Wednesday, August 5, 2020

See Through Face Masks

Environmental & Science Education
STEM
Health
Medicine
Invention
Society
Edward Hessler

Transparency is one of the most used words of the day. Often, though, transparency is difficult in practice and may seem opaque to those demanding it but here is a case where transparency and practice meet.

Case: transparent face masks.

Who really needs them? Deaf people and the hard of hearing who read lips  Teachers who work with children. Caregivers who work with the elderly. Those who miss smiling at their students.

To my surprise, prototypes and custom made models are increasingly available and according to a report on transparent face masks, NPR's  Business Desk correspondent, Yoki Noguchi"At least one company — Clear Mask (her essay provides a link), based in Baltimore — has gone so far as to seek and earn FDA "'clearance'" that its mask with a transparent panel is "'substantially equivalent'" to a medical-grade surgical mask for hospitals and other front-line uses."

ClearMask, was started by four Johns Hopkins University students and has attracted considerable attention worldwide according to Noguchi.

You may wonder whether the transparent face shields work. Obviously, they would appear to. But there is an issue as Noguchi notes. "[T]hey are open at the bottom and not recommended by the CDC "'for normal everyday activities or as a substitute for cloth face coverings,'" according to the agency's website (linked). And after a coronavirus outbreak in a Swiss restaurant recently — one in which employees wearing face shields became infected with the virus, while those in cloth masks didn't — health officials in Switzerland and some European countries also have been panning reliance on face shields (linked)."

I have seen health care professionals using both non-see through masks and face shields which seems like a good practice, e.g., "open your mouth and say "Ah" where faces are close to one another.

One mask seamstress who is an elementary teacher has turned her summer to making masks as well as  custom transparent masks that use the plastic, Mylar. When asked about the efficacy of such homemade masks, David Aronoff, director of infectious disease at the Vanderbilt Institute for Infection, Immunology and Inflammation said "'We know that the virus cannot penetrate plastic or solid materials, so see-through masks provide potentially a great option for balancing infection prevention with the desire to be able to see somebody's mouth move.'

"'The main thing that we really need to get people to understand is that wearing a face covering is really important. And if it helps them to wear one that has a cut-out in the middle with a piece of plastic to make it easier to see — that's great.'"


Tuesday, August 4, 2020

A Vital New Sign in Health Care

Environmental & Science Education
STEM
Health
Medicine
Edward Hessler

I've never had a conversation initiated by a physician rather than by me on the cost of health care--the financial effects on me. Three physicians from three different institutions--two in Virginia and one in Boston--concerned about the cost of care, "have changed how we work."

In an essay in STAT they write, "We now ask our patients about financial side effects at every encounter, after first explaining why we are doing this. We ask because it is rare for patients to tell us unprompted what financial challenges they are facing, what sacrifices they have made to adhere to their care, and when and where they haven't been able to get the care they feel they need."

The questions include "out-of-pocket expenses, including out-of-pocket costs at the pharmacy, copays or bills for any tests, such as imaging studies; copays for clinic visits; and how and when they spend their annual deductible. We pay attention to our patient's insurance coverage, knowing this might affect which drug we decide to prescribe, or which tests we recommend."

And the questions continue. Do "they sometimes leave prescriptions unfilled or split or skip doses. We ask what sacrifices they make to pay for their care. If we have time during the visit, we ask if out-of-pocket costs for health care prevent them from spending their money on something else important to them or their family. We sometimes also as our insured patients about their annual premiums, including whether they've gone up over the past few years and how that has affected them. When we ask,we learn And when the answers worry us, we search for solutions. After all, one of our mandates is to first do no harm". (my emphasis)

Their essay includes other financial consequences--some personal, others broader but which affect a patient more invisibly (higher taxes) such as safety net programs and government-funded health insurance programs.

The doctors are confident that they are not alone in doing this but think that it is not a common-enough practice. Medicine is becoming more holistic--listening more to patients about their concerns, all of them and this financial review strikes me as an important part of complete health care. Patients always come from and return to their surrounding environment. A visit to see a doctor often has ramifications for the patient, for their environment as well as for the physician.




Monday, August 3, 2020

Why the Rapid Development of a Vaccine for Covid-19 is Happening so Fast

Environmental & Science Education
STEM
Health
Medicine
History of Science
Nature of Science
Edward Hessler

The reasons for the surprisingly rapid progress on a COVID-19 vaccine are reviewed by Andrew Joseph in STAT.

--A familiar family. The coronavirus is quite similar to "others that had previously leapt from animals to people" so rejiggering "vaccine projects" could be done quickly.

--An acute, not chronic infection. This infection is one "most people will clear on their own."

--Cutting-edge approaches. Innovations include determining the genetic sequence of the virus, "basic genetics, immunology and structural biology." By knowing the genetic sequence researchers "can string together the right pieces of (genetic) code to synthesize vaccines." (added)

--Money, money, money. Money has been no object. Usually companies wait for each phase of the trials on whether to make further investments. And one researcher, Dr. James LeDuc of the University of Texas Medical Branch's Galveston Medical Branch also noted that, "The fact that industry is able to hedge their bets like this and to make these investments is because the government has put up the money.”

In related reporting, NPR's Sydney Lupkin listed drug companies that have "agreements for the support of clinical trials, scaling-up of the manufacturing process and producing 100 million doses of vaccine": AstraZeneca, GlaxoSmithKline, Johnson & Johnson, Moderna, Novovax, Pfizer, and Sanofi.

--Regulatory Nimbleness. Since the West African Ebola crisis regulators have been more comfortable moving vaccine trials forward, including the use of collapsing the usual three phases "into Phase 1/2 or Phase 2/3 trials. Recall too that this is a somewhat familiar coronavirus so the trials could be shorter or collapsed.

In his STAT essay Andrew Joseph reminds us though that "progress so far remains just that. The vaccines are now facing their real tests: the monthslong, Phase 3 trials that will demonstrate whether or not they protect people from the virus."

The full essay is worth reading since it includes details and nuances that this brief doesn't.



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Sunday, August 2, 2020

The Wild Bison Return...to the United Kingdom

Environmental & Science Education
STEM
Sustainability
Nature
Wildlife
Biodiversity
Edward Hessler

It has been 6000 years since wild bison were found in the United Kingdom.

This is about to change. According to an article by Environment Editor Damian Carrington for The Guardian, a male and three female European bison (Bison bonasus), will be released in a forest in Kent and allowed to breed naturally to slowly repopulate the land. The bison will come from the Netherlands or Poland. It is expected that each female will produce one calf per year.

Bison are viewed as a keystone species and through their activities, it is hoped, these will change or re-make the land which in turn will encourage broader biological abundance. One of the most important changes they will make in the habitat into which they are introduced is by killing some of the trees which will create "a healthy mix of woodland, scrub and glades, boosting inset, bird and plant life."

It is fair to think of the bison as "ecosystem engineers" in this "nature-based" approach to habitat and wildlife management. One thing leads to another. Bison rub against trees, ultimately killing them, the dead wood provides habitat for insects, insects provide food for birds, and the openings created change environmental conditions allowing new plants to grow.

Carrington notes that "Once the bison are settled, the public will be able to visit the area with rangers and watch the animals from viewing platforms. In the Netherlands, where bison projects have been running for 15 years, people walk through the areas without incident. Free-living longhorn cattle, “iron age” pigs, and Exmoor ponies will also live alongside the bison and assist in restoring the woodland."

The article describes some of the details, including important links and includes three photographs: Blean Woods where they will be released and of bison on the land in Poland and Germany.

For a discussion of some of the differences between European and American bison, see here.



 


Saturday, August 1, 2020

Unsolicited Seeds by Mail: MDA Advises

Environmental & Science Education
STEM
Agriculture
Edward Hessler

The Minnesota Department of Agriculture released a statement July 31 on unsolicited seeds arriving through the mail which includes what you should do.

This includes upon their arrival in your postal box and/if you have planted them.

It is a quick and useful summary. "To date, over 700 Minnesotans have made reports to the department."

The Quokka

Environmental & Science Education
STEM
Behavior
Nature
Biodiversity
Edward Hessler

This Atlantic cinematic short documentary film (22 m 56 s) takes us to Rottnest Island (aka "Rotty"), off the coast of western Australia, to introduce the quokka (Setonix brachyurus), a relative of the kangaroo family. It is unafraid of humans and appears to smile for pictures.

So, of course, the quokka then becomes "the world's happiest animal." Filmmaker David Freid says "When you see one, it's a bonafide heart melter." He describes the film as a "quokkumentary."

The island's name is from the Dutch for"rat's nest." Dutch sea captain Willem de Vlamingh who visited the island in the early 1700s, in a case of mistaken identity, "dubbed (quokkas as) "a kind of rat as big as a common cat."