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Don’t delay kids’ routine vaccinations, health experts warn



With flu season and a possible resurgence of COVID-19 on the horizon for the fall, health experts are warning parents across Long Island not to delay their children’s routine vaccinations.

“There has been a real concern among pediatricians,” said Dr. Eve Meltzer Krief of Huntington Village Pediatrics. “There was a time we weren’t seeing children at all and doing mostly telemedicine.”

Vaccination rates dipped across the country in the months after the start of the pandemic, as fearful parents stayed away from medical facilities, worried they could be exposed to the coronavirus, doctors said. But falling behind on vaccines for measles, mumps, pertussis, chickenpox and other childhood diseases also puts kids at risk, doctors said. 

Making sure their young patients return in the fall for their flu shots will be another challenge for pediatricians. The CDC already has said flu shots are especially important this season to prevent the illness and the strain on a health care system already stressed by COVID-19.

“We’re kind of concerned about what the combination of flu and COVID at the same time is going to look like,” Krief said.

Missed or delayed childhood vaccines due to the COVID-19 pandemic is a global issue. The World Health Organization and UNICEF recently released a survey and put out a statement warning of an “alarming decline in the number of children receiving lifesaving vaccines around the world.”

A Centers for Disease Control and Prevention report in May pointed to a notable decrease in orders at the federally funded Vaccines for Children program.

Krief said her practice — like many others on Long Island — made special arrangements in their offices to ensure social distancing. They even constructed an outdoor tent for families who didn’t feel comfortable entering the office.

“That’s a really important message to get out there,” said Dr. James Schneider, chief of pediatric critical care medicine at Cohen Children’s Medical Center in New Hyde Park. “Health care facilities are actually safer than most places because we are putting a lot of emphasis on safety.”

He said the measles is one example of a disease that can come back quickly.

“When people fall off schedule and don’t get the measles vaccines, we see outbreaks,” he said. “These are life-altering and potentially life-threatening conditions.”

Nicole Sano, a mother of two young boys from North Bellmore, said she was initially reluctant to take them for their annual checkups during the pandemic.

“I didn’t think it would be a big deal to push it back,” Sano said. “Then I spoke to my doctor.”

Sano’s pediatrician explained the importance of staying on a vaccine schedule. She said seeing the precautions taken at the office, which included staying in her car until an examination room was available, helped put her at ease.

“I totally understand — it’s terrifying. You don’t want to expose your children to something,” Sano said. “But if you are not vaccinating them, you are exposing them to something else.”

Krief said she and other pediatricians at her practice have been successful at luring back wary families in recent weeks.

“Even if kids are not going to school in the fall, there are still potential exposures,” she said. “Any kind of public outing is potential exposure for an infectious disease.”

She pointed to pertussis, or whooping cough, as one example. It may develop as just a cough in older children, but can be deadly for infants.

The vaccine is administered in three doses over the first year of a baby’s life.

“Until that third set of whooping cough vaccine, they are susceptible,” Krief said. “And older kids need their booster shots at 11 so it doesn’t spread to the younger population.”

Even though seasonal flu vaccines are not typically available until October, the CDC already has taken to social media and other sources to remind the public that this is a particularly important year to get vaccinated — adults and children.

Experts said the vaccine is the best way to prevent flu, which can cause serious illness. If you do contract the flu, a vaccination can lessen the symptoms and prevent hospitalizations.

“When I see kids in the ICU with critical influenza, more often than not they were not vaccinated,” Schneider said. “If parents don’t bring their kids to get the flu vaccine, I may see a very busy winter in the ICU.”

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Fletcher, Gore Clash on Outsourcing Proposal for Jail Health Care – NBC 7 San Diego




Supervisor Nathan Fletcher joined community activists and county workers Monday to announce a proposal to have the Health and Human Services Agency administer medical and behavioral health services in jails, and prevent Sheriff Bill Gore from privatizing services.

Gore, who recently cited the Sheriff’s Department’s $90 million annual health care bill for inmates as a reason to look toward cost-saving strategies, will ask the Board of Supervisors on Tuesday to consider a request to look at possible vendors for the county’s health care needs in its jails and other facilities. The meeting will be conducted via teleconference in response to the COVID-19 pandemic.

Fletcher and his coalition launched a petition called “Stop the Sheriff from Outsourcing Medical and Mental Health Services,” contending that privatization could lead to worse healthcare overall and threaten county jobs.

“Instead, we need a system of care driven by providing the appropriate care and preparation for release and reintegration into society,” Fletcher told reporters. “Not a system designed to limit care to maximize profit.”

Along with having the Health & Human Services Agency manage healthcare needs at jails, Fletcher is also asking his fellow supervisors to halt all actions related to outsourcing until an evaluation is completed within 180 days.

The Sheriff’s Department currently operates a hybrid system of private contractors and county workers. According to Fletcher’s group, the county sees a suicide rate for inmates five times higher than the state prison system.

“We have been given a sneak preview of the outcome of (for-profit) care in jails and laying off county workers, and it is grim,” said Genevieve Jones-Wright, executive director of Community Advocates for Just and Moral Governance.

“The sheriff has failed to meaningfully address his abhorrent record concerning the deaths in our local jails, and now he is putting forward a proposal that will exacerbate the loss of lives even further,” she said.

David Garcias, president of Service Employees International Union Local 221, said Gore’s plan “is to sell out their jobs to for-profit companies that provide substandard care and force the public to pick up their bill for lawsuit and settlement costs.”

Gore responded to Fletcher’s criticism with a letter addressed to the supervisor, stating that the board “has no direct authority over the jail,” in terms of duties or operation.

“In fact, the penal code recognizes that a county sheriff may contract with providers of health care for the care of inmates,” the letter says.

“As sheriff, I am consistently looking for ways to provide the highest level of medical services for inmates in the county jail system. “There is no reason to delay the process for 180 days.”

In response to Fletcher’s claim of poor healthcare outcomes for inmates and low morale among staff, Gore argued that his department “has worked diligently to improve timely access to care for our inmate population.”

In a July 31 opinion piece in the San Diego Union-Tribune, Gore wrote it would be irresponsible of him “not to explore all available options” for inmate mental and medical health care, especially given fiscal pressures on the county caused by the pandemic.

Gore argued that the county already spends over $20 million on contracted services for inmates. “The only way to find out if that money is providing the highest value is to explore options,” he wrote.

The sheriff also praised his department’s medical services staff for their “exceptional work every day in a very challenging environment.”

Read Gore’s letter in full here.

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Multnomah County health officer to hold COVID-19 news conference




PORTLAND, Ore. — Multnomah County Health Officer Dr. Jennifer Vines will hold an 11:30 a.m. news conference to discuss the spread of COVID-19.

Multnomah County, Oregon’s most densely populated, is among the counties with the most rapid spread of COVID-19. Last week, Gov. Kate Brown added Multnomah, Marion and Hood River counties to Oregon’s COVID-19 County Watch List.

In a news conference last week, Dr. Vines said the coronavirus is widespread in Multnomah County, with 62% of the county’s cases not traceable to a known source.

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‘These very young students saw combat-level injuries’: health care students’ reflect on Walmart mass shooting a year later




EL PASO, Texas (KVIA) — El Paso medical professionals had just minutes to prepare for one of the most difficult days in their careers: August 3, 2019, the day of the Walmart mass shooting. In the chaos, some nursing and medical students suddenly found themselves on the front lines.

A year later, the sights and sounds of the hospital still linger with medical student Christian Castro. Castro is of the many health care students who raced in to volunteer at hospitals after the mass shooting, rushing into the trauma and feeling compelled to go where they could help.

“It hit me that whatever is going on, however many people are hurt, the hospital’s going to need help,” he said.

“We came in on the opposite side of the emergency room,” Castro said. “It was very quiet, very empty, kind of an eerie feeling. As we got closer, the quiet, eerie feeling kind of changed to this more urgent, louder, noise-filled environment of the emergency room.”

At the time, Castro was a third-year medical student at the Paul L. Foster School of Medicine at Texas Tech University Health Sciences Center El Paso.

“Once I figured out that my immediate family and friends were all okay, my extended family of El Paso, I kind of had the sense that they were in danger,” Castro said. “I needed to be there. My community needed me.”

At University Medical Center, it quickly became clear: no job was too small.

“They were receiving these victims as they were coming in from pedestrian vehicles, from ambulances,” Castro said. “They were meeting them at the door, assessing them within a couple of seconds to minutes… Everyone had a little role to play in that time and kind of like this little symphony of chaos mended in its way into taking care of these patients.”

“No one looked out of  place,” he added. “Everyone knew that they had a job that needed to be done.”

Health care students became heroes, suddenly thrust into the middle of the crisis.

“Our students were in clinicals and they were in the ICU, the emergency department and also in OR,” said Dr. Stephanie Woods, the Dean of the Hunt School of Nursing at TTUHSC El Paso. “Very quickly we had to make a decision.

Nursing students at TTUHSC El Paso went on lockdown, but instead of sheltering in place, they jumped in to the fight.

“These very young students in their early twenties, mid-twenties, suddenly saw combat-level injuries,” Dr. Woods said. “They saw things they have never seen and would hope to never see again.”

It was a lesson they might not have learned in a classroom, and one they likely hoped they would never have to learn at all.

“When you commit to certain purposes in your life, you don’t get to ask yourself, ‘I’ll do that if that’s convenient,'” Dr. Woods said. “Nurses don’t have the option of saying, ‘I’m going to stand aside from this crisis.'”

For Castro, instinct took over.

“Everything happened so quickly,” Castro said. “It really wasn’t until I got home later that night that I had a chance to sit down and like take a deep breath and then think like, ‘wow, this really happened.’ The families we helped. The families we couldn’t help. The patients, the doctors and the nurses and the things we saw and the things we heard. It kind of rushed in all at once.”

A year later, Castro knows the impact will last a lifetime.

“If it wasn’t already clear to me, it became crystal clear that that’s where I was meant to be. I was right where I was supposed to be,” Castro said. “It did kind of serve as an example, or like a very clear magnifying glass, for me to see that I truly am on the right path and I’m doing what I’m supposed to be doing. There’s no question about it.”

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