Nearly 1 million people signed up during special enrollment

By Margot Sanger-Katz and Sarah Kliff
The New York Times

Nearly 1 million Americans have signed up for Affordable Care Act coverage during the first 10 weeks of a special open enrollment period the Biden administration began in February.

A total of 940,000 people enrolled in Obamacare coverage between Feb. 15 and April 30, new data released Thursday, May 6 by Health and Human Services shows. Of those new enrollees, nearly half bought coverage last month, after Congress added billions in subsidies included in the most recent stimulus package.

With that additional funding, the average monthly premium that Healthcare.gov consumers paid fell to $86 for those signing up in April, down from $117 in February and March (before the new subsidies).

The surge in sign-ups reflects a growing demand for health insurance. Many Americans have lost job-based coverage during the pandemic, and others who were uninsured before found themselves newly interested in coverage. The numbers undercount the overall new insurance sign-ups; they reflect enrollment only in the 36 states with marketplaces that the federal government manages.

Click here to read the full story.

Arizona testing sites and numbers

Updated as of Thursday, May 13, 2021, all 15 Arizona counties have confirmed cases with a combined total of 871,168 cases across the state and 17,438 deaths and 5,431,712 vaccinations administered.* In Pima County: 115,905 cases 2,407 deaths and 731,795 vaccinations administered.* For up-to-date numbers, click here. 

Click here for vaccine finder locations.

Arizonans are able to access COVID-19 testing at more than 600 various sites throughout the state. Click here to find information on where to find the COVID-19 testing sites, hours of operation and information about pre-registration. If you have a testing site you would like to be included on this list, please use this form to provide information about your site.

*Vaccination numbers are displayed by the county of vaccine administration. Vaccinations administered at State of Arizona vaccination sites (PODs) are included in the state totals but not the county totals. 

State sites started vaccinating 12- to 15-year-olds

Arizona-run vaccination sites in the Phoenix area, Tucson, Yuma and Flagstaff, along with many pharmacies and other providers around the state, began offering the Pfizer COVID-19 vaccines to children 12 to 15 years old on Thursday, May 13. This exciting step forward follows Wednesday, May 12 approval by the U.S. Centers for Disease Control and Prevention (CDC).

“This is great news for families across Arizona,” said Dr. Cara Christ, Director of the Arizona Department of Health Services (ADHS). “In addition to encouraging parents and guardians to protect those ages 12 to 15 from COVID-19, we hope adults in the family will roll up their sleeves as well if they haven’t already done so.”

Arizona has nearly 400,000 children ages 12 to 15. As of reporting on Thursday, May 13, 5,431,712 doses of COVID-19 vaccine have been administered to 3,085,000 individuals, with 2,550,867 now fully vaccinated. 

The Food and Drug Administration authorized the Pfizer COVID-19 vaccine for age 12-15 on Monday, May 10, followed by Wednesday's (May 12) CDC recommendation. The approval applies only to the Pfizer vaccine, which had been available to ages 16 and older. The Moderna and Johnson & Johnson vaccines are authorized for those 18 and older.

Beginning Thursday (May 13) morning, parents and guardians were able to bring those ages 12 to 15 to state vaccination sites as walk-ins or schedule an appointment at podvaccine.azdhs.gov. Many pharmacies and other providers with Pfizer also planned to begin vaccinating this age group on Thursday, May 13. The ADHS vaccine finder available at azdhs.gov/FindVaccine allows visitors to filter locations by vaccine type.

ADHS is coordinating with rural counties that until now have received only the Moderna and Johnson & Johnson vaccines so 12- to 15-year-olds can get vaccinated.

A parent or guardian must accompany the child and sign a consent form in person that includes an attestation that the child is at least 12 years old. No identification is required for the child. Place of permanent residence isn’t a factor in whether someone can be vaccinated at a state site.

Click here to read the full press release. 

More doctors' offices, clinics can order COVID-19 vaccine

The Arizona Department of Health Services (ADHS) is advancing COVID-19 vaccine availability farther into communities by enabling eligible doctors’ offices and other neighborhood health care providers to order the Moderna vaccine.

This change, which took effect Monday, May 3, will allow providers registered with ADHS to order vaccine directly from the U.S. Centers for Disease Control and Prevention (CDC) without needing an allocation from a county health department. It applies to nearly 1,200 providers statewide that are set up to order vaccine through ADHS. While some providers may have already received a vaccine allocation from their local health departments, this change makes others eligible to receive vaccine for the first time.

“As we get more doses into the state, we are expanding the places where Arizonans can get the vaccine,” said ADHS Director Dr. Cara Christ. “From the beginning, we wanted to ensure Arizonans could receive the vaccine in locations they normally receive their health care ‒ including their primary care providers’ offices, clinics and pharmacies. This will further reduce barriers and help more Arizonans access the vaccine.”

The Moderna vaccine is ideal for use in doctors’ offices and similar settings because of its less-stringent storage requirements and smaller lot sizes than the Pfizer vaccine.

Click here to read the news release. Click here to read below about AIPO reminding providers on best practices for storage and handling of the Moderna COVID-19 vaccine.

Proper storage and handling of Moderna COVID-19 doses

Because of independent provider ordering opening up in ASIIS for the Moderna COVID-19 vaccine on May 3, 2021, the Arizona Immunization Program Office (AIPO) would like to remind you of the storage and handling best practices. 

Important Notes:

• The AIPO has put together a flyer on best practices for storage and handling of the Moderna COVID-19 vaccine which can be found here. 
  • Unpunctured Moderna COVID-19 vials can be stored in a normal freezer for up to six months.
  • If Moderna COVID-19 doses are stored in a refrigerator, unpunctured vials can ONLY be stored for 30 days and then they must be wasted.
    • CDC has a beyond-use date/time tracking label resource for refrigerator storage to track when doses would need to be wasted. That resource can be found here.  
  • Once a vial is punctured, all doses must be used within 12 hours, after 12 hours if any doses remain they must be wasted.

• If any doses need to be wasted, a wasted/expired form must be filled out and submitted. Instructions on how to complete wastage of any doses can be found here. 
  • To report unused Moderna COVID-19 doses in a punctured vial please use code: W5 - Open vial/all doses not administered.
  • To report Moderna COVID-19 doses that exceed the 30 days in refrigerator storage, please use code: R8 - Spoiled - other.

Guidance for health care providers: Do not use Antibody testing to assess immunity to SARS-CoV-2 after COVID-19 vaccination

Some providers have ordered serologic testing for SARS-CoV-2 and then look for ways to get their patients an additional dose of vaccine when the antibody level is “low” or “negative.”

The current COVID-19 vaccines have been approved under FDA Emergency Use Authorization with Pfizer and Moderna for use as a two-dose vaccine series and Janssen as a one-dose vaccine.

The CDC does not currently recommend testing for immunity to SARS-CoV-2 following COVID-19 vaccination:

• The clinical utility of post-vaccination testing has not been established.
• Antibody tests currently authorized under an EUA have variable sensitivity, specificity, as well as positive and negative predictive values, and are not authorized for the assessment of immune response in vaccinated people.
• The serologic correlates of protection have not been established.
• Antibody testing does not evaluate the cellular immune response, which may also play a role in vaccine-mediated protection.

CDC recommendations on serologic testing after vaccination, when to re-vaccinate, or when to give additional doses of COVID-19 vaccines may be updated when additional information is available.

A new kind of network to serve Southern Arizona

We’ve just lived through the most difficult year that health care professionals have ever experienced, one that I hope will never be repeated. But it served to point out the disparity in our health care system that needs to be addressed by all of us.

One of the ways Banner Health is looking to address health inequality is by providing greater access to health care. In Southern Arizona, we are doing so by creating a new neighborhood model for care that includes a clinically integrated network.

As the Medical Director for this new network, Banner Network Southern Arizona, I’m looking forward to working with many of you as we create a more cohesive network model to meet the needs of those under our care.

Banner Network Southern Arizona centers around a neighborhood concept where providers collaborate for referrals, integrated services and convenience for patients on the continuum of care. Local physician leadership determines standards of care and quality benchmarks, which lead to better outcomes for patients.

Practices can earn additional rewards based on their quality scorecards. If the network meets benchmarks, shared savings payments may be available to practices who meet their goals. Banner will have teams in place to support your practices and help your practice to be successful to reach those benchmarks.

One of the things that drew me back to Tucson is the tremendous connectedness within the community. There are few other places where people look after one another the way Tucsonans do. I can’t imagine a better time to make an impact on the health of everyone in our community.

My journey back to Tucson, includes completing my residency in pediatrics at Banner – University Medical Center Tucson and moving to Alaska to work with the Alaska Native population. I then returned to Tucson as the Chief Quality Officer for Carondelet Health Network.

I have returned to Tucson, once again, after being a Chief Medical Officer for Adventist Health in California. I am happy to be part of Banner Health as we dedicate efforts to making health care easier, so life can be better. I am very excited to be back home and to be part of the initiative to transform health care.

I hope you’ll consider joining us on the journey to transform health care in Southern Arizona.

Patricia Iris, MD is a pediatrician and is the Medical Director of Banner Network Southern Arizona. Click here to access the new network’s website.

Banner opens new children's cancer center in Tucson

A new, state of the art, dedicated children’s cancer outpatient clinic, the Diamond Children’s Cancer Center, has opened its doors and began treating children with cancer and blood disorders on Wednesday, April 28.

This $3 million clinic built by Banner Health is the new home for children’s hematology and oncology treatment in an outpatient setting in Arizona.

The Diamond Children’s Cancer Center is located at 1625 N. Campbell Ave., Tower #3, Tucson, 85719 and is committed to family-centered care.

Banner – University Medicine Tucson hosted a private grand opening event for the media on Wednesday, May 5.

Guest speakers included: Adia Barnes, University of Arizona women’s basketball head coach; Chad Whelan, MD, Chief Executive Officer Banner – University Medicine Tucson; Emmanuel Katsanis, MD, Chief, PCMS member, Tucson-Phoenix Integrated Division of Pediatric Hematology/Oncology and Director, Banner/University of Arizona Cancer Center Hematopoietic Cellular Therapy and Transplant Program; Jasel Molina, Banner – University Medical Center Tucson transporter and patient.

The center provides the consultation, treatment and follow-up services dedicated exclusively to children and young adults up to 29 years, who have blood disorders or cancer, including:

• Pediatric Hematology Services
• Pediatric Oncology Services
• Pediatric Hematopoietic Transplant and Cell Therapies
• Immunotherapies
• Pediatric Infusion Therapy
• In addition to cancer care, the Diamond Children’s Cancer Center offers access to cutting-edge research through innovative clinical trials.

The comprehensive children’s cancer care team includes pediatric hematology-oncology board certified physicians, certified advanced practitioners, social workers, child life specialists and other health care professionals who work with patients and families to meet their treatment goals.

Click here to read the full press release.

Banner front-line medical workers share
personal 'things they carry' during pandemic

Banner Health is offering media an opportunity to preview and share an emotionally compelling and visual project, “The Things They Carry,” which launched on Sunday, May 9 to highlight front-line medical workers and the personal items that help them cope and connect during the pandemic.

Through a series of portraits, video interviews and emotional stories on social media, the nonprofit organization will feature medical staff and the things they carried for strength and inspiration to get through the toughest times since COVID swept through Arizona.

Examples in the ongoing series include:

• ICU nurse Craig Rufener, whose silver Buddhist prayer ring etched with 82 microscopic words helped him endure grueling overnight shifts
• Physical therapist Piper Daulton, whose black Hawaiian pearl necklace was a gift from her grandma who died from a non-COVID issue during the pandemic
• Patient transporter Steve Stanek, who creates bracelets from guitar strings and gives them to patients having an especially tough day
• ICU nurse Kaleena Holmes, whose plastic unicorn keychain gave her and her co-workers a much-needed reason to smile

The project is inspired by a popular book about the Vietnam War, The Things They Carried by Tim O’Brien, which humanized the story of the soldiers by focusing on unique things they carried during combat. Profiles will publish on social media during National Hospital Week, which started Sunday, May 9, and runs through Saturday, May 15. 

Biden shifts vaccination strategy in drive to reopen by July 4

By Sharon LaFraniere and Noah Weiland
The New York Times

In a speech at the White House, Mr. Biden said he was launching a new phase in the fight against the coronavirus, with a goal of at least partly vaccinating 70 percent of adults by Independence Day and with a personal plea to all of the unvaccinated: “This is your choice. It’s life and death.”

After three months of battling supply shortages and distribution bottlenecks, the Biden administration is confronting a problem that the president said was inevitable: Many of those who were most eager to get vaccinated have already done so. Vaccination sites at stadiums once filled with carloads of people seeking shots are closing, and states that once clamored for more vaccines are finding that they cannot use all of the doses that the federal government wants to ship to them.

Yet the administration’s own health experts say tens of millions more Americans must be vaccinated before the infection rate is low enough to return to what many people consider ordinary life.

To build up confidence in vaccines, federal officials plan to enlist the help of family doctors and other emissaries who are trusted voices in their communities.

In a new effort to match supply with demand, federal officials informed states on Tuesday, May 4 that if they did not order their full allocation of doses in any given week, that vaccine would be considered part of a federal pool that is available to other states that want to order more. Until now, if states failed to order all of the doses allotted to them on the basis of population, they could carry over that supply to the next week.

Click here to read the full story. 

U.S. backs waiving intellectual property rules on vaccines

By Jamey Keaten and Zeke Miller
Associated Press

The Biden administration is throwing its support behind efforts to waive intellectual property protections for COVID-19 vaccines in an effort to speed the end of the pandemic.

United States Trade Representative Katherine Tai announced the government’s position in a Wednesday, May 5 statement, amid World Trade Organization talks over easing global trade rules to enable more countries to produce more of the life-saving vaccines.

“The Administration believes strongly in intellectual property protections, but in service of ending this pandemic, supports the waiver of those protections for COVID-19 vaccines,” Tai said in the statement.

But she cautioned that it would take time to reach the required global “consensus” to waive the protections under WTO rules, and U.S. officials said it would not have an immediate effect on the global supply of COVID-19 shots.

“This is a global health crisis, and the extraordinary circumstances of the COVID-19 pandemic call for extraordinary measures,” said Tai. “The Administration’s aim is to get as many safe and effective vaccines to as many people as fast as possible.”

Tai’s announcement came hours after WTO Director-General Ngozi Okonjo-Iweala spoke to a closed-door meeting of ambassadors from developing and developed countries that have been wrangling over the issue, but agree on the need for wider access to COVID-19 treatments, WTO spokesman Keith Rockwell said.

The WTO’s General Council — made up of ambassadors — was taking up the pivotal issue of a temporary waiver for intellectual property protections on COVID-19 vaccines and other tools, which South Africa and India first proposed in October. The idea has gained support in the developing world and among some progressive lawmakers in the West.

Rockwell said a WTO panel on intellectual property was set to take up the waiver proposal again at a “tentative” meeting later this month, before a formal meeting June 8-9.

No consensus — which is required under WTO rules — was expected to emerge from the ambassadors’ two-day meeting Wednesday, May 5 and Thursday, May 6. But Rockwell pointed to a change in tone after months of wrangling.

Click here to read the full story. 

CDC easing mask recommendations for those fully vaccinated

By Roni Caryn Rabin and Apoorva Mandavilli
The New York Times

In a sharp turnabout from previous recommendations, federal health officials on Thursday, May 13 advised that Americans who are fully vaccinated against the coronavirus may stop wearing masks or maintaining social distance in most indoor and outdoor settings, regardless of size.

The advice from the Centers for Disease Control and Prevention comes as welcome news to Americans who have tired of restrictions and marks a watershed moment in the pandemic. Masks ignited controversy in communities across the United States, symbolizing a bitter partisan divide over approaches to the pandemic and a badge of political affiliation.

Permission to stop using them now offers an incentive to the many millions who are still holding out on vaccination. As of Wednesday, May 12 about 154 million people have received at least one dose of a COVID-19 vaccine, but only about one-third of the nation, some 117.6 million people, have been fully vaccinated.

But the pace has slowed: Providers are administering about 2.16 million doses per day on average, about a 36 percent decrease from the peak of 3.38 million reported in mid-April.

The new advice comes with caveats. Even vaccinated individuals must cover their faces and physically distance when going to doctors, hospitals or long-term care facilities like nursing homes; when traveling by bus, plane, train or other modes of public transportation, or while in transportation hubs like airports and bus stations; and when in prisons, jails or homeless shelters.

Click here to read the full story. 

CDC panel recommends Pfizer COVID vaccine to 12- to 15-year-olds

By Elizabeth Weise
USA TODAY

Adolescents ages 12 to 15 should get the Pfizer-BioNTech COVID-19 vaccine and they can get their other routine vaccinations along with it, a federal advisory committee said Wednesday, May 12.

The Centers for Disease Control and Prevention's panel met to discuss the safety, immune response and effectiveness of the vaccine in this age group, after the Food and Drug Administration signed off Monday, May 10 on the shots. Click here to read the FDA story below. 

The same Advisory Committee on Immunization Practices last December signed off on the Pfizer-BioNTech vaccine for adults and teens ages 16 to 17.  Fourteen members of the panel on Wednesday, May 12 endorsed lowering the age limit to 12, with one member recusing herself.

Out of an abundance of caution, the original recommendation for COVID-19 vaccines had included a two-week window of separation between a COVID-19 vaccine and any other vaccine so the cause of any side effects would be clear and so that safety data could be collected.

The recommendation also was updated for all age groups by the committee on Wednesday, May 12, said CDC's Dr. Kate Woodworth.

In a statement, the American Academy of Pediatrics recommended COVID-19 vaccination for all children and adolescents, 12 years of age and older who do not have a medical reason not to.

Click here to read the full story. 

Lag in vaccination among Arizona's racial, ethnic groups
is unlikely to change

By Alex Devoid
Arizona Daily Star

White people have been vaccinated against COVID-19 at a higher rate than other racial or ethnic groups in Arizona, even though they have had the lowest overall rate of COVID-19 cases per capita during the pandemic.

The Arizona Department of Health Services didn’t expect the racial and ethnic makeup of vaccinated people to align with the makeup of the general population “due to the phased approach of vaccine distribution,” according to a disclaimer on the department’s online chart of COVID-19 vaccine administration.

Health experts point out that the older population, which is populated by more whites, was given vaccine priority because age is such a big risk factor for severe COVID-19 illness. So it’s not surprising that the overall makeup of vaccinated people skews whiter.

On Friday, April 30, however, the Arizona’s top health official, Dr. Cara Christ, walked back the health department’s disclaimer that vaccine distribution in the state isn’t expected to align with the racial and ethnic makeup of the state’s general population.

“That probably should come down off of our website. I’ll talk to the team,” she said. “Now that we are vaccinating the general population and we’ve had multiple weeks where everybody has been eligible, that disclaimer probably should come off of our website.”

On March 24, Arizona opened vaccine eligibility to everyone 16 and older. (On May 13, Arizona opened vaccine eligibility to everyone 12 and older.)

While this opened up vaccines to more people of color, the state’s cumulative vaccine distribution has remained misaligned with the makeup of the state’s general population.

Click here to read the full story. 

U.S. map and case count

This is a round up of COVID news,
which has occurred over the past couple of weeks. 

Pfizer expects to apply to the FDA in September
for EUA for vaccine for 2-11 year olds

Pfizer expects to apply to the Food and Drug Administration in September for emergency authorization to administer its coronavirus vaccine to children between the ages of 2 and 11, the company told Wall Street analysts and reporters on Tuesday, May 4 during its quarterly earnings call.

The company said it also plans to apply this month for full approval of the vaccine for use in people from ages 16 to 85. And it said it expected to have clinical trial data on the safety of its vaccine in pregnant women by early August.

The Food and Drug Administration on Monday, May 10 authorized use of the Pfizer-BioNTech COVID-19 vaccine for 12- to 15-year-olds in the United States.

Click here to read the full story.

~The New York Times~

New studies suggested vaccines can protect
against some variants, severe COVID cases

Several new studies released on Wednesday, May 5 offered encouraging news about the ability of widely used vaccines to protect against severe COVID-19 cases, including illness caused by some dangerous variants.

Two published studies found that the Pfizer-BioNTech vaccine was extraordinarily effective against severe disease caused by two variants, including the dominant one in the United States. And the results of an early-stage trial of the Moderna vaccine — though not published or vetted by scientists — suggested that a single dose given as a booster was effective against variants first identified in South Africa and Brazil, the company said.

The emergence of new variants, and whether vaccines are effective against them, is a subject of continued concern as a variant first detected in India, called B.1.617, spreads across the country. There is also a risk that further variants will arise there as the country’s outbreak grows, experts say. Another worrisome variant, P.1, is wreaking havoc across South America.

Click here to read the full story.

~The New York Times~

Variant found in India now officially 'variant of concern,' WHO says

Amid a deepening crisis in India, the World Health Organization announced Monday, May 10 that it had designated the B.1.617 variant, which has been growing more common in the country, as a variant of concern. Scientists still don’t know much about the variant yet, but they are worried that it may be helping to fuel the rise in the nation’s coronavirus infections, which experts say are likely undercounted.

“There is increased transmissibility demonstrated by some preliminary studies” of the variant, said Dr. Maria Van Kerkhove, the technical lead of the WHO’s coronavirus response.

Dr. Van Kerkhove also said that a study of a limited number of patients, which had not yet been peer reviewed, suggested that antibodies from vaccines or infections with other variants might not be quite as effective against B.1.617. However, the agency said that vaccines will likely remain potent enough to provide protection against B.1.617.

Click here to read the full story.

~The New York Times~

Study: Sleeping too little in middle age may increase dementia risk

By Pam Belluck
The New York Times

Could getting too little sleep increase your chances of developing dementia?

For years, researchers have pondered this and other questions about how sleep relates to cognitive decline. Answers have been elusive because it is hard to know if insufficient sleep is a symptom of the brain changes that underlie dementia — or if it can actually help cause those changes.

Now, a large new study reports some of the most persuasive findings yet to suggest that people who don’t get enough sleep in their 50s and 60s may be more likely to develop dementia when they are older.

The research, published Tuesday, April 20 in the journal Nature Communications, has limitations but also several strengths. It followed nearly 8,000 people in Britain for about 25 years, beginning when they were 50 years old. It found that those who consistently reported sleeping six hours or less on an average weeknight were about 30 percent more likely than people who regularly got seven hours sleep (defined as “normal” sleep in the study) to be diagnosed with dementia nearly three decades later.

FDA authorizes use of Pfizer vaccine for 12- to 15-year-olds

By Apoorva Mandavilli
The New York Times

The Food and Drug Administration on Monday, May 10 authorized use of the Pfizer-BioNTech Covid-19 vaccine for 12- to 15-year-olds in the United States, a crucial step in the nation’s steady recovery from the pandemic and a boon to tens of millions of American families eager for a return to normalcy.

The authorization caps weeks of anticipation among parents, who have been grappling with how to conduct their lives when only the adults in a household are immunized. It removes an obstacle to school reopenings by reducing the threat of transmission in classrooms, and affords millions of adolescents the opportunity to attend summer camps, sleepovers and get-togethers with friends.

“This is great news,” said Dr. Kristin Oliver, a pediatrician and vaccine expert at Mount Sinai Hospital in New York. “It feels like we’ve been waiting a long time to start protecting children in this age group.” The Pfizer-BioNTech vaccine was already available to anyone over 16.

The FDA’s go-ahead was not the final hurdle. An advisory committee of the Centers for Disease Control and Prevention met Wednesday, May 12 to review the data and made the recommendation for the vaccine’s use in 12- to 15-year-olds. Click here to read the CDC story above. 

Click here to read the full story. 

The world's leading medical journals don't write about racism. That's a problem

By Rhea Boyd, MD, MPH, Nancy Krieger, PhD, Fernando De Maio, PhD,
and Aletha Maybank, MD, MPH
Time

Over the past year, rising deaths from COVID-19, police brutality, anti-Asian hate crimes and the inequitable damage of climate breakdown, have made the manifold harms of racism easier for everyone to see. Harms that were once shielded from public consumption by segregation or shrouded from public scrutiny by stories depicting the United States as a nation of fairness and freedoms, are now the center of an ongoing national confrontation with racism and its impacts on health, safety and justice.

Yet amid growing calls for anti-racism and health equity, troubling reports have emerged highlighting the ways the U.S. health care industry avoids even talking about, let alone addressing, racism.

Few know just how extensive this problem is.

Our new report published in Health Affairs examined the top four medical journals in the world and found that they almost never publish scientific articles that name racism as a driver of poor health outcomes. Of the more than 200,000 total articles published over the past 30 years in the New England Journal of Medicine (NEJM), The Lancet, the Journal of the American Medical Association (JAMA), and British Medical Journal (BMJ), less than 1 percent included the word “racism” anywhere in the text. And among the few articles that did, upward of 90 percent were predominantly opinion pieces, not scientific investigations.

Just think about that. In a field that maligns anecdotal evidence as the least rigorous and most untrustworthy, our examination found that the primary “evidence” accepted and published about racism were people’s scholarly opinions. Brilliant as those opinions may be, medicine is purportedly built upon the rigor of empirical scientific investigations, not the substance captured in commentaries. But when we looked at the science published on racism in the four leading medical journals in the world, we found it was thin, to say the least.

Among these top medical journals, during the past 30 years, each managed to publish as few as four and at most 29 scientific studies that included the term “racism.” Moreover, most of these empirical investigations were solely descriptive in nature. In other words, the studies would describe a gap in health outcomes between racial groups but never empirically test if or how racism contributed to the gap and never determined the effectiveness of potential interventions. In fact, you could count on one hand the articles that attempted to even measure forms of racism as potential drivers of a health outcome. For the New England Journal of Medicine, arguably the most influential medical journal in the world, you only need a single finger. Perhaps most notably, JAMA — a journal recently thrust into public discourse after its editor-in-chief was placed on administrative leave for sponsoring a podcast that denied the existence of structural racism in medicine — has not published a single empirical study measuring racism in the 30 years we looked at.

Yet, racism is neither a niche topic nor a rare exposure: 40 percent of the U.S. population are people of color (i.e., are not “white non-Hispanic”), research illustrates that experiences with racism are common, and the impacts of structural racism on health are well-established. Indeed, there is nearly 200 years of knowledge connecting racism to poor health outcomes. And other credible scientific journals are publishing plenty of empirical studies directly investigating the impact of structural, institutional, interpersonal and internalized racism on health. But you would never know that by reading today’s preeminent medical journals.

That alarms us. Because in medicine, nearly everything we do is based on evidence. And the evidence that is weighed most heavily are the data published in our field’s top journals.

Click here to read the full story. 

Rhea Boyd, MD, MPH, is a pediatrician, public health advocate and scholar who writes and teaches on the relationship between structural racism, inequity and health. Nancy Krieger, PhD, is Professor of Social Epidemiology, American Cancer Society Clinical Research Professor, Department of Social and Behavioral Science, at the Harvard T.H. Chan School of Public Health. Fernando De Maio, PhD, is Director, Health Equity Research and Data Use, at the Center for Health Equity, American Medical Association. Aletha Maybank, MD, MPH, is Chief Health Equity Officer and Senior Vice President at the American Medical Association.

The world may need to learn to live with the virus

By Andrés R. Martínez
The New York Times

Early in the pandemic, there was hope that the world would one day achieve herd immunity, the point when the coronavirus lacks enough hosts to spread easily. But over a year later, the virus is crushing India with a fearsome second wave and surging in countries from Asia to Latin America.

Experts now say it is changing too quickly, new more contagious variants are spreading too easily and vaccinations are happening too slowly for herd immunity to be within reach anytime soon.

That means if the virus continues to run rampant through much of the world, it is well on its way to becoming endemic, an ever-present threat.

Virus variants are tearing through places where people gather in large numbers with few or no pandemic protocols, like wearing masks and distancing, according to Dr. David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine.

As more people contract the virus, developing some level of immunity, and the pace of vaccinations accelerates, future outbreaks won’t be on the scale of those devastating India and Brazil, Dr. Heymann said. Smaller outbreaks that are less deadly but a constant threat should be expected, Dr. Heymann said.

Click here to read the full story. 

Hot Topics in Risk Management

Our Risk Management Team is here to help you minimize and mitigate Medical Professional Liability risk. 

Is Telemedicine the best fit?

Telemedicine is a new alternative to in-person appointments, but not all patients and presenting conditions are a safe or effective fit. According to the Federation of State Medical Boards, whether delivering care electronically or in-person, physicians must prioritize, among several things, the patient’s welfare and acceptable and appropriate medical practice standards. In a professional liability lawsuit, the physician’s telemedical care will be held to the same legal standard (i.e. what a reasonable and prudent physician with similar training and experience would do under the same or similar circumstances) as in-person care. Yet, virtual physical examinations have limits, and the available clinical data may be insufficient to support an accurate diagnosis via telemedicine. A selection methodology that considers the presenting clinical concern and individual patient factors will help practice staff schedule the most appropriate type of appointment.

Click here to read the full Hot Topic.

Senior Risk Management Consultants are ready to help with questions and provide more information. You can reach a Consultant Monday-Friday 8:30 a.m.-5 p.m. MST at (800) 352-0402  Ext. 2137, (602) 808-2137, or rm_info@mica-insurance.com.

Mutual Insurance Company of Arizona (MICA) is a Friends of the Society member.

Major vaccination centers in Pima County

The county has expanded COVID-19 vaccine eligibility to those 12 and older. (Pfizer is for ages 12 and older. Moderna and Johnson & Johnson are for those 18 and older.) 

While there are no more restrictions on eligibility other than age, only the Pfizer vaccine has been approved for 12 and older. Pfizer is available at the state-run site on the University of Arizona campus, at Banner-South and, potentially, at local pharmacies.

Those younger than 18 who are getting vaccinated need a parent or legal guardian with them to complete the consent forms. The only exception is if an accompanying adult brings a notarized letter stating that the parent allows the accompanying adult to complete the consent forms.

Pima County ready to deliver Pfizer vaccine to those 12 and older

Pima County and its community partners are offering expanded opportunities to be vaccinated now that the Food and Drug Administration and the Centers for Disease Control and Prevention have endorsed the Emergency Use Authorization of the Pfizer vaccine to include children ages 12 to 15.

“The announcement earlier today (Wednesday, May 12) is a welcome step in our ongoing battle against COVID-19,” said Dr. Theresa Cullen, Pima County Health Department Director. “We have been watching and worrying about young people and the variants of COVID-19 for a few weeks. This is an extra and excellent layer of protection to keep them and their loved ones safe.”

The Moderna and Janssen vaccines are only approved for those 18 and older.

Pfizer is available at the University of Arizona location, run by the Arizona Department of Health Services, as well as at Tucson Medical Center’s vaccination site at Morris K. Udall Park and selected pharmacies.

A parent/guardian must be present to consent for their minor child to get a vaccine.

Click here to read the full release.  Click here to read the FAQs.

Local school districts offering special summer programs

By Christina Duran
Tucson Local Media

Schools throughout Pima County will offer free summer school programs thanks to an increase in federal funds.

Marana Unified School District expanded its free summer programs, from preschool programs to high school summer recovery programs, for June and July. Marana is also offering remote or virtual options for some of the summer programs.

Amphitheater Unified School District is also offering free summer programs from kindergarten through high school in their Amp Up Summer Programs. Those programs are in-person only.

Tucson Unified School District, like Marana Unified School District, will offer remote options for some summer programs, including K-5 GATE Summer Enrichment Program and the Summer High School Blocks. Parents and students have until June 2 to register for the TUSD Summer Experience programs.

Click here to read more. 

Schools fear dropouts will surge as result of pandemic

Associated Press

U.S. educators are doing everything they can to track down high school students who stopped showing up to classes and to help them get the credits needed to graduate, amid an anticipated surge in the country's dropout rate during the coronavirus pandemic.

There isn't data available yet on how the pandemic has affected the nation's overall dropout rate — 2019 is the last year for which it is available — and many school officials say it's too early to know how many students who stopped logging on for distance learning don't plan to return. But soaring numbers of students who are failing classes or are chronically absent have experts fearing the worst, and schools have been busy tracking down wayward seniors through social media, knocking on their doors, assigning staff to help them make up for lost time and, in some cases, even relaxing graduation requirements.

Click here to read the full story.

'There is no doubt: Schools must be open' in fall,
says president of the nation’s second-largest teachers’ union

By Dana Goldstein
The New York Times

Randi Weingarten, president of the nation’s second-largest teachers’ union, called on Thursday for a full reopening of the nation’s schools for the next academic year, saying: “There is no doubt: Schools must be open. In person. Five days a week.”

Her remarks come with about half of the nation’s public schools not offering five days per week of in-person learning to all students and with many families uncertain about whether they will have the option for a more traditional schedule in the fall.

Teachers’ unions have been one key barrier to a broader opening this school year, accused of slowing reopening timelines as they sought strict virus mitigation measures, even after teachers began to be vaccinated in large numbers.

“It’s not risk-free,” Weingarten, president of the American Federation of Teachers, which has 1.7 million members, said. She argued that the health risks can be managed through a range of practices — some of them relatively simple, such as masking and handwashing, and some of them more difficult to achieve at scale, such as decreasing class sizes to maintain distance and procuring additional spaces to meet outside cramped school buildings.

Click here to read the full story.

UA ends spring semester with low COVID-19 numbers,
vaccination efforts continue on campus, underserved communities

By Alexis Blue
University Communications

In his final COVID-19 briefing of the spring semester, University of Arizona President Dr. Robert C. Robbins thanked university students, employees and supporters for their efforts to mitigate the spread of the virus and allow for a successful end to an unprecedented school year. 

Wednesday, May 5 was the last day of spring classes at the university, and the number of positive COVID-19 infections on campus remains low, thanks in large part to increased vaccine availability and ongoing cooperation with public health measures such as social distancing, mask wearing and regular university-mandated testing.

Between April 26 and May 1, the university administered 4,731 COVID-19 tests, with 10 positives – a positivity rate of 0.21 percent Wastewater testing on and around campus also suggests that infections are continuing to decline, Dr. Robbins said.

The university was able to finish the semester in Stage 3 of its operational plan, which allows for classes of up to 100 students to meet in person. Graduation seniors will be able to celebrate the end of the school year in a series of scaled-down in-person graduation ceremonies May 10-18.

"We could not have reached this point in the semester without the incredible efforts of our faculty and staff. Thank you all for your incredible hard work this academic year," said Dr. Robbins. "I also want to give a special thanks to our students, as well as their families and supporters. I know this year has presented new challenges at every turn, and you have still accomplished a great deal while adapting alongside our faculty and staff to new ways of working, learning and communing with one another. Thank you all for your incredible effort."  

Monday's (May 3) briefing was the last in a series of regular weekly briefings on the university's COVID-19 status, offered virtually throughout the school year by Dr. Robbins and 17th U.S. Surgeon General Dr. Richard Carmona, a Distinguished Professor in the Mel and Enid Zuckerman College of Public Health and PCMS member.   

The university will pause the weekly briefings during the summer, holding them only as needed. Regular briefings are expected to resume as the fall semester nears.

Vaccination efforts continue on campus, in underserved communities

The university's vaccination POD, or points of distribution, continues to operate, and to date has administered more than 212,000 shots as of reporting on Monday, May 3. Because of the heat, the POD moved fully indoors on Monday, May 3. All vaccinations are now offered in the Ina E. Gittings building, 1737 E. University Blvd.

"The positive impact created by the POD is a testament to the skill, expertise and dedication of our entire vaccination team, which includes faculty, staff (and) community volunteers, many of whom are our students," Dr. Robbins said.

Walk-ins are accepted at the POD. Those who would prefer to schedule an appointment can do so by visiting podvaccine.azdhs.gov. Those who need assistance with scheduling can call (602) 542-1000 or (844) 542-8201 for help in English or Spanish. Those with additional questions about the UA POD can call the COVID Ambassador Team hotline at (520) 848-4045 between 7 a.m. and 7 p.m. daily or e-mail covidhelp@arizona.edu.

As of Thursday, May 13 an estimated 42.9 percent of Arizona residents and 40.0 percent of Pima County residents have received at least one dose of the vaccine.

Click here to read the full story.

Meet MedCats

Meet two MedCats who are now doctors. The Convocation at
The University of Arizona College of Medicine – Tucson
was held on Wednesday, May 12 at 9 a.m.

Meet a MedCat: Dr. Sandra Vazquez Salas

Sandra Vazquez Salas, MD, just completed her fourth year as a medical student at the University of Arizona College of Medicine – Tucson. She graduated Wednesday, May 12 with distinctions in Community Service, Rural Health and Medical Spanish. After graduation, Sandra will be heading to Johns Hopkins in Baltimore for a residency in Pathology. She chose this specialty after seeing the comfort and answers pathology reports provided patients in the clinical setting and during histological examinations.

It was Dr. Vazquez Salas' personal experiences and hardships that caused her to become interested in a career in medicine. Dr. Vazquez Salas was raised in the small town of Cuernavaca, Mexico. It was during this time that she experienced the reality of being underserved. “My family and I endured economic and social challenges that prevented us from accessing basic services, including medical care. Due to the great poverty and lack of opportunities, my mother made the tough decision for us to immigrate to the United States, leaving my father behind ... Four years after we left, my father unexpectedly passed away from a stroke caused by untreated hypertension. My devotion to medicine stemmed from my upbringing and father’s illness. I wanted to help others overcome the many challenges I had to face, and work towards closing the gaps for people to afford and have access to health care.” 

Dr. Vazquez Salas is very proud of her Mexican heritage, traditions and values. She is also proud of the Hispanic Women’s Scholarship she received upon entering medical school. “Receiving this scholarship gave me the validation that someone else believed in me – even if I didn’t quite believe in myself yet.” 

Click here to read the full story.

Meet a MedCat: Dr. Karen Ibarra

Karen Ibarra, MD, is a self-described “Wildcat at heart.” She is from San Luis, Ariz., and moved to Tucson to attend the University of Arizona. She earned a Bachelor's of Science in Public Health and then completed the College of Medicine – Tucson (COM-T) Pre-Medical Admissions Pathway (P-MAP) Program, which led her to COM-T. Dr. Ibarra loves being a part of COM-T because, “it really values diversity and serving the underserved.”

Growing up in a small town, Dr. Ibarra experienced health disparities firsthand, which sparked an interest to help people and give back to her community. She is most proud of her roots and her parents who, “are the reason why I am where I am today. My parents came from Mexico to the U.S. with work permits and they raised four children, they are truly the definition of hard work.”

Dr. Ibarra graduated on Wednesday, May 12 with distinctions in Rural Health, Medical Spanish and Community Service. She will pursue residency in Neurology, and looks forward to learning and talking about the nervous system every day, and to the close patient relationships it requires. Dr. Ibarra was always intrigued with the nervous system, “my interest was further reassured through my Neurology rotation and other Neurology electives that showed me how there are many disparities within Neurology and it is a specialty where I can really create change.”

Click here to read the full story. 

Arizona Center for Rural Health CMEs:
Opportunities for Arizona physicians

Arizona physicians who are authorized to prescribe Schedule II controlled substances and hold a valid U.S. Drug Enforcement Administration (DEA) registration number are required to participate in at least 3 units of opioid related, substance use disorder related or addiction continuing medical education each licensing renewal period. Linked are some online opportunities for CMEs, which may fulfill this requirement. This is not an exhaustive list. It is intended to help Arizona physicians access opioid-related CMEs.

Click here to read more.

Arizona Hospital and Healthcare Associations (AzHHA) Thoughtful Life Conversations

Introduction to POLST:

Wednesday, May 19, 2021
Friday, June 25, 2021
10-11 a.m.

This one-hour workshop equips health care professionals with knowledge and resources to begin using POLST in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST,  and learn the process of submitting health care planning documents to the Arizona Healthcare Directive Registry.

The target audience is health care professionals who plan on using POLST or caring for patients/residents who have a POLST in all care settings.

• Click here to register for May 19 virtual event at 10 a.m.
• Click here to register for June 25 virtual event at 10 a.m.

For a listing of education opportunities, visit Pima County Medical Society's CME page by clicking here or Programs/Events page by clicking here.