Current healthcare reimbursements may create incentives for excess use of ventilators to treat COVID-19 patients. Recent research has shown that healthcare providers, including hospitals, have experienced substantial financial losses as a result of the COVID-19 pandemic. Alternative, less-invasive treatments for critically ill COVID-19 patients could potentially improve patient outcomes. But these approaches expose hospitals to… Read More » Author information Katya Fonkych Katya Fonkych, PhD is a research economist at RTI International, an independent, non-profit research institute. Her current work involves design, implementation and research of alternative payment models on behalf of Center for Medicare and Medicaid Services. Her previous research focused on provider markets, healthcare pricing, utilization and costs. She received her PhD in Policy Analysis from RAND Graduate School. Views expressed are the author’s and do not necessarily reflect those of RTI. | The post Excess Use of Ventilators to Treat COVID-19 appeared first on The Medical Care Blog.

Successfully implementing an intervention within a complex service delivery system requires multiple, inter-related adoption strategies.  The Veterans Administration’s (VA) renewed emphasis on Hepatitis C treatment offered a perfect opportunity to study which strategies worked. In this post, I will review those findings. Then, I will discuss the importance of accounting for the complexity of strategy… Read More » Author information Ben King Research Scientist at UT Austin, Dell Medical School Ben King is an epidemiologist and a Clinical Assistant Professor at the University of Texas at Austin, where he teaches Environmental Health. He is also a Research Scientist at UT Austin's Dell Medical School in the Department of Neurology and President of Methods & Results, a research consulting service. His own research is often focused on the intersection between housing, homelessness, & health. Other interests include neuro-emergencies, diagnostics, and a bunch of meta-analytic methods like measurement validation & replication studies. For what it's worth he has degrees in neuroscience, community health management, and epidemiology. | LinkedIn | The post Implementation of HCV Treatment Programs appeared first on The Medical Care Blog.

Postpartum depression is common, preventable, and treatable. The Agency for Healthcare Research and Quality (AHRQ) challenge competition, “Cross-Sectional Innovation to Improve Rural Postpartum Mental Health,” identifies what communities are doing to improve access to mental healthcare for rural women. Furthermore, the challenge seeks new solutions to ensure that more women and families receive the help… Read More » Author information Priscilla Novak Priscilla Novak, PhD is a program analyst with the Agency for Healthcare Research and Quality. Her work focuses on generating solutions to address healthcare equity and accessibility with a focus on mental health and substance abuse. | Twitter | The post Rural Postpartum Mental Health: the Challenge to Improve appeared first on The Medical Care Blog.

When a call came in from the county coroner, it was never good news. Every once in a while, her work included a shock big enough to share with the public health team where I served as Medical Director. This was the case that Monday afternoon. Two teenage deaths, likely from opioid overdoses, likely the… Read More » Author information Jack Westfall | The post Moving Upstream to Reduce Harm from Fake Opioids appeared first on The Medical Care Blog.

As COVID-19 cases continue to rise, the pandemic has spotlighted the heroic efforts of our nation’s healthcare workers. Healthcare workers are providing much needed front-line patient care. However, in doing so, they also place themselves at risk of exposure to infectious disease, psychological distress, and burnout. But as the COVID-19 pandemic continues, another concern for… Read More » Author information Alexa Ortiz Health IT Scientist at RTI International Alexa Ortiz graduated from the University of North Carolina at Charlotte in 2009 with a Bachelor of Science in Nursing. Before receiving her graduate degree she was a practicing nurse for five years and has clinical experience in the field of both Cardiology and Neurology. In 2014 she received a Master of Science in Nursing specializing in nursing informatics from Duke University. Presently, she works as a Health IT Scientist at RTI International in the Center for Digital Health and Clinical Informatics. Despite no longer working in a clinical setting, she continues to maintain an active nurse license in the state of North Carolina. Her primary areas of research at RTI International focus on the clinical implementation of health information technology and the evaluation of consumer wearable devices. | Twitter | The post COVID-19 & Violence Against Healthcare Workers appeared first on The Medical Care Blog.

It is tough to fundraise for healthcare when the economy is do well. It must be extremely challenging to do it during an economic crisis and a pandemic. My heart goes out to all the charities, foundations and grassroots teams out there who are raising money right now. Their determination is inspiring. In the early

Blog by Joe Babaian Let’s think about what it means to work together. We all do it almost every day and I’d venture a guess that we all have experienced varying levels of quality in these collaborations. To formalize it a bit, let’s think of authentic collaboration. Here’s a personal story that I have just experienced

The largest Health IT event in Canada – the eHealth Conference – had to move online this year due to COVID-19. It would have been held in lovely Vancouver, but instead the eHealth Virtual Pop-Up event is happening next week, July 20-21st. The conference is hosted by Canada Health Infoway, the Canadian Institute for Health

Blog post by Joe Babaian It’s the kind of mistrust of science because science is viewed as authority. And there’s a lot of anti-authority feeling. I think that’s the kind of thing that drives the anti-vaxxers, the people who don’t believe the science of vaccination and don’t want to get their children vaccinated. It’s all

The world’s attention is justifiably focused on battling the COVID-19 pandemic which continues to ravage indiscriminately across the globe. There are, however, three other epidemics that we were dealing with prior to COVID-19 that are at risk of being forgotten: The Opioid epidemic The Obesity epidemic The Physician Burnout/Mental Health epidemic All three have been

The Emergency Committee on COVID-19, convened by the WHO Director-General under the International Health Regulations (2005) (IHR), held its fourth meeting on 31 July. In its statement following the meeting, published today, it expressed “appreciation for WHO and partners’ COVID-19 pandemic response efforts, and highlighted the anticipated lengthy duration of this COVID-19 pandemic, noting the importance of sustained community, national, regional, and global response efforts.”  After a full discussion and review of the evidence, the Committee unanimously agreed that the outbreak still constitutes a public health emergency of international concern (PHEIC) and offered this advice to Dr Tedros Adhanom Ghebreyesus, WHO Director-General.Dr Tedros accepted the advice of the Committee and confirmed that the outbreak of COVID-19 continues to constitute a PHEIC. The Director-General declared a PHEIC—WHO’s highest level of alarm under IHR—on 30 January at a time when there were fewer than 100 cases and no deaths outside China. He issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR. “The pandemic is a once-in-a-century health crisis, the effects of which will be felt for decades to come," Dr Tedros told the Committee in his opening remarks on Friday. "Many countries that believed they were past the worst are now grappling with new outbreaks. Some that were less affected in the earliest weeks are now seeing escalating numbers of cases and deaths. And some that had large outbreaks have brought them under control." The Committee made a range of recommendations to both WHO and State Parties. It advised WHO to continue to mobilize global and regional multilateral organizations and partners for COVID-19 preparedness and response, to support Member States in maintaining health services, while accelerating the research and eventual access to diagnostics, therapeutics, and vaccines. It advised countries to support these research efforts, including through funding, and to join in efforts to allow equitable allocation of diagnostics, therapeutics and vaccines by engaging in the Access to COVID-19 Tools (ACT) Accelerator among other initiatives.The committee also advised countries to strengthen public health surveillance for case identification and contact tracing, including in low-resource, vulnerable, or high-risk settings and to maintain essential health services with sufficient funding, supplies, and human resources. Countries were advised to implement proportionate measures and advice on travel, based on risk assessments, and to review these measures regularly.The Committee’s statement, with further details of the meeting and their recommendations, is available hereA list of the Committee members is available here The Emergency Committee will be reconvened again within three months or earlier, at the discretion of the Director-General.

The fourth meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the coronavirus disease (COVID-19) took place on Friday, 31 July 2020 from 12:00 to 17:45 Geneva time (CEST). Proceedings of the meetingMembers and advisors of the Emergency Committee were convened by videoconference.The Director-General welcomed the Committee, highlighted the advances in global understanding of the SARS-CoV-2 virus since the declaration of the public health emergency of international concern (PHEIC) on 30 January 2020, and outlined key areas where further attention by the Emergency Committees is needed.Representatives of the legal department and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities. The Ethics Officer from CRE provided the members and advisers with an overview of the WHO Declaration of Interest process. The members and advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the committee. Each member who was present was surveyed and no conflicts of interest were identified.The Secretariat turned the meeting over to the Chair, Professor Didier Houssin. Professor Houssin also welcomed the Committee and reviewed the objectives and agenda of the meeting.  The WHO Regional Emergency Directors and the Executive Director of the WHO Health Emergencies Programme (WHE) provided regional and the global situation overview. WHO continues to assess the global risk level of COVID-19 to be very high. Dr David Heymann, chair of the WHE Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH), presented on national best practices and global COVID-19 experiences. Dr Johanna Jordaan presented an overview of the International Civil Aviation Organization (ICAO) Council Aviation Recovery Taskforce (CART)’s report and public health focused recommendations. The Committee expressed appreciation for WHO and partners’ COVID-19 pandemic response efforts. The Committee noted progress made on the Temporary Recommendations issued on 1 May 2020 and examined additional areas that require further attention. The Committee highlighted the anticipated lengthy duration of this COVID-19 pandemic, noting the importance of sustained community, national, regional, and global response efforts.  The Committee encouraged all individuals, in particular young people, and communities to continue to play an active role in preventing and controlling transmission of COVID-19. The Committee recognized that State Parties should enable and support communities and individuals and thus build trust in governments’ response measures. After ensuing discussion, the Committee unanimously agreed that the pandemic still constitutes a public health emergency of international concern and offered advice to the Director-General.The Director-General declared that the outbreak of COVID-19 continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR (2005). The Emergency Committee will be reconvened within three months, at the discretion of the Director-General. The Director-General thanked the Committee for its work.Advice to the WHO SecretariatContinue to distill and rapidly communicate lessons learned and best practices from the COVID-19 pandemic and national intra-action reviews.Continue to coordinate and mobilize global and regional multilateral organizations, partners and networks for robust political commitment and resourcing of COVID-19 pandemic preparedness and response, including for development of vaccines and therapeutics.Provide nuanced, pragmatic guidance on criteria for appropriate COVID-19 response activities to reduce the risk of response fatigue in the context of socio-economic pressures.Continue to support State Parties and partners in conducting active and community-based COVID-19 surveillance, through technical and operational resources, such as guidance, tools, and trainings on case definitions and identification, contact tracing, and death certifications; encourage State Parties to continue reporting relevant data to WHO through platforms such as the Global Influenza Surveillance and Response System.  Accelerate research into remaining SARS-CoV-2 critical unknowns, such as the animal source and potential animal reservoirs, and improve understanding of the epidemiology and severity of COVID-19 (including its long-term health effects; viral dynamics such as modes of transmission, shedding, potential mutations; immunity and correlates of protection; co-infection; as well as risk factors and vulnerabilities) and the effectiveness of public health measures.Continue to work with partners to counter mis/disinformation and infodemics by developing and disseminating clear, tailored messaging on the COVID-19 pandemic and its effects; encourage and support individuals and communities to follow recommended public health and social measures.Support diagnostics, safe and effective therapeutics and vaccines’ rapid and transparent development (including in developing countries) and equitable access through the Access to COVID-19 Tools (ACT) Accelerator; support all countries to implement the necessary clinical trials and to prepare for the rollout of therapeutics and vaccines.Work with partners to revise WHO’s travel health guidance to reinforce evidence-informed measures consistent with the provisions of the IHR (2005) to avoid unnecessary interference with international travel; proactively and regularly share information on travel measures to support State Parties’ decision-making for resuming international travel.Support State Parties, particularly vulnerable countries, in strengthening their essential health services and accompanying supply chains as well as preparing for and responding to concurrent outbreaks, such as seasonal influenza.Temporary recommendations to State PartiesShare best practices, including from intra-action reviews, with WHO; apply lessons learned from countries that are successfully re-opening their societies (including businesses, schools, and other services) and mitigating resurgence of COVID-19.Support multilateral regional and global organizations and encourage global solidarity in COVID-19 response.Enhance and sustain political commitment and leadership for national strategies and localized response activities driven by science, data, and experience; engage all sectors in addressing the impacts of the pandemic.Continue to enhance capacity for public health surveillance, testing, and contact tracing. Share timely information and data with WHO on COVID-19 epidemiology and severity, response measures, and on concurrent disease outbreaks through platforms such as the Global Influenza Surveillance and Response System.Strengthen community engagement, empower individuals, and build trust by addressing mis/disinformation and providing clear guidance, rationales, and resources for public health and social measures to be accepted and implemented.  Engage in the Access to COVID-19 Tools (ACT) Accelerator, participate in relevant trials, and prepare for safe and effective therapeutic and vaccine introduction.Implement, regularly update, and share information with WHO on appropriate and proportionate travel measures and advice, based on risk assessments; implement necessary capacities, including at points of entry, to mitigate the potential risks of international transmission of COVID-19 and to facilitate international contact tracing.Maintain essential health services with sufficient funding, supplies, and human resources; prepare health systems to cope with seasonal influenza, other concurrent disease outbreaks, and natural disasters.

The theme of World Breastfeeding Week 2020 is “Support breastfeeding for a healthier planet”. In line with this theme, WHO and UNICEF are calling on governments to protect and promote women’s access to skilled breastfeeding counselling, a critical component of breastfeeding support.

WHO takes this opportunity to remind Member States that are Parties to the WHO Framework Convention of Tobacco Control (FCTC) of their obligations under the Convention. Heated tobacco products are tobacco products, meaning that the WHO FCTC fully applies to these products. (Decision FCTC/COP8(22)) Specifically, Article 13.4(a) obliges Parties, to prohibit "all forms of tobacco advertising, promotion and sponsorship that promote a tobacco product by any means that are false, misleading or deceptive or likely to create an erroneous impression about its characteristics, health effects, hazards or emissions." WHO reiterates that reducing exposure to harmful chemicals in Heated Tobacco Products (HTPs) does not render them harmless, nor does it translate to reduced risk to human health. Indeed, some toxins are present at higher levels in HTP aerosols than in conventional cigarette smoke, and there are some additional toxins present in HTP aerosols that are not present in conventional cigarette smoke. The health implications of exposure to these are unknown. On 7 July 2020, the US FDA authorized the marketing of a heated tobacco product, the IQOS Tobacco Heating System, under the Federal Food, Drug and Cosmetic Act. This Act requires pre-market authorization of new tobacco products before they can be placed on the US market. The US FDA statement noted that, “Even with this action, these products are not safe nor “FDA approved“. The exposure modification orders also do not permit the company to make any other modified risk claims or any express or implied statements that convey or could mislead consumers into believing that the products are endorsed or approved by the FDA, or that the FDA deems the products to be safe for use by consumers.”The US FDA authorization rejected claims that the use of the product is less harmful than another tobacco product or reduces risks to health. The FDA orders also require the company to monitor youth awareness and use of the products to help ensure that the marketing of the MRTPs does not have unintended consequences for youth use. The company must also keep the FDA apprised of efforts to prevent youth access and exposure. Given that health may be affected by exposure to additional toxins when using HTPs, claims that HTPS reduce exposure to harmful chemicals relative to conventional cigarettes may be misleading. Moreover, the relevant orders grant a temporary market authorization within the US and are based on factors specific to the US, which is not a Party to the WHO Framework Convention on Tobacco Control (WHO FCTC). All tobacco products pose risks to health and WHO urges full implementation of the WHO FCTC. Rigorous implementation will support quit attempts and reduce initiation by non-users of tobacco products, especially the young. WHO recommends cessation of all tobacco use with interventions, such as brief advice from health professionals, national toll-free quit lines, nicotine replacement therapies and cessation interventions delivered via mobile text messaging.  

The second edition provides an improved basis for policy debate and informed decision-making at a critical time for global health.