President Trump’s preferred coronavirus treatment is the focus of a new study suggesting it could cause more harm than good, but not everybody agrees. We discuss the fallout as trials around the world are paused and countries diverge over policy advice.
12:12 Are we rushing science?
Coronavirus papers are being published extremely quickly, while normally healthy scientific debate is being blown up in the world’s press. Is there a balancing act between timely research and accurate messaging?
18:49 One good thing
Our hosts pick out things that have made them smile in the last week, including hedgerow brews and a trip into the past using AI.
Even limited hearing loss might be associated with cognitive decline. If true, early intervention with hearing aids might help people have better cognitive performance.
Michael Johns III, MD, online editor for JAMA Otolaryngology, speaks with Justin Golub, MD, MS, assistant professor of otolaryngology at Columbia University, whose research has shown that very mild hearing loss can be associated with cognitive disability.
COMMENTARY
Hearing loss and cognitive ability decline together as we age, starting earlier in some people than others.
LIVING A HEALTHY LIFE STYLE-with good SLEEP, DIET, EXERCISE and COGNITIVE STIMULATION -seems to help benefit almost everything, including hearing, while a poor life style, neglecting the 4 Pillars, smoking, and drinking alcohol to excess seems to hasten our aging.
Certain medications, often taken to treat the results of a poor life style, can also harm our hearing.
LOUD SOUNDS (such as AMPLIFIED MUSIC), especially if prolonged, are particularly bad. SOUND POLLUTION contaminates the modern world as much as industries‘ excesses. I would often wear ear plugs to Football games (108 dB on my meter) and even in row 4 of the Symphony.
Once damaged, the delicate HAIR CELLS of our inner ear don’t grow back, although medical science once again is working feverishly to save us from ourselves.
Hearing aids can now be programmed to compensate for our particular pattern of frequency loss.
The premise made in the above article and podcast, that decreased HEARING is accompanied by (and Causes?)decreased COGNITION could be supported by a study demonstrating that Improved hearing restores the cognition. I understand that early results may suggest a cognitive benefit of hearing aids.
But PRESERVING BOTH with healthy living would of course be better- at least in my opinion.
Prevention, unfortunately, is a very hard sell in a world of costly medical treatments, where we are protected from directly confronting those costs by ever-expanding insurance. How about Medical savings accounts?
Atrial fibrillation is chaotic and irregular atrial arrhythmia, the prevalence of which increases progressively with age. It causes significant morbidity and death. Many patients are asymptomatic or have symptoms that are less specific for cardiac arrhythmias, such as mild dementia or silent strokes.
Gregory Lip, Price-Evans Chair of Cardiovascular Medicine, University of Liverpool, gives us an overview of the condition.
The Coronapod team pick through the latest news, plus we hear from the researchers making lemonade out of lockdown lemons.
In this episode:
01:10 Can contact-tracing apps help?
Governments around the world are banking on smartphone apps to help end the spread of the coronavirus. But how effective might these apps might be? What are the risks? And how should they fit into wider public health strategies?
Our hosts pick out things that have made them smile in the last week, including blooming trust in scientists, cooking experiments, and a neighbourhood coming together to clap for healthcare workers.
21:34 Unexpected opportunities
We hear from three researchers making the most of lockdown, studying tiny earthquakes, building balcony-based citizen science projects, or enlisting gamers to fight the coronavirus.
Direct-to-consumer (or on-demand) telemedicine, a 21st-century approach to forward triage that allows patients to be efficiently screened, is both patient-centered and conducive to self-quarantine, and it protects patients, clinicians, and the community from exposure.
Interview with Dr. Judd Hollander on how health systems can use telemedicine services during the Covid-19 pandemic.
It can allow physicians and patients to communicate 24/7, using smartphones or webcam-enabled computers. Respiratory symptoms — which may be early signs of Covid-19 — are among the conditions most commonly evaluated with this approach.
Health care providers can easily obtain detailed travel and exposure histories. Automated screening algorithms can be built into the intake process, and local epidemiologic information can be used to standardize screening and practice patterns across providers.
Disasters and pandemics pose unique challenges to health care delivery. Though telehealth will not solve them all, it’s well suited for scenarios in which infrastructure remains intact and clinicians are available to see patients. Payment and regulatory structures, state licensing, credentialing across hospitals, and program implementation all take time to work through, but health systems that have already invested in telemedicine are well positioned to ensure that patients with Covid-19 receive the care they need. In this instance, it may be a virtually perfect solution.
Health journalist Judy Foreman talks about her new book Exercise Is Medicine: How Physical Activity Boosts Health and Slows Aging
This is Scientific American’s Science Talk, posted on April 24th, 2020. I’m Steve Mirsky. And under our current, often locked-down situation, it’s still really important to try to get some exercise. Judy Foreman is the author of the new book Exercise is Medicine: How Physical Activity Boosts Health and Slows Aging. She’s a former nationally syndicated health columnist for the Boston Globe, LA times, Baltimore Sun and other places, and an author for the Oxford University Press. We spoke by phone.
This Podcast is worth listening to in full. It will introduce some of the upcoming themes of DWWR.
Exercise is one of the 4 pillars of health, thriving and longevity, along with Diet, Sleep, and Intellectual Stimulation. We look forward to highlighting and reveling in these subjects.
Judy Foreman’s thesis “ exercise is medicine” is true in many dimensions, including industries desire to capture the many beneficial biological effects of exercise in a pill; it requires effort to get off your duff, and you need to budget the time to work out.
My preference is WALKING and WATER EXERCISE. I make passing the time PLEASANT by listening to BBC “in our time”, recorded on a water-proof mp-3 player. EXERCISE is both VALUABLE and ENJOYABLE!
Benjamin Thompson, Noah Baker, and Amy Maxmen discuss the role of antibody tests in controlling the pandemic, and how public-health spending could curtail an economic crisis. Also on the show, the open hardware community’s efforts to produce medical equipment.
In this episode:
02:08 Betting on antibodies
Antibody tests could play a key role in understanding how the virus has spread through populations, and in ending lockdowns. We discuss concerns over their reliability, how they could be used, and the tantalising possibility of immunity.
Jim Yong Kim, former president of the World Bank, argues that strong investment in public health is crucial to halt the ongoing pandemic and to prevent a global financial crisis. We discuss his work with US governors to massively increase contact tracing, and his thoughts on how researchers can help steer political thinking.
Our hosts talk about staying positive, and pick a few things that have made them smile in the last 7 days, including a tiny addition to the team, a newspaper produced by children in lockdown, and a gardening update.
Researchers are stepping up efforts to design and produce ventilators and personal protective equipment for frontline medical staff. We hear how the open hardware movement is aiding these efforts, and the regulations that teams need to consider if their designs are to make it into use.
Coronavirus Testing and Tracking (1) are the two pillars of surveillance which will hopefully replace the “shotgun” method of universal distancing that America has tried so far. Quarantining only those who are contagious makes much more social and economic sense than quarantining everybody, and it seemed to work in South Korea (2) and Taiwan (3).
There are problems both with testing-accuracy and availability- and tracking, which is in tension with individuality and freedom. Still we have no choice but to try, because people and businesses need to socialize and make some money.
Some epidemiologists predict that Covid 19 will smolder on, hopefully not overtaxing our health system, until “herd immunity” gets to 60-70 percent of the population.
As a highly susceptible octogenarian, I plan to keep my distance and become one of the minority protected by herd. And maybe an effective immunization or drug will come along.
In the current times that we live in health care professionals are looking for ways to provide safe, quality care from a distance. Telehealth and Digital health are proving to be the perfect tools during this COVID-19 pandemic.
PART I
In today’s episode Part I, we are joined with Dr. Amit Sachdev and Dr. Curtis Lowery. Dr. Sachdev is a physician most recently at the Brigham and Women’s Hospital, Harvard Medical School and he is currently working on the COVID response.
Dr. Curtis Lowery is the director of the UAMS Institute for Digital Health and Innovation. He also serves as a professor for the UAMS Department of Obstetrics and Gynecology. This episode is in two parts and it serves as an introduction to telehealth and digital health amidst the COVID-19 pandemic.
PART II
In part 2 of our conversation with Dr. Amit Sachdev and Dr. Curtis Lowery over the usefulness of telehealth and digital health during the COVID-19 pandemic. Dr. Sachdev is a physician most recently at the Brigham and Women’s Hospital, Harvard Medical School and he is currently working on the COVID response. Dr. Curtis Lowery is the director of the UAMS Institute for Digital Health and Innovation. He also serves as a professor for the UAMS Department of Obstetrics and Gynecology. Let’s continue the conversation.
The BMJ’s new podcast aims to help doctors feel more connected, heard, and supported
“Deep breath in … and out. Again, deep breath in … and out.”
We tune in to patients’ breath sounds, seeking confirmation of a diagnosis—one more supporting piece of evidence to reassure anxious patients or to narrow the differential.
But since the SARS-CoV-2 pandemic arrived, saying “deep breath in” has been replaced by the need to take one ourselves: before looking at the morning news, before venturing out (or logging on) to work each morning, and before ringing the next patient on your list with the ominous note alongside their name: “fever and cough for a week, now feeling breathless.” Although chosen in what seems like a different era, the name for The BMJ’s new podcast for general practitioners—Deep Breath In—seems fitting for our troubled times.
Rebooting general practice
Before anyone in Wuhan fell ill, GPs had already been feeling the strain. In the UK, despite government promises of 5000 new practising GPs by 2020, there were 6.2% fewer full time equivalent GPs in 2019 than in 2015.1 Similarly, physicians in the US have been compensating for an estimated shortfall of some 14 500 primary care doctors since 2017.2 Recent attempts to take the strain off GPs in England by funding allied health professionals have faltered because of onerous new demands on fledgling primary care networks.3 Turning it off and switching it back on again is often the only thing that works when your computer grinds to a halt. Perhaps coronavirus will do the same for primary care.
Primary Care Physicians are a vanishing species [1]. This is unfortunate, since PCPs are the only doctors who attend the whole field of Medicine (have you ever asked an orthopedist about your cough?).
However, some of the slack is being taken up by Nurse Practitioners [2] and Physicians Assistants [3].
If you know a retired Internist or Family Practice Physician, be sure to cultivate a friendly relationship (and give them a hug when the Covid 19 epidemic cools off). They might be inclined to be that greatest of all Medical Resources- the Patient Advocate [4].
—Dr. C.
Empowering Patients Through Education And Telemedicine
Doctors Without Waiting Rooms 