Seattle is at risk for explosive coronavirus growth
Seattle is at risk for explosive coronavirus growth
A physician’s chilling COVID-19 diagnostic journey
We watched as the new viral outbreak happened in a remote place in China, wondering if this would be a quick flameout or if Mother Nature would again exert her majesty on us mortals.
My associate, Madilyn, and I watched with more interest, knowing that her sister was in South Korea teaching English. She was due to return in late February, …
A physician’s chilling COVID-19 diagnostic journey
More worried about the coronavirus than the seasonal flu? Here’s why you should be.
The spread of the new coronavirus, which has infected over 80,000 people worldwide and resulted in the death of more than 3,000, has raised alarms around the world.
At the same time, the seasonal influenza, known as the flu, causes severe illness in between 3 million and 5 million people, with hundreds of thousands of deaths every year worldwide.
With …
More worried about the coronavirus than the seasonal flu? Here’s why you should be.
The alarming risk of COVID-19 in nursing homes
An outbreak of coronavirus disease in a nursing home near Seattle is prompting urgent calls for precautionary tactics at America’s elder care facilities, where residents are at heightened risk of serious complications from the illness because of the dual threat of age and close living conditions.
As of Monday afternoon, the emergence of the novel contagious illness at the Life Care Center of Kirkland, Washington, had left four residents dead and …
The alarming risk of COVID-19 in nursing homes
How many people have coronavirus? We don’t really know.
It has been nearly three months since the first cases of a new coronavirus pneumonia appeared in Wuhan, China, and it is now a global outbreak. And yet, despite nearly 90,000 infections worldwide (most of them in China), the world still doesn’t have a clear picture of some basic information about this outbreak.
In recent weeks, a smattering of scientific papers and government statements have begun to sketch the …
How many people have coronavirus? We don’t really know.
During the coronarvirus outbreak: A failure to recognize physicians’ worth
Recently, Congressman Jimmy Gomez, D-California, questioned HHS Secretary Alex Azar about improper preparation of health care workers before and during their interactions with Americans repatriated from Wuhan, China. A whistleblower reported to the California congressman that while assisting evacuees housed at Travis Air Force Base, federal health employees were not given personal protective equipment or briefed on protocols to avoid exposure and spread of the novel virus COVID-19.
More shocking than …
During the coronarvirus outbreak: A failure to recognize physicians’ worth
COVID-19 and coronavirus FAQs
A case study seemed to confirm the presence of asymptomatic transmission within China, where a woman was afebrile with no chest CT abnormalities or laboratory abnormalities. She did not develop the virus, while five of her relatives did.
An earlier report out of Germany found a woman traveling to Germany from China with …
COVID-19 will expose EMTALA and the physician shortage
Coronavirus, a.k.a. COVID-19, is lurking on the edges of the United States. What it will do here has yet to be seen. I was initially very concerned since I work on the front lines in community emergency medicine. For the last week or so, I have felt a little better after reading several articles. I suspect it will not have a high lethality among otherwise healthy individuals. But I’m no …
COVID-19 will expose EMTALA and the physician shortage
As the coronavirus spreads, should unvaccinated people be allowed to fly?
As the coronavirus spreads, the nation’s leading health official told a Senate committee on Feb. 25 that “we cannot hermetically seal off the United States to a virus.”
The comments from Alex Azar II, head of Health and Human Services, heightened concerns about the effects of the coronavirus in the U.S., which so far has sickened a relatively small number – 57 – of people in the …
As the coronavirus spreads, should unvaccinated people be allowed to fly?
The problems with testing for novel coronavirus
Just weeks into the federal government’s efforts to contain the novel coronavirus, a new California case has exposed weaknesses in the testing procedures that could be masking more widespread reach of the disease.
A woman in Solano County, California, who hadn’t traveled abroad or had contact with another known patient with the illness was diagnosed with the virus Wednesday, raising concerns that cases are going undetected because of the federal government’s narrow …
The problems with testing for novel coronavirus
How businesses are handling COVID-19
Chances are, if you work for a large company, you received an email like one sent to Volkswagen employees Monday: Coronavirus concerns mean some limits on business travel, everyone should remember to “wash your hands frequently” and stay home if sick.
As the viral illness, dubbed COVID-19, continues to spread, some employers are canceling conferences and limiting travel, checking supplies, and dusting off their emergency preparedness plans, just as they have …
How businesses are handling COVID-19
Doctors: Take a sick day
Every winter, flu season descends upon the hospital. The most consistent reaction among any of our physicians — trainee and attending alike — who succumb to this nasty virus is one of guilt. Even the thought of “calling out sick” leads to such extreme guilt that many colleagues choose to come to work sick instead.
Several trainees have admitted to suffering from flu-like symptoms but pushing themselves to come to the …
Antibiotic resistance is the climate change of medicine
Imagine a looming global crisis that threatens the health of countless people, confounding scientists and governments with its sheer magnitude and complexity and growing at a pace that will quickly exceed our ability to reverse course.
Sounds a little like climate change, right?
The existential threat I’m referring to in this case is microscopic: antibiotic-resistant bacteria and fungi.
In a way, antibiotic resistance is the climate change of medicine. It has potentially lethal …
Antibiotic resistance is the climate change of medicine
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How to help your patients understand antibiotic stewardship
Antibiotics are ubiquitous in today’s society. Prescriptions for these bacterial killers have become so prevalent that a wonder drug cure phenomenon for any illness has become the cultural norm. The evidence is overwhelming that antibiotics are far too overprescribed for viral illnesses. They are 100 percent ineffective against viruses. And the number of inappropriate antibiotics prescribed has been increasing for decades, as high as 30 percent in one study.
For years, …
How to help your patients understand antibiotic stewardship
Please stop the over-diagnosis of UTIs
I admitted an elderly woman to the hospital recently. The previous week, she had presented to the emergency department (ED) with chest pain and shortness of breath. For some unknown reason, a urinalysis was obtained and was found to be abnormal. The patient left the hospital with a prescription for cephalexin, in addition to unexplained chest pain and shortness of breath. The patient presented to the hospital this time with, …
Please stop the over-diagnosis of UTIs
Doctors shouldn’t feel guilty about sick days
It’s 2 a.m. And I’m in the emergency room. There are beads of sweat dripping from my forehead. One of my nurses comments that I just don’t look quite right. I can feel the urge to vomit and know where the nearest trash can is at all times.
I’m clearly sick. Febrile. Shouldn’t be working. But it’s the middle of a night shift, and I’ve got patients to see. I place …
Doctors shouldn’t feel guilty about sick days
The erroneous belief that the elderly have the healing power of younger individuals
A wise professor of medicine always told me as a young physician, “Eighty-year olds are to be revered and not messed with.” This is especially true for those 90 or older. Here in South Florida, there is always some senior citizen telling us today’s 80 is yesterday’s 60, and today’s 70 is yesterday’s 50. It just isn’t so. I see this erroneous belief of the elderly having the healing power …
The erroneous belief that the elderly have the healing power of younger individuals
MKSAP: 19-year-old man with lightheadedness and nightly fevers
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 19-year-old man is hospitalized with a 6-day history of lightheadedness and nightly fevers. He also reports sore throat, headache, joint and muscle aches, and a dry cough. He recalls a blotchy rash on his trunk and arms, which has resolved. He returned home 12 days ago from a …
MKSAP: 19-year-old man with lightheadedness and nightly fevers
Why developing new antibiotics is a losing battle
“We believe that the current entrepreneurial development model for antibiotics is broken and needs to be fundamentally transformed.”
This provocative opinion is from a recent editorial in the New England Journal of Medicine. The introduction of penicillin, the first antibiotic miracle drug, led to an 80 percent reduction in mortality from infectious diseases. Other antibiotics quickly followed, reducing death rates even further. Over the past several decades, however, the discovery …
Why developing new antibiotics is a losing battle
Can CRP testing guide antibiotic decisions?
In response to concerns about the unnecessary use of antibiotics, researchers have sought to identify simple, non-specific tests to help clinicians determine which patients require antibiotics and which do not. Indeed, such tests could facilitate challenging management decisions, which currently rely predominately upon a thorough clinical assessment. To compound the challenge, patients often have pre-conceived ideas about whether or not …
Can CRP testing guide antibiotic decisions?
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Past Week
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The insurance maze that single-payer health care would end
-
The conflict of interest that discloses as nothing
-
How to reassure patients: 5 steps beyond normal tests
-
AI in prior authorization: 3 contract questions for 2027
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How to build a dementia care pathway, not a referral sheet
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Underage online gambling needs more than a checkbox
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Past 6 Months
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Why CDC opioid guidelines get the overdose data wrong
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Retirement isn’t the end of medicine, it’s a second act [PODCAST]
-
Sensory processing in autism and the brain’s volume control
-
What maternity care deserts cost a town
-
Why medicine needs a national physician license now
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A cold cost $945. The cost of primary care is broken.
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Recent Posts
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5 competencies the future of medical education requires
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AI chatbots and psychosis: Families see the harm first
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Hearing screening in primary care is a single question
-
After-hours charting isn’t a backlog. It’s a team problem.
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Autism behavior therapy needs a physician in the room
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AI and physician judgment: the risk when AI is mostly right
-