I love helping people understand issues and look at them from a different perspective. In this blog, I hope I can offer you some new insights—bridging the gap between basic science and your medicine chest—as I am still a practicing physician, as well as having had broad clinical research experience. I'm interested in developing new medicines and treatments, as well as caring for patients—and explaining these topics for you.
As medicine has evolved, so have my interests. I have also become increasingly interested in health disparities, social justice issues, and ethics. I invite you to join me as we explore a variety of territories. I hope that reading these posts will encourage you to learn, engage, and above all, work for the forces of good.
If there are topics you'd like to see me cover, please let me know—I welcome your input as to what you would like us to discuss in this column.
Coronavirus - COVID19
Please note that I will be posting Coronavirus Tidbits of news here. You can sign up for updates by clicking the box at the right and subscribe to Covid, Politics, and Science. All Covid posts will go here, and I will upload back issues as I have time. Please share w friends. Thanks!
I’m going to have a reference file here for articles I have found particularly worthwhile, and will update this here as we learn new information. Click on the COVID-19 Resources, below, to expand that.
If you see something terrific, please share. We’re all in this together.
Updated today’s post on loss of smell: UK ENTs now say if you develop that symptom, you should self-isolate. First US immigration agency employees test positive for coronavirus A staff member at the Elizabeth, New Jersey, facility and one other at an undisclosed location has been confirmed https://www.theguardian.com/world/2020/mar/19/coronavirus-us-immigration-detention-center Op-Ed: Asian countries that have been successful in containing the virus without locking down society, such as Hong Kong, Singapore, and Taiwan, routinely use masks. As of March 17, the three countries together had fewer than 1,000 cases of the coronavirus — despite having close connections to China’s Hubei province, So what needs to be done here in the United States? Cover your face. Nonmedical masks should be worn by everyone going outside. Inexpensive cloth masks are available for purchase online. Alternatively, scarves, bandana-style neck gaiters, and other similar face coverings can work effectively. Masks should be placed over the mouth and nose and removed carefully, without touching the outside surface, and cloth masks should be washed frequently. https://www.bostonglobe.com/2020/03/19/opinion/guidance-against-wearing-masks-coronavirus-is-wrong-you-should-cover-your-face/?p1=Article_Feed_ContentQuery Diagnostics: New rapid test, but not yet validated by FDA http://outbreaknewstoday.com/coronavirus-testing-georgia-researchers-develop-2-hour-test-11076/ Drugs: Small study, not randomized, but combination of #hydroxychloroquine + #azithromycin was more effective at clearing #SARSCoV2 than hydroxychloroquine alone https://www.mediterranee-infection.com/wp-content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf Epidemiology/Infection control: What have other countries done successfully? Singapore,…Read More
My new post @Forbes: An Unexpected Loss Of Smell And Taste In Coronavirus Patients https://www.forbes.com/sites/judystone/2020/03/20/theres-an-unexpected-loss-of-smell-and-taste-in-coronavirus-patients/#4a59103f5101 Epidemiology: From Stanford ER: Of the 562 patients, 127 (22.6%) were positive for other viruses. (24.5% if we use 181+336 = 517 as denominator). Of the 49 positive SARS-COV-2 results, 11 (22.4%) also had a co-infection. Of the 127 positive for other viruses, 11 (8.66%) had a SARS-COV-2 co-infection. These co-infection rate are much higher than previously reported rates. Good explainer on incubation and infectious periods by Ian Mackay, Australian virologist https://virologydownunder.com/politically-infectious-period/ Coronavirus is running so rampant in Colorado’s mountains residents, visitors should “minimize all contact with other people” https://coloradosun.com/2020/03/15/coronavirus-colorado-mountains/ Our health department reports no cases…but refuses to say how many have been tested. https://www.times-news.com/coronavirus/health-department-no-confirmed-covid–cases-in-allegany-county/article_8da0f816-69e0-11ea-8403-ef41c28159a6.html Health care workers: In Italy 9% of all infections are among medical personnel. In Lombardy alone, 20% of providers were infected. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30627-9/fulltext For medical staff: As a MICU pharmacist taking care of COVID patients, one strategy I’ve implemented to minimize the number of times a nurse needs to enter the room (thus saving PPE) is to consolidate and bundle all medication due times. For example… 1/5 Most patients often receive medications no more than QID or every 6 hours (now…Read More
For the past couple of weeks, I’ve been sending out almost daily news “tidbits” to friends and colleagues. I have been asked to share more broadly, so will post here as well. I will post back issues as I have time. This will enable you to share more readily with friends or on social media, if you find the news and tips helpful. Basically, I obsess and read about this all day so you don’t have to, and send you information from sources I feel are most reliable. I am trying to figure out a way to tag individual topics. In the meantime, apparently best to Enter site: www.drjudystone.com/politics-science-and-other-assorted-musings/ and then your specific search term into the search box.* Good news: Smart move: Medicare to cover virtual doctor visits CMS is urging states to expand telehealth services for low-income people in their Medicaid programs. Problem is that many states, esp in the south, refused to expand Medicaid, so a lot of people—the working poor—still won’t be covered. Testing: Ontario’s Public Health Lab at @PublicHealthON has tested more people for Coronavirus than the *entire* US lab system. Epidemiology: Bad news: We are not talking about 2 months and back to normal….Read More
Earlier in September, Reps. Eshoo and Adam Schiff had an op-ed in the Washington Post, “Opinion | China’s grip on pharmaceutical drugs is a national security issue.” I couldn’t have agreed more. I wrote a letter to the editor, “How a trade war could turn deadly,” published September 19. It was based on my detailed article below, which first appeared in Forbes, last spring: Do you know where your medicines are made? Have you been switched between different generic forms of your medicine, only to find that you responded differently? Ma’s pills in a ginger jar. – Judy Stone Two recent books have echoed my longstanding concern about America’s dependence on other countries for basic needs and the security of our supply chain for medicines. My concern has heightened with the news this week of a tightening trade war with China and saber rattling about Iran. Many of the key ingredients for antibiotics are produced only in China. These are called APIs, or Active pharmaceutical ingredients. Medicine and supply shortages As an infectious disease physician, I was regularly hampered by drug shortages. A global shortage of piperacillin-tazobactam, a critically important antibiotic, occurred because of an explosion at a Chinese factory which was the sole source…Read More
This post first appeared in Forbes last year. While we are thinking of fall and that we can relax our guard, this is your friendly reminder that ticks are still quite active–and will be any time there is not a freeze. It’s time to worry and ramp up your protective moves; tick season is getting more active. I can’t say it is just starting, as we found ticks on us and the dog in both January and February, most unexpectedly when we had unseasonably warm days. Any time it is above freezing is a risk, but April–September is prime time for the buggers. There are many different types of ticks, but the one we need to be most careful to avoid is the black-legged or deer tick, Ixodes scapularis (or Ixodes pacificus on the West Coast) because it transmits Lyme disease, often difficult to diagnose and treat, and a number of other infections. Deer ticks are most commonly confused with dog ticks, according to Dr. Tom Mather, director of the University of Rhode Island’s Center for Vector-Borne Disease and its TickEncounter Resource Center. Deer ticks and dog ticks are two of the three species most frequently submitted to TickEncounter. The distinction is important, as dog…Read More
Is nothing safe anymore? Just in time for summer fun, the CDC announced an increase in infections from swimming pools and hot tubs. In their new Morbidity and Mortality Weekly Report (MMWR), the CDC announced that cases of a parasite, cryptosporidium, had increased approximately 13 percent each year between 2009–2017, with 444 outbreaks reported in total. Cryptosporidium is a single-celled organism, a protozoan. It causes diarrhea that often lasts for two to three weeks and is readily missed by the lab. This is because often only a stool culture is ordered, and the parasites are instead seen on direct examination of stool through a microscope. Many community hospitals don’t have techs skilled in this and have resorted to sending stool samples “for ova and parasites” to a reference lab, causing further diagnostic delays. Cryptosporidium is now the leading cause of water-borne outbreaks in the U.S. This parasite made a grand debut in 1993, sickening more than 400,000 people in Milwaukee, Wisconsin—a quarter of the city’s population—and killing sixty-nine, mostly immunocompromised hosts. As a result, many places now filter their water to remove the organism prior to chemical treatment. More recently, Cryptosporidium has been associated mostly with water parks and swimming pools. This is…Read More
Being summer–and a wet one at that–it seems appropriate time to repost this favorite from Forbes: Many Americans surveyed in June on how to protect themselves from mosquito-borne diseases like Zika, dengue and Chikungunya are ill-prepared. The June survey by Spectrum Brands Holdings showed that respondents were extremely overconfident about their knowledge. While almost a quarter of participants could not name even one effective active ingredient in insect repellents, 82% incorrectly believed that specific products were effective. Knowledge of insect repellents As explained in yesterday’s post about the survey results, many participants lacked even basic knowledge about what repellents are effective, although they were confident in their knowledge. Almost all were unfamiliar with some effective insect repellent ingredients, especially picaridin and IR3535, although most recognized DEET. More troubling is that “natural” ingredients, such as citronella, were believed to be effective by 73% of respondents, although they are not. Why the confusion? The topic is not easy to understand and, more importantly, marketing seems very misleading. Here’s what you need to know. What insect repellents are the most effective? Mosquitoes are attracted to people by the scent of several chemicals we produce: lactic acid and 1-octen-3-ol, two skin compounds produced by our…Read More
It’s tick season again, so I’m sharing this article that first appeared in Forbes in 2015 as a reminder of what to look for. Unfortunately, little has improved in our ability to diagnose Lyme since then. My best advice is to treat your clothes and shoes with Permethrin regularly and to do tick checks several times per day after being outside. The tiny ticks are easy to overlook. I didn’t see the tiny danger lurking in my own yard. Yet for Lyme disease awareness month, just ended, it seems I am learning experientially. I’ve had Lyme at least once before, and found three attached deer ticks on me just in 10 days. I may have had Lyme a second time, last year, but diagnostic tests are so poor that we don’t know. Here’s some of what I learned from my experience and for caring for others in my infectious disease practice. Lyme is increasing I was in disbelief the first time I had Lyme. We hadn’t had problems with it in western Maryland though it was a problem downstate. I didn’t realize that between 1992 and 2010, the number of reported Lyme cases doubled, to about 23,000. In Maine, where I…Read More