Career-college CEO says to take a look at health care careers

By Bruce Kepley

In the mid-1990s, I started and ran a business that trained workforces on specific computer software. Large companies would hire us to come in and train their entire workforce to use the new tools the company had purchased.

It was interesting work and we were good at it, but a small segment of our business was even more interesting to me. Our industry called them “career-changers.”

These were individuals who wanted to do more than just learn a specific piece of software that they would use at their existing job. They wanted to retool their career for a newly emerging, more tech-savvy economy. The students wanted to become software developers or engineers.

Each of those students had a different personal story, but they were united in realizing that economic shifts represent opportunity for those who are willing to keep learning.

Along the way, I’ve shifted too. I moved away from workforce training, to career-oriented colleges. And I’m now the majority owner of MedQuest College, which is focused on health-career related occupations. But the students we work with today have much in common with those students I met 30 years ago.

The economic tides have shifted several times since the mid-90s. The dot.com bubble came and went. The terrorist attacks of 9/11 caused huge shifts in our national priorities and interests. Then, in 2008 we saw the beginning of the Great Recession.

What I saw each time was greater interest in education and higher enrollment at colleges like MedQuest. According to the U.S. census, enrollment jumped 29 percent at two-year colleges during the Great Recession.

Our current economic downturn is unlike anything any of us have experienced. The future is filled with many uncertainties. Unemployment has skyrocketed — and it’s hard to know how quickly those jobs can come back.

But this month, MedQuest and other colleges — proprietary, private and public — will be starting new classes. Those classes will be filled with students who see education as a path into a brighter future. At MedQuest in particular, the students tell us that by preparing for a career in health care they are choosing to be part of the solution in a time of uncertainty.

When responsible colleges see sudden growth in interest or enrollment, they worry about outcomes — will all these new students be both dedicated to finish and will there be jobs waiting for them when they are done? But my experience in previous downturns makes me confident that, in fact, education is part of the way we pull ourselves out of economic slumps.

For the high-school seniors who graduated this month, for the people who are watching health-care heroes and wondering how they can become a part of that critical industry, and for those who have suddenly experienced reduced hours, furloughs or layoffs, I recommend that you take a moment to explore higher education options. Whether you’re adding a new skill or credential, or revamping your career entirely, this may be the best time to act. That’s a way all of us can help build a better economy.

Bruce Kepley is CEO of MedQuest College in Louisville. This first appeared in the Courier Journal.

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Easing stress and seeking normalcy in traumatic times

For most Americans, 2020 has already been a rough year — and it’s not even half over. A pandemic, natural disasters, economic decline, and, for many, the loss of a job have taken a toll on their mental health.

“Stress is particularly acute when you’re experiencing a situation that is outside of your control,” says Dr. Kerry Ressler, professor of psychiatry at Harvard Medical School. “You may feel stuck, frozen, or helpless.” After a traumatic period, even when things settle down, it can be difficult to move on and regain a sense of normalcy.

Reducing stress and regaining your footing

So, how can you reduce your stress and regain your footing after going through a bad time, whether that’s the result of a large-scale national emergency or even just a personal patch of bad luck?

Step back. When traumatic events are occurring, whether it’s a natural disaster, pandemic, or mass shooting, you need to stay abreast of the news, but at the same time avoid retraumatizing yourself by becoming immersed in round-the-clock coverage, says Dr. Ressler. Limit the time you spend in front of screens or reading about the events of the day. The goal is to stay informed without increasing your anxiety level. Turn off the notifications on your phone, and be particularly wary of spending too much time on social media. “People have the tendency to amplify each other’s panic,” says Dr. Ressler. “Instead, limit your exposure to checking in on the news a couple of times a day, and then turn it off. Listen to an unrelated podcast, or go for a run.”

Take action. “What we do know from research is that one of the biggest precipitators of anxiety is a feeling of helplessness, when everything seems out of your control,” says Dr. Ressler. To take back some control, get involved in activities that can help others or address the situation. Volunteer, or help with food drives. Even helping a friend or a neighbor with a problem can make you feel like you are in an active, not passive, role in the face of uncertainty. Taking on a hobby or self-improvement project can also help you move forward. If you lose your job, use some of the unexpected time to take a class or learn a new skill you’ve always wanted to master. For example, there are a lot of great apps you can use to learn a new language.

Reach out. Social connections are crucial in difficult situations. If you can’t see people in person, then connect with apps and technology, such as videoconferencing or even a simple phone call.

Get rose-colored glasses. While advice to look on the bright side in the face of hard times may seem trite and unhelpful, don’t scoff. Evidence shows that positive thinking and having the ability to reframe a situation in more positive terms can help people become more resilient in the face of problems, says Dr. Ressler. Look for silver linings whenever you can. A job loss, for example, may lead to new opportunities.

Be patient. Moving on from a traumatic event takes time. Give yourself permission to grieve. Grief doesn’t just occur when you experience a death; rather, people experience grief in many situations, says Dr. Ressler. This may include the loss of an opportunity or missing out on something you were looking forward to doing. Allow yourself time to grieve, but eventually try to ready yourself to move past it. “You can get into the habit of grief,” says Dr. Ressler. So, set small goals. Use behavioral rewards, and strategies such as deep breathing, mindfulness, aromatherapy, and physical activity to reduce your anxiety and start pushing yourself to move forward.

Seek help for depression

Get help. Make sure that sadness and stress don’t cross over into depression. “The symptoms of depression overlap with normal symptoms of stress and grief,” says Dr. Ressler. But if you start to experience significant alterations in appetite, energy, or motivation, or if you begin to get sad or tearful without knowing why — and these symptoms last for more than a week or two — these may be warning signs that you are experiencing depression and need to seek medical help.

“If you have a period of sadness that goes on for more than a couple of weeks and it’s really getting in the way of you moving on or functioning at work or home, it may be wise to reach out,” says Dr. Ressler.

Call your doctor, or healthcare plan, to learn about options. Additionally, in the US, the Disaster Distress Helpline (800-985-5990, or text “TalkWithUs” to 66746) offers emotional support and resources to people struggling in the wake of disaster, and the National Suicide Prevention Hotline (800-273-8255) offers free support for people who are in emotional distress or a suicidal crisis.

The post Easing stress and seeking normalcy in traumatic times appeared first on Harvard Health Blog.

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Federal appeals court upholds ruling against 2018 Kentucky law banning abortion procedure used in second trimester

https://www.kentucky.com/news/politics-government/article243212861.html

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Beshear says more time needed to detect a 'new bump' in virus cases; says Supreme Court upholds his orders on gatherings

Kentucky Health News chart shows upward two-week trendline slightly lowered by latest report. 

As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

As he announced 155 more cases of the novel coronavirus in Kentucky, Gov. Andy Beshear said he still wants more time to analyze the upward trend of recent days.

"It's going to take five, six, seven days to try to truly see if this was perhaps related to our testing in long-term care [where] we are seeing an escalation of cases," he said at his daily briefing. "We want to try to make reasonable determinations based on data and we simply don't have enough right now to suggest that there is a new bump right now."

Beshear said a week ago that the state had begun the long-forecast decline from a plateau of several weeks, but high numbers at the end of the week reversed the two-week trendline, a key metric for any epidemic. Tuesday's number of 155 cases was much lower than those on three of the last four days, which had 214 or more cases. But the two-week trend remained decidedly upward.

"I still believe that if we are not plateaued, we are decreasing, but the data is going to bear that out," Beshear said. "We are going to have to watch and see."

The governor did not give an update on long-term care facilities Tuesday, but the latest long-term care facility report, dated May 31, showed that 1,358 residents and 621 employees had tested positive for the virus in 124 facilities, and 250 residents and two employees had died from it.

Beshear reported an adjusted total of 10,185 cases of the virus in Kentucky, at least 3,275 of whom have recovered. He said 481 people are hospitalized with covid-19, including 85 in intensive care. The counties with the highest number of new cases Tuesday were Jefferson, 46; Franklin, 17; and Fayette and Warren, each with 10.

He said 253,585 tests for the virus have been done in Kentucky, bringing it into the top half of states. As he has reopened the state's economy, Beshear has encouraged Kentuckians to consider getting tested monthly, and more often if they have lots of contacts, to track the spread of the virus. "It helps us to restore our economy safely," he said.

Beshear also announced that have been three more deaths from covid-19, bringing the state's death toll to 442. The fatalities were a 69-year-old woman from Clay County, a 94-year-old man from Jefferson County and a 92-year-old man from Muhlenberg County.

“Let’s keep lighting our homes up green” in honor of the dead, Beshear said. “Let’s continue to ring our bells at 10 a.m. Let’s do it for those that we’ve lost from this and from senseless violence. Everybody that we’ve lost that should still be here deserves that same level of compassion.”

The first part of Beshear's briefing was spent on an update of the protests against police violence that have been going on in Louisville and across the state. He reiterated that black Kentuckians continue to be disproportionately affected by the virus, at a rate more than double their share of the state's population.

"Before what we are seeing in Louisville and around the country, this again was showing what inequality results in, which is death," he said. "We were seeing that because of inequalities that have lasted hundreds of years and absolutely exist in our health-care system. . . . This is not OK and we're going to do something about it."

Beshear said he would announce later this week an initial plan to address inequalities in health care, which will intend to "actually make change in the health of individuals."

“Just like in many ways it shouldn’t have had to take some terrible incidents around our country to wake people up or to get them to listen to the type of injustices that are occurring in our society, it shouldn’t take a one-in-every-100-year pandemic for us to see the same in health care," he said.

Beshear again cautioned protesters that the virus is still spreading, and asked them to do their best to be safe by wearing a mask, social distancing, and staying away from seniors and others vulnerable to the disease.

Switching to the courts and politics, Beshear noted that last Friday, the Supreme Court issued an order upholding the California governor's orders limiting mass gatherings in houses of worship, orders similar to those issued by Beshear and other governors. The vote was 5-4, with Chief Justice John Roberts joining the court's four liberals.

A Beshear news release noted that Roberts said state officials have broad latitude to protect public health. Roberts wrote, “Where those broad limits are not exceeded, they should not be subject to second-guessing by an ‘unelected federal judiciary,’ which lacks the background, competence, and expertise to assess public health and is not accountable to the people.”

Beshear said the ruling should resolve all current federal-court challenges to his emergency orders.

For additional information, including an up-to-date list of cases and deaths, as well as breakdowns of the virus by county, race and ethnicity, click here.

More covid-19 news for Tuesday: 

• MedPage Editor in Chief Dr. Martin Makary of Johns Hopkins University talks about what the second wave of infections could look like, what vaccines and treatments in the pipeline are most exciting to him, and the value of wearing a mask, noting that the risk of airborne transmission is far greater than from the transmission of the virus through surfaces. "We're increasingly learning the value of wearing masks in a situation like this," he writes, "and I think it's powerful."
• White House coronavirus response coordinator Deborah Birx said the U.S. should not expect the coronavirus outbreak to wane over the summer, Politico reports.. "None of us can be lulled into this false sense of security that the cases may go down this summer," Birx said in a discussion with the German Marshall Fund president during the organization's Brussels Forum webcast. She added that American leaders are preparing actively for the possibility of finding and containing future outbreaks through contact tracing and proactive surveillance.
• About seven in 10 Americans say they would get a vaccine to protect against the coronavirus if it was free and available to everyone, according to a Washington Post-ABC News poll. This number was higher among Democrats than Republicans, 81% and 58% respectively, the Post reports.
• The University of Kentucky's College of Public Health and Gatton College of Business and Economics will hold a free webinar from noon to 1 p.m. June 3 to discuss research demonstrating that strong social-distancing measures imposed at the onset of the pandemic were effective in slowing disease transmission, thereby saving lives. Click here for more details.
• The Lexington Herald-Leader offers tips on how to stay safe at yard sales in the pandemic. Experts also tell the Herald-Leader in a separate article that playgrounds are not safe and can lead to the spread of the disease. 
• A Lexington pharmaceutical company is developing a nasal spray to treat covid-19, Alex Acquisto reports for the Herald-Leader. The spray would be used on patients who've been diagnosed with the virus, but who "have not yet exhibited symptoms severe enough to require hospitalization," says the press release. 
• The pandemic has resulted in the closing of more than 100 day centers for elderly adults and adults with disabilities in Kentucky, leaving about 9.500 individuals "suddenly cut off from the daily meals, health services, therapy and social activites they and their caregivers rely on," Deborah Yetter reports for the Louisville Courier Journal. 

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Writer worries about spread of virus in Central Ky. restaurants

By Randy Patrick

I'm worried that almost none of the restaurants in Clark and Jessamine counties are following the guidelines for safe reopening of their dining rooms.

I just went to one of my favorite places for carryout, and there must have been 10-15 people crowded into a small space, many at a lunch counter not more than six inches apart (rather than the six feet required). None of the tables were closed off. There was a big jug of sanitizer on the counter, but no dispenser. You would have to handle it and unscrew the cap to use it. The condiment bottles and salt shakers were sitting out on the counter so everyone could handle them. And I was the only one wearing a mask. The cook wasn't. The server wasn't. Not one of the customers were. And none of the workers were wearing gloves.

This was the worst I've seen, but it's been almost as bad at other places. Is no one enforcing the public safety rules? I like to local, independent businesses, but they've been the worst. At least the big chains seem to make a bit more of an effort. Two that seem to be doing it right are Starbucks and Jimmy John's. But for the mom-and-pop places, it's like "the deadly virus is over because the governor has allowed us to reopen." It isn't.

We just passed the 100,000 dead mark in this country. Think about that -- 10,000 people a week in only about 10 weeks, or nearly twice as many as died in 10 years of the Vietnam war. I don't want to sound like an alarmist, but people, this is a crisis. If you can't do this right, the government is going to have to shut it all down again, and the gains we made in March and April through social distancing and business closures will have been for nothing.

I know people who have had this disease. I know people with relatives who have had it. Here in Clark County, the numbers have more than doubled in the past few days. Epidemiologists say it hasn't even come to rural America yet, but it's coming.

Randy Patrick is a reporter for the Winchester Sun. He posted this on his personal Facebook page. He posted the first comment: "I'll have to say, as much as I like the food at the place I got lunch at today and the guy who owns it, I won't be going back. He may not take this seriously, but I do."

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60 Minutes promotes one hospital’s “promise of plasma”

I’m a bit late on this with only a few excuses.  The birth of a new grandson.  Computer problems.  Living in the Minneapolis area and being focused on the death of George Floyd and the ensuing protests.

But this is worth addressing, even though a little late.

CBS 60 Minutes broadcast a story it called, “The Promise of Plasma,” about a trial of convalescent plasma at just one medical center in New Jersey.

You’re going to hear a lot about convalescent plasma because the approach makes intuitive sense.  But science needs to prove that things work. Intuition is not sufficient.  And the 60 Minutes story did a pretty weak job of establishing the difference. (The Mayo Clinic explains convalescent plasma on its website.)

Here are some of the things that could have been improved in the 60 Minutes story.

• There are many clinical trials of convalescent plasma all over the US and all over the world.  CBS referred to tests at “numerous hospitals” – which is a bit of an understatement.  And the only one mentioned, the only one profiled by CBS, was one in New Jersey, which CBS notes is “just a 30-minute drive from midtown Manhattan,” where 60 Minutes is based.  Perhaps that’s why CBS chose to shine its light only on one hospital.
• The tone of the piece was highly promotional.  It referred to the hospital’s “breakneck battle” and “all out battle.” The segment’s title – “The promise of plasma” – is alluring alliteration. But “promising” was one of the words patients have told me they don’t need to hear in medical news stories.
• The only data – the only evidence – provided by 60 Minutes was what this one hospital told them:  “So far, 31 of the 46 patients who received plasma in this study appear to have recovered more quickly than those who didn’t.”  There are many holes in that statement and many questions left unanswered by CBS.  And no data from all of the other clinical trials around the globe were presented.
• There was also no independent perspective in the story.  All of the input came from one hospital and one research team.  Nothing from anyone at any of the other clinical trial sites, no comment from the National Institutes of Health or the Food and Drug Administration. It was wonderful PR for the New Jersey hospital.  It was not the best journalism for 60 Minutes viewers.
• Often it is what journalists allow interviewees to say – unchallenged – that is most concerning.  That happened with this 60 Minutes story.

CBS quoted a researcher who is helping to lead the New Jersey hospital’s convalescent plasma trial.  This is how the story ended.

CBS’ Bill Whitaker: Based on what you have seen so far, what does your gut tell you?

David Perlin, researcher: My gut says that this is going to work. The initial response of the patients is incredibly encouraging. But as a scientist, I’m trained to be cautious. And so right now this is our best approach, we are going to take it, we’ll be aggressive with it but we’ll see how patients respond.

Benjamin Mazer, MD, a physician who is very active on social media, tweeted:

If you’re a doctor who goes on TV to say that convalescent plasma for COVID19 still needs more evidence but you’ve seen great outcomes in the patients you gave it to…you know exactly what you’re doing.

The public is going to hear “this probably works.”

— Benjamin Mazer (@BenMazer) June 1, 2020

Another physician joined Mazer with pointed skepticism:

When the expected recovery rate is 98% no one can confidently say they “see” a difference. pic.twitter.com/ru1P1fp4YQ

— Mark Hoofnagle (@MarkHoofnagle) June 1, 2020

So, even though researcher Perlin made an attempt to remind himself to be cautious, he went ahead and called the experiment “our best approach.”  Well you can’t say that it’s the best approach because you don’t know that. That is why you’re doing the trial.  And CBS should have addressed that.  They didn’t, and that’s the take home message they ended with.

An RN/paramedic on Twitter reflected on the impact of stories like this on viewers:

We have criticized 60 Minutes in the past.  Just two examples:

60 Minutes piece on Kanzius cancer cure not worth 60 seconds

CBS proclaims ‘cancer breakthrough’ – doesn’t explain what FDA means by that term

As always, when we criticize, we try to do so constructively, pointing to ways in which a story could have been improved – often with little effort. We hope 60 Minutes pays attention.

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214 new covid-19 cases reported Monday, keeping trendline up; protests spread virus; experts say key is 80% wearing masks

Kentucky Health News chart shows two-week trendline about where it was on Saturday: up.

As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

Coronavirus cases showed a big drop on Sunday, but jumped again on Monday to a number similar to the elevated numbers seen near the end of last week. Prior to the elevation in numbers late last week, the state had seen a downward trend for almost two weeks. 

“Kentucky has had 131 new positive cases with zero new deaths on Sunday and 214 new cases with eight new deaths on Monday,” Health Commissioner Steven Stack said in a news release. “We continue our efforts to expand testing, ramp up contact tracing and urge the public to practice social distancing and wear cloth face coverings to reduce the spread of covid-19.”

After almost two weeks with no day higher than 166 new cases, Kentucky's numbers jumped to 283 last Friday and 247 on Saturday. Gov. Andy Beshear said Saturday that those numbers were driven by increased testing in long-term care facilities, but no explanation was given for today's increase.

The counties with the highest number of new coronavirus cases on Sunday were Jefferson, 27; Kenton, 17; Fayette, 16; and three counties with 14, including Boone, Oldham and Warren.

Monday, the most new cases were in Jefferson, 54; Fayette, 30; Allen, 21; Warren, 19; and Boone and Shelby, both with nine.

The state has reported 10,046 cases of the novel coronavirus, with 457 people currently hospitalized with covid-19, including 90 in intensive care. At least 3,232 have recovered. The number of reported deaths stands at 439.

The deaths include an 84-year-old woman from Campbell County; an 82-year-old woman from Gallatin County; a 98-year-old woman from Grayson County; three Jefferson County men, aged 33, 53 and 75; a 90-year-old woman from Kenton County; and an 88-year-old man from Logan County.

Beshear did not hold his daily news conference today, having already held one to address the weekend protest against police violence in Louisville that resulted in a death.

At the end of that briefing, Beshear asked protesters to wear masks, practice social distancing if possible, and avoid contact with seniors and those with underlying health conditions.

The state provides additional information, including up-to-date lists of positive cases and deaths, as well as breakdowns of coronavirus infections by county, race and ethnicity: for Sunday’s information, click here; for Monday’s information, click here.  The daily nursing home report was last updated Saturday, May 30.

Other covid-19 news Monday: 

• Public-health officials say that protests could lead to a surge of coronavirus cases, Route Fifty reports. “There’s going to be a lot of issues coming out of what’s happened in the last week, but one of them is going to be that chains of transmission will have become lit from these gatherings,” former Food and Drug Administration commissioner Scott Gottlieb said Sunday on CBS's "Face the Nation."
• Dr. Kevin Kavanagh of Somerset, founder of HealthWatchUSA, a group focused on preventing infection in health care, writes in Infection Control Today about why the public should wear masks during the pandemic, reporting that "new modeling is reported to show that if over 80% of the public wears a mask, the epidemic will markedly decrease." 
• The University of Louisville Trager Institute offers a weekly online covid-19 information session. The next one is 10 to 11 a.m. EST Tuesday, June 2, with the topic "Restaurants are Up for the Reopening Challenge." Click here for the Zoom link and here for more information. 
• Fewer Americans are concerned about necessary medical trips exposing them to the virus, according to a Gallup poll taken May 14-24. The poll found that 64 percent of U.S. adults are very concerned or moderately concerned about exposure to the virus at a doctor's office or a hospital. This is a 20-point drop from the March 28-April 6 poll. It also found that the number of U.S. adults who are not concerned about medical trips has more than doubled, from 16% to 37%. The poll found that men are less concerned than women (55% and 70%), and Republicans are much less concerned than Democrats (58% and 19%). 
• An epidemiologist and evolutionary biologist at the University of Chicago, Sarah Cobey, tells reporters at The Washington Post, "The virus is here to stay. The question is, how do we live with it safely?" William Wan and Carolyn Y. Johnson write, "Even after a vaccine is discovered, and deployed, the coronavirus will likely remain for decades to come," like measles, HIV and chickenpox. They write that combating the virus will require long-range thinking, as well as "time, money and, most of all, political will." 
• According to a Washington Post-ABC News poll, nearly six in 10 Americans say the pandemic has had a severe economic toll on their communities, and 57% of them say trying to control the spread of the virus is more important than restarting the economy (favored by 37%). By party, 81% of Democrats say controlling the virus is more important than restarting the economy, 59% of independents; and 27% of Republicans, reports the Post. 
• Anthony Fauci, the director of the National Institute for Allergy and Infectious Diseases, talked with Stat about covid-19 reopenings, vaccines and more, with a copy of the transcript included in the article.

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