Latest / Morning Medical with Dr. Chow / Vaccine Updates, Antibiotic Resistance Threats, and Managing Test Result Access

Transcript

Vaccine Updates, Antibiotic Resistance Threats, and Managing Test Result Access · Morning Medical with Dr. Chow

• 0:00
  Good morning, everyone, and welcome to another episode of Morning Medical with Dr.
• 0:05
  Chow.
• 0:06
  I'm your host, Dr.
• 0:07
  Chi-Ming Chow, and today we're diving into some of the latest and most pressing medical news
• 0:12
  from around the globe.
• 0:15
  Let's start with a topic that's been making headlines: vaccine fatigue.
• 0:19
  Recent surveys indicate that roughly half of the people in the United States will skip both
• 0:24
  COVID-19 and flu shots this year.
• 0:30
  A growing number of U.S.
• 0:31
  adults are hesitant to get recommended vaccines this fall, a new survey has found.
• 0:36
  The poll, which included one thousand and six people, revealed that only forty-three percent
• 0:41
  of respondents have either gotten or plan to get the COVID-19 vaccine.
• 0:46
  Only a slight majority, fifty-six percent, of adults said they have either gotten or plan to
• 0:52
  get the flu shot this fall.
• 0:55
  The poll also found that thirty-seven percent of those who have gotten vaccines in past years
• 1:01
  plan to skip the shots this season.
• 1:04
  This hesitancy is particularly prevalent among younger adults, while adults aged sixty-five
• 1:10
  and older are the most likely to get the recommended immunizations.
• 1:14
  The nationwide survey was conducted by The Ohio State University Wexner Medical Center in
• 1:20
  mid-August 2024.
• 1:23
  These findings come just weeks after the U.S.
• 1:25
  Food and Drug Administration approved updated COVID-19 vaccines from Moderna and Pfizer for
• 1:31
  the 2024-2025 season.
• 1:34
  "We're at the start of respiratory virus season, when you have the triple threat of flu,
• 1:38
  COVID-19, and RSV," said Dr.
• 1:42
  Nora Colburn, medical director of clinical epidemiology at Ohio State's Richard M.
• 1:48
  Ross Heart Hospital, in a press release.
• 1:52
  "Unfortunately, there is a lot of misinformation about vaccinations, but the
• 1:56
  reality is that they are safe and highly effective in preventing serious illness and
• 2:00
  death," she added.
• 2:03
  Dr.
• 2:04
  Jacob Glanville, Chief Executive Officer of Centivax, a biotechnology company in San
• 2:09
  Francisco, also reacted to the poll's findings.
• 2:13
  "It's obviously not surprising that thirty-seven percent of people said they had
• 2:17
  been vaccinated in the past but were not planning to this year," he told Fox News
• 2:21
  Digital.
• 2:22
  "We just had a vaccine mandate a couple of years ago, and furthermore, childhood vaccines
• 2:27
  are very broadly administered, so those thirty-seven percent are people who would not
• 2:32
  be getting a vaccine normally anyway."
• 2:35
  Dr.
• 2:36
  Marc Siegel, senior medical analyst for Fox News and clinical professor of medicine at New
• 2:41
  York University Langone Medical Center, finds the poll's findings concerning.
• 2:46
  "Both vaccines wane over six months, so a yearly booster makes sense for high-risk
• 2:51
  groups," he told Fox News Digital.
• 2:53
  "I recommend a yearly booster for the elderly, immunocompromised, and those with chronic
• 2:58
  illness."
• 3:00
  Dr.
• 3:00
  Siegel estimates that this year's flu season will be similar to last year's, which was
• 3:06
  moderate, with twenty-five thousand deaths and four hundred thousand hospitalizations.
• 3:13
  "The flu shot decreases severity and number of hospitalizations by about a quarter and helps
• 3:20
  to provide community immunity," he added.
• 3:23
  For COVID-19, Dr.
• 3:25
  Siegel warned that the virus' activity is still fairly high, especially in the western United
• 3:30
  States.
• 3:31
  He also warned of a new variant circulating in Europe, known as the XEC subvariant, which he
• 3:37
  expects will soon reach the United States.
• 3:40
  "It seems to be more contagious—it causes congestion, cough, loss of smell and appetite,
• 3:46
  sore throat, and body aches," he said.
• 3:50
  "The new vaccine should provide at least some coverage."
• 3:53
  Dr.
• 3:54
  Paul Offit, director of the Vaccine Education Center and an attending physician in the
• 3:59
  Division of Infectious Diseases at Children's Hospital of Philadelphia, also weighed in.
• 4:05
  He noted that very young children are being hospitalized at a greater rate, likely because
• 4:10
  they have not been vaccinated with the primary series.
• 4:14
  "I recommend a yearly booster for the elderly, immunocompromised, and those with chronic
• 4:20
  illness, along with anyone who is at risk for long COVID or has had it previously," Dr.
• 4:26
  Offit said.
• 4:28
  The U.S.
• 4:28
  Centers for Disease Control and Prevention has issued the following vaccine recommendations:
• 4:33
  For flu, everyone six months and older is advised to get vaccinated.
• 4:38
  For COVID-19, the latest version of the vaccine is recommended for everyone six months and
• 4:43
  older.
• 4:44
  For RSV, the vaccine is recommended for everyone aged seventy-five and older, as well
• 4:50
  as those aged sixty to seventy-four who have certain chronic medical conditions, such as
• 4:56
  lung or heart disease, or who live in nursing homes.
• 5:00
  Pregnant women are also advised to get the vaccine during weeks thirty-two through
• 5:06
  thirty-six of pregnancy.
• 5:08
  For pneumococcal pneumonia, everyone younger than five years and aged sixty-five and older
• 5:15
  is advised to get the vaccine, along with those who are at increased risk of severe disease.
• 5:22
  Let's shift gears now to a deeply concerning topic: the rise of antibiotic-resistant
• 5:27
  superbug infections.
• 5:29
  A new study projects that nearly 40 million people could die from these infections between
• 5:35
  now and 2050.
• 5:37
  The study, published in the journal The Lancet, highlights the ongoing and worsening superbug
• 5:42
  crisis.
• 5:44
  Antimicrobial resistance, or AMR, occurs when pathogens like bacteria and fungi evolve to
• 5:51
  evade the medications designed to kill them.
• 5:55
  The World Health Organization has labeled AMR as one of the top global public health and
• 6:01
  development threats.
• 6:02
  This crisis is driven by the misuse and overuse of antimicrobial medications in humans,
• 6:09
  animals, and plants, which helps pathogens develop resistance.
• 6:14
  Dr.
• 6:14
  Chris Murray, the lead author of the study and director of the Institute for Health Metrics
• 6:19
  and Evaluation at the University of Washington, emphasized the severity of the issue.
• 6:26
  "We need appropriate attention on new antibiotics and antibiotic stewardship so that
• 6:32
  we can address what is really quite a large problem," he said.
• 6:36
  The researchers, from the Global Research on Antimicrobial Resistance Project and other
• 6:41
  institutions, analyzed data from 1990 through 2021.
• 6:46
  They estimated deaths and illnesses attributable to AMR for 22 pathogens, 84
• 6:52
  pathogen-drug combinations, and 11 infections across 204 countries and territories.
• 6:58
  About 520 million individual records were part of the data.
• 7:02
  One of the most alarming findings is the disparity in AMR-related deaths among different
• 7:07
  age groups.
• 7:08
  From 1990 to 2021, deaths from AMR fell by over 50 percent among children younger than five,
• 7:15
  thanks to vaccination, water, and sanitation programs.
• 7:19
  However, deaths increased by over 80 percent among adults aged 70 and older.
• 7:24
  This trend is expected to continue, given the aging global population.
• 7:30
  The pathogen-drug combination with the largest increase in causing deaths was
• 7:35
  methicillin-resistant Staphylococcus aureus, or MRSA.
• 7:41
  Deaths attributable to this combination nearly doubled from 57,200 in 1990 to 130,000 in 2021.
• 7:51
  Using statistical modeling, the researchers projected deaths and illnesses attributable to
• 7:56
  AMR by 2050 under three scenarios: if the current climate continues, if new potent
• 8:02
  antibiotic drugs are developed, and if there is improved quality of healthcare and better
• 8:07
  access to antibiotics.
• 8:09
  In a scenario where the current climate continues, deaths from AMR are expected to rise
• 8:15
  significantly.
• 8:17
  In 2050, the number of global deaths attributable to AMR could reach 1.9 million,
• 8:22
  with those associated with AMR reaching 8.2 million.
• 8:27
  The regions most affected would be South Asia, Latin America and the Caribbean, and
• 8:33
  sub-Saharan Africa.
• 8:35
  Many of these regions lack equitable access to quality healthcare.
• 8:39
  Dr.
• 8:40
  Steffanie Strathdee, associate dean of global health sciences at the University of California
• 8:46
  San Diego School of Medicine, shared her personal experience with AMR.
• 8:51
  Her husband nearly died from a superbug infection in 2015.
• 8:55
  He was eventually treated successfully with phages, viruses that selectively target and
• 9:00
  kill bacteria.
• 9:02
  This treatment approach offers hope as an alternative to traditional antibiotics.
• 9:08
  The study underscores the urgent need for global investments and targeted actions to
• 9:13
  combat AMR.
• 9:15
  Improving access to antibiotics, newer antimicrobial medications, vaccines, clean
• 9:21
  water, and other aspects of quality healthcare is crucial.
• 9:26
  Reducing the use of antibiotics in livestock, food production, and the environment is also
• 9:31
  essential to curbing the rise of resistant pathogens.
• 9:34
  Dr.
• 9:35
  Strathdee remains hopeful.
• 9:38
  "There is possible hope on the horizon," she said.
• 9:41
  "If we were to scale up these interventions, we could dramatically reduce the number of deaths
• 9:46
  in the future."
• 9:48
  Let's shift gears now to a topic that has been causing quite a stir in the medical community:
• 9:53
  immediate access to test results.
• 9:56
  This has been a double-edged sword for both patients and healthcare providers since the
• 10:00
  enactment of the 21st Century Cures Act in 2021.
• 10:04
  The legislation aimed to empower patients by granting them immediate access to their
• 10:10
  electronic medical records, including test results and provider notes.
• 10:14
  While this move was intended to increase transparency and patient engagement, it has
• 10:20
  also introduced a slew of complications.
• 10:24
  Dr.
• 10:24
  Fred Pelzman, an associate professor of medicine at Weill Cornell and medical director
• 10:29
  of Weill Cornell Internal Medicine Associates, recently shared his experiences dealing with
• 10:34
  this issue.
• 10:35
  "Dr.
• 10:35
  Pelzman, can you explain what all those scary little red arrows pointing up mean?" This is a
• 10:40
  common question he receives from patients who are puzzled and often alarmed by the flagged
• 10:45
  abnormalities in their lab test results.
• 10:48
  Patients often bombard their healthcare providers with questions like, "My basophils
• 10:53
  are marked as abnormal; they seem on the low side.
• 10:56
  What can I do to increase them?" or "My labs show that my carbon dioxide is 32, and the
• 11:03
  upper limit of normal is 31.
• 11:05
  Is there something wrong with my breathing?
• 11:08
  Google said this might be a problem." Dr.
• 11:11
  Pelzman even mentioned a patient who was worried about having mucus in their urine.
• 11:17
  This immediate access to test results has undoubtedly increased patient anxiety.
• 11:24
  Dr.
• 11:24
  Pelzman points out that before the 21st Century Cures Act, the common practice was to reassure
• 11:30
  patients with the phrase, "No news is good news." However, this approach often led to gaps
• 11:36
  in communication and missed follow-ups.
• 11:39
  Nowadays, the standard is "No news is no news," emphasizing the importance of closing the loop
• 11:46
  on patient care.
• 11:47
  But this has also led to an overwhelming influx of messages and inquiries for healthcare
• 11:51
  providers, often before they have had a chance to review the test results themselves.
• 11:58
  Dr.
• 11:58
  Pelzman describes how his in-basket is often filled with not only test results but also
• 12:04
  multiple portal messages from anxious patients.
• 12:08
  This constant stream of information can be overwhelming and stressful for providers, who
• 12:13
  are already juggling numerous responsibilities.
• 12:17
  The immediacy with which patients receive their results can sometimes lead to them discovering
• 12:23
  serious conditions, like cancer, before their doctors have had a chance to even read the
• 12:28
  report.
• 12:30
  To manage this influx, some healthcare providers have developed efficient workflows to
• 12:36
  handle in-basket results.
• 12:38
  They use tools within electronic medical records to manage results, communicate with
• 12:45
  patients, and ensure that the care loop is closed.
• 12:48
  Some providers manage to clear their in-basket by the end of each day, while others struggle
• 12:53
  to keep up, sometimes only reviewing results at the end of the week or month.
• 12:58
  Dr.
• 12:59
  Pelzman and his team have been working on projects to analyze different strategies for
• 13:03
  managing these results.
• 13:04
  They aim to build new tools, including advanced technologies that can help providers quickly
• 13:10
  respond to patients.
• 13:11
  These tools would ideally be smart enough to differentiate between normal, clinically
• 13:16
  insignificant abnormalities and truly critical results that require immediate attention.
• 13:22
  The goal is to make sure nothing falls through the cracks and that every patient receives
• 13:27
  timely and appropriate care.
• 13:30
  In conclusion, while immediate access to test results has its benefits, it also brings
• 13:35
  challenges that need to be addressed.
• 13:36
  Healthcare providers are working hard to develop better systems and workflows to manage
• 13:42
  this information effectively.
• 13:44
  The ultimate aim is to ensure that patients are well-informed and receive the care they need
• 13:50
  without adding unnecessary stress to both patients and providers.
• 13:55
  That wraps up today's episode of Morning Medical with Dr.
• 13:58
  Chow.
• 13:58
  Thank you for joining us as we navigated through some of the most pressing issues in
• 14:02
  healthcare today.
• 14:03
  I'm your host, Dr.
• 14:05
  Chi-Ming Chow.
• 14:06
  Stay healthy, stay informed, and we'll see you next time.