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Morning Briefing

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Tuesday, Mar 16 2021

Full Issue

Viewpoints: Should Doctors Graduate Earlier?; Stroke Patient Protocols Need Update

Opinion writers weigh in on these public health issues.

To help fight the COVID-19 pandemic, a number of medical schools are permitting students to graduate early in their final year. This development brought to mind a memorable letter I received when I was dean at the University of Virginia School of Medicine. Medical school usually lasts four years, and this letter came from the mother of a fourth-year student. She said her daughter had had a lot of time off and was about to fly to Tanzania to go hiking. She wondered whether she and her husband should be paying for this and whether it helped their daughter to be a better doctor. Good questions. I have asked myself the same things, and more. As I look back, when I attended Duke medical school, Duke had just started a new two-year base curriculum. The 1966 change meant the final two years of the four-year program were largely research and work with patients. Did that help to make better doctors? Or worse doctors? Maybe two years is enough. We don’t know. (Dr. Arthur "Tim" Garson Jr., 3/13)

In February, professional golfer Tiger Woods was seriously injured in a car accident. As is standard for trauma patients across the country, he was taken to a Level 1 trauma center, rather than the closest local hospital. This decision was made by first responders due to the severity of his injuries and the nature of the accident. Quick action by the hospital’s trained trauma team meant Woods then immediately got the right treatment. This is precisely the kind of response needed for stroke patients, of whom there are roughly 795,000 each year in the United States. The majority of stroke patients do not receive the same specialized, lifesaving treatment as trauma patients, and it’s not because they aren’t Tiger Woods. It’s because stroke protocols in many states are out of date or nonexistent when it comes to triaging and transporting patients to facilities that can treat its complexities. (Dr. William Mack, 3/15)

On Feb. 16, 2021, a very grim, but familiar scene played out at the downtown waterfront in Seattle. Port of Seattle police saw Derek Hayden holding a knife, and believing him to be suicidal, tried to subdue him by firing foam-tipped projectiles. When that proved unsuccessful, the Port officers called the Seattle Police Department. Officers arrived, drew firearms, and as Hayden approached them, he was filmed saying “Do it, do it, please kill me. ”One in every 10 calls for police response involves a person suffering from a mental illness. One in every four people killed by police suffers from mental-health issues. The danger inherent in police encounters with individuals experiencing a crisis is so obvious that “suicide by cop” was sought by Hayden and so many others before him. This is a public-safety failure. (Adam Smith, 3/15)

For around two decades, Roche’s breast cancer drug Herceptin has prolonged the lives of people with breast cancer, and AbbVie’s immunosuppressive drug Humira has eased the symptoms of rheumatoid arthritis patients. Such are the remarkable benefits of biologic drugs — large molecules that are manufactured using living cells. These kinds of drugs are typically received either in doctors’ offices as an infusion, or self-administered by injection. But for all their benefits, Herceptin, Humira and dozens of other older biologic drugs lie at the heart of the United States’ drug pricing crisis, racking up billions in annual U.S. sales from their persistently high prices. (Peter B. Bach and Mark R. Trusheim, 3/15)

Also —

The United States will soon have more Covid-19 vaccines than it needs to inoculate its own people. The surplus ought to go to developing countries. And, to turn a slogan on its head, the priority should be Mexico. A vaccine surplus is hard to imagine. The dominant narrative of the pandemic has been one of scarcity. From personal protective equipment to ventilators and Covid tests to the rollout of the vaccine itself, we never seem to have enough. Yet, with regard to vaccines, we're likely to go from having too little to having too much -- and soon. (Michael Camuñez, 3/15)

A bill in the Kansas Legislature would prevent businesses from taking someone’s vaccination status into account — for COVID-19 or anything else — in decisions on hiring, firing, compensation, benefits, promotions or leave. Instead of protecting the public from contagion, it would make the potentially contagious a protected class. So whose bad idea is this? (3/15)

The plans are there. On shelves across the collar counties of Philadelphia. Local emergency and public health officials even ran multiday drills in recent years to practice them in the event of a mass-scale medical emergency, including a pandemic. They’re on file with the state Department of Health, and the U.S. Centers for Disease Control and Prevention financed their creation and continual updating. I’m referring to emergency vaccine distribution plans. Medical countermeasures (MCMs), in technical parlance. They are hyperlocal. Tailored to get medicine in large quantities to the residents of these counties, based on how the counties themselves understand it should best be done. (Maria Panaritis, 3/15)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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