Inside the PPE Underworld; Spotting Racism in Medicine

  • As the U.S. continues to break records for coronavirus cases and deaths, hospitals are once again facing PPE shortages. Doug Bock Clark explores the dark underworld of the PPE supply chain and the federal government’s inadequate response ~ Inside the Chaotic, Cutthroat Gray Market for N95 Masks (The New York Times)
  • “Each tube, about the size of a pinkie finger, contains a few precious droplets of frozen coronavirus vaccine,” which can provide one shot of protection to five people, writes Carolyn Y. Johnson, of the delicate and time sensitive process of getting a vaccine to patients ~ A vial, a vaccine and hopes for slowing a pandemic — how a shot comes to be (The Washington Post)
  • Emily A. Wang, MD, MAS, and colleagues discuss the ways in which U.S. prisons and COVID are “deeply entangled,” creating a perfect breeding ground to spread the virus ~ A Report From the National Academy of Sciences, Engineering, and Medicine ~ COVID-19, Decarceration, and the Role of Clinicians, Health Systems, and Payers (JAMA)
  • Growing up, Betial Asmerom watched doctors treat her family with disrespect but it wasn’t until she took a course on health disparities that she realized how often communities of color had similar experiences. Elizabeth Lawrence explores the fundamental changes medical school curricula must undergo to address health disparities and racism in medicine ~ What Doctors Aren’t Always Taught: How to Spot Racism in Health Care (Kaiser Health News)
  • When Kevin M. Simon, MD, fields questions from parents, colleagues and friends about how to talk about racial tensions, he combines evidence with the lived experiences of black men. As a black man and a physician, Simon has found “caring for Black boys and their families is one of the most rewarding and emotionally challenging endeavors I face” ~ Them and Me — The Care and Treatment of Black Boys in America (New England Journal of Medicine)
  • Arif H. Kamal, MD, MBA, MHS, and colleagues discuss the essential role palliative care can play when patients and their families face life-threatening conditions ~ The Role of Palliative Care During the COVID-19 Pandemic (Mayo Clinic Proceedings)
  • “With mounting death tolls, increasing case burdens, and public confusion, we face an enormous task,” write Moncef Slaoui, PhD, and colleagues, regarding the need to develop effective therapeutics against COVID while the nation waits for safe and effective vaccines ~ Bridging the Gap at Warp Speed — Delivering Options for Preventing and Treating Covid-19 (New England Journal of Medicine)

Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what’s going on in the world of primary care medicine. Pelzman’s Picks is a compilation of links to blogs, articles, tweets, journal studies, opinion pieces, and news briefs related to primary care that caught his eye.

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A UPS exec reveals how the pressures of the pandemic can make drone deliveries a reality as it starts flying medical supplies, PPE, and medicine



a man riding on the back of a red building: UPS has launched two health care-related drone delivery trials during the pandemic. Courtesy of UPS


© Courtesy of UPS
UPS has launched two health care-related drone delivery trials during the pandemic. Courtesy of UPS

  • UPS, along with other delivery and logistics companies, is in a race to launch regular, commercial drone delivery systems.
  • In the past few months, UPS has begun pilot programs with CVS and a major hospital system, using drones to make deliveries and transport critical supplies.
  • In an exclusive interview with Business Insider, UPS’ VP of Advanced Technologies explained how the COVID-19 pandemic has highlighted the use cases for drones.
  • Visit Business Insider’s homepage for more stories.

The logistics industry has been buzzing about drone delivery for years, but aside from a few high-profile pilot programs and conceptual tests, the tech has failed to materialize as a real-world solution for moving goods.

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But drones are steadily coming closer to serving a practical use, according to Bala Ganesh, head of the Advanced Technologies Group at UPS.

“What we are right now in the process of, as we work through the integration pilot program with the FAA, is turn[ing] the corner to get to a more sustainable operation,” Ganesh told Business Insider during an exclusive interview at the IGNITION: Transportation summit this week. “What we’ve been in so far has been a test and learn journey.”

The COVID-19 pandemic has only heightened the urgency of drone delivery — and highlighted its potential.

“The initial step for drones would be in this critical health care slash other industries that really require something urgently,” Ganesh said. “As the technology becomes more mature and costs go down,” he said, drones could be integrated into more routine purposes and deliveries.

UPS has launched two health care-related trials during the pandemic. One, at the Villages retirement community in Florida, delivers prescription medication to residents from a nearby CVS. The other, at the Wake Forest Baptist health system in Winston-Salem, North Carolina, offers fast shipping of time-sensitive medical supplies and PPE between the health system’s central campus and its other locations.

A key challenge to taking drone deliveries mainstream is the complex approvals needed from the FAA, as well as methods to avoid nearby air traffic. That, coupled with the difficulties of navigating around tall and dense development, makes it likely that drone deliveries will start out in rural and suburban areas, Ganesh said.

One of the most interesting use cases the company has explored, Ganesh said, is a “driver assist” system, in which each time the driver makes a delivery stop in a rural location, they launch the drone from the top of their truck and have it make the next delivery on the route. It would effectively double the number of deliveries a driver can make in a given time.

While drone delivery in cities is still something UPS plans to develop, that will likely come later, Ganesh said.

“There’s a lot of ideas” to solve the challenge of urban drone delivery, Ganesh said. “I’m sure that time will come,” he added, “but it may not

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Most Home Health Aides Need to Work, Even When Lacking PPE

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.



Sue Williams-Ward — pictured with her granddaughter Tamarya Burnett — was a home health aide who died of COVID-19 on May 2 after six weeks in the hospital.

In March, Sue Williams-Ward took a new job, with a $1-an-hour raise.

The employer, a home health care agency called Together We Can, was paying a premium — $13 an hour — after it started losing aides when COVID-19 safety concerns mounted.

Williams-Ward, a 68-year-old Indianapolis native, was a devoted caregiver who bathed, dressed and fed clients as if they were family. She was known to entertain clients with some of her own 26 grandchildren, even inviting her clients along on charitable deliveries of Thanksgiving turkeys and Christmas hams.

KHN and The Guardian are tracking health care workers who died from COVID-19 and writing about their lives and what happened in their final days.

Without her, the city’s most vulnerable would have been “lost, alone or mistreated,” said her husband, Royal Davis.

Despite her husband’s fears for her health, Williams-Ward reported to work on March 16 at an apartment with three elderly women. One was blind, one was wheelchair-bound, and the third had a severe mental illness. None had been diagnosed with COVID-19 but, Williams-Ward confided in Davis, at least one had symptoms of fatigue and shortness of breath, now associated with the virus.

Even after a colleague on the night shift developed pneumonia, Williams-Ward tended to her patients — without protective equipment, which she told her husband she’d repeatedly requested from the agency. Together We Can did not respond to multiple phone and email requests for comment about the PPE available to its workers.

Still, Davis said, “Sue did all the little, unseen, everyday things that allowed them to maintain their liberty, dignity and freedom.”

He said that within three days Williams-Ward was coughing, too. After six weeks in a hospital and weeks on a ventilator, she died of COVID-19. Hers is one of more than 1,200 health worker COVID deaths that KHN and The Guardian are investigating, including those of dozens of home health aides.

During the pandemic, home health aides have buttressed the U.S. health care system by keeping the most vulnerable patients — seniors, the disabled, the infirm — out of hospitals. Yet even as they’ve put themselves at risk, this workforce of 2.3 million — of whom 9 in 10 are women, nearly two-thirds are minorities and almost one-third are foreign-born — has largely been overlooked.

Home health providers scavenged for their own face masks and other protective equipment, blended disinfectant and fabricated sanitizing wipes amid widespread shortages. They’ve often done it all on poverty wages, without overtime pay, hazard pay, sick leave and health insurance. And they’ve gotten sick and died — leaving little to their survivors.

Speaking out about their work conditions during the pandemic has triggered retaliation by employers, according to representatives of the Service Employees International Union in Massachusetts,

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We created a new form of PPE to restart surgery for deaf children during coronavirus

  <span class="attribution"><span class="source">Douglas Hartley</span>, <span class="license">Author provided</span></span>
Douglas Hartley, Author provided

When the coronavirus pandemic first hit the UK, thousands of surgical procedures were put on hold. For a surgeon like me who performs operations on deaf children to restore their hearing, this created a significant moral dilemma – I wanted to get back into surgery to provide this vital care, but I didn’t want to inadvertently catch or pass on COVID-19 in the process.

I regularly carry out cochlear implant surgery, a process in which a surgeon embeds an electronic device which stimulates the hearing nerve in the ear. The scientific evidence is clear that this surgery needs to be performed at the earliest opportunity so that these children can benefit from being able to hear at a vital stage in their development.

But performing the surgery as normal would have put both children and surgical teams in danger. We needed to come up with another way of doing things. Our team in Nottingham had to combine creativity and science to develop a novel and safe way to restart cochlear implant surgery in a matter of just a few weeks.

This article is part of Conversation Insights
The Insights team generates long-form journalism derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.

A grave risk

Soon after the pandemic began, some of the earliest reports, notably those from China and Italy, suggested that healthcare workers were at significantly higher risk of contracting COVID-19 compared to the general public, and that treating ear, nose and throat (ENT) conditions was particularly risky.

I was deeply saddened when I was told that the one of the first healthcare workers in the UK to die of COVID-19 was Amged El-Hawrani, a 55-year-old ENT colleague from the university hospitals of Derby and Burton. El-Hawrani succumbed to this dreadful disease on March 28 in Leicester’s Glenfield hospital. Although I never had the pleasure of meeting him, his passing was a huge shock to us all. And his exposure to the virus during his care for his patients was a stark reminder of the brutality of this disease.

A picture of Amged El-Hawrani, smiling wearing medical scrubs.
Amged El-Hawrani was one of the first health workers in the UK to lose his life to coronavirus. University Hospitals of Derby and Burton/NHS

Like other ENT departments across the world, our service at Nottingham University Hospitals NHS Trust initially halted all elective procedures in March when the pandemic hit the UK, so we could concentrate our team’s efforts on the management of our sickest patients, including those conditions requiring emergency admission, and our cancer services.

Although this initial response proved effective, we were aware that we were not meeting the needs of other patients with time-critical, albeit not life-threatening, conditions. These patients included children who are born deaf and need cochlear implant surgery to restore their hearing as quickly as possible to maximise their chances of developing normal speech and language. Delaying cochlear implant surgery can

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