Weekly Brief 4August2020

Today is the first Tuesday in August. It is also National Night Out. This is an event which was started in 1984 and is intended to help people reengage with their communities. If you have the time tonight and the weather permits, I would encourage you to turn on your front porch light and get outside, while wearing a facemask and standing at a distance of six feet, to talk with your neighbors.

Bottom Line Upfront

  • Hospital Updates 
  • Testing Positivity 
  • Mini Grand Rounds: Building a Thoracic Oncology Program in the Midst of the COVID-19 Pandemic
  • Important Updates
    • Take Time to Celebrate Your Colleagues 
    • Kaleida Health Launches Thermal Imaging Infrared Camera Technology at Screening Checkpoints
  • Practice Updates
    • HHS Launches Telemedicine Learning Series for Ambulatory Providers 
    • SBA Lender Match Program 
    • American Medical Association Physicians Guide 
    • National Academy of Medicine COVID-19 Resource Guide 
    • ACP: Physician Well-being and Professional Fulfillment 
    • NYS Medical Society Practice Resources 
  • Updates in The Literature
    • Evaluation of the mRNA-1273 Vaccine against SARS-CoV-2 in Nonhuman Primates 
    • Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia
    • Immune complement and coagulation dysfunction in adverse outcomes of SARS-CoV-2 infection
    • Escape from neutralizing antibodies by SARS-CoV-2spike protein variants 
    • Experimental Theory: Discovery of mechanism behind HIV infections could also hold key to COVID-19

Hospital Census

National Trend (Percent of Positive Cases)

Mini Grand Rounds

When:
Wednesday, August 5, 2020
7:30-8 a.m.

How to Access:
Skype: https://lyncmeet.kaleidahealth.org/droman/M4TTL8WD
Phone: 716-859-7444 (Conference Number 1142805)

Important Updates

Take Time to Celebrate Your Colleagues

  • We all work in the company of true heroes. Each of us knows colleagues who personify the best traditions in health care. Others should know about them too
  • I would encourage you to take a couple of moments to nominate them for recognition as one of this year’s “Top Doctors”
  • The link is available at:
    https://www.buffalospreetopdoctors.com/login

Kaleida Health Launches Thermal Imaging Infrared Camera Technology at Screening Checkpoints

  • On Saturday, August 1, Kaleida Health began using thermal imaging infrared camera technology – called Thermal Mirror – to screen providers, employees and visitors entering its facilities
  • This new technology – which is being used in other organizations and industries in our community and across the country – allows for a safer, more effective, and efficient temperature screening process. Staff who have used the new cameras said they are so much easier and appreciate the modern/high-tech approach. Click HERE to see a video of how the process works 
  • To learn more:
    https://www.kaleidahealth.org/coronavirus/support/resources/general/Thermal-Temperature-Monitoring-Device-FAQ-Sheet.pdf

Practice Updates

HHS Launches Telemedicine Learning Series for Ambulatory Providers

  • The US Department of Health and Human Services (HHS) has partnered with the ECHO Institute at the University of New Mexico and the Public Health Foundation’s TRAIN Learning Network to deliver a 10-week, virtual learning community to support telemedicine implementation. 
  • The series will highlight best practices related to telemedicine workflows, documentation and reimbursement
  • It will also include five discussion sessions on incorporating telemedicine into practice. Continuing Medical Education and Continuing Education Unit credits are available for attending at no cost to participants
  • Sessions will be held on Wednesdays from July 22 to September 23; click here to register

SBA Lender Match Program

  • The Small Business Administration has developed a new tool to help match businesses with local lenders
  • This is an import resource as practices work to develop a strategy for recovering from the impact of the pandemic and moving forward
  • It is available at:
    https://www.sba.gov/funding-programs/loans/lender-match

American Medical Association Physicians Guide

ACP: Physician Well-being and Professional Fulfillment

NYS Medical Society Practice Resources

Updates in the Literature

Evaluation of the mRNA-1273 Vaccine against SARS-CoV-2 in Nonhuman Primates

  • The NEJM published an article last week reported some encouraging news about the potential for an effective vaccine to help stop the spreads of the coronavirus
  • The authors report that the “(v)accination of nonhuman primates with mRNA-1273 induced robust SARS-CoV-2 neutralizing activity, rapid protection in the upper and lower airways, and no pathologic changes in the lung.”
  • The full article is available at: 
    https://www.nejm.org/doi/full/10.1056/NEJMoa2024671

Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia

Immune complement and coagulation dysfunction in adverse outcomes of SARS-CoV-2 infection

  • A letter published in this week’s Nature Medicine which addresses our understanding of the pathophysiology of the COVID-19 infection
  • The authors describe their retrospective observational study and found that history of macular degeneration (a proxy for complement-activation disorders) and history of coagulation disorders (thrombocytopenia, thrombosis and hemorrhage) are risk factors for SARS-CoV-2-associated morbidity and mortality—effects that are independent of age, sex or history of smoking
  • They go on to suggest that the results highlight the value of using a multimodal analytical approach to reveal determinants and predictors of immunity, susceptibility and clinical outcome associated with infection
  • The full article is available at:
    https://www.nature.com/articles/s41591-020-1021-2

Escape from neutralizing antibodies by SARS-CoV-2spike protein variants

  • An interesting article was published this week in which the authors explore the relationship between protein variants in the SARS-CoV-2 virus and the body’s immune response
  • They suggest that neutralizing antibodies elicited by prior infection or vaccination are likely to be key for future protection of individuals and populations against SARS-CoV-2 and discuss the potential for antibody resistant strains of the virus
  • The full article is available at:
    https://www.biorxiv.org/content/10.1101/2020.07.21.214759v1.full.pdf

Experimental Theory: Discovery of mechanism behind HIV infections could also hold key to COVID-19

  • A recently published paper in the Journal of the American Society of Microbiology discusses how HIV attacks cells and the lessons that this might offer in helping us develop a better understanding of COVID-19 and the opportunity for developing novel anti-viral therapies 
  • The full discussion can be found at:
    https://mbio.asm.org/content/11/2/e03395-19

Today’s theme is about the power of collective purpose. There are certain events in history that serve to shape and define a generation. For our parents and grandparents, this event was World War II. From its earliest days, it was evident that this was a fight that would be larger than any single army or any single nation. There was an understanding that we would get through the war together or not at all. The result of this understanding was that the United States of 1945 was a better nation than it had been only four years earlier. While we were by no means perfect, America and her Allies had beat back the forces of tyranny and came through the war with a better understanding of who we were as a people. In the 1940s, Americans understood that success demanded that we all be in this together, and this understanding would help to shape the next 50 years of our history. The veterans of WWII left the military, but took the experience of collective purpose with them. The traditions of service, cooperation and mutual support that helped them fight a war, became the cornerstones for transformation through the rest of the 20th century. With the passage of time, we are beginning to lose that generation, and with their passing, it is too easy for the wisdom they shared to fade in our memories. We cannot let this happen. Today, more than ever, these are the very lessons that we will need to succeed. As a nation and a planet, we are facing our own generational experience. While the threat of the pandemic might not seem as immediate or as visceral as a war, it will, for good or for bad, define us as a generation. This moment will be recorded in history books and our response to it will inform how future generations remember us. Do we use this moment to reinforce our divides and pursue our personal interests or do we accept the challenge that history has put in front of us and choose a different path? The truth is unavoidable. We are facing a collective threat. To defeat it, we will need to harness more strength any single city, state or nation can muster. It is now that we must turn to each other and learn to cooperate because this is the only way we can beat back our common challenges. Time is of the essence, and the moment for action is here, but if we act together, we will turn back this pandemic, and perhaps relearn what the greatest generation always knew. By working for a common purpose, we will build a better tomorrow for everyone.

Tom Hughes