Latest / Morning Medical with Dr. Chow / Trust in Healthcare, Dementia Projections, Neuralink Updates, and LA Wildfires Impact

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Trust in Healthcare, Dementia Projections, Neuralink Updates, and LA Wildfires Impact · Morning Medical with Dr. Chow

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Welcome to Morning Medical with Dr.
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Chow.
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I'm your host, Dr.
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Chi-Ming Chow.
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Today, we're diving into the fascinating world of public trust in healthcare professions, as
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revealed by the latest Gallup Poll on Most Trusted Professions.
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This poll is an annual tradition that sheds light on how Americans perceive the honesty and
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ethical standards of various professions.
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For the 23rd consecutive year, nurses have claimed the top spot as the most trusted
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profession in America.
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According to the poll, an impressive 76 percent of respondents rated nurses as having high or
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very high ethical standards.
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This speaks volumes about the pivotal role nurses play in our healthcare system and the
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unwavering trust they inspire in their patients.
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Jennifer Mensik Kennedy, President of the American Nurses Association, remarked on this
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achievement, highlighting the incredible impact nurses have on patient care and their
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dedication to advocating for policies that support a healthy workplace culture.
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Following nurses, grade-school teachers ranked second, with 61 percent of respondents
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acknowledging their high ethical standards.
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Military officers came in third with 59 percent, while pharmacists and physicians
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rounded out the top five, with 57 percent and 53 percent, respectively.
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Despite the challenges posed by recent years, including the COVID-19 pandemic, healthcare
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professionals continue to be seen as pillars of integrity and dedication.
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Nancy Hagans, President of National Nurses United, also commented on the results,
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emphasizing the sacred bond of trust between nurses and their patients.
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She noted that nurses remain committed to advocating for their patients, whether by
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demanding safe care conditions or addressing broader public health issues.
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It's interesting to note that while nurses have consistently topped the list since 1999, with
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the exception of 2001 when firefighters were recognized following the 9/11 attacks, the
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average trust ratings for the 11 core professions have seen a decline over the years.
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Gallup suggests this decline reflects a broader decrease in Americans' confidence in United
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States institutions.
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Physicians, for example, saw a significant drop in their ethics rating, which fell from a high
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of 77 percent in 2020 to its lowest since the mid-1990s at 53 percent.
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Similarly, other professions like pharmacists and nursing home operators have also seen their
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ratings dip below pre-pandemic levels.
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This decline in trust is not limited to healthcare.
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The clergy, for instance, experienced the most significant drop among all professions since
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the early 2000s, with a 26-percentage point decrease.
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Judges also saw a notable decline, possibly influenced by high-profile legal decisions and
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cases in recent years.
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As we continue to navigate these complex times, it's crucial to recognize the vital role
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healthcare professionals play in our society.
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Their dedication and ethical standards remain a cornerstone of the trust we place in them, even
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as broader societal confidence fluctuates.
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A recent analysis published in Nature Medicine has brought to light some startling projections
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regarding dementia in the United States.
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By the year 2060, it's estimated that the number of adults developing dementia each year
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will double, reaching a staggering one million cases annually.
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This is a significant increase from the 514,000 cases reported in 2020.
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The study, led by Dr.
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Josef Coresh from New York University Grossman School of Medicine, highlights that the
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lifetime risk of developing dementia is now estimated at 42 percent.
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This risk increases notably after the age of seventy-five.
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The study also found that certain groups, including Black adults, women, and carriers of
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the APOE4 gene, have even higher projected rates, with lifetime risks ranging from
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forty-four to fifty-nine percent.
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These findings are based on a diverse sample from the Atherosclerosis Risk in Communities
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cohort, which took into account various geographic, racial, and socioeconomic factors.
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This cohort followed individuals from 1987 to 2020, offering a comprehensive view of dementia
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risk over time.
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The study's authors emphasized the growing importance of addressing dementia risk and
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tackling racial inequities in healthcare.
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Interestingly, Dr.
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Coresh pointed out that while the risk of developing dementia between ages fifty-five and
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seventy-five is relatively low at four percent, it rises significantly to twenty percent by age
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eighty-five and then to forty-two percent by age ninety-five.
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This underscores the importance of focusing on prevention strategies, particularly for older
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adults.
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The analysis also sheds light on the role of lifestyle factors in dementia risk.
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According to Coresh, about half of the dementia risk is preventable.
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The Lancet Commission has summarized evidence supporting the control of vascular risk factors
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such as blood pressure, obesity, diabetes, and smoking, along with optimizing exercise, sleep,
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and social engagement.
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Addressing hearing and vision limitations, as well as preventing falls and head injuries, are
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also key strategies in later life.
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The Alzheimer's Association's chief science officer, Maria Carrillo, emphasized the urgent
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need to address Alzheimer's disease and dementia, particularly among high-risk groups
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like Black Americans, Hispanic Americans, and women.
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She noted that these groups have often been underrepresented in research, which further
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complicates efforts to mitigate their risk.
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As the Baby Boom generation ages, the projected increase in dementia cases highlights the need
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for comprehensive public health strategies.
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Current trials, such as the ongoing POINTER trial, are examining whether lifestyle
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interventions targeting multiple risk factors can effectively protect cognitive function in
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people at increased risk of cognitive decline.
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While the study has provided valuable insights, it's worth noting some limitations.
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The researchers acknowledged that some dementia cases might have been misclassified or not
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captured at all, and the study has not been externally validated.
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Future studies with longer follow-up periods and comprehensive dementia assessments are
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needed to confirm these lifetime risk estimates.
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In a recent interview streamed on his social media platform, Elon Musk announced that a
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third individual has received a brain implant from his company, Neuralink.
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Neuralink is one of many organizations striving to connect the human nervous system to
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machines, a field that is rapidly expanding and gaining attention.
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Musk expressed enthusiasm about the progress, stating, "We’ve got three humans with
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Neuralinks and all are working well."
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Since the initial brain implant about a year ago, Neuralink has made significant
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advancements in the technology.
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The devices now boast more electrodes, higher bandwidth, and longer battery life, all of
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which contribute to improved performance and functionality.
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Musk also mentioned plans to implant the device in 20 to 30 more individuals this year,
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indicating the company's ambition to scale up its operations.
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While Musk did not provide specific details about the latest patient, he shared updates on
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previous recipients.
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The second recipient, who has a spinal cord injury, received the implant last summer.
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This individual has been able to play video games with the device's assistance and is
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learning to use computer-aided design software to create three-dimensional objects.
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Similarly, the first patient, also paralyzed due to a spinal cord injury, has used the
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implant to play video games and chess.
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Neuralink's developments often capture public interest, but it is important to note that many
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other companies and research groups are also working on brain-computer interface technology.
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Two studies published last year in the New England Journal of Medicine highlighted how
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brain-computer interfaces have helped individuals with amyotrophic lateral sclerosis,
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or ALS, to communicate more effectively.
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According to Rajesh Rao, co-director of the Center for Neurotechnology at the University of
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Washington, there are over 45 trials involving brain-computer interfaces currently underway.
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These efforts aim to treat brain disorders and overcome injuries, among other applications.
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Rao noted that while Neuralink's approach is unique in using robots to implant flexible
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electrode threads, other companies like Synchron, Blackrock Neurotech, and Onward
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Medical are exploring less invasive or more versatile techniques that combine neural
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recording with stimulation.
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Marco Baptista, chief scientific officer of the Christopher & Dana Reeve Foundation, described
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brain-computer interface technology as "very exciting" due to its potential benefits for
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individuals with paralysis.
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He emphasized the importance of clinical trials in determining the most effective approaches.
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While the foundation supports various research teams, it has not provided funding to
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Neuralink, highlighting the need to back "high-risk, high-reward endeavors."
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The testing and regulation of brain-computer interfaces like Neuralink's are crucial to
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ensuring their safety and efficacy.
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In 2023, Neuralink received permission from U.S.
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regulators to begin human trials.
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High-risk medical devices require an investigational device exemption from the Food
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and Drug Administration, which Neuralink has reportedly obtained.
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Dr.
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Rita Redberg, a cardiologist at the University of California, San Francisco, explained that
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the FDA is involved in all steps from patient recruitment to data analysis, focusing on
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safety as a priority.
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Additionally, any research involving human participants must undergo review by an
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institutional review board, also known as an ethical review board.
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These boards ensure that there is a reasonable risk-to-benefit ratio and that participants are
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fully informed before enrolling in a study.
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This regulatory framework is designed to protect participants and maintain ethical
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standards in research.
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The wildfires raging across Los Angeles County have put immense pressure on the region's
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healthcare facilities and first responders.
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The fires have forced evacuations and closures, adding strain to hospitals, clinics, and
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nursing homes.
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At least one medical clinic has burned down, and senior patients have had to be evacuated
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from nursing facilities amid swirling embers.
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Many healthcare providers have been directly affected, with some losing their homes or
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needing to evacuate, making it difficult for them to get to work and for healthcare centers
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to maintain adequate staffing.
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Dr.
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Ravi Salgia, an oncologist at City of Hope National Medical Center, experienced the chaos
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firsthand.
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As his house in Eaton Canyon was threatened by flames, he and his family had to evacuate
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quickly.
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Despite the personal upheaval, Salgia reported to his hospital, which had become an emergency
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command center.
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He and his colleagues, many of whom had also evacuated, worked to ensure patient care
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continued uninterrupted.
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In Pacific Palisades, the St.
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John's Physician Partners clinic was destroyed by fire.
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Nearby, Providence St.
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John's Health Center in Santa Monica was on the verge of evacuation, prompting staff to
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coordinate with other hospitals for patient transfers.
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USC Verdugo Hills Hospital and others faced similar risks, with the Hospital Association of
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Southern California noting the significant operational challenges posed by the fires.
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The fires have strained emergency services, with high call volumes and road closures
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complicating the transport of patients and supplies.
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Some health facilities have experienced power outages, further hindering operations.
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The California Department of Managed Health Care has ordered health plans to ensure that
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those affected by the wildfires have access to necessary medical services, including
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prescription refills.
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Hospitals across Los Angeles County have reported treating patients for burns, smoke
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inhalation, and eye irritation.
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Over 700 people have been evacuated from nursing homes and care facilities.
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The West Valley Health Center closed due to a power outage, and several UCLA Health clinics
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were affected by utility shutoffs.
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Children's Hospital Los Angeles closed two specialty care clinics because of the fires'
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impact.
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The two largest fires, the Palisades Fire and the Eaton Fire, have caused widespread
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destruction, burning over 50 square miles and thousands of structures.
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They have also claimed at least 24 lives and severely injured many more.
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Although the winds fueling the fires have calmed somewhat, they still pose significant
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challenges for firefighters.
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Routine medical care is likely to be disrupted for many in the coming days.
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Kaiser Permanente has closed multiple sites, including a pharmacy, laboratory, and eye
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clinic.
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Huntington Hospital in Pasadena is dealing with evacuation notices and heavy smoke.
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Some hospitals, like Dignity Health's facilities, are operating on generator power
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and have canceled elective surgeries.
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Christine Kirmsse, a registered nurse who evacuated her Santa Monica home, emphasized the
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importance of continuing to work despite the personal challenges.
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"There's obviously so much help that's needed," she said, highlighting the power of community
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in times of crisis.
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As residents begin to return to their homes in Southern California following the devastating
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wildfires, it's crucial to be aware of the risks posed by ash and air pollution.
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While the flames may have spared some structures, the air quality remains a
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significant concern, with smoke and ash potentially seeping into homes.
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This can pose serious health risks, even if your property hasn't suffered direct fire
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damage.
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Katherine Pruitt, the national senior director for policy at the American Lung Association,
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has emphasized the dangers of inhaling fumes and particles that might be present indoors.
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It's important to avoid contact with ash, whether through inhalation or on your skin and
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eyes.
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The Los Angeles Public Health has declared a local health emergency, prohibiting the use of
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air blowers, including leaf blowers, to minimize health risks from ash and particulate
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matter.
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Wildfires burn more than just vegetation; they also consume cars and buildings, releasing
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toxic chemicals.
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These substances can linger in the air and on surfaces long after the smoke clears.
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Studies have shown that indoor surfaces like walls and furniture can absorb these chemicals
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and release them over time, a process known as off-gassing.
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This can continue for weeks or even months, contributing to unhealthy indoor air quality.
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The American Lung Association's State of the Air report for 2024 identified Los Angeles as
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one of the top cities for year-round particle pollution, and it's been number one for ozone
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pollution for decades.
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With the recent wildfires, the air quality index has remained at unhealthy levels for
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several days.
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Particle pollution from wildfires is particularly harmful to the respiratory system,
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causing symptoms like burning eyes, runny noses, and more serious issues such as
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bronchitis.
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A study of the 2024 Marshall Fire in Boulder, Colorado, found that even after smoke had
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cleared, harmful substances like metals and polycyclic aromatic hydrocarbons remained
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indoors.
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Similarly, exposure to volatile organic compounds, or VOCs, can have long-term health
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impacts.
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Residents near the Boulder fire reported symptoms like headaches and coughing, even
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months after the event, underscoring the persistent nature of these pollutants.
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To reduce exposure to these harmful substances, experts recommend checking and replacing HVAC
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filters frequently, especially if they appear dirty.
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Using high-efficiency filters, such as MERV-13 or higher, and running the HVAC system's fan
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continuously can help improve indoor air quality.
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Portable air cleaners with HEPA and charcoal filters can also be beneficial, particularly in
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rooms where people spend the most time.
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It's advisable to limit activities that could increase indoor particle pollution, such as
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frying food or vacuuming without a HEPA filter.
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Avoid smoking or burning candles indoors, as these activities can worsen air quality.
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For cleaning, stick to soap and water instead of chemical cleaners that might react with ash.
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If you're using a vacuum with a HEPA filter, lightly mist surfaces with water first to
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reduce airborne particles.
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When cleaning up, it's important to protect yourself by wearing gloves, goggles, long
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sleeves, and a respirator mask, such as an N95 or P100.
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Surgical masks or cloth masks won't provide sufficient protection against fine particles.
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After cleaning, wash any ash off your skin promptly and change clothes to prevent
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spreading ash to other areas.
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Individuals with heart or lung conditions, as well as the elderly, children, and pregnant
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people, should avoid participating in cleanup efforts due to their increased vulnerability to
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particle pollution.
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Pets should also be kept away from ash to prevent illness.
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Taking frequent breaks from cleaning to get fresh air is recommended, especially if outdoor
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air quality has improved.
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As we wrap up today's episode, remember that staying informed and taking precautions can
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help protect your health in these challenging times.
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Thank you for joining me on Morning Medical with Dr.
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Chow.
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Stay safe and take care.