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Vaccines: the most important part of modern Medicine

marketingsermowpuser — Mon, 23 Mar 2015 12:00:42 +0000

~by Jennifer Hanrahan, D.O.

Whenever I talk to healthcare workers about vaccines, there is always a group of people waiting to inform me of the dangers of vaccines. The first time this happened, I was surprised. It seemed strange that people whose lives are dedicated to helping others based on science would become part of the anti-vaccine movement. I am going to speak about this topic, knowing that there will be some negative responses.

Nothing in modern medicine has saved as many lives as vaccines. Debilitating, fatal diseases are now often a thing of the past. The great success of vaccines has allowed us to forget about horrible diseases that used to occur regularly. Because we don’t have to see these diseases, we have the luxury to debate the merits of vaccines. Every time a new epidemic occurs, the first question is whether there is a vaccine or whether one could be developed. Thousands of lives and untold human suffering would have been spared if a vaccine for Ebola were available.

Before routine vaccination, there were 13,000-20,000 cases of paralytic polio in the U.S. every year. The last case occurred here in 1979. There were 20,000 cases of congenital rubella syndrome annually prior to rubella vaccination. Before routine measles vaccination, almost everyone in the U.S. got measles. Some went on to have terrible complications such as subacute sclerosing panencephalitis, which ended in death. Fortunately, measles is uncommon in developed countries now. In 2004, there were an estimated 454,000 measles deaths, which translates into more than 1,200 deaths every day or 50 people dying every hour from measles. In 2013, this number decreased to 16 deaths per hour from measles, due to ongoing vaccination efforts. Almost 16 million deaths were averted due to measles vaccines administered from 2000-2013.

Bacterial meningitis used to be an early childhood illness. Due to vaccination programs for H. influenzae type B and pneumococcus, the average age of bacterial meningitis is now 41.9 years.

Measles, Rubella, Smallpox, Polio, bacterial meningitis in children- all of these are almost diseases of the past, because vaccines work. Despite their great success, people are eager to believe myths about vaccines, and choose not to get themselves, or their children vaccinated. Keeping all of these diseases in the past requires herd immunity. Even a small decrease in herd immunity leads to reemergence of disease.

After the publication of a paper in Lancet in 1998 by Wakefield, et al. vaccination rates decreased, and in 2008, measles and rubella were declared endemic again in the U.K.

This paper was fabricated by the author and was retracted by Lancet. The authors were investigated and barred from practicing medicine in the U.K. Still; many people choose to believe that there is a link between vaccines and autism, as well as myriad other ailments.

How people make decisions has little to do with data, and more to do with emotions. This topic is investigated and described in a great book, “Mistakes were made, but not by me,” by Carol Tavris and Elliot Aronson. Once a decision is made, all additional data is used to support the decision. Even data that clearly goes against the opinion is used as further support. Physicians are, unfortunately, not immune to this phenomena.

A new vaccine was just released for prevention of HPV. Gardasil 9 includes five additional strains of HPV. Many of the patients I see, who would have been eligible for vaccination, have not received HPV vaccines, and by the time I see them, they are older than 26, and no longer eligible. I am hoping that doctors will think more about immunizing adults, and help to prevent suffering.

What are your experiences with anti-vaxxers? Do you find it difficult to keep up with all of the changing recommendations for vaccinations?

We discuss this and a myriad of clinical topics inside SERMO. If you’re an M.D. or D.O., please join us.

References:

1. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(97)11096-0/abstract

2. http://www.who.int/mediacentre/factsheets/fs286/en/

3. Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, et al. Emerging Infections Programs Network. Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 2011;364:2016-25.

4. http://www.americanscientist.org/bookshelf/pub/an-interview-with-carol-tavris

Jennifer Hanrahan, D.O. is an infectious disease physician at MetroHealth Medical Center and is medical director of infection prevention at MetroHealth Medical Center. She has served as co-medical director of the Cleveland Department of Public Health, and has extensive experience teaching residents, fellows and medical students. Her areas of expertise include influenza, hospital-acquired infections, legionella, HIV/AIDS, and hospital preparedness for infectious diseases.

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Poll: How doctors feel about compassionate use

marketingsermowpuser — Mon, 23 Feb 2015 13:00:22 +0000

A patient lies on death’s door. His physician knows of a promising drug in clinical trials that could save his life, but there is no FDA approval, no final results. Should compassionate use be allowed to save a patient’s life?

We posed this question to the SERMO community recently; the results and discussion shed light on physician sentiment.

Should compassionate use be allowed for unproven drugs or therapies?

74% Yes, but only when the patient has no other options
19% Yes, clinical trials take too long
7% No, it’s unethical to do so

What Doctors Think of Compassionate Use

In the wake of Ebola and the use of experimental treatment options and rushed vaccine trials, many doctors discussed the pros and the cons. A family practitioner wrote, “As with almost everything in medicine, you weigh the risk of the treatment and the disease to the benefit and try to make an intelligent decision. In Ebola, the risk of the disease is astronomical, so even a little benefit or a potential benefit is acceptable. If the benefit is essentially zero, as in many alternative treatments, then even a small risk of treatment outweighs and precludes its ethical use. “

A surgeon countered, “these treatment options are offered at a time when coercion is remarkably easy. “What have you got to lose? Are you going to miss out on a potential cure?” and worse, to families, “Are you gonna let money stand between you and the chance to save your parent/spouse/child?”

“Compassionate use has to be offered in a VERY circumspect fashion, and patient and family must be treated as fairly as possible,” he continued. “And frankly, I’m not sure that playing fair with families, in this situation, is EVER possible.

A second family practitioner talked about private insurance decision-making. “I was frequently presented this question when I was in charge of medical policy for a large insurance company. Cost was not the main consideration; plausibility was. This is, there had to be a good reason to believe the proposal could work.”

Several doctors voiced the need to take profit out of the equation when making these tough decisions. An internist wrote, “compassionate use should be mediated through the 340B drug program to avoid profiteering from a serious illness scenario.”

As a physician, what do you think about compassionate use? Has the recent Ebola crisis and the experimental drugs used on some patients changed your perspective? Have you ever had the opportunity to assist a patient through a compassionate use scenario? We discuss this and a myriad of clinical topics inside SERMO, if you’re an M.D. or D.O., please join us.

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Measles Infographic on Current Epidemic

marketingsermowpuser — Mon, 02 Feb 2015 12:00:40 +0000

Ebola, Whooping Cough, now Measles. Infectious disease numbers are spiking in the U.S. and physicians are speaking out about the best strategies to contain outbreaks and prevent epidemics.

A recent SERMO poll found 92 percent of doctors think the current measles outbreak is directly attributable to parents who do not vaccinate their children. Further, a physician poll conducted in August 2014 found the majority of doctors think unvaccinated children should not be allowed to attend public schools.

Public health officials agree, last week a California high school barred 66 students from attending school for not having the MMR vaccine when a suspected measles case appeared in the study body.

Measles Infographic

Our infographic shows the importance of a measles vaccine, and its impact on patients. A recent discussion inside SERMO talked about the problem. One internist wrote, “It is dangerous for every other patient in your practice. An anti-vax kid brought in by a parent for a rash sitting in the waiting room of a busy pediatric practice could spread measles to countless others in a matter of minutes.”

Some doctors believe seeing non-vaccinated patients is an opportunity to educate. An OBGYN wrote, “We have a large community of anti-vaxxers in my state, and it would be difficult to refuse them outright. Instead, I use persuasion to try to educate them and make my advocacy position very clear. I have had some limited success with this tactic.”

The American Academy of Pediatrics has urged doctors to respect each patient’s preferences but continue to educate about vaccinations unless there is a heightened medical issue for getting a vaccine.

What do you think about vaccinations and the current measles outbreak? Should unvaccinated children be banned from public schools? Should doctors urge patients to get vaccinated and turn away those who refuse? If you’re an M.D. or D.O. you can join the conversation right now inside SERMO.

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Global medicine: A true breakthrough for healthcare

marketingsermowpuser — Mon, 26 Jan 2015 13:00:50 +0000

by Linda Girgis, MD, FAAFP

The world watched with anxiety as Ebola spread across country lines. Here in the US, we responded in shock as this disease appeared first in Dallas and spread to American health care workers. Many didn’t think it would ever happen here, but medicine and disease are truly global now.

Doctors here never diagnosed or treated Ebola before. Hospitals had no guidelines for isolating suspected cases. How did we get prepared? Solutions were found largely through global medicine. The CDC and WHO made grand attempts to educate the global community. We also learned lessons from doctors in other countries and we all shared our wisdom. Without this global effort, the Ebola epidemic could have been much worse.

Research is happening on various diseases all throughout the world. Imagine if we can all share the results of those studies to make people healthier. For example, researchers in Germany last year developed an innovative prosthesis for patients. If we can all share our technology, we can help alleviate suffering. It is hard enough for a patient to lose a limb. But letting best practices cross borders means a patient can receive the best possible care, no matter where it originated.

Global Medicine is easy given the evolution of the internet and social media channels. We do not have to know any high ranking people to share information across countries. Phone tag is now history. We can now harness the power of the virtual world to make global medicine happen. Whoever followed the CDC’s Twitter chats about Ebola saw this happen before their very eyes. We can now connect with hundreds or thousands of people at the same time.

The US obesity epidemic is going global. The rising numbers of those affected are scary. Disease related to obesity is also climbing such as heart disease, osteoarthritis, certain types of cancers, etc. There has never been a greater need to share these statistics globally. The US expertise on obesity-related disease should be shared globally for maximum impact. With global feedback, we can find solutions quickly improving patient outcomes. It is no longer acceptable to just tell a patient to diet and exercise. We need to tell them how and we need to discuss this across country borders.

Doctors are increasingly communicating globally. And this is a good thing for medicine. Why?

Conferences are becoming increasingly international. We can share practice tips and learn about the latest research
Social media channels allow doctors to connect directly and instantly to share information and best practices
Online private, physicians’ only communities allow doctors to share cases without worrying about disclosing private, protected information to the public. We can share protocols, and we can get help on difficult cases. To be able to do this globally is a major break- through in medical communication.
Increasingly, we are asked to practice evidence-based medicine. But, much research happens in other countries. Global medicine allows us to do online research utilizing medical journals around the globe.

Clearly global medicine is a breakthrough that can improve the lives of millions. Physicians can share research, disease information, and novel treatments. Patients anywhere in the world can benefit from discoveries made in remote labs overseas. In the US, being one of the leaders of medical technology, we can spread our knowledge to ease suffering and cure disease all over the world. Those who do not take advantage of this innovation will soon be left behind.

Editors Note: Global medicine is discussed regularly inside SERMO. If you’re an M.D. or D.O. please join us.

Bio

Dr. Linda Girgis MD, FAAFP is a family physician in South River, New Jersey. She has been in private practice since 2001. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter’s University Hospital and Raritan Bay Hospital. She teaches medical students and residents from Drexel University, UMDNJ, and other institutions. Dr. Girgis earned her medical degree from St. George’s University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University. She has appeared in US News and on NBC Nightly News.

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Influenza Update: 2014 – 2015 flu season changes

marketingsermowpuser — Wed, 21 Jan 2015 17:04:29 +0000

~ by James M. Wilson V, MD

Media reports have recently focused on CDC statements indicating we are having a “severe” season of influenza. This concern was initially driven by the discovery of a vaccine mismatch involving the type A/H3N2 component of the vaccine. We have discussed this issue extensively in previous posts here on SERMO and emphasized the following points:

The phrase “vaccine mismatch” does not guarantee a severe season of influenza. The current 2014-15 season is comparable to the activity seen in 2012-13, a non-mismatch season.
The main exception of concern is the elderly, which will be discussed in this post.
That vaccine mismatch associated with a dominant A/H3N2 season is common and not unexpected.

The term “severe” is imprecise. It is as imprecise as the terms pandemic, epidemic, and outbreak in today’s public health discourse. At the Ascel Bio National Infectious Disease Forecast Center, we use terms that describe the level of socio-economic disruption to a community that are captured in the Infectious Disease Impact Scale (IDIS).

Figure 1. The Infectious Disease Impact Scale (IDIS). From top to bottom, this scale is a heuristic model that describes the transition points of socio-economic disruption experienced by a community in the context of an infectious disease outbreak or epidemic.

We use the IDIS to provide a “bottom line,” high level view of infectious disease activity and are using this analytic tool to describe the effect of Ebola on the core involved countries in West Africa:

Figure 2. Signature tracing of socio-economic disruption caused by Ebola over time in Sierra Leone. The X axis is the day, going back to the beginning of the disaster. Ebola has generated persistent IDIS Cat 6 conditions for months in Sierra Leone.

The best analogy for the IDIS is a comparison to the Fujita scale, which is a heuristic model used to describe the magnitude and potential impact of tornadoes. The IDIS is an important tool for our analysts because an “epidemic” of disease in one country may be described an “epidemic” in another- but be associated with completely different IDIS categorizations that relate to that country’s medical infrastructure and response capacity.

Currently in the United States, we have yet to document a community experiencing more than IDIS Category 2 conditions for influenza. Despite media attention, we are not observing unusual socio-economic disruption levels.

There are reasons for these observations. First, let’s take a look at the current surveillance data from this year’s influenza activity.

From a pediatric (i.e. birth to 18 years old) perspective, we are seeing a routine season of influenza in our younger birth to 4 year old children, but high activity in the 5-17 year old age group.

Figure 3. Influenza hospitalizations in the pediatric age group. The Y axis on the left corresponds with
incidence for prior seasons except the pandemic season of 2009-10, where children were severely effected. Pandemic incidence is read on the right hand Y axis associated with the orange trend line. [Data source: CDC FluView]

Figure 4. Pediatric mortality due to influenza. This is the true bottom line for severity from a clinical perspective. We are not seeing an unusual level of mortality so far in the pediatric patient population compare to prior seasons. The main caveat is mortality data is delayed sometimes by weeks, so a final assessment at the conclusion of the season (i.e. in the summer) will be required. [Data source: CDC FluView]

From the perspective of our working age group, which is responsible for maintaining economic throughput for the nation, this continues to be a routine influenza season.

Figure 5. Influenza hospitalizations in the working age group. In this age group, the 2009-10 pandemic season’s impact for the end of December / early January time period was comparable to a routine influenza season. This year’s influenza activity level is routine. [Data source: CDC FluView]

The elderly, however, have been hit hard by this season’s influenza, and this is the key observation for this season that has been called “severe.”

Figure 6. Influenza hospitalizations in older adults and the elderly. In this age group, the 2009-10 pandemic season was not severe at the end of December / early January. What is notable is the 2014-15 season is associated with the highest level of hospitalizations in this age groups since before the pandemic. [Data source: CDC FluView]

From the perspective of overall mortality due to pneumonia and influenza, this season is routine, however the data is still being compiled and will require re-examination in early summer.

Figure 7. Overall mortality due to pneumonia and influenza. So far, mortality appears to be comparable to all prior seasons of influenza. Caveat: there are inherent time delays in reporting of mortality data, so this information should be interpreted with that in mind. [Data source: CDC FluView]

In summary, we observe the following:

The current influenza season overall is not “severe” and is comparable to the prior two years of seasonal activity. We observe no higher socio-economic disruption than IDIS Category 2 (non-crisis) conditions.
For older adults and the elderly, this is a severe season.

One last point of importance: the concern about a “mismatched” vaccine. The majority of America, including its physicians appear to hold a belief that the vaccine is “useless” because mismatch has occurred. Yet both WHO and CDC continue to recommend the use of the vaccine. It is critical to keep in mind the following key points:

The vaccine, while mismatched, is not fully. In other words, there remains a probability the vaccine will keep an individual out of the ICU or from dying.
Patients should question a physician who does not offer the influenza vaccine, despite the mismatch. Physicians should offer the vaccine to patients regardless of the observation of a mismatch. If anything, observation of a “mismatch” is a major warning to society to encourage even broader vaccination than is normally done.
Tamiflu may or may not save your life if you are hospitalized with influenza. Tamiflu is considered by the majority of physicians to be of questionable value when a patient has been ill for several days and later hospitalized. The bottom line is don’t depend on Tamiflu to save your life if you choose not to vaccinate.

Biography

Dr. James Wilson, a pediatrician and infectious disease expert with AscelBio, he is a frequent contributor to the SERMO blog.

Season flu and it’s movements in the US are discussed frequently inside SERMO. If you’re an MD or DO please join us for the latest news shared by your peers.

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Poll: 2015 Trends in Medicine

marketingsermowpuser — Mon, 05 Jan 2015 13:00:48 +0000

Medicine and technology will continue to integrate creating the biggest trends in medicine in 2015 according to a poll of physicians from SERMO. The top three trends to look for are:

Remote patient monitoring through wearable apps
Telemedicine expanding with compensation to physicians
More genetic discoveries to improve patient diagnoses and care

Remote patient monitoring via Apps

Cardiologists are familiar with the strap on heart rate monitors that then must be sent to a lab for analysis. What if you could skip that step and monitor a patient in real-time, at the click of a button? From a contact lens that monitors a diabetic’s insulin levels, to a smart phone app that detects behavioral changes when the flu is coming on, there are many areas of research with promising early results. In the video below, Dr. Sandy Pentland from MIT’s Media Lab talks about how veterans with mental health issues can be tracked when medications are adjusted to see if they are working.

Caveat: Physicians need solid research proving the devices and apps are as effective as current monitoring systems or improve on diagnostic tools already in place. Without those standards in place, they will be at a greater risk for malpractice suits.

Telemedicine expands

Instead of coming in regularly to check on insulin levels, what if a diabetic could handle it all remotely with a quick phone or video call with their doctor? Or what if a specialist hundreds of miles away could review records electronically and offer a consult without putting the patient through unnecessary stress or travel?

Telemedicine has been around for decades but with a boost from technology it’s got new legs. Physicians can easily share patient files with anyone, anywhere. While some patients absolutely need to see a doctor in an exam room, there are many instances where a video call can be just as effective. This has particular value with monitoring patients with long-term, but manageable disease and in rural parts of the country where access to specialists may be limited.

Caveat: Currently most private insurers and government reimbursement programs do not cover telemedicine. Many physicians who consult electronically can not get reimbursed for their time. We need to look at laws and guidelines that will open up this treatment option.

Genetic discoveries continue

2014 saw several genetic discoveries, perhaps one of the most important being a genome sequence for under $1,000 when just a few short years ago it cost tens of thousands of dollars. Acting in the opposite direction, the FDA’s squelching of genetic information to laypeople via companies like 23 and Me dampens database growth and big data research, while perhaps protecting potential patients from false or missed diagnoses.

The video below from genetic researcher John Quackenbush, Ph.D., professor at Dana-Farber Cancer Institute and Harvard School of Publish Health discusses the intersection between genomics and how physicians can use it with their patients.

Caveat: We’re still in the early days of genomics research, physicians need to watch the research closely for where it can best help their specialties and their patients, particularly with rare disease diagnosis.

Complete Poll Results

We asked our physicians to predict the Top Three Trends in Medicine for 2015 (choose three). We’ve already discussed the top three vote getters. Below are the full results:

42% patient monitoring using wearable apps
41% telemedicine taking a foothold and becoming compensated
39% more genetic discoveries
36% an Ebola vaccine
29% new diabetes medications coming to market
28% interoperable EHR systems
20% breakthroughs in cancer treatment
16% a migration to DPC models of payment
13% improvement in the efficacy of the influenza vaccine

As a physician, what trends do you think will uptick in 2015? From the list above what do you consider the Top 3? If you’re an MD or DO please join us inside the Sermo physician community for further discussion of the latest research and medical techniques.

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Sermo Announces Eight New Hubs

marketingsermowpuser — Wed, 19 Nov 2014 20:37:40 +0000

We are pleased to announce the creation of eight new SERMO Hubs, or online information libraries, in several specialty areas.

The new content pages will pull content from around the web and from within the Sermo community to one centralized location. Each Hub will include topic-specific posts, videos, new research, and polls as well as areas for physicians to discuss the latest updates.

If you are a physician, please join us at our newest Hubs, they are:

Infectious Diseases
Depression
Bipolar Disorder
Dermatology
Pain Medicine
Asthma
Rheumatoid Arthritis
Pain Medicine

One of the strengths of our community, is the number of doctors who are contributing to the Hubs. There are over 40 ambassadors who regularly write fresh, thought-provoking posts aimed at improving patient outcomes and sparking debate among fellow physicians.

As an example, the Infectious Diseases Hubs has had recent conversations on Ebola, EV-D68, the upcoming flu season, and HIV/AIDS. Our Depression Hub currently has an active conversation about the incidence of over-diagnosis for bipolar disorder.

Our newest Hubs join other ongoing information centers for a total of 13:

Multiple Sclerosis
Oncology
Diabetes
Cardiology
Obesity

If you are an M.D. or D.O., please join our community and explore our latest Hubs, polls and posts. There is a conversation just waiting for your input.

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Tech Titans Wade Deeper Into Medicine

marketingsermowpuser — Fri, 07 Nov 2014 13:00:08 +0000

Perhaps you saw the Facebook request at the top of your screen this morning asking you to help Ebola? Or maybe you read the news yesterday about Google now paying for pricey genetic testing for employees and their families who face cancer?

The fact is cash-rich companies have the power to affect real change and they are doing it increasingly in the field of medicine. Beyond tech-heavy body trackers and health oriented software programs what does this mean for healthcare?

Google To Pay for Cancer Testing

FoundationMedicine, a company that does genetic testing to pinpoint the best cancer treatment options for patients announced a partnership with Google yesterday. They will cover the cost of testing for any Google employee or family member who needs it. The two tests the company offers are $5,800 and $7,200 a piece so this isn’t a light commitment.

By mapping the genome of cancer cells, scientists can cross-check against a database of successful treatment options and give an oncologist a more accurate picture of which treatments will be effective.

Facebook Fights Ebola

Facebook currently features a prominent box in your stream asking if you’d like to help fight Ebola, with a click through button to donate immediately. Donors can choose from three charities, the International Medical Corps, the International Federation of the Red Cross and Red Crescent Societies and Save the Children. The plea will be shown to 1.2 Billion people in hopes a big cash influx will help curb the epidemic.

Facebook has done this before raising $486 million for disaster relief after the earthquake in Haiti and $88 million to aid victims of Typhoon Haiyan.

Mark Zuckerberg, founder of Facebook, also said they will provide free internet access in Sierra Leone, Liberia and Guinea to help with the relief efforts. Having reliable wifi connection will enable relief workers to coordinate better, distribute supplies, and help the sick. As the countries recover from the outbreak, it will allow a better flow of communication will have an impact on their economies and culture for decades.

Zuckerburg Personally Responds to a Troll

A few critics of Zuckerberg’s Ebola campaign have criticized him for being opportunistic and simply marketing. He responded to one troll yesterday. What do you think of his response?

Zuckerberg responds to troll on Ebola

We have a proposal for Mr. Zuckerberg; our patient case software allows doctors to upload patient information under HIPAA guidelines to allow physicians to collaborate on diagnoses and treatment options. We currently work with Floating Doctors in remote areas of Panama, and we’d be happy to extend our expertise to health care workers on the ground in Africa. We also have an Infectious Disease Hub, which brings together physicians to discuss Ebola and other infectious diseases. Seriously … call us.

As a physician what do you think about tech companies helping out in the medical space? Do you think their abundant resources are being put to good use? Do you think there is any marketing upside to charitable work? We will be discussing this inside Sermo if you’re an M.D. or D.O., please join us in our community.

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Why Ebola Preparedness Is So Haphazard

wpsitecare — Tue, 28 Oct 2014 19:23:20 +0000

Click to enlarge

Ebola news scrolls by on our screens fast and furious. A suspect case here, a hospital failing there, airborne rumors, social chatter with scary and conflicting information. There seems to be precious little information coming out of official government channels

Twenty-six Ebola outbreaks have occurred since 1976. Researchers and medical teams documenting information about containment, contact lists, and patient care. This outbreak, the first to touch an urban area, has screamed out of control debilitating nations as the death count relentlessly mounts. The World Health Organization predicts up to 10,000 cases a week and in a best case scenario two months before the virus is back under control.

Extensive information about containment exists. Ebola protocols have been around for decades and have improved as we learn from each outbreak. Why then are so many mistakes happening now that Ebola has reached the United States?

Ebola Mistakes

Many within the community spoke about the Keystone Cops calamity that seems to be out there. A list of mishaps include:

Releasing the first patient for two days into the community before transporting him by ambulance for hospitalization.
Hospital staff wearing light protection in the early days of Duncan’s treatment; now two nurses have contracted Ebola, and the contact list reaches 76 people.
A nurse with a fever and Ebola patient contact calls the CDC about her low-grade fever and is cleared to fly; now 132 passengers and airline staff are on another watch list.
Dr. Nancy Snyderman, after being potentially exposed to Ebola when her cameraman contracted the disease, “elopes” on voluntary quarantine for Chinese food. Her “sorry, not sorry” response was she was asymptomatic and therefore not a threat.

Our most recent Ebola posts here.

We are also hearing from the physicians on the front-lines that they have received little, if any training.

One ER physician wrote, “As an ED physician, I have received no Ebola preparedness training. Neither has any other ED doctor or any of our ED nursing staff. We have NO IDEA if we have any personal protective gear or any protocol in place. But I did read in our local paper that our hospital is telling the media we are prepared for Ebola. In fact, they are holding a press conference today to explain it to the public! What a farce.”

A second physician wrote, “As an ED physician at a county hospital, I have still had ZERO training from my hospital on how to screen or isolate a potential Ebola patient. We have had no drills. No meetings. We have no isolation protocols, no plan. We are not prepared. No one believes it will come here, or infect enough people to be a real threat to the U.S. The CDC has told them not to worry and that it is hard to get sick from Ebola. So they don’t worry.”

Medical Personnel Search Online for Answers

Our infographic looks at the disconnect between medical teams and the flow of information. Physicians, are searching for best practices and are often turning to online sources. As of today, approximately 60 percent of all conversations in the Sermo community are focused on Ebola. Physicians are sharing stories about preparedness, patient treatment options, the possible Ebola vaccine and travel bans.

Doctors look to multiple channels for Ebola information. Fifty-four percent of doctors say they are checking with the CDC regularly, and 52 percent they are getting clinical information from their peers in Sermo. If you’re an M.D. or D.O. you can join the community to learn more about Ebola.

What do you think about Ebola preparedness in the United States? Do you support strict measures such as a travel ban from hot zones? Where do you get clinical information about Ebola?

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Doctors Reject Ron Klain as Ebola Czar

lisasermo — Mon, 20 Oct 2014 13:00:42 +0000

click to enlarge, credit: Whitehouse.gov

Ron Klain, the newly appointed Ebola Czar, has come under harsh criticism from physicians for having no prior healthcare experience. Klain, formerly was Chief of Staff to Joe Biden and Al Gore and is known as a Washington insider. He is a lawyer with no formal medical training.

We asked our doctors, “Do you approve of the newly appointed Ebola Czar, Ron Klain?” The response was overwhelming:

79 % No
21% Yes

What Doctors Think of the Ebola Czar

A few physicians were willing to take a wait and see approach. One Physiatrist wrote, “There are few physicians qualified or competent to run a major government task force. He is running an organization, not making medical decisions. The team will likely contain qualified scientists and physicians as well as on-the-ground experienced people. I would reserve judgment until we see the team assembled, and the responses developed and implemented. Right now, it’s all just knee jerk reactions.”

For more about Ebola protocols, click here.

One ophthalmologist reflected the majority opinion. He wrote, “Something is terribly wrong when the Czar is obviously chosen on the basis of who is most likely to contain the political fallout, rather than who has the most expertise in containment of bio-hazard. The Czar should specialize in bio-terrorism and bio-warfare. This should be obvious to anyone who understands the medical, environmental, and healthcare systems hazards.”

Do We Need an Ebola Czar

Many physicians questioned why we needed another administrative position to execute on Ebola matters. One Family Practitioner asked about Nicole Lurie, MD, MPH, who is the Assistant Secretary for Preparedness and Response (ASPR) for the Department of Health and Human Services.

From the HHS website, “The ASPR serves as the Secretary’s principal advisor on matters related to bioterrorism and other public health emergencies. The ASPR also coordinates interagency activities between HHS, other Federal departments, agencies, and offices, and State and local officials responsible for emergency preparedness and the protection of the civilian population from acts of bioterrorism and other public health emergencies. The mission of the office is to lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters.”

As a physician, what do you think about the new Ebola Czar? What attributes should a candidate have? We discuss Ebola thoroughly on our new Infectious Disease Hub, if you’re an M.D. or D.O., please join us.

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