said.

She was not on the conference call Friday as de…

When Monahan said the gear was vital to keeping cops safe, de Blasio said, “You definitely need it,” and told Barbot, “Oxiris, you’re going to fix this right now,” the source said.

Last week, Barbot — who’s been a routine participant in de Blasio’s daily coronavirus briefings — was noticeably absent when Blasio announced that the city’s public hospital system would oversee a major testing and tracing program, even though the DOH has previously run similar programs.

Hizzoner also heaped praise on the head of NYC Health + Hospitals, Dr. Mitchell Katz, saying, “When you have an inspired operational leader, you know, pass the ball to them is my attitude.”

De Blasio named Barbot the city’s health commissioner in 2018 following the resignation of Dr. Mary Bassett, who took a job at Harvard University’s School of Public Health amid an investigation into the DOH’s failure to alert federal officials to elevated levels of lead in the blood of children living in city housing projects.

“During the height of COVID, while our hospitals were battling to keep patients alive, there was a heated exchange between the two where things were said out of frustration but no harm was wished on anyone,” Department of Health press secretary Patrick Gallahue said, noting that Barbot “apologized for her contribution to the exchange.”

The NYPD declined to comment.

City Councilman Joe Borelli and Congressman Max Rose on Wednesday night joined Lynch in calling for Barbot’s outster.

“I judged the mayor incorrectly for shifting duties away from her if this is how she feels about her job,” Borelli said, referencing de Blasio’s decision to transfer the city’s testing in trace program from the Dept. of Health to Health + Hospitals.

Rose tweeted: “This kind of attitude explains so much about City Hall’s overall response to this crisis. Dr. Barbot shouldn’t resign, she should be fired.”

Additional reporting by Craig McCarthy

This content was originally published here.

International dentistry program at USC marks a milestone

The Herman Ostrow School of Dentistry of USC is celebrating a milestone.

Nearly 50 years ago, seven Cuban refugees were among the first class of students who graduated from the school’s international dentistry program.

Originally called the USC Special Student Program and later the International Student Program, the Advanced Standing Program for International Dentists (ASPID) was created in 1967 in response to the Cuban refugee crisis of the late ’50s and early ’60s when members of the professional class fled the country after Fidel Castro came into power. The United States government put out a call to schools to take in doctors and dentists to train them to practice here.

USC’s ASPID was the first program of its kind in the nation.

USC international dentistry: Diversity among students

These days, dentists from all over the world attend USC to acquire the skills taught in the United States.

“It’s well known that the U.S. has a very advanced dental education system, and oral health providers are very well trained in all specialty areas,” said Yang Chai, associate dean of research and an ASPID graduate, who came to the U.S. from China. “It is quite useful to be trained through the American system by attending a program like ASPID at USC.”

ASPID is a two-year program that begins with an intensive summer introduction to American dentistry. Afterward, students — who must have already completed National Dental Board Examination Part I to be accepted into the program — join their third-year colleagues in the regular DDS program. Following eight months of fundamental, technical and academic procedures training, their focus turns toward clinical training, where they begin working with patients in USC’s oral health clinics and community service programs.

“We get trained with the DDS students,” said ASPID student Amrita Chakraborty, who is from India. “I think that is a huge advantage for us because we get to learn a lot about the culture.”

Chai said ASPID’s diversity is an added bonus.

We not only learned from the professors at USC, but we also learned from our classmates. That was a really fun part of the program.

Amrita Chakraborty

“It’s a group of individuals who bring their unique backgrounds into the program,” he said. “We not only learned from the professors at USC, but we also learned from our classmates. That was a really fun part of the program.”

Melika Haghighi said her favorite procedure so far is learning about digital dentures, but one ASPID class in particular made a special impact.

“Cultural sensitivity was an amazing course,” she said. “There were lectures that made me cry, and they emphasized the importance of understanding different cultures. USC provides an environment that makes everyone comfortable.”

From Dubai to L.A.: USC international dentistry

Haghighi was born and raised in Iran, but she studied dentistry in Dubai, United Arab Emirates. After graduation, she practiced for a year but felt her environment was too limiting. So she started researching different countries to see how to take her skills to the next level. She moved to the United States and started volunteering at USC’s mobile clinic and the John Wesley Community Health dental clinic on Skid Row, which validated her decision to apply to ASPID.

“My experience working on Skid Row was amazing,” she said. “I witnessed the impact USC has on oral health and the community. I chose USC because, to me, it’s more satisfying to have that influential effect on the community rather than in private practice. I saw that USC would prepare me for that.”

USC international dentistry addresses cultural challenges

The challenges international dentists face in the United States are not only cultural. Since every country practices dentistry differently, dentists who want to earn a DDS need to learn all aspects of standard care.

“They need to learn the material,” said Eddie Sheh, an ASPID graduate and its current director. “They need to know the rules and the language. Everything. Just like if you are a doctor, and you want to practice in the U.S., you need to know how we do things.”

Sheh, who was a dentist in Taiwan, said his schooling was very different than the hands-on training USC provides to it students.

“USC is very strong in practicing how to do it in a simulation lab and then treating many, many patients until you graduate,” he said. “Not many other schools in other parts of the world are like that.”

In many countries, dental school starts right after high school and is a six-year program. In Taiwan, when Sheh was studying, fifth-year students were allowed to go to the hospital and observe faculty perform procedures.

“If you were lucky, you got to step in and do a few procedures. If not, you just watched,” Sheh said. “You might be doing a lot of pediatric dentistry because they’re busy, and they need your help. Or you’d just be watching someone do a crown preparation, and you didn’t get to touch it. In my case, I never actually completed a crown preparation or a denture. I just watched.”

What USC does is simply everything, according to Sheh. Students get clinical training in which they are actually treating multiple patients with differing procedures until they are perfected.

“You get to practice what you are trained in,” he said. “You know exactly what to do.”

Aiming for perfection

Chakraborty noted two chief differences between her schooling in India and with ASPID.

“No. 1, you are trained to become a perfectionist,” she said. “USC teaches you to not do work that is just passable. They teach you to strive to do really good work. Another would be professionalism — how to approach patients, how to explain treatments and basically how to treat a patient.”

Treatment planning is the major emphasis of the program, Chai said, and students spend a lot of time learning how to provide a comprehensive treatment plan for patients along with doing procedures.

ASPID accepts 34 students each year out of the more than 1,000 who apply. The ASPID Class of 2020 is 67 percent female; 63 percent of the class are international students requiring a student visa, 29 percent are U.S. citizens and 8 percent are permanent U.S. residents. One hundred percent of the class has earned a foreign bachelor of dental surgery, doctor of dental surgery or doctor of dental medicine degree.

Stay or go home?

Another obstacle international dentists face when they come here is the feeling of starting from square one. After completing years of schooling and practicing dentistry in their countries, often the only jobs they can secure in the United States at first is as dental assistants.

“You graduate from your own country, and you are called a doctor,” Haghighi said. “Then you come here and you have to repeat everything.”

As an ASPID alumnus, Sheh understands what the students go through.

“I understand what they have to endure. That’s the good thing — they know I graduated from the program, and I can tell them what to expect when they complete it.”

The majority of ASPID alumni stay stateside, Sheh said: “That is why they come here. Unless they have other reasons to go back, like for their parents, I would say 99 percent stay here. That was what the program was designed for.”

Whether students stay here or return to their countries, the training they receive with ASPID is unrivaled.

“USC has such a long history and very strong reputation in the community as one of the leading institutions for educating future dentists,” Chai said. “And, naturally, everyone who wants to learn how to practice the best dentistry possible will come to USC.”

This content was originally published here.

China Sends Doctors to North Korea as TV Report Fuels Speculation About Kim Jong Un’s Health

China has sent a team of doctors to North Korea to help determine supreme leader of North Korea Kim Jong Un’s health status, Reuters reported on Friday. Hong Kong Satellite Television reported that Kim was dead, though there has been no confirmation from U.S. sources at this point.

“While the U.S. continues to monitor reports surrounding the health of the North Korean Supreme Leader, at this time, there is no confirmation from official channels that Kim Jong Un is deceased,” a senior Pentagon official not authorized to speak on the record told Newsweek. “North Korean military readiness remains within historical norms and there is no further evidence to suggest a significant change in defensive posturing or national level leadership changes.”

Kim’s last confirmed public appearance was on April 11, at a politburo meeting, though state media also shared footage of him attending aerial assault drills the following day. It was his absence from April 15 Day of the Sun celebrations dedicated to his grandfather, North Korean founder Kim Il Sung, that first sparked speculation regarding his well-being.

On Monday, rumors spread that the North Korean head of state was in ill health after undergoing heart surgery on April 12, sparked by an anonymous source featured in the South Korea-based Daily NK outlet, a publication linked to a U.S. Congress-funded think tank among other institutions, along with a CNN article citing an unnamed U.S. official that said Kim was in grave danger following the operation.

These rumors were subsequently discounted by U.S. intelligence, with two U.S. officials telling Newsweek on Tuesday they had no reason to think that Kim had suffered any kind of serious illness. Similarly, at the time, South Korea’s Yonhap News Agency cited a government official who said there was nothing unusual coming from North Korea that could suggest Kim was ill.

The South Korean Foreign Ministry did not respond to Newsweek‘s request for comment the following day, but referred to a Blue House statement in which the office of South Korean President Moon Jae-in also said no unusual activity related to North Korea or the health of its dynast had been reported. Chinese and Russian officials have questioned the sourcing of the U.S. and South Korean media reports, as has President Donald Trump, the first sitting U.S. leader to meet a North Korean supreme leader.

The president said Thursday he believed CNN’s report was “incorrect,” but had no further information to provide about Kim’s condition.

“We have a good relationship with North Korea, as good as you can have,” Trump told reporters. “I mean we have a good relationship with North Korea. I have a good relationship with Kim Jong Un and I hope he’s okay.”

Kim Jong Un
North Korea’s leader Kim Jong Un before a meeting with US President Donald Trump on the south side of the Military Demarcation Line that divides North and South Korea, in the Joint Security Area (JSA) of Panmunjom in the Demilitarized zone (DMZ) on June 30, 2019.
Brendan Smialowski / AFP/Getty

Kim and his familial predecessors have long been the subject of international press conjecture as information within North Korea is strictly controlled, leaving little room for leaks. Since Kim took over following his father’s death in 2011, he has been known to at times disappear, his longest absence being over a month in 2014.

But unlike those who ruled before him, the youngest, current supreme leader lacks any clear line of succession known to the outside world. With only foreign sources claiming Kim and his wife, Ri Sol Ju, may have had any children, the young ruler has no official heir. Some have speculated that his younger sister Kim Yo Jong, reported to be 31 and one of Kim’s key lieutenants, could succeed her brother, who has steadily promoted her position in recent years.

Secretary of State Mike Pompeo discussed Kim Yo Jong in an interview Thursday with Fox News.

“Well, I did have a chance to meet her a couple of times, but the challenge remains the same. The goal remains unchanged,” Pompeo said. “Whoever is leading North Korea, we want them to give up their nuclear program, we want them to join the league of nations, and we want a brighter future for the North Korean people. But they’ve got to denuclearize, and we’ve got to do so in a way that we can verify. That’s true no matter who is leading North Korea.”

After a tense 2017 filled with exchanges of nuclear-fueled threats, the Trump administration set out in 2018 to strike an unprecedented denuclearization-for-peace deal with Pyongyang. The effort yielded some early good-faith measures on both sides, as well as three historic meetings between Trump and Kim but ultimately failed to produce an agreement, leading to a gradual renewal in frictions between the longtime foe still technically at war since their 1950s conflict that still dominates the divided Korean Peninsula.

This is a developing story and will be updated as more information becomes available.

This content was originally published here.

Nicole ‘The Lip Doctor’ Bell redefining cosmetic dentistry

Long Island native Dr. Nicole Bell, also known as “The Lip Doctor,” has risen to success as a result of fusing dentistry and advanced esthetics.

After graduating from Baldwin Senior High School, Bell attended Manhattan College in Riverdale, New York, on a full academic scholarship. Her dental career began with studies at Meharry Medical College in Nashville, Tennessee, where she earned a doctor of dental surgery degree in 2001.

Currently, Bell shares two locations — in Long Island’s Freeport village and in downtown Brooklyn — where she is certified to treat with lasers and performs most procedures without the use of a drill or anesthetic. 

Rolling out had the opportunity to speak with Bell about her passion for cosmetic dentistry, what differentiates her practices, and her advice for entrepreneurs in the medical field.

When did you realize that you wanted to be a doctor?

When I was 5 years old I won a science fair, and after the competition, I was asked what I wanted to be when I grow up. I said, “I want to be a doctor.” Having my parents segue and guide me along the way made me feel like there was nothing to prevent me from becoming a doctor. The word doctor just stuck with me, and I continued to move forward. Medicine was intriguing but, more specifically, dentistry became appealing to me in college. I was heavily influenced by the dean of my dental school who is now the president of the dental school at Meharry Medical College.

Click continue to read more.

God, Fam, Biz, and Good Vibes. Writing about the things and people who matter that are making an impact in our community. Content Producer / Editor, entrepreneur and former Fortune 500 Sales and Marketing Executive.

This content was originally published here.

Maine restaurant loses health and liquor licenses after defying state virus orders — Business — Bangor Daily News — BDN Maine

Click here for the latest coronavirus news, which the BDN has made free for the public. You can support our critical reporting on the coronavirus by purchasing a digital subscription or donating directly to the newsroom.

NEWRY, Maine — The co-owner of Sunday River Brewing Co. in Newry who defied state orders by opening his doors to diners on Friday afternoon has lost his state health and liquor licenses, he said.

Restaurants must obtain state heath licenses to legally serve food.

More than 150 people came to Sunday River Brewing Co. in Newry on Friday afternoon after co-owner Rick Savage announced Thursday night that he would reopen in defiance of state orders meant to prevent the spread of the coronavirus.

After learning that he’d lost the licenses around 4:30 p.m., Savage initially said he planned to keep operating the restaurant and just pay the daily fines that he would face. However, later in the evening, Sunday River Brewing Co. published a Facebook post stating that the restaurant would be closed until further notice.

Watch: Rick Savage on losing his health and liquor licenses

Frustration with the state’s coronavirus-related business restrictions has been growing in some circles, but the restaurant’s deliberate act of disobedience appeared to be the clearest example yet of those tensions boiling over in Maine.

Although the restaurant initially said it would open at 4 p.m., it started serving food after people showed up around noon in defiance of a March order from Gov. Janet Mills that barred dine-in restaurant service.

By 4:30 p.m., the crowd of diners lined up around the building on Route 2 had grown to a peak of around 150. By 6 p.m., the restaurant had served roughly 250 people, according to an employee.

Robert F. Bukaty | AP
A crowd waits to get into Sunday River Brewing Company, Friday, May 1, 2020, in Newry, Maine. Rick Savage, owner of the brew pub, defied an executive order that prohibited the gathering of 10 or more people and opened his establishment during the coronavirus pandemic.

Savage, who announced the restaurant’s opening on Fox News on Thursday night while criticizing the Democratic governor and reading her cellphone number on the air, said that he was not worried some of the diners coming from areas with more documented coronavirus cases would spread it in his restaurant.

That was partly because he was enforcing distancing guidelines that other businesses have adopted during the pandemic. If Home Depot, Lowes and Walmart “can do 6-foot spacing and be open,” then his restaurant could as well, he said.

“I really don’t believe it. I don’t believe it at this point,” he said, when asked if it might be dangerous to let those diners into the restaurant. “I’m not a medical expert. I serve food, you know.”

As for the many diners standing less than 6 feet from each other while waiting for a seat, he said, “I can’t tell them where to stand and what to do. We’re America. If they want to isolate, they can isolate.”

Violating orders made under the governor’s emergency powers are punishable as a misdemeanor crime and the deputy director of the state’s liquor regulator said Savage could face a penalty if he opened to dine-in customers.

Robert F. Bukaty | AP
Rick Savage, center, owner of Sunday River Brewing Company, talks with customers Jon and Tiffany Moody after Savage defied an executive order prohibited the gathering of 10 or more people by opening his establishment during the coronavirus pandemic Friday, May 1, 2020, in Newry, Maine.

However, Savage earlier said that he did not think he would lose his liquor license because he decided against serving booze on Friday. He violated the state’s orders with the hope that other businesses would decide to join him and so that he could support his 65 employees, he said.

In general, there appears to be support for the restrictions Mills has put in place. She has received high polling marks for the state’s response to the pandemic, with 72 percent of Mainers saying they somewhat or strongly approve of her handling of the outbreak in a national survey released this week by researchers from Northeastern, Harvard and Rutgers universities.

But the hospitality industry has hammered a plan released by Mills this week that would limit restaurants and hotels into the summer. The crowd that turned out to Newry on Friday afternoon was also vehemently opposed.

Watch: Why one woman came to Sunday River Brewing Co.

At one point, diners waiting outside Sunday River Brewing Co. gave Savage a round of applause when he emerged from the restaurant. In interviews, some said they had come to support his operation because they disagreed with Mills’ orders and felt they would be too onerous for the tourism industry.

The fact that some of them were more elderly and at-risk from the harmful effects of the coronavirus did not deter them.

“This is Vacationland,” said Dick Hill, 78, who had driven two hours from his home in Bath after seeing Savage on Fox News. “If she doesn’t let hotels and restaurants open, we’re going to be crushed.”

Most of the cars in the parking lot Friday afternoon were from Maine, but a handful had plates from other states such as Massachusetts, New Hampshire, New Jersey and Florida.

Just after they had reached the front of the line, Tom Bayley, 60, and his 34-year-old son Gaelan expressed similar frustrations about Mills’ orders and said they had come to the restaurant to show solidarity.

Robert F. Bukaty | AP
Rick Savage, owner of Sunday River Brewing Company, walks out of his restaurant after he defied an executive order that prohibited gathering 10 or more people and opened his establishment during the coronavirus pandemic, Friday, May 1, 2020, in Newry, Maine.

The Bayleys run a family campground with 750 sites in Scarborough, they said, and they worry that most out-of-state families won’t be able to justify taking a vacation when those orders call for two weeks of quarantine in Maine. They also said it will be possible for businesses such as theirs to responsibly open without contributing to the health crisis.

“It’s directly hitting our business,” Gaelen Bayley said.

Some of the diners wore red hats supporting President Donald Trump featuring his “Make America Great Again” slogan. But others in the ski town on Friday afternoon were less pleased with the diners’ choices.

“Make America stupid again!” one woman yelled out the window of a passing car.

Watch: The line at Sunday River Brewing Co. on Friday

This content was originally published here.

Police, health officials rebut Whitmer’s claims about hospital protest problems

Police, health officials rebut Whitmer’s claims about ambulance protest problems

Beth LeBlanc
The Detroit News
Published 10:52 AM EDT Apr 21, 2020

Lansing — Gov. Gretchen Whitmer said during a Monday press conference that protesters last week blocked ambulances from reaching Sparrow Hospital, but local law enforcement and hospital officials have countered the claims. 

Whitmer’s assertions stem from a Wednesday protest called Operation Gridlock during which more than 4,000 people — most staying in their cars —  surrounded the Capitol for hours to protest the governor’s extended and tightened stay-home order. 

Police have said the gridlock caused no issues for ambulances, but Whitmer has since maintained otherwise in at least two public press conferences. The Democratic governor has been under pressure from Republican legislative leaders, certain business groups and some residents to carve out exceptions to her tightened stay home order that still follow federal guidance and create a plan for gradually reopening parts of Michigan’s economy.

Gov. Gretchen Whitmer gives a COVID-19 update.

“The blocking of cars and ambulances trying to get into Sparrow Hospital immediately endangered lives,” Whitmer said Monday. “…While I respect people’s right to dissent, I am worried about the health of the people of our state.”

Sparrow Hospital is located on Michigan Avenue about a mile east of the Capitol. 

When questioned last Thursday about the assertion, Whitmer’s spokeswoman Tiffany Brown said the governor was referring to a tweet by Gongwer News Service Executive Editor and Publisher Zach Gorchow, showing an ambulance in traffic near the Capitol, as well as “multiple posts” from medical workers inside the hospital. 

The ambulance took five to seven minutes to make it through the vehicles — starting from the time it turned on its lights and sirens, Gorchow said.  

“What was not clear to me was whether the ambulance was called to a run and trying to get to a call or if the drivers had no run but were alarmed that traffic had not moved for close to an hour and used their lights and siren to clear a path,” he said.

Brown sent The News screen grabs showing Facebook posts from two Sparrow Hospital health care workers who said ambulances were blocked from entering the hospital. 

“I work at sparrow and I will tell you THEY ARE BLOCKED and ppl are HONKING their horns where people are trying to rest and recover!! SELFISH. Our employees can’t even get to work!! Our cancer patients can’t to their appointments!” Lindsay Bowman wrote last week on the WILX News 10 Facebook page. 

Capital Area Transportation Authority on Wednesday said service was temporarily disrupted downtown and surrounding areas because of the protests. 

“CATA is unable to accommodate life-sustaining and medically necessary trips to or from these areas,” the agency posted on Twitter. 

But hospital, ambulance and police officials said they had no reports of any patients being endangered by the protest.

Sparrow Hospital spokesman John Foren said last week that some hospital personnel were delayed in making their shifts on the day of the protest, causing some personnel to work past the ends of their normal shifts. 

But the ambulance entrance to and from the hospital remained clear, Foren said. The Sparrow spokesman said Thursday he had received no reports that ambulances were stuck in traffic farther out from the hospital, either.

Despite some “confusion,” Lansing police had no complaints about any ambulance being locked in traffic during an emergency, said Robert Merritt, a spokesman for the Lansing Police Department. When ambulances on non-emergency runs were in traffic, “rally participants slowly cleared a path,” he said.

“There were NO complaints from any emergency services vehicle being held up while on an emergency run (lights and siren),” Merritt said in an email. 

“There are many photos/videos floating around that show an ambulance moving slow within the vehicles in the rally. This ambulance and some other emergency services vehicles (not on emergency runs) were seen driving through parts of the rally.”

Mercy Ambulance, which is located just east of Sparrow on Michigan Avenue, also had no delays but some units did take alternate routes because of the traffic, said Dennis Palmer, president and CEO of Mercy Ambulance. 

The accommodations were no different from what the company would have to make if there were a Michigan State University game, a traffic crash or construction, Palmer said. 

“In fact, we were more prepared because we were given advance notice,” the Mercy Ambulance CEO said.

There was a potential for a delay and his employees remarked as much on social media, Palmer said. But there were no actual delays to service, he said.

While Lansing police were responsible for enforcement in the city at large, Michigan State Police had jurisdiction over the Capitol grounds. Michigan State Police said early on that, despite a lack of social distancing by some demonstrators, they would only intervene in the protest if there was a threat to human life or vandalism. 

Michigan State Police made one arrest during the hours-long protest when one protester allegedly assaulted another, but otherwise the crowds largely were “polite” and “respectful,” said First Lt. Darren Green. 

Lansing Mayor Andy Schor, likewise, has never maintained ambulances were trapped during the protest. But the mayor issued Friday a press release warning protesters that next time he would ask for mutual aid from local police departments to help manage the crowds and enforce social distancing.

“Lansing Police will monitor Lansing ordinance violations and cite offenders when we have available offices and as possible to ensure officer safety,” Schor said. “Violations such as excessive noise, purposely blocking roads, and public urination or defecation, and others.”

The rally organizer, the Michigan Conservative Coalition, sent a letter Sunday to Schor noting “an unrelated group” was responsible for the individuals who left their cars and protested on the Capitol lawn. 

Coalition President Rosanne Ponkowski said the group is not planning on organizing future events, but other groups were “co-opting” the name and idea of Operation Gridlock. Ponkowski said the group is encouraging residents to avoid any upcoming rallies. 

“Our goal was to bring attention to the irrational rules in place that were putting over 1,000,000 workers on the unemployment line,” Ponkowski wrote. “We feel the governor has heard the people’s message at Operation Gridlock and she needs time to act to restart the economy.  Now.”

eleblanc@detroitnews.com

This content was originally published here.

Filipinos to now pay 3% of salary for health insurance

Under the universal healthcare law, overseas Filipinos are classified as ‘direct contributors’.

Starting this year, Filipinos in the UAE and across the world are required to pay three per cent of their income to the Philippine Health Insurance Corporation (PhilHealth), the authority reiterated in its latest circular.

The increase in PhilHealth premiums was rolled out late last year and, on April 22, the corporation published a detailed circular elaborating on the contribution and collection of payment from overseas Filipino members.

Also read: FAQs on Philippine health insurance contribution

PhilHealth said expats’ three per cent premium rate will be computed based on their monthly pay, with the range set at P10,000 (Dh730) to P60,000 (Dh4,385).

If one’s monthly salary is higher than Dh4,385, the individual will still pay P1,800 (Dh132)  every month, or the three per cent of the income ceiling.

For an entire year, an expat earning Dh4,385 or more will have to shell out P21,600 (Dh1,579).

“While the premium is computed based on the monthly income, payment shall be made every three-month, six-month or full 12-month period,” the circular said.

It added that 2020 will serve as the transition year, so an initial payment of P2,400 (Dh175) can be made to meet the new policy requirements. The remaining balance, however, shall be settled within the year.

“A member who fails to pay the premium after the due date set by the corporation shall be required to pay all missed contributions with monthly compounded interest,” it said.

“By January 1, 2021, the minimum acceptable initial payment is a three-month premium based on the prescribed rate at the time of payment,” it added. “Still, the member has the option to pay the balance in full or in quarterly payments.”
 
Membership must be updated

Under the Philippines’ universal healthcare law, overseas Filipinos are classified as ‘direct contributors’, therefore, “payment and remittance of premium contributions is mandatory”, as stated in the circular.
 
Expats should update their PhilHealth membership and submit a proof of income, which shall serve as the basis for the mandatory contribution.

The new policy covers even those who are not employed. “This circular covers all overseas Filipinos living and working abroad, including those on vacation and those waiting for documentation, whether registered or unregistered to the National Health Insurance Program,” the circular said.
 
Coverage includes hospitalisation abroad

A PhilHealth representative – whom Khaleej Times spoke to through the agency’s hotline – confirmed that members and their dependents can avail of the insurance’s benefits even if they are outside the country.

“Should a member be hospitalised abroad, he or she will just have to submit the bills, medical abstract and filled-out Claim Form 1 and Claim Form 2,” he said in Filipino. Claim forms can be downloaded from the PhilHealth’s website. 

“Documents should be submitted within 180 days after the patient has been discharged,” he added.

Premium  to increase yearly till 2024-25

Filipino expats’ PhilHealth contributions shall also increase every year until 2024-25, according to the circular.

From three per cent this year, the premium will be at 3.5 per cent in 2021; 4 per cent in 2022; 4.5 per cent in 2023; and 5 per cent in 2024 and 2025.

The income ceiling will also increase to P70,000 (Dh5116) in 2021, 80,000 (Dh5,847) in 2022, 90,000 (Dh6,578) in 2023, and 100,000 (Dh7,309) from 2024 to 2025.

kirstin@khaleejtimes.com

This content was originally published here.

We Didn’t ‘Flatten The Curve,’ We Flattened The U.S. Health Care System

When the lockdowns began last month, we were told that if we didn’t stay home our hospitals would be overwhelmed with coronavirus patients, intensive care wards would be overrun, there wouldn’t be enough ventilators, and some people would probably die in their homes for lack of care. To maintain capacity in the health-care system, we all had to go on lockdown—not just the big cities, but everywhere.

So we stayed home, businesses closed, and tens of millions of Americans lost their jobs. But with the exception of New York City, the overwhelming surge of coronavirus patients never really appeared—at least not in the predicted numbers, which have been off by hundreds of thousands.

During a press conference Wednesday, Florida Gov. Ron DeSantis noted that health experts initially projected 465,000 Floridians would be hospitalized because of coronavirus by April 24. But as of April 22, the number is slightly more than 2,000.

Even in New York, where Gov. Andrew Cuomo said last month he would need 30,000 ventilators, hospitals never came close to needing that many. The projected peak need was about 5,000, and actual usage may have been even lower.

Other overflow measures have also proven unnecessary. On Tuesday, President Trump said the USNS Comfort, the Navy hospital ship that had been deployed to New York to provide emergency care for coronavirus patients, will be leaving New York. The ship had been prepared to treat 500 patients. As of Friday, only 71 beds were occupied. An Army field hospital set up in Seattle’s pro football stadium shut down earlier this month without ever having seen a single patient.

It’s the same story in much of the country. In Texas, where this week Gov. Greg Abbott began gradually loosening lockdown measures, including a prohibition on most medical procedures, hospitals aren’t overwhelmed. In Dallas and Houston, where coronavirus cases are concentrated in the state, makeshift overflow centers that had been under construction might not be used at all.

In Illinois, where hospitals across the state scrambled to stock up on ventilators last month, fewer than half of them have been put to use—and as of Sunday, only 757 of 1,345 ventilators were being used by COVID-19 patients. In Virginia, only about 22 percent of the ventilator supply is being used.

Meanwhile, hospitals and health care systems nationwide have had to furlough or lay off thousands of employees. Why? Because the vast major of most hospitals’ revenue comes from elective or “non-essential” procedures. We’re not talking about LASIK eye surgery but things like coronary angioplasty and stents, procedures that are necessary but maybe not emergencies—yet. If hospitals can’t perform these procedures because governors have banned them, then they can’t pay their bills, or their employees.

To take just one example, a friend who works in a cardiac intensive care unit (ICU) in rural Virginia called recently and told me about how they had reorganized their entire system around caring for coronavirus patients. They had cancelled most “non-essential” procedures, imposed furloughs and pay cuts, and created a special ICU ward for patients with COVID-19. So far, they have had only one patient. One. The nurses assigned to the COVID-19 ward have very little to do. In the entire area covered by this hospital system, only about 30 people have tested positive for COVID-19.

If Hospitals Can Handle The Load, End The Lockdowns

I’m sure the governors and health officials who ordered these lockdowns meant well. They based their decisions on deeply flawed and woefully inaccurate models, and they should have been less panicky and more skeptical, but they were facing a completely new disease about which, thanks to China, they had almost no reliable information.

However, in hindsight it seems clear that treating the entire country as if it were New York City was a huge mistake that has cost millions of American jobs and destroyed untold amounts of wealth. Now that we know our hospitals aren’t going to be overrun by COVID-19 cases, governors and mayors should immediately reverse course and begin opening their states and communities for business.

Of course, some already are—and in a phased, cautious manner, as they should. But the overarching narrative that we all bought into, that unless we stayed home and “flattened the curve” our hospitals would be inundated, and if your kids got sick there would be no beds available to treat them, has turned out to be false. It hasn’t happened, and it most likely won’t happen, especially now that new evidence is emerging that suggests many more people have already contracted COVID-19 than previously thought, which means the disease might be far less lethal than we feared.

Public officials responsible for the lockdowns will no doubt claim that without these draconian measures, our hospitals surely would have been overwhelmed. And who knows? Maybe they would have. It’s an unfalsifiable assertion.

But at this point we should all be able to agree that the predictions were way off, and not just because they didn’t take into account stay-at-home orders or business closures, because they did. The experts, in this case, were wrong. The best thing governors and mayors can do now is admit as much, and start lifting their lockdown orders so people—including doctors and nurses—can get back to work.

This content was originally published here.

More Local Hospitals Report Children With Possible COVID-19 Health Consequences – NBC New York

Amid new concerns about the possible impact of COVID-19 on children, one Long Island hospital tells NBC New York they have seen about a dozen critically ill pediatric patients in the past two weeks with similar inflammatory symptoms. 

“We now have at least about 12 patients in our hospital that are presenting in a similar fashion, that we think have some relation to a COVID infection,” said Dr. James Schneider, Director of Pediatric Critical Care at Cohen Children’s Hospital in Nassau. “It’s something we’re starting to see around the country.”  

Cohen is one of several local hospitals where pediatricians say they are concerned about recent hospitalizations of previously healthy children who have become critically ill with the same features, resembling Toxic Shock Syndrome and Kawasaki disease. Kawasaki is an autoimmune sickness that can be triggered by a viral infection and if not treated quickly, can cause life-threatening damage to the arteries and the heart.  

Top news stories in the tri-state area, in America and around the world

“They are scattered. Each center has one or two cases,” said Pediatric Cardiologist Dr. Nadine Choueiter of Montefiore Medical Center in the Bronx.

While Dr. Choueiter noted the cases are still rare, she added, “Yes, we are seeing them and it’s important to talk about it to raise awareness so as pediatricians we look for these symptoms and treat them.”

Symptoms can include fever for more than five days, rash, gastrointestinal symptoms, red eyes and swollen hands and feet. In addition to a dozen cases at Cohen Children’s Hospital, a source at Mount Sinai Hospital says the number of cases in their pediatric ICU grew by several this week, up from two cases on April 28. 

A Mount Sinai spokesman declined to comment. 

NBC New York has also confirmed at least one case at Montefiore Medical Center and another case of a toddler at NYU Langone, who was released in recent days after being treated for Kawasaki disease.  

At Columbia Presbyterian, a spokesperson did not respond to repeated requests from NBC New York about a published report of three cases in their hospital. 

Pediatricians say besides the serious inflammatory symptoms, what many of these children have in common is that they test positive for COVID-19 or the antibodies. They also say some of the children test negative for COVID-19, but are believed to have been exposed to the virus by immediate family members.

Now doctors are comparing notes, trying to figure out if COVID-19 is triggering an overreaction of the immune system in some previously healthy children, perhaps even weeks after they were exposed. 

“The interesting part is only now are we seeing these patients show up,” Dr. Schneider said, adding that the question remains “Is this a typical surge in Kawasaki disease or is this the typical post-infectious response to a COVID infection?” 

Doctors say it is also possible that these cases are unrelated to COVID-19, but it is hard to know, since health officials do not require such symptoms in children to be tracked. It is still unclear if local public health officials have started counting these cases to determine if there is an uptick.

The New York City Health Department seemed unaware of the local cases when NBC New York first inquired about doctors’ concerns at a news conference with Mayor Bill de Blasio on April 29.

“We have not seen this to date,” said Commissioner Oxiris Barbot of the NYC Department of Health and Mental Hygiene.

Two days later on May 1, when NBC New York asked for an update, Commissioner Barbot said she is trying to learn more about any potential health threat to children.

“We are looking closely at this, “ Barbot said. “My team has reached out to the pediatric hospitals to get more information about specific cases that they have concerns are indicating an inflammatory cardiovascular response in children that had not been previously observed.” 

Barbot said she had also personally communicated with the NYC Medical Examiner who is attempting to compile any information on children abroad who may have died after developing these symptoms. British pediatricians and health officials also issued a warning on April 26 about a possible COVID-Kawasaki link in young children. 

“It just goes to show that COVID does not spare any age group and can lead to very serious illness, even in kids,” said Dr. Schneider.

This content was originally published here.

Florida megachurch pastor arrested for holding services despite health order

A Florida pastor was arrested on Monday for holding services at a Tampa megachurch in violation of a public health order prohibiting large gatherings to stem the spread of the coronavirus.  

Pastor Rodney Howard-Browne was charged with misdemeanor counts of unlawful assembly and violation of the public health rules, according to Fox 13, Tampa Bay’s local affiliate.

Howard-Browne’s apprehension came after he held two Sunday services with up to 500 attendees, even offering bus service to the church.

“His reckless disregard for human life put hundreds of people in his congregation and thousands of residents who may interact with them this week in danger,” said Hillsborough County Sheriff Chad Chronister, who issued an arrest warrant earlier Monday.

Despite social distancing measures to curb person-to-person transmission of the coronavirus, the River at Tampa Bay Church announced earlier this month that it intended to remain open to comfort those in need, even as the number of confirmed coronavirus cases rose across the country.  

“In a time of national crisis, we expect certain institutions to be open and certain people to be on duty. We expect hospitals to have their doors open 24/7 to receive and treat patients. We expect our police and firefighters to be ready and available to rescue and to help and to keep the peace. The Church is another one of those essential services. It is a place where people turn for help and for comfort in a climate of fear and uncertainty,” the church said in a statement.

The River at Tampa Bay Church was one of several regional churches that drew hundreds of worshipers recently despite bans on public gatherings amid the coronavirus pandemic.

Earlier in March, a Louisiana church held a service attended by about 300 people despite a ban on gatherings of more than 50 people by Gov. John Bel Edwards (D). The Rev. Tony Spell of Life Tabernacle Church in East Baton Rouge Parish said at the time that the virus was “not a concern.”

President TrumpDonald John TrumpCuomo grilled by brother about running for president: ‘No. no’ Maxine Waters unleashes over Trump COVID-19 response: ‘Stop congratulating yourself! You’re a failure’ Meadows resigns from Congress, heads to White House MORE last week said during a Fox News town hall at the White House that he would “love to have the country opened up and just raring to go by Easter,” describing his April 12 target date as a “beautiful timeline” and adding that he hoped to see “packed pews.”  

But Trump reversed course on Sunday, announcing the White House would keep its guidelines for social distancing in place through the end of April to try to blunt the spread of the coronavirus.

This content was originally published here.

Sedation Dentistry Options For Children – from 123Dentist

Types of Sedation

There are several levels of sedation your dentist may choose to use depending on your child and the procedure to be undertaken.

Nitrous oxide, commonly known as laughing gas, is the lowest level of sedation. It is blended with oxygen and administered through a small breathing mask. It is non-invasive, and once your child stops breathing nitrous oxide then the drug will quickly leave their system, and they will return to normal. Nitrous oxide won’t put your child to sleep, but it will help them to relax.

Mild sedation is usually induced using orally administered drugs. Your child will remain awake and usually be able to respond normally to verbal communication, but their movement and coordination may be affected. Respiratory and cardiovascular reflexes and functions are not affected at all, so there is no need for any additional monitoring equipment or oxygen.

Moderate sedation will make your child drowsy, and although they will usually respond to verbal communication they may not be able to speak coherently. They are likely to remain a little sleepy after the procedure, and most children cannot remember all or any of the procedure. This type of sedation can be reversed easily and breathing and cardiovascular function are generally unaffected.

Deep sedation is induced using intravenous drugs and will mean that your child is fully asleep. They may move a little and make sounds in response to repeated stimulation or any pain, but they will be in a deep sleep. Recovery from this type of sedation takes a little longer, and it is highly unlikely that your child will remember anything that happened. Sometimes respiratory or cardiovascular function can be impaired using these types of drugs, so there will be an extra qualified person present to monitor your child throughout the procedure.

The deepest option is a general anaesthetic, also induced using intravenous drugs. During a general anaesthetic, your child will be completely asleep and unable to respond to any stimulation, including pain. Your child will not remember any of the procedure, and should remain drowsy for some time afterwards. During this type of sedation, your child would be monitored by an anaesthetist who is trained in taking care of people under general anaesthetic. Recovery time is a little longer after a general anaesthetic than the other sedation types, and your child may need assistance with breathing during the procedure.

When Is Sedation Required?

There are a few reasons why sedation might be necessary for your child during a dental procedure. First of all, the procedure may be painful, so sedation would be appropriate to avoid unnecessary discomfort. Depending on the type and length of the procedure required, any of the above types of sedation might be appropriate.

If your child is at all anxious about visiting the dentist, it is important to make their experience as smooth as possible to avoid worsening the problem. The level of sedation required will depend on the level of anxiety and the procedure. For mild anxiety, nitrous oxide or mild sedation would help your child relax. If your child is very young, then a higher level might be appropriate to prevent them from moving during the procedure. In more extreme cases of anxiety or phobia, higher sedation levels may be required.

Sedation is sometimes required for children with behavioural disorders or other special needs. It can be difficult, or impossible, to explain to these children why dental care is required. The whole experience can therefore be very frightening for them, so an appropriate level of sedation may be used to help them remain calm and still for the procedure.

Concerns and Contraindications

Sedation has been used in dentistry for a long time, and the drugs and methods used are constantly reviewed. Anyone recommending or administering sedation is specially trained to do so safely, and during deep sedation and general anaesthetic your child is monitored by a trained professional in the room solely for that purpose.

Sometimes sedation can result in side effects such as nausea, vomiting, prolonged drowsiness, and imbalance. These effects usually wear off by themselves. After a deep sedation or general anaesthetic your child should be closely supervised to prevent falling, choking if they vomit, or airway obstruction.

Sedation of children for dental procedures is a common and safe practice. It may be worrying when your dentist first suggests it, but it is important not to increase your child’s anxiety so that they can maintain excellent dental care throughout their lives.

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This content was originally published here.

NYC declares war on ‘rim jobs’ in Health Dept. report

NYC’s Department of Health is bending over backwards to warn the public about a whole new threat — “rim jobs.”

The city’s health agency issued graphic guidelines for safe sex practices during the coronavirus pandemic Saturday, and while many were quick to take jabs at the agency for declaring masturbation as safer than sex with a partner, most missed the backdoor rim shot.

Yes, the city specifically called out rimming — or using the tongue on the anal rim of another person for sexual pleasure — as particularly dangerous in a jaw-dropping section of the public safety alert.

“Rimming (mouth on anus) might spread COVID-19. Virus in feces may enter your mouth,” the city warned in the section titled, “Take care during sex.”

Eagle-eyed Twitter users, naturally, had a field day with the bizarre bullet point, whipping it into the butt of jokes online.

“The NYC Health Department has a document about sex and coronavirus that includes a statement about rimming,” one person wrote. “tl;dr ‘Stay at least six feet from other people, and be sure not to lick anyone’s anus.’”

“Day 13 of quarantine: my parents read the NYC coronavirus sex guidelines and are now discussing rimming at the dinner table. Need evacuation ASAP,” one person wrote.

Day 13 of quarantine: my parents read the NYC coronavirus sex guidelines and are now discussing rimming at the dinner table. Need evacuation ASAP

— WFH Stan Account (@plerer) March 23, 2020

Others were shocked the Department of Health didn’t let this particular sex act fall through the cracks — and in fact added it right after the section on kissing.

“The nyc coronavirus sex advice goes from kissing straight to rimming a-s which just goes to show how badly nyc was begging for a plague,” another joked.

It’s not always better to love the one you’re self-isolating…

Some, however, were impressed the city poo-pooed the sex act, commonly known as a “rim job,” which is popular for many same-sex partners.

“Important, inclusive, informational. I’m here for this,” one person said.

The Department of Health reiterated advice to social distance to prevent the spread of coronavirus on Saturday, days before the Big Apple became the epicenter of the virus with more than 13,000 cases and as many as 125 deaths from COVID-19.

The agency urged city dwellers to remain six feet apart from one another, but the document also offered “some tips for how to enjoy sex and to avoid spreading COVID-19.”

“You are your safest sex partner,” the document read. “Masturbation will not spread COVID-19, especially if you wash your hands (and any sex toys) with soap and water for at least 20 seconds before and after.”

The agency, however, didn’t knock bumping uglies with a virus-free partner or live-in mate.

“The next safest partner is someone you live with,” the document continued. “Having close contact– including sex — with a small circle of people helps prevent spreading COVID-19.

The document also encouraged seeking out sex in virtual form, including advising sex workers to turn to the web.

“If you usually meet your sex partners online or make a living by having sex, consider taking a break from in-person dates,” the document added. “Video dates, sexting or chat rooms may be options for you.”

So for those looking for rim jobs, best to try a Google search.

This content was originally published here.

‘Our health care system has not been overwhelmed’ by COVID-19, says Pence | PBS NewsHour

Vice President Mike Pence:

Judy, I will tell you that we’re — we’re going to get to the bottom of what happened with the World Health Organization and why the world wasn’t informed by China about what was happening on the ground in Wuhan with the coronavirus.

There’ll be time for that in the days ahead. And the president has made it clear that we’re going to hold the World Health Organization and — and China accountable for that.

But I have to tell you, having — having been asked by the president to lead the White House Coronavirus Task Force in late February, that the actions that our president took in January, where he suspended all travel from China, the first time any American president had ever done that, bought us an invaluable amount of time to stand up the national response that has us here today, at a time when our health care system has not been overwhelmed.

And while — while you — you cite statistics from Europe, the reality is, when you look at the European Union as a whole, which is roughly the size of the United States, thanks to the commitment of our health care workers, thanks to the response of the American people, while we grieve the loss of more than 33,000 Americans today, the truth is, the mortality rate in the United States today is — is far less than half of that in Europe.

It’s a tribute to our — our system. It’s a tribute to the American response. And, frankly, it’s a tribute to the fact that President Trump suspended all travel from China, initiated efforts to get our CDC into China by mid-February.

And so, by the time we — we learned of the first community spread in late February in the United States, we were able to surge the resources and — and raise up the kind of countermeasures that have us in the place that we are today.

This content was originally published here.

Nevada Orders Closure of Health Food Stores, While Liquor Stores Remain Open


You can’t make this stuff up. Nevada governor says health food stores are not essential, but liquor stores are.

It may sound like something out of the Twilight Zone, but it’s real:

The Governor of Nevada has ordered small health food stores (excluding Amazon-owned Whole Foods) to close, calling them “non-essential businesses,” according to a press release by the Natural Products Association.

Meanwhile, liquor stores are still up and running. No joke.

“Governor Sisolak’s decision is shortsighted and inconsistent with the federal government and other states and amounts to an assault on small businesses,” writes CEO of the NPA Daniel Fabricant.

“Amidst the recent COVID-19 outbreak, we’ve seen firsthand the importance of supporting a healthy immune system. Proper nutrition is a cornerstone of a ‘health-first’ strategy and essential vitamins and minerals, like Vitamin C, are highly efficient ways to support your daily health and wellness…Don’t let Governor Sisolak and his accomplices take away health choices away from your family.”

A health food store called Stay Healthy of Las Vegas shared on its website that the store was forced to close as of April 7.

Due to a Mandate issued by Governor Sisolak we are considered NON-Essential, contrary to Federal Guidelines, and had to temporarily CLOSE our doors. We need your help! Please call Governor Sisolak at (775) 684-5670 or to State of Nevada Homepage to at least allow Curbside Pick Up for us.”

Please click here to sign the Natural Products Association’s petition to the governor to let these essential businesses open back up.

The post Nevada Orders Closure of Health Food Stores, While Liquor Stores Remain Open appeared first on Return to Now.

This content was originally published here.

No, The Health Department Did Not Say To Microwave Face Masks To Sterilize Them

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Y’all…please do not microwave your face masks. I guess somewhere on the internet there was a post telling people to do this. No. Do not do this!

There are people that are showing images of their burnt masks because they followed this advice that someone gave on the internet.

Health Departments are speaking up and asking you to not do this.

Fabric/home made masks are to be marked as to which side you will wear as inside to be consistent. These masks are to be…

Posted by

You wash your face mask. If you microwave it you will burn it. You could even catch your house on fire!

DO NOT TRY TO STERILIZE FABRIC MASK IN THE MICROWAVE as directed on facebook. This is what happened to mine this morning.This was at 2 minutes in an unsealed Ziploc bag.

Posted by

You can wash your face masks in your clothes washing machine. Mine has a sanitizing setting, so that is what I would use. But even if you don’t have that setting you can still do a hot water wash with laundry soap.

People are saying you can sterilize a face mask by placing it in a plastic baggy and microwaving it for 2 to 3 minutes. NO!

Do not put your face mask in the microwave to sanitize it , my house stinks bad ! My favorite mask to . Bummer

Posted by

Thankfully, those that tried it are speaking up so that others do not make the same mistake. Masks are hard to get, even if you are making your own, you don’t want to ruin it.

Do Not put cloth face mask in microwave!! This is mine on 1 1/2 minutes!!!!!

Posted by

I did a very quick search and came across many posts with the same results. Burnt, ruined face masks.

Don’t microwave the mask

Posted by

So do yourself a favor and skip the microwave. Just wash them in the washing machine or you can even hand wash them if needed. Give them a good soak and scrub, rinse and hang them to dry.

This content was originally published here.

Concerts Won’t Return Until “Fall 2021 at the Earliest,” Health Expert Warns | Consequence of Sound

Large-scale gatherings such as conferences, sport events, and live concerts won’t be safe to attend until “fall 2021 at the earliest,” according to Zeke Emmanuel, director of the Healthcare Transformation Institute at the University of Pennsylvania.

Emmanuel was part of an expert panel assembled by the New York Times on life after the COVID-19 pandemic. The problem, according to Emmanuel, is “You can’t just flip a switch and open the whole of society up. It’s just not going to work. It’s too much. The virus will definitely flare back to the worst levels.”

As he sees it, “restarting the economy has to be done in stages,” and crowded events will be the last part of our old lives to return. He said,

“It does have to start with more physical distancing at a work site that allows people who are at lower risk to come back. Certain kinds of construction, or manufacturing or offices, in which you can maintain six-foot distances are more reasonable to start sooner. Larger gatherings — conferences, concerts, sporting events — when people say they’re going to reschedule this conference or graduation event for October 2020, I have no idea how they think that’s a plausible possibility. I think those things will be the last to return. Realistically we’re talking fall 2021 at the earliest.”

So why do we have to wait until the second half of 2021? That has to do with the development timeline of the coronavirus vaccine. And Emmanuel isn’t alone in thinking a vaccine will take 12-18 months — in fact, that seems to be the expert consensus.

Larry Brilliant, the epidemiologist who led the effort to eradicate smallpox, told The Economist, “I think we will have a vaccine that works in less than a couple of months.” Unfortunately, that’s the easy part. “Then it will be the arduous process of making sure that it is effective enough and that it is not harmful. And then we have to produce it. [America’s Director National Institute of Allergy and Infectious Diseases] Tony Fauci’s estimate of 12 to 18 months before we have a vaccine, in sufficient quantities in place, is one that I agree with.”

But Brilliant, who also consulted on the 2011 Steven Soderbergh film Contagion, sounds even more pessimistic than Emmanuel. He thinks the COVID-19 virus will still be a problem — at least for a while — after the development of a vaccine.

“I just want to mention, once we have that vaccine, and we’ve mass vaccinated as many people as we could, there will still be outbreaks. People are not adding on to the backend of that time period the fact that we will then be chasing outbreaks, ping-pong-ing back and forth between countries. We will need to have the equivalent of the polio-eradication program or the smallpox-eradication program, hopefully at the WHO. And that mop-up—I hate to use that word when we’re talking about human beings—but that follow-on effort will take an additional period of time before we are truly safe.”

In other words, the re-opening of society will be slower and more painful than some are anticipating.

For now musicians have adapted with quarantine videos and isolation livestreams, as when Willie Nelson announced a digital Farm Aid with Neil Young, Dave Matthews, and more over the weekend. For a full list of upcoming concerts and livestreams, click here. But that’s not going to replace the lost revenue stream for middle-class and rising artists. If you want to help musicians impacted by the novel coronavirus, or are yourself a musician looking for help, check out our pandemic resource guide.

This content was originally published here.

Mertz Family Dentistry

Prominent Longmont family dentistry relocates and updates facilities

Everyone knows those semi-annual trips to the dentist are crucial to preserving and perfecting your smile…but something to smile about? If you’re one of the many loyal patients with Mertz Family Dentistry, it’s not out of the question that you may actually look forward to your dental visits. That sort of anticipation tends to happen when those whose services you consult provide ongoing attentive care; they become practically family. What’s more, the team at Mertz Family Dentistry are truly invested in making your experience as enjoyable as possible. This goal has just gotten all the easier to accomplish, thanks to a new, brighter, airier, more spacious setting; one which they plan to show off at an upcoming Open House from 4 – 7 p.m. on June 15.

Formerly located on Terry Street, Mertz Family Dentistry recently made the move to 1325 Dry Creek Drive, Suite 304. The new, modern facility offers twice as much space, allowing the team to optimize their capacity to provide superior care to an expanded number of patients. It offers a few new perks in comfort, too, featuring heated massage chairs with patient-operated remotes and sunlit rooms that lend a spa-like feel not typically associated with the dentist’s chair. “Our previous location was a great facility from which to provide excellent dental care in the past,” Dr. Peter Mertz says. “But looking into the future, we couldn’t be more excited about the new location and its capacity to further service our community well into the next decades. I wanted to create a facility that gave us a platform to provide the best in dental care while utilizing the latest, most up-to-date, technology. It’s a very modern, bright, relaxing setting. It’s inviting.”

Founded in 1985 by Dr. Guy Mertz, Mertz Family Dentistry is family-focused and family-rooted. In 2000, Dr. Peter Mertz joined his uncle in the mission to provide the best, most comprehensive and technologically advanced dental health care possible. Dr. Brett Nelson, who is now approaching his one-year anniversary with the practice since joining the team, says the close-knit staff of 16 is like family. “The long-term staff really distinguishes this amazing practice,” says Dr. Guy Mertz.

High-tech and high-service meet at the new Mertz Family Dentistry location to provide patients with an overall pleasant experience.

“Everyone is very dedicated. We have several employees who have been here 20, 30 years.”

Dr. Peter Mertz, who now owns the practice, has been selected as a top dentist for more than a decade consecutively, recently receiving that designation for the 11th time this year. He has advanced implant, sedation, CEREC single-visit crowns, and the most up-to-date Solea® laser systems training available.

Dr. Guy Mertz began his esteemed career 33 years ago with the opening of his practice, and is dedicated to the Longmont community. He has extensive training in laser dentistry systems. Dr. Guy Mertz was also selected as a top dentist by 5280 Magazine for the past two years.

A second-generation dentist originally from Indiana, Dr. Brett Nelson is a member of the American Academy of Cosmetic Dentistry, American Association of Endodontists, Academy of General Dentistry, American Academy of Implant Dentistry, and is a certified Invisalign provider. He is further certified in sedation dentistry. Dr. Nelson takes great care to practice what he refers to as ‘golden rule’ dentistry. “I treat all patients exactly as I would treat my closest friends and family members,” he says.

Prioritizing a personalized approach, doctors and staff at Mertz Family Dentistry take time to genuinely listen and understand the needs of each patient. And, the team does all they can to ensure they are equipped to meet those needs. They are highly skilled in pediatric dental care, and sensitive to the importance and personal means of helping children develop a positive relationship with healthy dental hygiene.

Throughout all ages and stages of life, Mertz Family Dentistry is invested in the wellbeing of its patients. “We’ve watched children grow up, go to college, and start their own families,” says Dr. Guy Mertz. “We have a great staff. We all enjoy each other, and we love our patients.” Dr. Peter Mertz attributes the notable, steady increase in patients the practice serves in great part to the warmth and dedication of his team. “We believe our staff is a big reason that our patients want to come back,” he says. “They each bring a high level of caring to their work.”

Bright new spaces have a spa-like feel, emphasizing relaxation and comfort for patients.

Alongside caring and understanding, Mertz Family Dentistry offers exceptional expertise. The wide range of services goes well beyond standard offerings, including sedation dentistry, Invisalign, and Laser Dentistry. Mertz’ cosmetic dentistry includes teeth whitening, porcelain veneers and crowns. Botox and Juvederm treatments are also performed on site. What’s more, all procedures are provided as comfortably as possible.

Mertz Family Dentistry has always been committed to investing in state-of-the-art, best practice technologies that provide the ultimate in dental care for patients. In fact, Dr. Peter Mertz is one of only a very few general dentists in the area to use a surgical microscope during dental procedures. “You can’t treat what you can’t see,” Dr. Peter Mertz says, stressing the significance of this technology. “The surgical microscope ensures the greatest accuracy possible.”

At Mertz Family Dentistry, three-dimensional X-rays provide the most thorough, comprehensive information for complex dental procedures. Such technologies further increase efficiency and ease for patients. “Utilizing our three-dimensional x-ray and scanner, we can have a guide fabricated for implants before the patient is even here, allowing for minimally invasive procedures,” Dr. Nelson says, explaining a few of the many benefits.

Mertz Family Dentistry was the first in Longmont to offer a special technology, which debuted 15 years ago- an advanced system that can create a crown or set of veneers in just a matter of hours. Each step is completed right in the office for same day fittings. Mertz Family Dentistry uses a detailed camera to map and measure the contours of the tooth. The remaining specifications are added into a chair-side computer, and the new piece is milled to tight specifications, increasing capability to closely match the new surface to surrounding teeth.

Skilled, caring professionals, cutting-edge technology, and a wide range of services offered-what more could one hope for in a dental office? How about painless visits? At Mertz Family Dentistry, the use of in-office lasers allows for anesthesia-free fillings, as well as other procedures to be completed without the use of shots. For all patients, and the youngest in particular, this is significantly reassuring.

Why not check out Mertz Family Dentistry for yourself? Stop by the new office at 1325 Dry Creek Drive on Friday, June 15, from 4- 7 p.m. Enjoy hors d’oeuvres, wine, and the opportunity to visit with staff and tour the office. “We would love to extend an invitation to our whole community to join us, see the new space, and celebrate our grand opening with us,” Dr. Peter Mertz invites. “Come on by.”

This content was originally published here.

About half of France’s coronavirus patients in intensive care are under 65, health official says

A French health official says warnings to stay home in the coronavirus pandemic are in some cases falling on deaf ears while noting that the virus hasn’t just been posing a risk to seniors.

French health ministry official Jérôme Salomon said Monday that the situation is “deteriorating very quickly” while providing this statistic: of the between 300 and 400 coronavirus patients in intensive care in France, about half of them are younger than 65, The New York Times reports.

Salomon is looking to “dispel the notion that the virus seriously threatens only the elderly,” the Times reports, and Mother Jones observes that even though the novel coronavirus is “understood to be particularly lethal among the elderly,” these numbers “underscore the reality that younger generations can still face serious consequences.”

Salomon also said Monday that in France, “a lot of people have not understood that they need to stay at home,” and as a result, “we are not succeeding in curbing the outbreak of the epidemic,” per Reuters. Most nonessential businesses in France were ordered to be closed over the weekend.

France has confirmed more than 5,400 cases of the novel coronavirus, and by Sunday, the number of deaths had risen to 127. Salomon said Monday the number of cases has been doubling “every three days.” Brendan Morrow

NBCUniversal announced Monday it will make Universal Pictures films that are playing in theaters right now, including The Invisible Man and The Hunt, available to rent at home for $19.99 beginning this Friday, per The Hollywood Reporter. The rental period will last 48 hours. This is a game-changer for theatrical moviegoing, as major studio films typically play in theaters exclusively for about three months before being made available for home viewing. The Hunt hit theaters just three days ago.

Universal’s new policy will also apply to at least one upcoming movie: Trolls World Tour, which is set to be made available digitally on the same day it’s released in theaters — at least, the theaters that are still open. The policy isn’t expected to apply to all of Universal’s upcoming movies, the Reporter says.

“We hope and believe that people will still go to the movies in theaters where available, but we understand that for people in different areas of the world that is increasingly becoming less possible,” NBCUniversal CEO Jeff Shell said.

Is Sen. Mitt Romney (R-Utah) ready to join the Yang Gang?

Romney is out with a proposal that should make entrepreneur and former 2020 Democratic candidate Andrew Yang proud, on Monday saying every American adult should receive a check for $1,000 amid the COVID-19 coronavirus pandemic.

This step, Romney said, will “help ensure families and workers can meet their short-term obligations and increase spending in the economy.” Romney added that “expansions of paid leave, unemployment insurance, and SNAP benefits” are also “crucial,” but the $1,000 check “will help fill the gaps for Americans that may not quickly navigate different government options.”

The Utah senator offered numerous other proposals for responding to the coronavirus crisis, including providing grants to small businesses impacted by the pandemic and deferring student loan payments “for a period of time to ease the burden for those who are just graduating now, in an economy suffering because of the COVID-19 outbreak.”

Yang’s central proposal during his 2020 campaign was to provide Americans with a universal basic income of $1,000 a month, an idea that some Democrats have been re-upping in the midst of the coronavirus crisis. Like Romney, Sen. Sherrod Brown (D-Ohio) is also backing the $1,000 payment idea, saying a check in that amount should go to all middle class and low-income adults because “we can’t leave the hardest-hit Americans behind.”

Romney’s proposal is for a one-time check and not a monthly payment as Democrats like Yang have called for. But Rep. Alexandria Ocasio-Cortez (D-N.Y.) tweeted Monday, “GOP & Democrats are both coming to the same conclusion: Universal Basic Income is going to have to play a role in helping Americans weather this crisis.”

This content was originally published here.

Sedation Dentistry Options For Children

Children can often be apprehensive about dental treatment, but keeping oral health in good condition is important, especially at a young age. In certain situations, your dentist might recommend using a type of sedation during your child’s treatment. This can be a worrying concept, but the right information will help to put your mind at rest.

Types of Sedation

There are several levels of sedation your dentist may choose to use depending on your child and the procedure to be undertaken.

Nitrous oxide, commonly known as laughing gas, is the lowest level of sedation. It is blended with oxygen and administered through a small breathing mask. It is non-invasive, and once your child stops breathing nitrous oxide then the drug will quickly leave their system, and they will return to normal. Nitrous oxide won’t put your child to sleep, but it will help them to relax.

Mild sedation is usually induced using orally administered drugs. Your child will remain awake and usually be able to respond normally to verbal communication, but their movement and coordination may be affected. Respiratory and cardiovascular reflexes and functions are not affected at all, so there is no need for any additional monitoring equipment or oxygen.

Moderate sedation will make your child drowsy, and although they will usually respond to verbal communication they may not be able to speak coherently. They are likely to remain a little sleepy after the procedure, and most children cannot remember all or any of the procedure. This type of sedation can be reversed easily and breathing and cardiovascular function are generally unaffected.

Deep sedation is induced using intravenous drugs and will mean that your child is fully asleep. They may move a little and make sounds in response to repeated stimulation or any pain, but they will be in a deep sleep. Recovery from this type of sedation takes a little longer, and it is highly unlikely that your child will remember anything that happened. Sometimes respiratory or cardiovascular function can be impaired using these types of drugs, so there will be an extra qualified person present to monitor your child throughout the procedure.

The deepest option is a general anaesthetic, also induced using intravenous drugs. During a general anaesthetic, your child will be completely asleep and unable to respond to any stimulation, including pain. Your child will not remember any of the procedure, and should remain drowsy for some time afterwards. During this type of sedation, your child would be monitored by an anaesthetist who is trained in taking care of people under general anaesthetic. Recovery time is a little longer after a general anaesthetic than the other sedation types, and your child may need assistance with breathing during the procedure.

When Is Sedation Required?

There are a few reasons why sedation might be necessary for your child during a dental procedure. First of all, the procedure may be painful, so sedation would be appropriate to avoid unnecessary discomfort. Depending on the type and length of the procedure required, any of the above types of sedation might be appropriate.

If your child is at all anxious about visiting the dentist, it is important to make their experience as smooth as possible to avoid worsening the problem. The level of sedation required will depend on the level of anxiety and the procedure. For mild anxiety, nitrous oxide or mild sedation would help your child relax. If your child is very young, then a higher level might be appropriate to prevent them from moving during the procedure. In more extreme cases of anxiety or phobia, higher sedation levels may be required.

Sedation is sometimes required for children with behavioural disorders or other special needs. It can be difficult, or impossible, to explain to these children why dental care is required. The whole experience can therefore be very frightening for them, so an appropriate level of sedation may be used to help them remain calm and still for the procedure.

Concerns and Contraindications

Sedation has been used in dentistry for a long time, and the drugs and methods used are constantly reviewed. Anyone recommending or administering sedation is specially trained to do so safely, and during deep sedation and general anaesthetic your child is monitored by a trained professional in the room solely for that purpose.

Sometimes sedation can result in side effects such as nausea, vomiting, prolonged drowsiness, and imbalance. These effects usually wear off by themselves. After a deep sedation or general anaesthetic your child should be closely supervised to prevent falling, choking if they vomit, or airway obstruction.

Sedation of children for dental procedures is a common and safe practice. It may be worrying when your dentist first suggests it, but it is important not to increase your child’s anxiety so that they can maintain excellent dental care throughout their lives.

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Sen. Joe Manchin erupts into shouting match with McConnell: You’re ‘more concerned about the health of Wall Street’ – Alternet.org

Sen. Joe Manchin erupts into shouting match with McConnell: You’re ‘more concerned about the health of Wall Street’

by David Edwards

Sen. Joe Manchin (D-WV) called out Senate Majority Leader Mitch McConnell (R-KY) on Monday for being more concerned with propping up the economy than providing supplies to hospitals fighting the novel coronavirus.

“You can throw all the money at Wall Street you want to,” Manchin said after McConnell blamed Democrats for a stalled stimulus bill. “People are afraid to leave their homes. They’re afraid of the health care. I’ve got workers who don’t have masks. I’ve got health care workers who don’t have gowns.”

“And it looks like we’re worried more about the economy than we are the health care and the wellbeing of the people of America,” the West Virginia senator complained.

McConnell interrupted: “The American people are waiting for us to act today! We don’t have time for this! We don’t have time for it!”

“Let me ask you a question,” Manchin implored.

“Answer my question!” McConnell demanded. “In what way would the Democratic Party be disadvantaged?”

“Thirty hours [of debate] or 30 days, as long as you have the votes, 51 votes rule,” Manchin said. “So the final vote is going to be on passage, whether you have to negotiate or not with us.”

“Here’s the way it works!” McConnell exclaimed. “We have been fiddling around as the senator from Maine pointed out for 24 hours…”

At that point, Manchin reclaimed his time, silencing McConnell.

“We just have a little different opinion about this,” Manchin said. “You can’t throw enough money to fix this if you can’t fix the health care.”

“My health care workers need to be protected,” he added. “But it seems like we’re talking about everything else about the economy versus the health care. That doesn’t make any sense to me whatsoever.”

“It seems like we’re more concerned about the health care of Wall Street,” Manchin remarked. “That’s the problem that I’ve had on this.”

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In just 24 hours, 1,000 retired health care workers volunteered to help fight coronavirus in New York City – CBS News

In just 24 hours, 1,000 retired health care workers in New York City volunteered to join the fight against coronavirus, Mayor Bill de Blasio said in an interview with WCBS 880 on Wednesday. The mayor likened their bold decision to his parents’ generation entering war.

“This is going to be like a war effort. Most New Yorkers haven’t experienced what this city and this country is like in a full-scale war,” de Blasio said. “My parents both served in the war effort in WWII. I heard these stories from the youngest years of my life.”

“When the entire community, the entire city, the entire nation are in common cause, it’s a different reality and everyone is going to have to work together to overcome this crisis, and we’re going to use every tool, every building, every resource to get us through this,” the mayor said.

He added that he asked earlier this week for retired health care workers to return to work, and he had good news: “In the last 24 hours, 1,000 New Yorkers who are retired medical personnel have volunteered to join the effort to fight coronavirus. I think that’s so inspiring. So many people are coming forward to help and that’s how we’re going to beat this back.”

Last week, other elected officials called on “former” health care workers to rejoin the workforce, including Colorado Governor Jared Polis and New York Governor Andrew Cuomo.

According to Polis, former health care workers include anyone retired or working in another field whose medical license is still active or can be reactivated.

Health care workers have been struggling to balance providing care with the fear of exposing their families to the illness. Some say they do not have the protective equipment they need.

“We are two weeks or three weeks away from running out of the supplies that we need most for our hospitals,” de Blasio said Thursday, according to The Associated Press

Lack of hospital beds has also been a concern — especially in New York City. In his interview with WCBS 880, de Blasio said the city is looking to convert large spaces like hotels into health care facilities or logistics staging. On Wednesday, Cuomo said President Trump agreed to send a Navy ship to New York City that will function as a hospital. 

This content was originally published here.

Simple math offers alarming answers about Covid-19, health care – STAT

Much of the current discourse on — and dismissal of — the Covid-19 outbreak focuses on comparisons of the total case load and total deaths with those caused by seasonal influenza. But these comparisons can be deceiving, especially in the early stages of an exponential curve as a novel virus tears through an immunologically naïve population.

Perhaps more important is the disproportionate number of severe Covid-19 cases, many requiring hospitalization or weekslong ICU stays. What does an avalanche of uncharacteristically severe respiratory viral illness cases mean for our health care system? How much excess capacity currently exists, and how quickly could Covid-19 cases saturate and overwhelm the number of available hospital beds, face masks, and other resources?

This threat to the health care system as a whole poses the greatest challenge.

As of March 8, about 500 cases of Covid-19 had been diagnosed in the U.S. Given the substantial underdiagnosis at present due to limitations in testing for the coronavirus, let’s say there are 2,000 current cases, a conservative starting bet.

We can expect a doubling of cases every six days, according to several epidemiological studies. Confirmed cases may appear to rise faster (or slower) in the short term as diagnostic capabilities are ramped up (or not), but this is how fast we can expect actual new cases to rise in the absence of substantial mitigation measures.

That means we are looking at about 1 million U.S. cases by the end of April; 2 million by May 7; 4 million by May 13; and so on.

As the health care system becomes saturated with cases, it will become increasingly difficult to detect, track, and contain new transmission chains. In the absence of extreme interventions like those implemented in China, this trend likely won’t slow significantly until hitting at least 1% of the population, or about 3.3 million Americans.

What does a case load of this size mean for health care system? That’s a big question, but just two facets — hospital beds and masks — can gauge how Covid-19 will affect resources.

The U.S. has about 2.8 hospital beds per 1,000 people (South Korea and Japan, two countries that have seemingly thwarted the exponential case growth trajectory, have more than 12 hospital beds per 1,000 people; even China has 4.3 per 1,000). With a population of 330 million, this is about 1 million hospital beds. At any given time, about 68% of them are occupied. That leaves about 300,000 beds available nationwide.

The majority of people with Covid-19 can be managed at home. But among 44,000 cases in China, about 15% required hospitalization and 5% ended up in critical care. In Italy, the statistics so far are even more dismal: More than half of infected individuals require hospitalization and about 10% need treatment in the ICU.

For this exercise, I’m conservatively assuming that only 10% of cases warrant hospitalization, in part because the U.S. population is younger than Italy’s, and has lower rates of smoking — which may compromise lung health and contribute to poorer prognosis — than both Italy and China. Yet the U.S. also has high rates of chronic conditions like cardiovascular disease and diabetes, which are also associated with the severity of Covid-19.

At a 10% hospitalization rate, all hospital beds in the U.S. will be filled by about May 10. And with many patients requiring weeks of care, turnover will slow to a crawl as beds fill with Covid-19 patients.

If I’m wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by six days (one doubling time) in either direction. If 20% of cases require hospitalization, we run out of beds by about May 4. If only 5% of cases require it, we can make it until about May 16, and a 2.5% rate gets us to May 22.

But this presumes there is no uptick in demand for beds from non-Covid-19 causes, a dubious presumption. As the health care system becomes increasingly burdened and prescription medication shortages kick in, people with chronic conditions that are normally well-managed may find themselves slipping into states of medical distress requiring hospitalization and even intensive care. For the sake of this exercise, though, let’s assume that all other causes of hospitalization remain constant.

Let me now turn to masks. The U.S. has a national stockpile of 12 million N95 masks and 30 million surgical masks for a health care workforce of about 18 million. As Covid-19 cases saturate nearly every state and county, virtually all health care workers will be expected to wear masks. If only 6 million of them are working on any given day (certainly an underestimate) they would burn through the national N95 stockpile in two days if each worker only got one mask per day, which is neither sanitary nor pragmatic.

It’s unlikely we’d be able to ramp up domestic production or importation of new masks to keep pace with this level of demand, especially since most countries will be simultaneously experiencing the same crises and shortages.

Shortages of these two resources — beds and masks — don’t stand in isolation but compound each other’s severity. Even with full personal protective equipment, health care workers are becoming infected while treating patients with Covid-19. As masks become a scarce resource, doctors and nurses will start dropping from the workforce for weeks at a time, leading to profound staffing shortages that further compound the challenges.

The same analysis applied to thousands of medical devices, supplies, and services — from complex equipment like ventilators or extracorporeal membrane oxygenation devices to hospital staples like saline drip bags — shows how these limitations compound one another while reducing the number of options available to clinicians.

Importantly — and I cannot stress this enough — even if some of the core assumptions I’m making, like the fraction of severe cases or the number of current cases, are off even by several-fold, it changes the overall timeline only by days or weeks.

Unwarranted panic does no one any good, but neither does ill-informed complacency. It’s inappropriate to assuage the public with misleading comparisons to the seasonal flu or by assuring people that there’s “only” a 2% fatality rate. The fraction of cases that are severe really sets Covid-19 apart from more familiar respiratory illnesses, compounded by the fact that it’s whipping through a population without natural immune protection at lightning speed.

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Individuals and governments seem not to be fully grasping the magnitude and near-inevitability of the national and global systemic burden we’re facing. We’re witnessing the abject refusal of many countries to adequately respond or prepare. Even if the risk of death for healthy individuals is very low, it’s insensible to mock decisions like canceling events, closing workplaces, or stocking up on prescription medications as panicked overreaction. These measures are the bare minimum we should be doing to try to shift the peak — to slow the rise in cases so health care systems are less overwhelmed.

The doubling time will naturally start to slow once a sizable fraction of the population has been infected due to the emergence of herd immunity and a dwindling susceptible population. And yes, societal measures like closing schools, implementing work-from-home policies, and canceling events may start to slow the spread before reaching infection saturation.

But considering that the scenarios described earlier — overflowing hospitals, mask shortages, infected health care workers — manifest when infections reach a mere 1% of the U.S. population, these interventions can only marginally slow the rate at which our health care system becomes swamped. They are unlikely to prevent overload altogether, at least in the absence of exceedingly swift and austere measures.

Each passing day is a missed opportunity to mitigate the wave of severe cases that we know is coming, and the lack of widespread surveillance testing is simply unacceptable. The best time to act is already in the past. The second-best time is right now.

Liz Specht is the associate director of science and technology at The Good Food Institute.

This content was originally published here.

Keeping the Coronavirus from Infecting Health-Care Workers | The New Yorker

The message is getting out: #StayHome. In this early phase of the coronavirus pandemic, with undetected cases accelerating transmission even as testing ramps up, that is critical. But there are many people whom the country needs to keep going into work—grocery cashiers, first responders, factory workers for critical businesses. Most obviously, we need health-care workers to care for the sick, even though their jobs carry the greatest risk of exposure. How do we keep them seeing patients rather than becoming patients?

In the index outbreak in Wuhan, thirteen hundred health-care workers became infected; their likelihood of infection was more than three times as high as the general population. When they went back home to their families, they became prime vectors of transmission. The city began to run out of doctors and nurses. Forty-two thousand more had to be brought in from elsewhere to treat the sick. Luckily, methods were found that protected all the new health-care workers: none—zero—were infected.

But those methods were Draconian. As the city was locked down and cut off from outside visitors, health-care workers seeing at-risk patients were housed away from their families. They wore full-body protective gear, including goggles, complete head coverings, N95 particle-filtering masks, and hazmat-style suits. Could we do that here? Not a chance. Health-care facilities don’t remotely have the supplies that would allow staff members to see every patient with all that gear on. In Massachusetts, where I practice surgery, the virus is circulating in at least eleven of our fourteen counties, and cases are climbing rapidly. So what happens if you are exposed to a coronavirus patient and you don’t have the ability to go full Wuhan? My hospital system, Partners HealthCare, has already sent more than a hundred staff members home for fourteen days of self-quarantine because they were exposed to the coronavirus without complete protection. If we had to quarantine every health-care worker who might have come into contact with a COVID-19 patient, we’d soon have no health-care workers left.

Yet there are lessons to be learned from two places that saw the new coronavirus before we did and that have had success in controlling its spread. Hong Kong and Singapore—both the size of my state—detected their first cases in late January, and the number of cases escalated rapidly. Officials banned large gatherings, directed people to work from home, and encouraged social distancing. Testing was ramped up as quickly as possible. But even these measures were never going to be enough if the virus kept propagating among health-care workers and facilities. Primary-care clinics and hospitals in the two countries, like in the U.S., didn’t have enough gowns and N95 masks, and, at first, tests weren’t widely available. After six weeks, though, they had a handle on the outbreak. Hospitals weren’t overrun with patients. By now, businesses and government offices have even begun reopening, and focus has shifted to controlling the cases coming into the country.

Here are their key tactics, drawn from official documents and discussions I’ve had with health-care leaders in each place. All health-care workers are expected to wear regular surgical masks for all patient interactions, to use gloves and proper hand hygiene, and to disinfect all surfaces in between patient consults. Patients with suspicious symptoms (a low-grade fever coupled with a cough, respiratory complaints, fatigue, or muscle aches) or exposures (travel to places with viral spread or contact with someone who tested positive) are separated from the rest of the patient population, and treated—wherever possible—in separate respiratory wards and clinics, in separate locations, with separate teams. Social distancing is practiced within clinics and hospitals: waiting-room chairs are placed six feet apart; direct interactions among staff members are conducted at a distance; doctors and patients stay six feet apart except during examinations.

What’s equally interesting is what they don’t do. The use of N95 masks, face-protectors, goggles, and gowns are reserved for procedures where respiratory secretions can be aerosolized (for example, intubating a patient for anesthesia) and for known or suspected cases of COVID-19. Their quarantine policies are more nuanced, too. What happens when someone unexpectedly tests positive—say, a hospital co-worker or a patient in a primary-care office or an emergency room? In Hong Kong and Singapore, they don’t shut the place down or put everyone under home quarantine. They do their best to trace every contact and then quarantine only those who had close contact with the infected person. In Hong Kong, “close contact” means fifteen minutes at a distance of less than six feet and without the use of a surgical mask; in Singapore, thirty minutes. If the exposure is shorter than the prescribed limit but within six feet for more than two minutes, workers can stay on the job if they wear a surgical mask and have twice-daily temperature checks. People who have had brief, incidental contact are just asked to monitor themselves for symptoms.

The fact that these measures have succeeded in flattening the COVID-19 curve carries some hopeful implications. One is that this coronavirus, even though it appears to be more contagious than the flu, can still be managed by the standard public-health playbook: social distancing, basic hand hygiene and cleaning, targeted isolation and quarantine of the ill and those with high-risk exposure, a surge in health-care capacity (supplies, testing, personnel, wards), and coördinated, unified public communications with clear, transparent, up-to-date guidelines and data. Our government officials have been unforgivably slow to get these in place. We’ve been playing from behind. But we now seem to be moving in the right direction, and the experience in Asia suggests that extraordinary precautions don’t seem to be required to stop it. Those of us who must go out into the world and have contact with people don’t have to panic if we find out that someone with the coronavirus has been in the same room or stood closer than we wanted for a moment. Transmission seems to occur primarily through sustained exposure in the absence of basic protection or through the lack of hand hygiene after contact with secretions.

Consider a couple of data points. Singapore so far appears not to have had a single recorded health-care-related transmission of the coronavirus, despite the hundreds of cases that its medical system has had to deal with. That includes one case reported this week of a critically ill pneumonia patient who exposed forty-one health-care workers in the course of four days before being diagnosed with COVID-19. These were high-risk exposures, including exposures during intubation and hands-on intensive care. Eighty-five per cent of the workers used only surgical masks. Yet, owing to proper hand hygiene, none became infected.

Our early experiences in the U.S. have so far been similar. The Centers for Disease Control and Prevention, in the face of limited information, recommended stricter precautions than have been employed in Asia, putting health-care workers on fourteen-day self-quarantine if they are exposed to an infected person for even a few minutes without protection, including a mask and goggles. That policy was implemented at U.C. Davis Medical Center, where the first case of community transmission was diagnosed, in late February. Eighty-nine health-care workers involved in the patient’s care were put under self-quarantine. None, it turned out, had been infected. Sacramento, Seattle, and San Francisco became coronavirus hot spots; as of this writing, however, significant occupational transmission has not been found.

This content was originally published here.

Orthodontist, dentist practices told to shut down offices

TROY – Cooney Orthodontics, one of the region’s larger practices, is closing its two offices for 11 days except for emergency cases per recommendations from the the American Dental Association, the American Association of Orthodontics and the New York State Dental Association Board of Trustees.

Other practices have announced the same, such as The Smile Lodge pediatric dentistry office in Clifton Park, which serves children from the Mohawk Valley, Capital Region and Adirondacks.

“At this point, taken together with Governor Cuomo’s announcement closing additional businesses, we have decided for the safety of our patients and staff to temporarily close both our Troy and Ballston Lake offices starting Tuesday March 17th through Friday March 27th,” Cooney wrote. “If you have an appointment scheduled during this time, we will be reaching out to reschedule shortly,” the practice said in an email to patients.

This content was originally published here.

Ohio health official estimates 100,000 people in state have coronavirus

A top health official in Ohio estimated on Thursday that more than 100,000 people in the state currently have coronavirus, a shockingly high number that underscores the limited testing so far.

Ohio Department of Health Director Amy Acton said at a press conference alongside Gov. Mike DeWine (R) that given that the virus is spreading in the community in Ohio, she estimates at least 1 percent of the population in the state has the virus.

“We know now, just the fact of community spread, says that at least 1 percent, at the very least, 1 percent of our population is carrying this virus in Ohio today,” Acton said. “We have 11.7 million people. So the math is over 100,000. So that just gives you a sense of how this virus spreads and is spreading quickly.”

She added that the slow rollout of testing means the state does not have good verified numbers to know for sure.

“Our delay in being able to test has delayed our understanding of the spread of this,” Acton said. 

The Trump administration has come under intense criticism for the slow rollout of tests. Dr. Anthony Fauci, a top National Institutes of Health official, acknowledged earlier Thursday it is “a failing” that people cannot easily get tested for coronavirus in the United States.

Not everyone with the virus has symptoms, and about 80 percent of people with the virus do not end up needing hospitalization, experts say. However, the virus can be deadly especially for older people and those with underlying health conditions.

The possible numbers in Ohio are a stark illustration of how many cases could be in other states as well, but have not been revealed given the lack of widespread testing.

More than 1,300 people in the U.S. have currently tested positive for the illness, according to data from Johns Hopkins University, while about three dozen people in the country have died.

Vice President Pence, who is overseeing the administration’s coronavirus response, said earlier Thursday that the U.S. can expect “thousands of more cases.”

Ohio officials said they are taking major actions to try to slow the spread of the virus. They are closing schools in the state for three weeks and banning large gatherings of 100 or more people. 

The state currently has just 5 confirmed positive cases, and 30 negative tests. Acton said Thursday that it appears that the number of cases of the virus doubles every six days.

As other experts have as well, she urged actions to slow the spread of the virus to avoid overwhelming the capacity of hospitals. Banning large gatherings and stopping school is part of that process.

“We’re all sort of waking up to our new reality,” she said, adding later that the state is “in a crisis situation.”

Noting the concerns about hospital capacity if the number of cases spikes too quickly, Acton said “there are only so many ventilators,” referring to machines that allow people to breathe when they cannot on their own.

Models indicate the number of cases could peak in late April to mid-May, she said.

If people are not seriously ill, she urged them to stay home so that only the sickest people who most need help are showing up at hospitals.

“This will be the thing this generation remembers,” she added. 

This content was originally published here.

Whistle-Blower Reports on U.S. Health Workers Response to Coronavirus Outbreak – The New York Times

The levels of protection varied even while he was at Miramar, he said. Standards were more lax at first, but once people arrived who appeared to be sick, workers began donning personal protective equipment. He is now back at work, and has yet to be tested for coronavirus exposure.

In the complaint, the whistle-blower painted a grim portrait of agency staff members who found themselves on the front lines of a frantic federal effort to confront the coronavirus in the United States without any preparation or training, and whose own health concerns were dismissed by senior administration officials as detrimental to staff “morale.” They were “admonished,” the complaint said, and “accused of not being team players,” and had their “mental health and emotional stability questioned.”

March Air Reserve Base in Riverside, Calif., housed 195 people evacuated from Wuhan, China, for 14 days beginning in late January, while Travis in Northern California has housed a number of quarantined people in recent weeks, including some of the approximately 400 Americans on the Diamond Princess cruise ship that had docked in Japan.

The staff members, who had some experience with emergency management coordination, were woefully underprepared for the mission they were given, according to the whistle-blower.

“They were not properly trained or equipped to operate in a public health emergency situation,” the official wrote. “They were potentially exposed to coronavirus; appropriate measures were not taken to protect the staff from potential infection; and appropriate steps were not taken to quarantine, monitor or test them during their deployment and upon their return home.”

Some of the staff raised concerns with top officials with the agency, but saw no changes. The whistle-blower said they complained to Charles Keckler, an associate deputy secretary at Health and Human Services, in an email on Feb. 10. After the email, the complaint said, top officials, including Lynn Johnson, the assistant secretary for the Administration for Children and Families, “admitted that they did not understand their mission,” and that her agency “broke protocols” because of the “unprecedented crisis” and an “‘all hands on deck’ call to action” by Dr. Robert Kadlec, the top official for public health emergencies and disasters.

Since learning of the whistle-blower’s concerns last Wednesday, Mr. Gomez’s office and officials with the Ways and Means Committee have repeatedly pressed the Centers for Disease Control and Prevention for details. The whistle-blower has also notified the C.D.C. and the health agency inspector general about the concerns.

Representative Richard E. Neal, Democrat of Massachusetts and chairman of the Ways and Means Committee, said the complaint appeared to be part of a pattern of ineptitude and mistrust of civil servants by the Trump administration.

“The president has spent years assaulting our health care system, draining resources from key health programs, and showing utter disdain for career federal employees who are the backbone of our government,” Mr. Neal said in a statement provided to The Times. “It’s sadly no surprise we’re seeing this degree of ineptitude during a terrible crisis.”

This content was originally published here.

America is about to get a godawful lesson in why health care should never be a for-profit business

For four decades, American corporations have been caught up in a whole series of refinements that are intended to improve efficiency and productivity. Our processes are lean. Our efficiency is six-sigma. Our productivity has mysteriously run far ahead of employee compensation in a way that has made CEOs billionaires while leaving workers on food stamps.

It’s a system that maximizes profit. But it’s also a system that assumes that everything can be stripped to the bare bones; that business can make do with minimal staffing, minimal supplies, minimal alternatives. Nothing is there that makes the system in the least unprofitable. The system stands like a house of glass, waiting for something to challenge its fragility.

And in the United States, health care is just that kind of system.

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Like every other system in America, we now have a super-lean, infinite-sigma healthcare system, absolutely dependent on every cog remaining in place. It’s one in which there are fewer than a million hospital beds for the entire nation; one in which many, many rural counties have no hospital at all. Because that’s the most profitable way of running the system, and that’s what happens when health care is subjected to the winnowing of the marketplace—just barely enough health care, at the highest possible prices people will tolerate without demanding a change.

It’s exactly where a nation does not want to be when encountering a health crisis. And it’s why America is, unfortunately, about to get a lesson in why there is much more to a national health system than whether you pay for it in taxes or with checks to an insurance company.

In the 1960s, astronauts used to joke about flying on a giant rocket built by a collection of contractors who submitted the lowest bids. But NASA had a safety culture then, and now, that demanded each of those components be tested and retested until its function was as near certain as possible. A spacecraft is the opposite of “lean,” with a backup, and a backup, and a backup to the backup’s backup at every possible point—and a massive staff of very smart people standing by to get creative if Murphy scores a perfect strike.

None of this is true for our healthcare system. Failure very much is an option at every clinic and hospital in America. A certain level of failure is even assumed. Building a system with redundancies and experts who were not always pushed to their absolute limits would cost more. Every intern, doctor, and nurse (especially nurse) who you ever met was overworked, because running the system on the ragged edge of failure is exactly the sweet spot. Or at least it is as far as corporations whose goal is to milk every penny from the process are concerned. In the average hospital visit, there are more people involved in billing you than in treating you.

This thinking isn’t just pervasive and accepted—it’s also actively considered a very good thing. During his press event on Wednesday afternoon, before fumbling the hot coronavirus potato into the waiting hands of Mike “Smoking is good for you” Pence, Donald Trump defended the cuts he had made to the CDC and the experts on pandemics he had dropped from the National Security Council and the epidemiologists he had flushed from his planning team. He didn’t want those people sitting around when they weren’t needed, said Trump. Besides, he claimed, you could always go and get them when they were needed. Because somewhere, somehow, there is a system that keeps vital specialists waiting in hermetically sealed containers, fresh, ready, and informed to meet the nation’s needs.

That is, it goes without saying, bullshit. But let me say it again. Bullshit. The value of an expert brought in to repair a system after disaster strikes is so much less than the value of having that person on hand to plan that the old ounce of prevention being greater than pound of cure formula doesn’t begin to cover it. You cannot decide to hire some pilots after the plane has crashed.

The thing about extraordinary events is that they’re extraordinary. Planning for them will never improve profits. It will only save lives.

By treating health care like a business, Americans have already seen one of the first people who dared ask to be tested for COVID-19 get handed a bill for thousands of dollars, the primary result of which will be to dissuade other Americans from asking to be tested. Which is, right there, exactly the result that is best for insurance companies—and worst for the nation.

It’s an absolute certainty that Americans will hide their sniffles, drown their symptoms in over-the-counter drugs, and try to “tough it out” because they can’t afford health care. Besides, they have no paid sick leave, no paid child care, and no guarantee that missing a day’s work won’t mean being cast to the curb. All that “socialist” crap.

And because our whole system runs so excellently lean, American hospitals are already seeing shortages of everything from gowns to masks to painkillers, because the single-source, lowest-price vendor of those items happens to be in an area that’s already been overrun with the coronavirus. Not only have those factories on the far side of the planet been sitting idle for weeks, but what production has been available has been needed close to home. 

Right now in Hubei province, Chinese healthcare workers are staggering around in exhaustion. Or, as American hospital workers call it, Thursday. Our understaffed, undersupplied, overworked facilities spend every day running at their limits. That’s what is considered normal.

The concern about dollars over people is so accepted that on Thursday the White House announced two new members of the Coronavirus Task Force—Treasury Secretary Steven Mnuchin and National Economic Council chief Larry Kudlow. Though to be fair, it’s not as if they completely lack expertise. Kudlow does have long familiarity with taking nasally administered drugs from rolled $100 bills. So there’s that. And if in this version of The Stand the role of the Rat Man is to be played by Mnuchin … no one can say that this is not good casting.

Disaster is far from certain. Local and state officials can still take measures that will slow the impact of COVID. And antiviral medicines may prove effective, or maybe a vaccine will come along more quickly than expected— though, should either happen, you can assume there will be a line of Pharma Bros on hand to buy the companies involved and raise the prices to eye-watering levels. After all, holding people’s lives hostage is exactly what our healthcare system is all about.

COVID-19 is going to swing a big hammer at the glass house of American health care. All anyone can do is hope they don’t get cut in the process.

And then vote to change the damn system.

This content was originally published here.

When you notice your mental health declining

5 Powerful Ways to Help You Deal With Depression

Depression is a very serious medical and psychological disorder that puts your outlook on life in negative and dangerous perspective.

By its definition, depression drains your hope, energy and your motivation, making it extremely difficult to feel better.

It is a quite common disorder and one in third people have experienced depression during their lifetimes, in one way or another.

One person out of ten, experiences moderate to severe symptoms of depression.

To overcome depression, the key is to start with small steps.

Healing and getting better takes time and it is important that you don’t expect overnight results.

Try to make positive choices for each and every day.

When dealing with depression, it is crucial to make an effort and take action, no matter how hard it may seem when you are overwhelmed with negativity.

One of the simple methods is to come up with so-called ‘happy thoughts’.

Those are things that you enjoy and that make you feel good even when thinking about doing them.

Exercising, going out, spending time with family, friends and engaging in a pleasurable hobby are all highly beneficial and recommended steps.

The things that are most difficult to tackle are those that will help you most in the long run.

However, it is important to start small, by doing something that will make you feel good right now.

Every small step that you make is one step closer to becoming a healthier and better version of you.

1. Stay connected and get support

It is crucial that you reach out to other people when dealing with depression.

By knowing that you have help and support will help you keep healthy perspective towards the future you are planning to build.

When you are depressed, it is oftentimes difficult to connect to friends and family, but staying active and involved in social situations with other people can keep a positive effect on your mood and outlook.

You will simply feel less depressed when you are around other people.

Try to talk to a friend or family member who is a good listener.

They don’t need to be able to offer any helpful solutions. Just the mere act of talking and sharing how you feel can help you relieve depression.

One of the ‘tricks’ is partaking in social activities that help others – like volunteering.

Researches have come to the conclusion that providing support to others in need, be it to people or animals will boost your mood.

It doesn’t have to be anything big.

You can start small by simply offering a listening ear to a friend in need.

You will see that these small steps will help you go a long way.

2. Engage in activities that make you feel good

Even if you don’t feel like it at the moment, if you force yourself to engage in activity that you know will make you feel better, you will give yourself opportunity to break the depression cycle you’re in at the moment and open up to positive outcomes.

Typical for this situation is that you will feel glad that you forced yourself to partake in the said activity, as it will make you feel so much better about yourself and life.

Doing fun and pleasurable activities won’t cure your depression, but they will help you feel more energetic and increase production of ‘happy hormones’ in your brain.

These activities are known to help people relieve effects of depression:

  • Spending time in nature and in the sun
  • Making a list of things that you like about yourself
  • Fill a bathtub with warm water and have a long and relaxing bath
  • Read a book that you enjoy
  • Play with your pet
  • Listen to the music that is on your ‘favorites’ playlist
  • Watch funny video compilations
  • Make a list of small and easily achievable tasks and complete them one by one
  • Go out with your friend or a group of friends
  • Find a hobby that you enjoy doing
  • Find the way to express yourself – through art, exercise, dancing, learning or a hobby
  • Make small trips to places you always wanted to visit.

3. Build healthy habits

Having enough sleep is one of the most important things when dealing with depression.

If you sleep less than optimal eight hours, oftentimes both your mood and energy for that day will suffer.

If you have troubles with sleep, think about the stressful situations that you are exposed to, and try to grasp what it is that stresses you.

Finding the way to take control over a situation that causes you stress will help you relieve the pressure and feel better.

One of the useful practices that you should adopt are relaxation exercises such as yoga, deep breathing, muscle relaxation, meditation and many others.

4. Pay attention to the food you eat

Learn about what foods are beneficial and what to avoid.

Intake of certain types of food directly affect your brain and mood. Typical examples are caffeine, alcohol and trans-fats.

Avoid those whenever possible and try not to skip meals as it will make you additionally irritable.

Avoid sugary snacks and refined carbs.

Although they can lift your mood for a short time, they are known as energy crashers.

5. Get help from a professional

Making these small steps can significantly help you when dealing with depression, but they are not a substitute for getting a professional help.

Depression is a serious condition that can negatively affect your life in more ways than just one, but it is treatable and easily manageable if you seek professional help.


Rest assured that all these small steps together will bring you speedy and complete recovery.

Start small and start today, with any single thing from this list.

The post When you notice your mental health declining appeared first on The Powerful Mind.

This content was originally published here.

International Women’s Day: A Celebration of Women in Dentistry

Times have certainly changed since 1898, when Emma Gaudreau Casgrain became the first woman licensed to be a dentist in Canada. Today women are a growing force in the dental industry within Canada and beyond. According to the Canadian Institute for Health Information, the number of women dentists in Canada rose from 16 percent in 1991 to 28 percent in 2001. By 2011, the proportion had grown to 29.5.

International Women’s Day is the ideal time to take a closer look at the role of women in the field of dentistry.

More Women Are Graduating With Dentistry Degrees

The number of women practicing dentistry in Canada should continue growing with women graduating with dentistry degrees than men. For example, in 2016, 34 women graduated from the University of British Columbia’s (UBC) dentistry schools for every 24 males. Many dentists estimate roughly half of their graduating class members were women.

Dr. Alison Fransen, a general dentist at Wesbrook Village Dental Centre who graduated from UBC in 1997, said she had a “great experience in dental school,” which gave her “lots to learn.”

Dr. Wise Tang, a general dentist at Burnaby’s Mega Dental Group, added her experience of going through dentistry school and finding employment was “Challenging, but very rewarding.”

Dr. Julia McKay and Dr. Carlos Quiñonez, in their article “The Feminization of Dentistry: Implications for the Profession” published in the Journal of the Canadian Dental Association, stated female dental students bring something different to the classroom than their male peers. Female students are more emotionally sensitive and expressive, qualities which help them socialize with other students and respond to the patients they see during internships and hands-on course components.

Women in Dentistry Have Prominent Female Figures to Inspire Them

More Women Are Graduating With Dentistry DegreesIn her 2006 Psychology of Women Quarterly article “Someone like me can be successful: Do college students need same-gender role models?,” Penelope Lockwood explained female students are significantly more influenced by a role model’s gender than male students.

Female students, she wrote, feel much more motivated when reading about a successful woman in their field than a successful man. When citing career role models, female students also tended to identify women they look up to, largely because they felt they may face similar industry challenges to the women that inspired them. It’s significant that as more women excel in dentistry, more women are inspired to follow in their footsteps.

Burnaby dentist Dr. Wise Tang says Dr. Karen Burgess, who she observed practice during her volunteer program, is one of her greatest inspirations. Dr. Burgess is a trailblazing oral pathologist who works closely with Dr. Jonathan Irish diagnosing and treating mouth cancers at Princess Margaret’s Dental Oncology, Ocular, and Maxillofacial Prosthetics Clinic. This clinic is the busiest of its kind in Canada, seeing 14,000 patients every year.

Vancouver dentist Dr. Alison Fransen still considers Dr. Marcia Boyd, the dean while Dr. Fransen studied at UBC Dentistry, one of her greatest career role models. An Order of Canada recipient, Dr. Boyd was the first Canadian woman to serve as the president of the American College of Dentists. She also led a task force on the future of organized dentistry in British Columbia for the province’s College of Dental Surgeons and was an organizer and speaker for the American Dental Education Association’s International Women’s Leadership Conference.

Female Dentists Are Providing a Different Experience for Patients

Female Dentists Tend to Work DifferentlyFor centuries, a trip to the dentist has been perceived as something to fear. However, as more women enter the field, that perception is slowly changing, according to McKay and Quiñonez. While most female dentists don’t think their professional experiences are any different from those of their male counterparts, studies show female dentists bring different traits and practices to their clinics.

Female dentists are said to be more empathetic and better able to communicate with their patients. They seem to be less rushed and willing to discuss their patients’ ailments and concerns in a more caring, humane way than male dentists. Just 8 percent of female dentists expect their patients to experience pain in the chair compared to 46 percent of male dentists. This suggests female dentists will often take greater care to reduce the pain their patients experience than male dentists.

Female Dentists Tend to Work Differently

Once dental practices were male-dominated spaces, but today female representation is at an all time high. In fact, one-third of the dentists at 123 Dentists are women. Female dentists can also bring a different kind of decision-making to any practice, according to self-reported research cited by McKay and Quiñonez. Men replied in a survey that they usually base their decisions on objectivity, logic, and consistency, while the women reported being more motivated by how they feel. Their personal values, sympathies, and desire to maintain harmony and tact are important factors in patient care.

Female Dentists Tend to Work DifferentlyThe personal qualities women typically possess see them spearheading unique dental programs like Ontario’s Project Restoring Smiles. The women behind this initiative provide free dental procedures to survivors of domestic violence who are self-conscious about what their abuse has done to their smiles. These dentists provides extensive procedures costing thousands, including orthodontics, bleaching, crowns and bridges, root canals, extractions, dental implants, and surgical facial reconstruction free of charge.

“Our vision is to restore confidence in women who have survived domestic violence by addressing the physical effects of abuse,” Dr. Tina Meisami explained in a statement cited by women’s blog SheKnows. “Restoring a woman’s smile has an incredibly powerful impact on her overall physical and mental health.”

Since launching in 2011, Project Restoring Smiles has treated more than 45 patients to more than $200,000 worth of complimentary dental services.

The different character traits female dentists exhibit, as seen in the team from Project Restoring Smiles, translate into the different approaches McKay and Quiñonez saw female and male dentists taking in clinical practice. They noted male dentists tend to use gloves, masks, and protective eyewear less frequently than female dentists, who reported being more concerned with infection control. Women also typically favour preventative measures, while male dentists are more likely to advocate significant restoration. The willingness that these women have to head off problems before they arise could have a significant impact on their patients and the entire dental industry, in fact.

Female dentists are also more likely to refer the patients to specialists rather than attempting to resolve patient problems themselves. McKay and Quiñonez stated 70.3 percent of female dentists have referred simple and complex surgical cases to specialists compared to just 49.5 percent of male dentists.

Female Dentists Come From Diverse Backgrounds

Female Dentists Come From Diverse BackgroundsVarious scientific studies acknowledge that diversity in any industry makes professionals more creative, more diligent, and more hard-working.

For that reason, the large number of female dental professionals that come from nations outside of North America is also notable.

Burnaby dentist Dr. Wise Tang hails from Hong Kong and offers her services in English, Mandarin, and Cantonese, and is the owner of two 123Dentist offices.

Dr. Roshanak Rahmanian received her Doctor of Dental Surgery in Iran before completing a two-year qualifying program at the University of Toronto to practice in Canada.

Today she works as a general dentist at the Lonsdale Dental Centre in North Vancouver.

Representation of Women in Dentistry Goes Beyond Dentists

Representation of Women in Dentistry Goes Beyond DentistsWhen assessing the impact of women in dentistry, it makes sense to analyze the number of practicing dentists. However, this doesn’t tell the entire story. Approximately 98 percent of Canada’s dental hygienists are women, along with 95 percent of its dental assistants. Both these roles feature in the top five female-dominated professions in Canada.

Women are also taking a growing role in leading dental practices. For example, 28 percent of 123Dentist clinic owners are women. Anecdotal evidence also suggests more women are specializing in dentistry.

While general dentistry remains popular, many female dentists say they see more of their peers pursuing roles in specialties like oral surgery and endodontics. Women like these continue to make strides in dental specialties and assert themselves in exciting new dental fields.

Dentistry Is Growing to Reflect What Women Want

Women in dentistry typically demand different things than their male colleagues. They often want time off to raise children and usually retire earlier. In his article “The 5 Most Dangerous Trends Facing Dentists and Their Families Today,” Evan Carmichael noted that male dentists typically work for 35 years, while female dentists usually work for 20 years in the profession. This statistic is bound to change since the ratio of women to men in the industry is continually changing, and will be interesting to observe over the coming decades.

Dentistry Is Growing to Reflect What Female Dentists WantAs more women take roles in dentistry, we are seeing dental practices create more flexible working environments that reflect the needs of women. The current crop of dentists encourages those of the future to continue striving for the working conditions and work-life balance they need to achieve success.

We surveyed a number of female dentists and below are some of their comments and advice for women considering becoming dentists.

“My advice for future women dentists would be to know yourself and how to manage the stress of being a perfectionist, which can be in the nature of those personalities that go into dentistry,” one respondent said. “It can be overwhelming to own a practice, and be a ‘perfect’ clinical dentist, ‘perfect’ employer, ‘perfect’ colleague, lifelong learner and ‘perfect’ mother and still juggle everything with the impossible standards we set for ourselves. We wear many hats.”

“Having a dental career while being a mom is tough,” another respondent said. “One should strive to balance her career and family life, but the drive is the influence one can give to each and every patient and it’s priceless.”

While juggling the demands of dentistry with home life can be challenging, our dentists are showing they can do it all with ease, all while bringing new elements and approaches to an established industry. Although this was once a male-dominated field, women and their successes have now become integral to dentistry in Canada and beyond.

So with all of that said, we’d like to wish you all a happy International Women’s Day!

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This content was originally published here.

Philippines declares state of public health emergency due to coronavirus | ABS-CBN News

Commuters mostly wearing face masks cross at a busy street in Mandaluyong on February 5, 2020. George Calvelo, ABS-CBN News

MANILA (UPDATE) – President Rodrigo Duterte has placed the Philippines under a state of public health emergency to arrest the spread of novel coronavirus infections after authorities confirmed local transmissions of the disease.

Over the weekend, health authorities confirmed 7 cases of COVID-19, bringing the total to 10. Duterte’s order came nearly 3 weeks after the Department of Health suggested declaring a public health emergency when the first cases emerged.

“The outbreak of COVID-19 constitutes an emergency that threatens national security which requires a whole-of-government response…” Duterte said in Proclamation No. 922 signed on Sunday.

“The declaration of a State of Public Health Emergency would capacitate government agencies and LGUs to immediately act to prevent loss of life, utilize appropriate resources to implement urgent and critical measures to contain or prevent the spread of COVID-19, mitigate its effects and impact to the community, and prevent serious disruption of the functioning of the government and the community,” he said.

READ: President Duterte issues Proclamation No. 922 declaring a state of public health emergency in the Philippines @ABSCBNNews pic.twitter.com/DPD5E5sME9

— Arianne Merez (@arianne_merez)

The declaration shall remain in effect until the President lifts or withdraws it.

With Duterte’s proclamation, all government agencies and local government units are urged to mobilize the necessary resources to “eliminate the COVID-19 threat.”

The health chief is also given authority to call upon the Philippine National Police and other law enforcement agencies for assistance in addressing the threat of the virus.

Health Secretary Francisco Duque III on Monday said the President’s proclamation paves the way for easier procurement of medical supplies needed to contain the virus as well as access to sufficient funding for agencies, including local government units, for proper response to the disease outbreak.

Duque added that the proclamation gives the government powers for mandatory quarantine of patients and requires health authorities to provide updates on issues concerning the disease outbreak.

Presidential Spokesman Salvador Panelo on Sunday said Duterte’s move came “after considering all critical factors with the aim of safeguarding the health of the Filipino public.” 

Over the weekend, the health department raised the country’s alert system to Code Red, Sub-level 1 because of the virus, which was meant to serve as a “preemptive call” for authorities and health workers to “prepare for possible increase in suspected and confirmed cases.” 

COVID-19 has killed 3,792 people while infecting more than 109,000 in 95 countries worldwide.

-with a report from Agence-France Presse

This content was originally published here.

Psychiatrist Prescribes Disney Trips As Mental Health Treatment

Mental Health has become more serious and frequently discussed in recent years. People are taking it more seriously to work out things going on inside their minds and find peace within situations that occur in our lives. While our society is more aware of the benefits of positive mental health, they are seeking help. There is no shame in that! Taking care of your personal health is important. So if you are thinking about seeing a Doctor and getting help, do it. Get the help you need. You may even get a Disney trip prescribed! In fact, one Psychiatric is even prescribing trips to Disney World or Disneyland! That is a treatment plan I fully support.

These new treatment plans have been used by Dr. Sanders at Psychiatry Today, who has been prescribing patients week-long getaways to Disney Resorts as part of his treatment plans. His approach is based on “humans exposed to environments encompassing the patient with positivity and experiences that are enriching have changed the outlook for the patients.” I can see why he believes the positive atmosphere manufactured by Disney would help people gain joy and be uplifting while dealing with a hard time. They are the World’s Happiest and most Magical place for a reason. While this is just part of his treatment plan We will leave the treatment plans and real work to the professionals.

We have discussed why it’s important for Adult Only Disney trips and we even listed the stress-free, positive environment. See, we were on to something! So if you need a trip to unwind, have some pixie dust sprinkled in your life, it looks like Disney is the way to go. Doctors orders. Even if it is just Doctor Who.

Is Disney your happy place? My name is Jamie Porter and Disney World has been my happy place for many years! My family and I have been AP for 8 years, and lucky enough to live here in Central Florida. I helped many friends and family plan their travel I became a Travel Agent with Amazing Magical Adventures. I have been a TA for 6 years and love it. If you have any questions or would like a FREE quote, feel free to follow me on Facebook @JamiePorterSellsTravel or email JamiePorter@AmazingMagicalAdventures.com

The post Psychiatrist Prescribes Disney Trips As Mental Health Treatment appeared first on Disney Addicts.

This content was originally published here.