Emergency Medicine

February 2, 2020

As coronavirus spreads, aggressive safeguards — not panic — should, too

A viral outbreak in central China — centered in its province of Hubei and its largest city of Wuhan — officially has burgeoned into a global health emergency.

The United States also has reacted to the pneumonia-like infection with its toughest warnings about travel to China and restrictions on Americans returning from it, as well as temporary bans on non-Americans entering this country after recent visits to areas around Hubei and especially Wuhan. Major U.S. airlines have canceled China flights and retail operations in China of global enterprises like Starbucks and Apple have shut down for now.

Global markets have been rattled by worries about the wider spread of the latest outbreak of coronavirus (see recent map from the Centers for Disease Control and Prevention)— an infection from a large family of illnesses that includes the common cold, as well as SARS (aka Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome).

January 30, 2020

They’re not just ‘headaches.’ Traumatic brain injuries are real. And serious.

by Patrick A. Malone

The nation’s commander-in-chief did a big disservice to recently injured service personnel and others who have suffered traumatic brain injuries by dismissing what happened as “not very serious” and just “headaches” of little consequence.

Pentagon officials sought to deflect attention from President Trump’s comments at a global economic forum in Davos, Switzerland — off-the-cuff remarks assailed by veteran groups.

Trump, asked about the rising number of service personnel who have been sent for advanced diagnosis and treatment at facilities outside the Mideast, where they were subjected to an Iranian missile attack, made this counter factual comment:

January 26, 2020

A cause for global concern: an exploding viral outbreak in central China

by Patrick A. Malone

The Year of the Rat has dawned in Asia in most inauspicious fashion, with public health officials grappling with an exploding viral outbreak centered in China.

Tens of millions of Chinese have been locked down in what officials are saying may be one of the largest health quarantines of its kinds, occurring during Asia’s major New Year holiday. Authorities in Beijing report dozens of deaths and hundreds of cases of what officials have called a novel coronavirus (officially, for now, the 2019-nCoV).

It has sickened or killed most of its victims in central China, in and around the city of Wuhan. The afflicted suffer a pneumonia-like illness, and medical scientists say that advances in genetics have allowed them to study the virus with unprecedented speed and accuracy.

December 20, 2019

Intoxicated drivers keep killing too many. New, targeted tactics may be needed.

by Patrick A. Malone

Politicians and police may need to step up their crackdown on drug- and alcohol-impaired drivers, targeting repeat offenders with substance-abuse and mental health problems who also are “disproportionately responsible for fatalities,” a leading traffic safety group recommends.

As the Wall Street Journal reported of new work by the Governors Highway Safety Association and its consultant Pam Fischer:

“Nearly 30% of all vehicular-crash deaths in the U.S. last year were alcohol-related … Last year, 10,511 people died in crashes involving at least one driver with a blood-alcohol concentration of at least .08%, the legal cutoff in every state except Utah, federal figures show. While that represented a 3.6% drop from 2017, alcohol-related fatality levels have largely stagnated for the past decade. ‘What we’re failing to do is get to the root cause of why they’re doing this, what’s behind the behavior,’ [said Fischer].”

December 13, 2019

How does science advance on brain injuries? One star’s grim diagnosis at a time.

by Patrick A. Malone

Clinicians drew in a postmortem conference a full portrait of patient K-0623, based on a detailed questionnaire and research they had conducted into his life. They learned all about the deceased’s happy childhood, his early high school graduation, and his athletic prowess, including his stardom in an elite collegiate football program.

The neurologists, neuropsychologists, and psychiatrists also learned that the subject, known to them for now only by a number, had taken painkillers at one point, so he could keep up an all-too-brief NFL career.

November 24, 2019

On vaping, gun violence, and health insurance, the big talk flows, but action, not so much

by Patrick A. Malone

When it comes to key health concerns of the American public, President Trump and his administration have offered evidence anew that whatever they say may not last to the next political moment, that inaction is its own powerful kind of action, and that what officials say they’re doing may be exactly the opposite.

This is not intended as partisan commentary. It reflects the turn of a few news cycles and how Trump and his officials have dealt with:

The outbreak of serious lung illnesses and deaths tied to vaping

November 19, 2019

Superbugs’ deadly rise has plunged planet into risky ‘post-antibiotic’ era

by Patrick A. Malone

Federal officials have put out some scary new findings about the state of patients’ health in the 21st century: Superbugs may be more common and potent than previously believed. And we may now have plummeted into what experts are calling the perilous “post-antibiotic age.”

This all amounts to far more than a hypothetical menace. It could affect you if you get, for instance, a urinary tract infection. Or if you undergo a surgery, say, for a joint replacement or a C-section. Depending where and how you live, you may see the significance of this health problem if you contract tuberculosis or some sexually transmitted diseases.

As the news website Vox reported of the startling new information from the federal Centers for Disease Control and Prevention: “Every 15 minutes, one person in the U.S. dies because of an infection that antibiotics can no longer treat effectively.”

November 12, 2019

New doubts cast on a key safety tool: police roadside alcohol-testing devices

by Patrick A. Malone

Although drunk drivers inflict terrible carnage on others traveling on the nation’s streets and highways, law enforcement agencies and skeevy device makers may be unwinding the trust in what has become a cornerstone of the nation’s safety regimes: roadside alcohol testing machines.

The New York Times reported that it “interviewed more than 100 lawyers, scientists, executives and police officers and reviewed tens of thousands of pages of court records, corporate filings, confidential emails and contracts” to discover “the depth of a nationwide problem that has attracted only sporadic attention.”

As the newspaper noted of roadside “breathalyzer” exams and devices used for them:

November 7, 2019

‘Any One of Us’ shows harsh realities and hope for spinal cord injury patients

by Patrick A. Malone

Extreme sports may be to blame. Or it might be a falling tree, an error with a surgery, or an auto wreck.

As the title of the tough, direct, and new HBO documentary makes clear, “Any One of Us” might suffer from a calamitous spinal cord injury (SCI). The 1-hour and 25-minute work by first-time director Fernando Villena focuses on pro mountain biker Paul Basagoitia but is carried by a “chorus” of 17 women and men who all have had significant injuries to their spinal cords.

November 3, 2019

Raging wildfires and major power shutoffs: Big tests in Calif. raise questions for the rest of us

by Patrick A. Malone

California’s raging wildfires may seem a far coast away, and this seasonal calamity attracts little attention among policy makers in official Washington. But the fires are sending sharp warnings that the rest of the nation might well heed.

The disasters have uprooted hundreds of thousands, destroyed dozens of homes and other buildings, and led to shutoffs of a basic service — electricity — to huge swaths of the nation’s most populous state. They also raise serious issues to anyone who is concerned about the:

fragility of the health care system, particularly the vulnerability of hospitals that the public will desperately need but may not be open in crises, despite the notable resilience that care givers and institutions now display;