By Colleen Campbell
While post-viral illnesses are not new, they have been considerably neglected by the public health, medical, and scientific communities. This invisibility has, in many ways, been constructed by institutional neglect and medical sexism.
The COVID-19 pandemic is now causing a reckoning with this institutional neglect. This is because COVID Long Haulers and patient advocates for the chronically ill are forcing an unprecedented recognition for these chronic complex diseases.
By Megan J. Shen
There is a common myth that Asians in the U.S. are successful and free from racial bias. This is often referred to as the ‘model minority’ myth.
This myth is not only inaccurate and a gross overgeneralization, but it also hurts public health efforts to address health inequities among Asians in the U.S.
By Chloe Reichel
State legislation blocking trans youth from accessing gender-affirming care puts kids at risk, thwarts physician autonomy, and potentially violates a number of federal laws, write Jack L. Turban, Katherine L. Kraschel, and I. Glenn Cohen in a viewpoint published today in JAMA.
So far this year, 15 states have proposed bills that would limit access to gender-affirming care. One of these bills, Arkansas’ HB1570/SB347, already has become law.
This legislative trend should be troubling to all, explained Cohen, Faculty Director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. In an email interview, he highlighted “how exceptionally restrictive these proposed laws are,” adding that they are “out of step with usual medical, ethical, and legal rules regarding discretion of the medical profession and space for parental decision-making.”
Turban, child and adolescent psychiatry fellow at Stanford University School of Medicine also offered further insight as to the medical and legal concerns these bills raise over email.
By Valarie K. Blake
The Biden administration and all three branches of government are poised to finally deliver a sex-based civil rights movement in health care that generations have waited for.
Sex discrimination is prevalent in health care, but especially so for LGBTQ people. Combine this with other forms of discrimination that LGBTQ people experience, and the result is a population that suffers from serious health disparities, including heightened risks of mental health conditions, substance use disorders, and suicide.
A much needed ban on sex discrimination in health care finally passed in 2010, as part of the Affordable Care Act (ACA). Section 1557 of the ACA prohibits health care entities that receive federal money from discriminating on the basis of sex, along with race, age, and disability. Specifically, Section 1557 bans sex discrimination in health care by way of extending Title IX, which previously applied to educational entities only. Section 1557 reaches most hospitals, providers, and insurers. Sex equality in health was a long time coming. Similar bans on discrimination by recipients of federal money had passed decades earlier: race discrimination in 1964, disability discrimination in 1973, and age discrimination in 1975.
Despite its historic nature, Section 1557 has yet to deliver on its promise, owing to delays and volatility in rulemaking and near-constant litigation. The statute was barebones, requiring interpretation, but the Obama administration only promulgated a rule and began full enforcement six years after the passage of the ACA. The Obama rule broadly banned gender identity and sexual orientation discrimination, but the part of the rule banning gender identity discrimination was judicially stayed only months later in Franciscan Alliance v. Burwell.
By Adrian Gropper
As COVID-19 vaccines become widely, if not fairly, available in different regions, both the public and private sector are working to develop vaccine credentials and associated surveillance systems.
Information technology applied to vaccination can be effective, but it can also be oppressive, discriminatory, and counter-productive.
But these systems can be tuned to reflect and address key concerns.
What follows is a list of ten separable concerns, and responsive design strategies. The concept of separation of concerns in technology design offers a path to better health policy. Because each concern hardly interacts with the others, any of them can be left out of the design in order to prioritize more important outcomes. Together, all of them can maximize scientific benefit while enhancing social trust.
This piece was adapted from a post that originally ran at On the Flying Bridge on March 28, 2021.
By Michael Greeley
With great fanfare last week, DoorDash announced an initiative to provide same-day home delivery of approved COVID-19 test collection kits.
Much of the business model innovation in health care today is to move as much care as is feasible to the home. But what does that mean for the homeless?
By Chloe Reichel
Uruguay, once hailed as a model for its pandemic response, recently has seen some of the world’s sharpest increases in COVID-19 cases. Earlier this month, the infection rate in the country surpassed 1,300 cases per 100,000 residents over a 14-day period.
What happened?
I asked Dr. Gonzalo Moratorio, virologist at the Institut Pasteur de Montevideo and professor on the Faculty of Science at the Universidad de la República, to explain the shift. Moratorio was instrumental to Uruguay’s early successes in the pandemic, developing and distributing test kits that allowed the country to efficiently identify and isolate cases.
In this Q&A, which has been edited and condensed, he offers a look at the past, present, and future of the COVID-19 pandemic in Uruguay.
By Chloe Reichel
“No One Is Safe Until Everyone Is Safe” goes the rallying cry for global vaccine equity.
We would think that the COVID-19 pandemic already has made this point clear enough.
And yet, pundits are heralding the “end” of the pandemic in the U.S., all while viral variants that may be capable of evading the protection of vaccines continue to crop up both domestically and internationally.
In this Q&A, South African journalist and human rights activist Mark Heywood offers a look at the national COVID-19 epidemic in South Africa. The sobering reality there, in terms of morbidity and mortality, and in terms of expectations for the future, underscores the urgency for globally coordinated leadership and action to address the pandemic.
Our conversation from late March 2021, which has been edited and condensed, follows.
By Marissa Wagner Mery
COVID-19 has highlighted that pandemic preparedness and management requires a strong, well-functioning health system.
Shoring up the health system and its workforce should be a national priority post-pandemic. First and foremost, we must recognize that the greatest asset of the health system is its people, and the system must reflect this. Second, our hospital-based, competition-driven health care landscape should be reformed to better meet the needs of our communities.
By Tarika Srinivasan
On February 28th, 2020, after an hour of incessantly refreshing my email inbox, I received an acceptance letter to my dream medical school. That same day, a conference in the city I would soon call home became the superspreader nexus from which up to 300,000 COVID-19 infections have been traced.
The ensuing months, which were meant to be an exercise in pomp and circumstance, were marked by a steady stream of anxiety, frustration, and disappointment associated with virtual learning.
As first-year medical students, it is hard not to feel that we comprise the bottom rung of a long, rigid hierarchy. We are fully aware of the limited role we play in this pandemic; we lack the useful clinical skills of a final-year medical student or an employed resident. Our presence in the hospital is more of a liability than an asset.
We witnessed classes of fourth-years graduating early to serve on the front-lines of the spring first wave (though reception to this call of duty ranged from appreciation to apprehension). We imagined that in a few short years, we too might be deemed so “essential” that folks would be clamoring to have us serve on the wards.
But, despite our limited skills, we preclinical students decided we could not simply wait in the wings for our cue. Though we were dedicated to the didactic portion of our curriculum, we were itching to be involved in the action. Thus, we sought to expand the scope of what medical students could do during a pandemic.