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When COVID Pushes Other Conditions Past the ‘Tipping Point’

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Physicians are seeing a shift in the types of COVID patients they see as Omicron spreads at an unprecedented rate — and it’s not just more of them. Instead of treating patients with classic COVID pneumonia symptoms, they are treating more vaccinated patients with other conditions whose COVID infections have thrown them into more serious health crises.

“We have tons of people hospitalized with COVID, the same number as last winter, but very different patterns,” said Christopher Cannon, MD, a cardiologist at Brigham and Women’s Hospital and Harvard Medical School in Boston. “Among the vaccinated patients, it’s more the COVID tip kind of thing. It overturns the other conditions of the patients to worsen.”

Instead of primarily treating people with lung problems and ventilators, patients now have issues that have something to do with COVID and something to do with things like heart failure or heart disease, Cannon said. He is one of several doctors surveyed to theorize that fewer people with existing health conditions sought medical help during last winter’s COVID-19 peak – perhaps fearing they would catch the virus in hospital – and the Lack of supply is now catching up on you.

Cardiologist Biykem Bozkurt, MD, PhD, of Baylor College of Medicine in Houston, suggested that the combination of delayed but necessary care that has accumulated over the years, staff shortages and an increase in at-risk individuals dying due to deteriorate from Omicron, progressively adds high.

“It creates a perfect storm in the healthcare system,” Bozkurt said.

The situation illustrates a growing challenge in monitoring and communicating about the virus.

Lay people and clinicians have engaged in a “with” versus “for” debate, in which COVID-19 is made as the primary diagnosis versus COVID-19 as the secondary or tertiary diagnosis.

Cardiologist Jim Januzzi, MD, of Massachusetts General Hospital and Harvard Medical School, calls this a false dichotomy. There can be both the patient with just COVID and a patient with another problem who happens to test positive for COVID. But there’s a lot in between. Someone who comes to the hospital – “with COVID” and not “because of COVID” – may already be affected by the virus. It might have caused the problem they showed up with in the first place.

For example, if someone comes into the hospital with a broken hip and they end up testing positive for COVID, it doesn’t make sense to say they happened to have COVID. “If they hadn’t gotten the coronavirus infection, they wouldn’t have been weak, they wouldn’t have fallen and they wouldn’t have broken their hips,” he said. “And that’s the distraction that we, as doctors and nurses, orderlies and others who see these patients, really want people to stop getting confused about.”

But doctors say more research is needed to know what proportion of patients are hospitalized because COVID has complicated their primary diagnosis. And then there’s an entirely different possibility: that the virus itself causes heart disease, or any number of seemingly separate conditions.

“It will be impossible to decipher whether this is just because they were initially weak and then contracted a severe respiratory illness that threw them over the edge, or whether the coronavirus has a specific cardiotropic aspect,” Januzzi said.

“We have numerous discussions at the hospital management level on this chicken-and-egg issue,” Bozkurt said. But right now, it’s difficult for doctors to simply dismiss the role COVID is playing in patients with other health conditions, she said. “It’s going to take a little more refinement in science and research for us to be able to immediately say, ‘Well, you know, these people just happened to discover they have COVID,'” versus a COVID-worsened condition, or COVID as Main reason for admission.

Omicron has been characterized as milder by some research, but even with so many people vaccinated, a smaller fraction of a much larger infected cohort still needs hospitalizations more frequently than hospitals can bear. Meanwhile, the unvaccinated continue to exhibit severe pneumonia-like symptoms typically associated with COVID-19: shortness of breath, low blood oxygen and fever.

Januzzi said that until the Omicron wave subsides, arguing about how a patient’s condition is categorized is beside the point. “Ultimately, whether with COVID or for COVID, the message should be the same, which is to get vaccinated, wear masks and practice cautious behavior until this wave subsides.”

  • Sophie Putka is a corporate and investigative writer for MedPage Today. Her work has been published in The Wall Street Journal, Discover, Business Insider, Inverse, Cannabis Wire, and others. She joined MedPage Today in August 2021. follow

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Women’s Health

Editorial: Roe v. Wade could soon be history. What will you do in this moment? – Decaturish

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By State Sen. Elena Parent

A political earthquake struck the United States on Monday, May 2, 2022. Politico published a leaked draft Supreme Court opinion in Dobbs v. Jackson Women’s Health Organization that showed 5 conservative Supreme Court justices had voted to explicitly overturn Roe v. Calf.

For half a century, since Roe in 1973 (reaffirmed in 1992’s Planned Parenthood v. Casey), women across the country have had a constitutional right to end a pregnancy pre-viability. That will end if this draft opinion becomes official, devastating women’s reproductive rights in many states across the country, including Georgia. While not completely unexpected, the draft opinion is extreme in both its rhetoric and judicial philosophy. The impact will be seismic, and more than half of US women could lose their right to abortion or see it severely restricted.

The opinion, written by Justice Samuel Alito, rests on an originalist judicial philosophy: rights that are not explicitly mentioned in the Constitution nor deeply rooted in the country’s history and tradition are not worthy of constitutional protection. Taken at face value, this can logically be extrapolated to mean that no right based on the right to privacy given over the past 60-plus years is a right after all, and all should be returned to legislatures to decide. gay marriage? Interracial marriage? Right to use contraception? All in question.

For women’s health specifically, the decision could have ramifications for access to birth control, the morning-after pill, and medication abortions. The Georgia Senate passed a bill with restrictions on medication abortions this past session, which did not pass the House. I expect that this bill, and others more restrictive, will see a renewed push when we reconvene. Some states, like Louisiana and Tennessee, have already begun to criminalize abortion, which could put women who have had miscarriages, already facing stress and heartbreak, in jeopardy of being falsely charged. Women’s rights to control their bodies, their families, their careers, and their lives are at risk. This means that women’s equality is at risk. According to the Brennan Center, one of the leading indicators of the health of a democracy is the status of rights for women. I do not overstate the risk of this decision could have on not just women, but our entire democracy.

If this opinion is adopted, the impact on Georgia would be profound. Even though a majority of Georgians support the right to choose, the Republican-controlled General Assembly passed HB 481, also known as the ‘heartbeat bill’, in 2019. This banned all abortions after fetal cardiac activity is first detected, at approximately six weeks of pregnancy—prior to when many women know they are pregnant. This law was blocked by the courts, but a Supreme Court decision undermining federal protection for abortion would pave the way for its implementation. Republican candidates in Georgia have already promised to pass an outright ban on abortion, without exceptions. A majority male Legislature, Governor, and Supreme Court making these hypocritical decisions for women is infuriating.

Ironically, Georgia otherwise does a poor job elevating women and children. Georgia is number 1 in maternal mortality and ranked 38th on an index of child well-being by the Annie E. Casey Foundation, which looks at 16 categories from poverty to access to education. Implementation of HB 481 means that women will have to remain pregnant, but upon birth, the state will not be as concerned about the outcomes of this woman or her child.

But HB 481 is even more radical than that. It grants personhood to an unborn fetus, giving it rights equal to the woman carrying it. The “logic” here is to set the foundation for a complete and total ban on abortion. This opens a legal and ethical minefield that was not vetted during the consideration of the legislation and could lead to all kinds of restrictions on the lives and freedoms of pregnant women. The law requires that the father provide support for prenatal care, but there is no safe way to test for paternity that early in a pregnancy. What if women engage in risky behaviors? What actions could be taken and by whom? Could women be surveyed for their pregnancy? How will this effect fertility treatments like IVF? Will this limit a couple’s ability to fertilize more eggs than they wish to carry? Much of this will be decided when the lawsuits begin. The father of the fetus, and friends and family members of the pregnant woman, will also be under a microscope should something go wrong with a pregnancy.

If this decision is confirmed, what can we do? First and foremost, we must exercise our power and vote. 68% of Georgians oppose overturning Roe v. Wade according to a recent AJC poll. This upcoming midterm will be critical for women and all Georgians. We must elect pro-choice candidates like Senator Raphael Warnock. Stacey Abrams as Governor and Jen Jordan as Attorney General will have a significant influence on how these laws are implemented. We have the chance to flip legislative seats all over the state. We can advocate for pro-choice policies. This may be as simple as writing an email to State and Federal lawmakers, or as complex as organizing to wield the immense political and economic power held by pro-choice Americans. We can donate to organizations that are advocating and litigating these issues like Planned Parenthood or to organizations supporting access for poor women and women of color, who will be disproportionately impacted by this decision.

When the public so disproportionately favors abortion rights, the cause is not hopeless. Yes, abortion opponents have stacked the courts and gerrymandered the districts. But if the people rise up, these rights can be restored. What do you want to do at this moment?

State Senator Elena Parent was elected to the State Senate in 2014. She represents District 42, which includes portions of central and north DeKalb County

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Report calls out gaps in women’s heart disease research, care |

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American Heart Association News

Women continue to be underrepresented in research for heart disease, and extensive changes are needed in how women’s heart health is studied, taught and treated, a new report says.

The report, published Monday as a presidential advisory from the American Heart Association in its journal Circulation, seeks to address problems that range from the way basic science is conducted to how women receive care.

“We are losing ground on key indicators of cardiovascular health among women, including blood pressure control, weight management and diabetes,” advisory co-author Dr. Véronique L. Roger said in a news release. Roger is a senior investigator at the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health.

Some heart disease risk factors are specific to women, the advisory said. For example, risks are higher for women who start their menstrual cycle younger than 11 or enter menopause younger than age 40.

Women also face risks related to high blood pressure or diabetes during pregnancy, as well as from oral contraceptive use and hormone replacement therapy. Depression and anxiety are associated with heart disease more frequently and at younger ages in women than in men.

Women also are disproportionately affected by inflammatory and autoimmune disorders such as lupus, rheumatoid arthritis and scleroderma, which are associated with increased risk of heart inflammation, heart and valve disease and heart attacks. And women face heart risks related to treatment for breast, uterine or ovarian cancer.

Despite all that, women continue to be underrepresented in research, leading to gaps in knowledge and understanding of how heart disease affects women.

“Comparing data from women with data from men inherently positions data from men as the gold standard,” said Roger. “For example, the belief that women having a heart attack will present more often with atypical symptoms carries an undertone that women present in the ‘wrong way.'”

Using data specific to women could improve diagnosis and treatment for heart disease, the advisory said. But nearly 7 out of 10 post-graduate medical trainees reported little to no training regarding gender-based medical concepts. Only 22% of physicians and 42% of cardiologists said they felt prepared to adequately assess heart disease specific to women.

“We must urgently address the pervasive gaps in knowledge and health care delivery to reduce gender-based disparities and achieve equity,” said report co-author Dr. Nanette K. Wenger, emeritus professor of medicine in the division of cardiology at Emory University School of Medicine in Atlanta.

The advisory said that declining heart health among US women who are considering pregnancy, and less-than-optimal levels of heart health among pregnant women, was particularly worrisome. Heart problems may lead to pregnancy challenges for the mother and health risks or complications for her and her children.

Solving that will take cooperation from experts in several fields, Wenger said. “We recommend cardiologists, primary care physicians and obstetricians and gynecologists work together to quantify and reduce the risks of cardiovascular disease throughout a woman’s life.”

According to AHA statistics, heart disease is the leading cause of death for US men and women, and 44% of women age 20 years and older between 2015 and 2018 had some form of cardiovascular disease, including high blood pressure.

But awareness among women, which rose before 2009, is slipping. In 2019, only 44% of women understood that heart disease was women’s leading cause of death.

The advisory recommended several actions, such as:

‒ launching new, culturally sensitive heart health awareness campaigns that emphasize the benefits of prevention and education.

‒ conducting more research studies focused on women, especially women from diverse racial and ethnic backgrounds, and at younger ages.

‒ collecting and analyzing data to help deliver more effective health care.

Affordable health insurance coverage and out-of-pocket costs are the two most important factors affecting whether people get health care, the advisory said, noting that under the Patient Protection and Affordable Care Act, signed into law in 2010, women between the ages of 19 and 64 saw the largest coverage gain of any demographic group.

In recent years, Medicaid coverage expansion through the ACA has been shown to increase coverage and health care among low-income women of reproductive age.

“We need to help women develop a ‘lifetime approach’ to their health, where they are empowered to proactively manage their heart disease risk in every life stage,” said Wenger.

If you have questions or comments about this American Heart Association News story, please email editor@heart.org.

Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to American Heart Association News.

Other uses, including educational products or services sold for profit, must comply with the American Heart Association’s Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.

HEALTH CARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and experiencing a medical emergency, call 911 or call for emergency medical help immediately.

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Women’s Health

Photos: Aspen Democrats rally in support of women’s rights

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A woman wearing a “my body, my choice” sign listens to the speakers during a pro-women’s rights rally put on by the Pitkin County Democrats on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

The Pitkin County Democratic Party hosted a rally on Saturday afternoon at Aspen’s Paepcke Park in support of women’s reproductive rights. The event was in response to the leak of Supreme Court Justice Samuel Alito’s draft decision on Roe v. Wade, which could potentially take away a woman’s right to an abortion at the federal level.

The organization said the event was “in support of a woman’s constitutional right to make her own reproductive health decision without a Republican in her uterus.”

The speakers included the Pitkin County Democrats’ own Howard and Betty Wallach, as well as current Aspen City Councilwoman Rachel Richards. Numerous women also took to the stage to share their stories and feelings when the microphone was opened up to the audience.

Next on the schedule for the Pitkin County Democrats is a town hall session at the Aspen Public Library on Monday from 5 to 6 pm with Colorado State House of Representatives District 57 Democratic candidates Elizabeth Velasco and Cole Buerger. The two candidates are seeking to run against District 57 incumbent Perry Will, a Republican from New Castle.

The entire Roaring Fork Valley, including Aspen and Basalt, will be part of District 57 next year as part of recent redistricting.

Monday’s event is not a debate, and will largely be Howard Wallach asking questions to the two candidates.

Howard Wallach of the Pitkin County Democrats talks during a rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

Josie Brands, who was among a group of middle school students raising money for the Jackson Women’s Health Organization, at an abortion clinic in Mississippi, accepts a donation during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspen .
Austin Colbert/The Aspen Times

People gather to take a photo with their signs after a pro-women’s rights rally put on by the Pitkin County Democrats on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

Aspen city councilwoman Rachel Richards talks during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

People gather to listen to the speakers during a pro-women’s rights rally put on by the Pitkin County Democrats on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

Eleanor Carroll, right, and Josie Brands were among a group of local middle school students raising money for the Jackson Women’s Health Organization, at an abortion clinic in Mississippi, during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspens.
Austin Colbert/The Aspen Times

Betty Wallach of the Pitkin County Democrats talks during a rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

A sign for the Pitkin County Democrats was on display during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

Eleanor Carroll was among a group of middle school students raising money for the Jackson Women’s Health Organization, an abortion clinic in Mississippi, during a pro-women’s rights rally on Saturday, May 14, 2022, at Paepcke Park in Aspen.
Austin Colbert/The Aspen Times

acolbert@aspentimes.com

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