“Everything we do before a pandemic will seem alarmist. Everything we do after will seem inadequate.” – Michael Leavitt Why are we writing this? The COVID-19 pandemic has reached a point where containment is no longer possible. The COVID-19 threat is real, and rapidly getting worse. Many of you are very nervous; some are unsure of the validity of the information you are reading. As physician leaders, we felt it was important to craft a resource you can rely on as being scientifically accurate and one which contains as much actionable information and guidance as possible. Accurate, actionable information during an epidemic can save lives. Physicians are on the front line of this epidemic. Not only are we treating the sick, but we are also cringing at the misinformation spread through both traditional broadcast and social media. Evidence matters. Unfortunately, (more…)

3D render of a medical background with abstract virus cells Some advice as an emergency physician, daughter, mother, and concerned citizen. Help keep older relatives and neighbors self-quarantined at home. Same goes for those of any age who are immune-compromised (cancer-patients, on immune-suppressant meds for autoimmune diseases, etc.) Pick up and deliver their groceries and prescriptions to their front-door for them. Health care workers (physicians, nurses, respiratory therapists, social workers, pharmacists, environmental services, EMS, etc.), law enforcement, and other public agency workers are essential personnel and need to go to work. College students home from school and older high school students can help by stepping up to provide childcare for these families. It is not a good idea to ask grandparents to provide childcare if at all possible. The young and healthy can do their part. Postpone all non-essential doctor’s (more…)

Sentences that start with the phrase “A guru once told me…” are, more often than not, eye-roll-inducing. But recently, while resting in malasana, or a deep squat, in an East London yoga class, I was struck by the second half of the instructor’s sentence: “A guru once told me that the problem with the West is they don’t squat.” This is plainly true. In much of the developed world, resting is synonymous with sitting. We sit in desk chairs, eat from dining chairs, commute seated in cars or on trains, and then come home to watch Netflix from comfy couches. With brief respites for walking from one chair to another, or short intervals for frenzied exercise, we spend our days mostly sitting. This devotion to placing our backsides in chairs makes us an outlier, both globally and historically. In the (more…)

American adults are in pain. A 2015 study from the National Institutes of Health showed that 25 million U.S. adults cope with chronic pain every day. While everyone’s suffering is different—there are as many sources of pain as people—for many, how you sleep plays a crucial role. Members of my own family are a part of this statistic: My grandma has purchased every pillow on the market to find one that supports her ever-aching neck, and my father relies on physical therapy exercises to keep his shoulder pain in check. I myself have tried purchasing a supportive mattress and pliable pillow, and I eat healthy and exercise regularly, but I still feel sore and stiff in the morning. According to the experts, it might be time to change my sleeping position. Advice for Side-Sleepers Most Americans sleep on their sides, (more…)

Creaking knees, stiff back, dodgy shoulders… Age is no friend to the human body. So how are veteran athletes like Roger Federer and Jo Pavey still at the top of their game? And what can you do to keep up? Slow down, that used to be the mantra for middle age. The dread half-century reached, fiftysomethings were expected to take up less challenging physical activities – if they were physical at all. A gentle stroll around the golf course, perhaps, rewarded with a gin and tonic at the 19th hole; or membership of the local bowling club, blazered crown green rather than 10-pin. Physical decline as the body aged was inevitable, something to be grumbled about, accepted and dealt with. That fundamental law has not changed, but the way we manage ageing has. Getting older need not mean getting weaker, (more…)

Data from the National Health and Nutrition Examination Survey In 2017–2018, the age-adjusted prevalence of obesity in adults was 42.4%, and there were no significant differences between men and women among all adults or by age group. The age-adjusted prevalence of severe obesity in adults was 9.2% and was higher in women than in men. Among adults, the prevalence of both obesity and severe obesity was highest in non-Hispanic black adults compared with other race and Hispanic-origin groups. The prevalence of severe obesity was highest among adults aged 40–59 compared with other age groups. From 1999–2000 through 2017–2018, the prevalence of both obesity and severe obesity increased among adults. Obesity is associated with serious health risks (1). Severe obesity further increases the risk of obesity-related complications, such as coronary heart disease and end-stage renal disease (2,3). From 1999–2000 through 2015–2016, (more…)

About 4 in 10 American adults are obese, and nearly 1 in 10 is severely so, government researchers said Thursday. The Centers for Disease Control and Prevention findings come from a 2017-18 health survey that measures height and weight. More than 5,000 U.S. adults took part. The survey found that the obesity rate was 42% — higher than the 40% found in a similar 2015-16 study. The severe obesity rate was more than 9% in the new survey, up from the 8% figure in the previous one. Those increases aren’t considered statistically significant: The survey numbers are small enough that there’s a mathematical chance the rates didn’t truly rise. But it’s clear that adult obesity rates are trending up, said the CDC’s Cynthia Ogden, one of the report’s authors. A half-century ago, about 1 in 100 American adults were severely (more…)

As availability of diagnostic testing for COVID-19 increases, clinicians will be able to access laboratory tests for diagnosing COVID-19 through clinical laboratories performing tests authorized by FDA under an Emergency Use Authorization (EUA). Clinicians will also be able to access laboratory testing through public health laboratories in their jurisdictions. This expands testing to a wider group of symptomatic patients. Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Decisions on which patients receive testing should be based on the local epidemiology of COVID-19, as well as the clinical course of illness. Most patients with confirmed COVID-19 have developed fever1 and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Clinicians are strongly encouraged to test for other causes of respiratory illness, including infections such as (more…)