Medical Transcription Programs: March 2021

Wednesday, March 31, 2021

France Bans Domestic Travel, Shuts Schools as COVID Surge Strains Hospitals

French President Emmanuel Macron announced on Wednesday that the nation was banning domestic travel and closing schools for several weeks as a surge in COVID-19 cases has strained hospitals across the country.

“We’re going to close nursery, elementary and high schools for three weeks,” Macron said in a televised address to the country, according to the Associated Press.

In addition to closing schools, Macron announced that nonessential domestic travel in France will be limited over the next month, a closure of nonessential businesses across the nation and a curfew from 7 p.m. to 6 a.m. local time.

The announcement by Macron comes as France faces a surge in COVID-19 cases and patients hospitalized. On Tuesday, France reported more than 5,000 COVID-19 patents in intensive care units (ICU). During his televised address to the nation, Macron said that France will increase the number of ICU beds “in the coming days” from 7,000 to 10,000.

France COVID-19 — French President Emmanuel Macron is seen on a TV screen as he speaks during a televised address, carried by French TV channel France 2, on the new COVID-19 restrictions from the Elysee Palace in Paris on March 31, 2021.
LUDOVIC MARIN/Getty

For more reporting from the Associated Press, see below.

In a televised address to the nation, Macron said new efforts are needed as “the epidemic is accelerating.”

It’s a departure from the government’s policy in recent months, which has focused on regionalized restrictions. School closures in particular had been seen as a very last resort.

Macron said restrictions already applying in the Paris region and elsewhere will be extended next week to the whole country, for at least one month. Under these restrictions, people are allowed to go outside for leisure, but within a 10-kilometer (6 miles) radius from their homes—and without socializing. Also, most nonessential shops are closed down.

In addition, Macron promised to speed up the vaccination campaign by giving access to all people aged 60 and over in mid-April, those aged 50 and over in mid-May and the rest of the population a month later. So far, France has prioritized people living in nursing homes and those aged 70 and over, as well as health care workers and people with serious health conditions.

“If we stay united in the coming weeks…then we will see light at the end of the tunnel,” Macron said.

He said the school closures aimed at avoiding major disruption by bringing forward the date of scheduled Easter holidays. All children will get online teaching next week, Macron said. Then they will go on vacation for two weeks.

Macron reaffirmed his views against a prolonged closure of schools as “increasing social inequalities.” According to figures reported by the U.N. education agency UNESCO, to this date, France has closed schools for 10 weeks in total since the start of the pandemic—compared to 27 weeks in the U.K., 28 weeks in Germany and 47 in the United States.

A debate is scheduled in parliament Thursday that will address the virus situation and the new measures.

Previous nationwide lockdowns in March and October 2020 were also announced by Macron in televised speeches.

After an overnight shift at an ICU in the northern French city of Amiens, Dr. Pauline Caillard described growing numbers of patients and mounting strain on medical staff.

“It is moving very fast,” she said. “I hope we do not have to make choices” between patients.

The renewed surge of infections has led to growing questions about Macron’s virus strategies. With presidential elections scheduled for 2022, Macron is having to weigh both political and health considerations.

An overnight nationwide curfew has been in place since January, and all France’s restaurants, bars, gyms, cinemas and museums have been closed since October.

Newsweek, in partnership with NewsGuard, is dedicated to providing accurate and verifiable vaccine and health information. With NewsGuard’s HealthGuard browser extension, users can verify if a website is a trustworthy source of health information. Visit the Newsweek VaxFacts website to learn more and to download the HealthGuard browser extension.

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Pfizer states COVID vaccine was 100?ficient in trial of kids ages 12 to 15

Pfizer and BioNTech revealed Wednesday that their coronavirus vaccine was found to be 100?ficient at securing versus COVID-19 in a trial of more than 2,200 kids between the ages of 12 and 15.

Information: The clinical trial was performed in the U.S. with 2,260 teenagers ages 12 to 15.

Pfizer and BioNTech also announced that the first doses were administered last week in a trial of children ages 6 months to 11 years

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Biden's massive infrastructure plan, a Covid vaccine for teens and the Final Four is set

Good morning, NBC News readers.

President Joe Biden is ready to unveil his $2 trillion dollar infrastructure plan, plus more good news on Covid-19 vaccines and with another upset, the men’s Final Four is set.

Here’s what we’re watching this Wednesday morning.

‘The wish list’: Biden makes his move with push for far-reaching infrastructure overhaul

In a speech Wednesday, President Joe Biden will lay out the first part of a massive, multitrillion-dollar infrastructure plan that is expected to include projects as varied as highways and “human infrastructure,” like child care.

The kitchen-sink approach is designed to push the economy in a greener and more equitable direction, paid for with higher taxes on corporations and the wealthy, NBC News’ Alex Seitz-Wald and Shannon Pettypiece report.

The $2 trillion proposal, which is being called the American Jobs Plan, will focus on projects that could get bipartisan support, like roads and bridges, expanded broadband internet access and investments in clean energy. It also includes an expansion of home health care services, which are in demand for the aging population.

The sweeping legislative package would be legacy-making for the nascent Biden administration, but it will face a steep climb up Capitol Hill, where time to pass major bills is already waning.

“There is a sense of spending fatigue on some quarters on Capitol Hill, not only among Republicans but some Democrats, as well,” said one Democratic political strategist.

Others might argue that now is the time to act and spend his political capital: Biden currently has high national approval ratings on his handling of the economy and Covid-19, according to new polling. But, there are warning signs, too: He’s getting lower marks on culturally divisive issues like immigration and gun control.

Wednesday’s top stories

Jan Hetfleisch / Getty Images file

Pfizer says its Covid vaccine is 100 percent effective in young teens

There is positive news on the vaccine front: the Pfizer and Moderna Covid-19 vaccines have been found to be 90 percent effective in their “real world” study, according to the Centers for Disease Control and Prevention. And Pfizer just announced Wednesday that its Covid vaccine is 100 percent effective in young teens and that it plans to request emergency use authorization for 12- to 15-year-olds within the coming weeks.

But, all that said, the White House and public health officials are sounding the alarm that we are not done with the pandemic yet. Andy Slavitt, the White House coronavirus senior adviser, warned Tuesday that governors who lift Covid-19 restrictions before enough people have been vaccinated are “playing with fire” and could risk sparking another wave of infections.

Day 2 of Derek Chauvin trial: Tearful witness regrets not doing more to possibly save George Floyd’s life

The teenage bystander who recorded a viral video of George Floyd’s death broke down in tears on the witness stand Tuesday, saying she regrets not doing more to possibly save his life. Catch up on how the case unfolded during Day 2 of testimony as Chauvin’s defense attempted to portray bystanders as an angry mob that diverted officers’ attention. By David K. Li and Janelle Griffith | Read more

Gaetz says DOJ probe into possible relationship with teen girl is part of extortion plot

Rep. Matt Gaetz, R-Fla., accused a former Justice Department official of a multimillion-dollar extortion plot on Tuesday, hours after a news report said the lawmaker was being investigated by the Justice Department over whether he had a sexual relationship with a minor and paid for her to travel with him. By Dartunorro Clark | Read more

OPINION: Racism against Asian Americans is heartbreaking. How do we talk to our kids about it?

Before we speak to children, we need to have an honest discussion with ourselves about our own experiences, the director of child, adolescent & family psychiatry at George Washington University Medical Center writes in an opinion piece. The goal is to give children both the language and an open door to talk about race and racism. By Suzan Song | Read more

Texas lawmakers weigh changes to protect families wrongly accused of child abuse

Following an NBC News and Houston Chronicle investigation, legislation has been introduced to require a second medical opinion before Child Protective Services can take a child from their family. By Mike Hixenbaugh | Read more

BETTER: 5 small things that successful couples do every week

The pandemic may have caused a shift in our career goals and personal dreams. Now is a good time to check in with your partner and get on the same page. By Dana McMahan | Read more

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One Holy Week

This week in Jerusalem, three of the world’s major religions are gathering for Holy Week. NBC News’ Matt Bradley reports on how the ongoing pandemic is impacting the religious observations.

“The people who live in Jerusalem, they are holy people,” said one longtime resident of the Old City. “Together Jews, Muslims, Christians… We give Jerusalem as an example to the world that we live, we suffer, but we live.”

Thanks for reading the Morning Rundown.

If you have any comments — likes, dislikes — send me an email at: petra@nbcuni.com

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Thanks, Petra

Image: Petra Cahill Petra Cahill

Petra Cahill is a senior editor and writer for NBC News Digital. She writes NBC News’ Morning Rundown newsletter.

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The Best of Medical Humor, A Collection of Articles, Essays, Poetry, and Letters Published in the Medical Literature

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Available in the US, Canada, Latin America, and South East Asia (except Japan) only. Not distributed by LWW in Europe.

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Medical transcription is the process that involves documentation of medical records from voice to text format. Physicians record patient details in audio format, and these details are sent to a transcriptionist to decode and store in digital format. Medical transcription helps make data interpretation and analysis easy as through this health records are stored in a structured format. With the adoption of new technology and improvements in the healthcare sector, the global medical transcription market is expected to experience various opportunities.

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COVID Monoclonal Antibodies: Do They Work in Dialysis?

Monoclonal antibody bamlanivimab appeared to work for end-stage renal disease (ESRD) patients in early data from dialysis providers, but there are plenty of questions that remain.

The first 40 dialysis patients who got the antibody treatment at U.S. Renal Care clinics had a 7-day hospitalization rate of 15% compared with 57% among a randomly sampled comparator group of 49 coronavirus-infected dialysis patients matched for age, gender, diabetes status, and race.

The 30-day hospitalization rate was 39% versus 65% for those patients treated from when the dialysis network first started administering the drug January 5 through the end of February.

That represents almost the totality of their experience with the drug, said Mary Dittrich, MD, chief medical officer of U.S. Renal Care, who reported their data at an American Society of Nephrology webinar earlier in March.

With falling case counts nationwide, only another five patients have been dosed since, she told MedPage Today. “A tradeoff that I’m very willing to make is that our infections have gone down, so our administrations have gone down.”

Fresenius Medical Care North America and DaVita Kidney Care have also been tracking their numbers and results, with their larger patient populations.

Across DaVita’s more than 220 infusions, no adverse events were reported with the infusion or in the 1-hour observation period after it, George Aronoff, MD, vice president in DaVita’s Clinical Affairs Office, told MedPage Today.

“Only about 9% of our patients who have received the infusion have required hospitalization within 21 days following infusion,” he noted.

Fresenius reported similar results: “Since offering this antibody treatment in our dialysis centers in early January, our preliminary data suggests that less than 10% of patients who received the therapy were hospitalized within the first 28 days after treatment,” said its chief medical officer, Jeffrey Hymes, MD.

Altogether, it appears that bamlanivimab — developed and sold by Eli Lilly — safely reduced progression of disease in the ESRD population, Dittrich said. “It’s small numbers and it’s early, but given the paucity of any data in our population…that’s the data we’re excited about.”

Few, if any, ESRD patients were included in those pivotal clinical trials, so some data is better than none, she noted.

“It has been gut-wrenching to be helpless in this pandemic,” Dittrich said. “To have any option both in terms of vaccines and these monoclonal antibodies is inspiring.”

However, there are some big cautions with this observational data. So much so that her group decided not to publish, she said.

Monoclonal antibodies have to be given as outpatient treatment after a positive for COVID-19, but there are logistical issues, Dittrich noted.

A large portion of dialysis patients are admitted soon after COVID-19 diagnosis, typically within 5 days. In U.S. Renal’s data, the average time to bamlanivimab administration after diagnosis was 4 days.

“There is inherent bias,” she warned. “It’s very possible that we selected for a certain group of patients to get bamlanivimab — those with milder disease, those who were going to stay outpatient for 4 days.”

Hymes noted that the early Fresenius data will also require further analysis to correct for possible baseline differences in the characteristics of patients who did and didn’t get the antibody.

Another issue is that the data only included bamlanivimab monotherapy, whereas distribution of that drug has stopped due to reduced efficacy against SARS-CoV-2 variants such as those identified from California and New York. Instead, the combination of bamlanivimab and etesevimab (also from Eli Lilly), and a two-antibody cocktail developed by Regeneron Pharmaceuticals, are the ones being distributed.

“I do worry about how the variants rising in prevalence is going to affect the efficacy of this therapy, and that’s one thing we’ll be watching closely,” Dittrich said. “I don’t know that we have the ability to genomically sequence all our patients, but we want baseline efficacy data out there, knowing that the variants may change that data.”

Fresenius continues to advocate use of monoclonal antibodies for appropriate patients, Hymes noted, with recently updated clinical guidelines to emphasize the availability of the combination antibody and the discontinuation of bamlanivimab monotherapy.

Monoclonal antibodies are still relevant even as vaccination will be rolling out to ESRD patients through dialysis clinics nationwide in the next few weeks, Dittrich said.

“With the variants and the country opening back up, we worry that numbers are going to go back up,” she said. “Especially if these variants cause more severe disease, which there is some suggestion they do, this will be even more relevant.”

Last Updated March 30, 2021

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Biden's Covid adviser to governors: You're 'playing with fire'

White House coronavirus senior adviser Andy Slavitt warned Tuesday that governors who lift Covid-19 restrictions before enough people have been vaccinated are “playing with fire.”

Slavitt was quickly joined by a chorus of public health experts who told NBC News that governors risk sparking another wave of coronavirus infections if they move too fast to return to “normal life” by dispensing with proven Covid-19 protections like mask mandates.

“People seem to forget that while there is a light at the end of the tunnel, we aren’t out of the tunnel yet,” added Summer Johnson McGee, who is dean of the University of New Haven’s School of Health Sciences.

“If people resume their normal activities and restrictions are rolled back without reaching herd immunity, a fourth wave is guaranteed,” McGee said. “When you combine spring break and increased travel with lifted restrictions and Covid fatigue, you have the perfect trifecta for another Covid wave.”

The experts spoke out as Covid-19 case numbers have been spiking in Michigan and rising at an alarming rate in states like New Jersey, West Virginia, Hawaii, Pennsylvania and Connecticut, even as the pace at which the vaccines are being distributed across the United States has rapidly accelerated under the Biden administration.

“Look, we’re not out of this pandemic yet. We still have an accelerating threat, and if you’ve been vaccinated, that’s wonderful, I’m really glad about that,” Slavitt told MSNBC’s Stephanie Ruhle. “But we also have to remember that there’s millions and millions of people who haven’t yet been vaccinated. And so, lifting all these restrictions, telling people not to wear masks, gathering in large crowds, that’s the equivalent of playing with fire.”

Dr. Sadiya Khan, an epidemiologist at the Northwestern University Feinberg School of Medicine, agreed.

“Even as vaccinations increase and we are seeing millions of people getting their shots, we are still not yet ready for normal life with big gatherings or life without masks,” she said. “But, we are so, so close. And focusing on the task at hand of getting vaccines to as many people as possible every day while maintaining all of the safety protocols is still necessary.”

The governors of states like Arizona, Connecticut, Maryland, Mississippi, Texas, West Virginia and Wyoming have, in recent weeks, lifted economic restrictions and either loosened — or done away with — safety measures like mask mandates over the objections of most public health experts.

Without naming names, Slavitt said that “the governors around the country, some of them don’t want to have any role in the rescue of our country and our citizens,”

“And the real question is, are we going to participate in that rescue, like the response from the Biden administration, or are we going to just wait and hope science rescues us?” Slavitt said. “And I think we can all work together, we can beat this much quicker.”

Slavitt told Ruhle that the increasingly good news from the vaccination front has lulled too many Americans into the thinking the pandemic is almost over.

“Well look, it’s just like last springtime,” Slavitt said. “You look outside, you know. You can’t see the virus. You see the vaccinations. And all of that feels good.”

But the message from the Biden administration, Slavitt said, is “we have an accelerated threat, we are accelerating our response.” And, he added, Americans should “hold on for a couple more weeks at least.”

“Within three weeks, 90 percent of Americans will be within five miles of a vaccine, and 90 percent of Americans will be eligible for the vaccines, and by May 1, that will be 100 percent,” he said.

Public health officials, including those working with the Biden administration, have said that more than 70 percent of the total U.S. population (332.5 million) would have to be vaccinated to reach herd immunity.

As of Tuesday, 52.6 million Americans have been fully vaccinated, the latest NBC News figures show.

“There is not enough immunity in the population through infection or vaccination to prevent another large surge, and case levels are still high enough in most places that that can happen rapidly,” said Josh Petrie, a research assistant professor of epidemiology at the University of Michigan School of Public Health. “We don’t know for sure whether vaccinated people can transmit the virus if they are exposed, so it is still important for vaccinated people to wear masks and social distance while so many other people are still susceptible.”

McGee echoed Petrie on the contentious issue of wearing masks.

“The scientific jury is still out on whether fully vaccinated individuals can transmit Covid-19 to other individuals, so that is a big unknown and a big risk,” McGee said. “Until we learn conclusively that transmission isn’t possible, even fully vaccinated individuals need to mask up to protect the health and safety of others.”

Meanwhile, a U.S. Census Bureau survey of nearly 80,000 adults from March 3 to March 15 appeared to show vaccine hesitancy was on the decline. It found resistance to getting the Covid-19 vaccine was shrinking rapidly among deeply skeptical groups like Black Americans and in conservative Southern states like Alabama, Louisiana, and South and North Carolina.

Young people, many of whom are only now starting to be vaccinated, still need more convincing, the survey found. Nearly a quarter of those ages 18 to 39 still say they probably won’t — or definitely won’t — get a shot. That’s a decline of just 5 percent since January, when the vaccine rollout began.

Public health experts like Marianne Udow-Phillips, who heads the Center for Health Research Transformation at the University of Michigan, have warned that after a year of lockdowns many Americans are contending with “pandemic fatigue” and are fed-up with having to wear masks and are eager to resume their old lives.

“Governors are in a tough spot with a lot of fatigue around restrictions,” Petrie added. “But if restrictions are loosened, they need to be eased in a way that still communicates the ongoing risk and importance of continued masking and social distancing when in public.”

In Michigan, where Gov. Gretchen Whitman has had to contend with fierce opposition to lockdowns and even a thwarted right-wing plot to kidnap her, a state official said they’re trying to do just that.

While the state has seen a surge in new coronavirus cases since Whitmer loosened some of the restrictions and allowed the resumption of previously banned activities, like organized youth sports, “unlike other states like Texas and Florida that have abandoned public health protocols altogether, Michigan continues to have smart health policies in place, such as a mask mandate and capacity limits on large gatherings,” Whitmer’s press secretary, Bobby Leddy, said in an email to NBC News.

“The state is moving forward with plans to ramp up testing for schools, businesses, and nursing homes,” Leddy said. “This is the first week of expanded testing protocols for all student athletes. And we have increased our vaccine program over the last couple of weeks, which has helped us reach a historic milestone of 4 million vaccines in under four months.”

Complicating the messaging problem is the legacy left by former President Donald Trump, whose refusal to listen to scientists, his opposition to lockdowns and other health measures, and his steady stream of misinformation about Covid-19 sowed widespread confusion among the American people about how best to combat the pandemic.

The U.S. continues to lead the world with nearly 30.5 million confirmed Covid-19 cases, according to the latest NBC News figures.

The 552,783 coronavirus deaths recorded in the U.S. is also a world-leading figure and equivalent to the populations of cites like Raleigh, North Carolina, or Grand Rapids, Michigan, or Concord, California.

http://medicaltranscriptionprograms.com/bidens-covid-adviser-to-governors-youre-playing-with-fire-2/

Tuesday, March 30, 2021

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