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Journal of General Internal Medicine

By Nirav Shah and Jason Wang

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Commentary

Jennifer E. Miller , Joseph S. Ross, Michelle Mello
STAT News, 2020

With vaccines against SARS-CoV-2, the virus that causes Covid-19, on the near-term horizon, U.S. policymakers are focusing on how to ensure that Americans get vaccinated. This challenge has been compounded by reports that White House officials are exerting undue influence over the agencies that would ordinarily lead such efforts, the Food and Drug Administration and the Centers for Disease Control and Prevention.

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Journal Article

Jeremy Goldhaber-Fiebert, David Studdert, Michelle Mello
JAMA Network, 2020

Few issues in the policy response to the coronavirus disease 2019 (COVID-19) pandemic have inspired as impassioned debate as school reopening. There is broad agreement that school closures involve heavy burdens on students, parents, and the economy, with profound equity implications, but also that the risk of outbreaks cannot be eliminated even in a partial reopening scenario with in-school precautions. Consensus largely ends there, however: the approaches states and localities have taken to integrating these concerns into school reopening plans are highly variable.

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Journal Article

Yasmin Rafiei, Michelle Mello
New England Journal of Medicine, 2020

On August 17, 2020, the Los Angeles Unified School District launched a program to test more than 700,000 students and staff for SARS-CoV-2. The district is paying a private contractor to provide next-day, early-morning results for as many as 40,000 tests daily. As of October 4, a total of 34,833 people had been tested at 42 sites. The program is notable not only because it’s ambitious, but also because it’s unusual: testing is conspicuously absent from school reopening plans in many other districts.

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Journal Article

Yasmin Rafiei, Michelle Mello
New England Journal of Medicine, 2020

On August 17, 2020, the Los Angeles Unified School District launched a program to test more than 700,000 students and staff for SARS-CoV-2. The district is paying a private contractor to provide next-day, early-morning results for as many as 40,000 tests daily. As of October 4, a total of 34,833 people had been tested at 42 sites. The program is notable not only because it’s ambitious, but also because it’s unusual: testing is conspicuously absent from school reopening plans in many other districts.

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Journal Article

Josip Car, Gerald Choon-Huat Koh, Pin Sim Foong, C. Jason Wang
The British Medical Journal, 2020

Even before the covid-19 pandemic, virtual consultations (also called telemedicine consultations) were on the rise, with many healthcare systems advocating a digital-first approach. At the start of the pandemic, many GPs and specialists turned to video consultations to reduce patient flow through healthcare facilities and limit infectious exposures. Video and telephone consultations also enable clinicians who are well but have to self-isolate, or who fall into high risk groups and require shielding, to continue providing medical care. The scope for video consultations for long term conditio

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Journal Article

Maria Polyakova, Geoffrey Kocks, Victoria Udalova, Amy Finkelstein
Proceedings of the National Academy of Sciences , 2020
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Journal Article

Rachel Schwartz, Susan M. Frayne, Sarah Friedman, Yasmin Romodan, Eric Berg, Sally Haskell, Jonathan Shaw
Journal of General Internal Medicine , 2020

When an experienced provider opts to leave a healthcare workforce (attrition), there are significant costs, both direct and indirect. Turnover of healthcare providers is underreported and understudied, despite evidence that it negatively impacts care delivery and negatively impacts working conditions for remaining providers. In the Veterans Affairs (VA) healthcare system, attrition of women’s health primary care providers (WH-PCPs) threatens a specially trained workforce; it is unknown what factors contribute to, or protect against, their attrition.

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Journal Article

Maimuna S. Majumder, Sherri Rose
Health Affairs, 2020

Although health care billing claims data have been widely used to study health care use, spending, and policy changes, their use in the study of infectious disease has been limited. Other data sources, including from the Centers for Disease Control and Prevention (CDC), have provided timelier reporting to outbreak experts.

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Journal Article

Maimuna S. Majumder, Sherri Rose
Health Affairs , 2020

Although health care billing claims data have been widely used to study health care use, spending, and policy changes, their use in the study of infectious disease has been limited. Other data sources, including from the Centers for Disease Control and Prevention (CDC), have provided timelier reporting to outbreak experts.

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Journal Article

Nirav R. Shah, Debbie Lai, C. Jason Wang
Journal of General Internal Medicine , 2020

Epidemiological modeling has emerged as a crucial tool to help decision-makers combat COVID-19, with calls for non-pharmaceutical interventions such as stay-at-home orders and the wearing of masks. But those models have become ubiquitous and part of the public lexicon — so Nirav Shah and Jason Wang write that they should follow an impact-oriented approach.

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Journal Article

Mark A. Hlatky, Marcia Stefanick
JAMA Cardiology, 2020

Cardiovascular disease is the leading cause of death among women in the U.S. and identification of sex-specific risk factors could enhance cardiovascular risk assessment and prevention. Pregnancy is an exposure unique to women: 85% of women give birth at least once in their lives, and up to 30% may experience an adverse pregnancy outcome (APO).

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Journal Article

Anna Zink, Sherri Rose
Journal of the International Biometric Society , 2020
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Journal Article

Alyssa Bilinski , Farzad Mostashari, Joshua Salomon
JAMA Network Open, 2020

Stanford Health Policy’s Joshua Salomon, a professor of medicine and senior fellow at the Freeman Spogli Institute for International Studies, and colleagues developed a mathematical model to examine the potential for contact tracing to reduce the spread of the coronavirus.

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Journal Article

Alexandra M. Daniels , David Studdert
New England Journal of Medicine, 2020

In a recent perspective published by the New England Journal of Medicine(NEJM), Stanford Law student Alexandra Daniels analyzed a growing body of federal litigation brought by prisoners with the hepatitis C virus (HCV) who are seeking access to treatment for their condition.

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Journal Article

C. Jason Wang, Henry Bair
JAMA Pediatrics, 2020

There is general consensus among experts that K-12 schools should aim to reopen for in-person classes during the 2020-2021 school year. Globally, children constitute a low proportion of coronavirus disease 2019 (COVID-19) cases and are far less likely than adults to experience serious illness. Yet, prolonged school closure can exacerbate socioeconomic disparities, amplify existing educational inequalities, and aggravate food insecurity, domestic violence, and mental health disorders. The American Academy of Pediatrics (AAP) recently published its g

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Journal Article

Michelle Mello, Jeremy A. Greene , Joshua M. Sharfstein
JAMA Network, 2020

In June 24, 2020, California Governor Gavin Newsom remarked on a disturbing phenomenon: health officers are “getting attacked, getting death threats, they’re being demeaned and demoralized.” At least 27 health officers in 13 states (including Nichole Quick of Orange County in southern California, Ohio Health Director Amy Acton, and West Virginia Health Officer Cathy Slemp) have resigned or been fired since the start of the coronavirus disease 2019 (COVID-19) pandemic.

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Journal Article

David Studdert, Mark Hall, Michelle Mello
New England Journal of Medicine, 2020

Since the onset of the Covid-19 crisis in the United States, government action taken to “flatten” the curve of disease transmission has varied dramatically among states, counties, and cities. The early epicenters — New York City, Washington State, and the San Francisco Bay Area — implemented aggressive measures in mid-March, many of which remain in place. Other states and localities opted for milder restrictions, acted much later, or barely intervened at all. Many states began unwinding restrictions weeks ago, although surging case numbers are prompting some to change course.

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Journal Article

Mark A. Hall, Michelle Mello, David Studdert
New England Journal of Medicine , 2020

In March 2020, when many U.S. states and localities issued their first emergency orders to address Covid-19, there was widespread acceptance of the government’s legal authority to respond quickly and aggressively to this unprecedented crisis. Today, that acceptance is fraying. As initial orders expire and states move to extend or modify them, legal challenges have sprouted. The next phase of the pandemic response will see restrictions dialed up and down as threat levels change.  As public and political resistance grows, further legal challenges are inevitable.

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Journal Article

Michelle Mello, Govind Persad , Douglas B. White
New England Journal of Medicine, 2020

In times of emergency, many legal strictures can flex. For example, to enable hospitals to respond to Covid-19, the Department of Health and Human Services (HHS) recently waived a swath of federal regulatory requirements. But though officials’ emergency powers are extensive, the ability to discard antidiscrimination protections is not among them. A hallmark of our legal system is that our commitment to prohibiting invidious discrimination remains steadfast even in times of emergency.

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Journal Article

Deparati Guha-Sapir , Maria Moitinho de Almeida, Mory Keita, Gregg Greenough, Eran Bendavid
Science Magazine , 2020

Nearly 120 million children in 37 countries are at risk of missing their measlescontaining vaccine (MCV) shots this year, as preventive and public health campaigns take a back seat to policies put in place to contain coronavirus disease 2019 (COVID-19). In March, the World Health Organization (WHO) issued guidelines indicating that mass vaccination campaigns should be put on hold to maintain physical distancing and minimize COVID-19 transmission.

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Case Studies

Jeremy Goldhaber-Fiebert, Douglas K. Owens, et al.
National Academies of Sciences, Engineering and Medicine, 2020

Yet there has been no national-level, comprehensive review of the evidence for public health emergency preparedness and response (PHEPR) practices. Recognizing this deficiency, the Centers for Disease Control and Prevention (CDC) went to the National Academies of Sciences, Engineering and Medicine three years ago and asked them to convene a national panel of public health experts to review the evidence for emergency preparedness and response. The committee members included Stanford Health Policy Director Douglas K.

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Journal Article

David Studdert, Mark A. Hall
New England Journal of Medicine, 2020

Urgent responses to the Covid-19 pandemic have halted movement and work and dramatically changed daily routines for much of the world’s population. In the United States, many states and localities have ordered or urged residents to stay home when able and to practice physical distancing when not. Meanwhile, unemployment is surging, schools are closed, and businesses have been shuttered. Resistance to drastic disease-control measures is already evident. Rising infection rates and mortality, coupled with scientific uncertainty about Covid-19, should keep resentment at bay — for a while.

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Journal Article

Michelle Mello, Ross D. Silverman, Saad B. Omer
New England Journal of Medicine, 2020

As Covid-19 continues to exact a heavy toll, development of a vaccine appears the most promising means of restoring normalcy to civil life. Perhaps no scientific breakthrough is more eagerly anticipated. But bringing a vaccine to market is only half the challenge; also critical is ensuring a high enough vaccination rate to achieve herd immunity. Concerningly, a recent poll found that only 49% of Americans planned to get vaccinated against SARS-CoV-2.

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Commentary

David Studdert, Matthew Miller, Garen Wintemute
The New York Times , 2020

Millions of Americans have experienced the coronavirus pandemic directly, as they or their loved ones suffered through infection. But for most of us, the experience is defined by weeks and months on end stuck at home. The shut-ins are testing the safety of our home environments.

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Journal Article

David Studdert, Yifan Zhang , Sonja A. Swanson, Lea Prince, Jonathan A. Rodden, Erin E. Holsinger, Matthew J. Spittal, Garen G. Wintemute , Matthew Miller
New England Journal of Medicine , 2020

BACKGROUND

Research has consistently identified firearm availability as a risk factor for suicide. However, existing studies are relatively small in scale, estimates vary widely, and no study appears to have tracked risks from commencement of firearm ownership.

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