Federal Medical Stockpile Is Running Out

From the beginning of the Coronavirus pandemic in the United States, a buzzword has been “flatten the curve.” With no treatment and no vaccine, the plan was to slow the rate of infection to prevent hospitals from being overwhelmed with cases of COVID-19. The wisdom of that strategy is now being illustrated by the fact that the strategic federal reserve of medical supplies is dwindling after an outbreak that is only six weeks old.

Axios reports that 90 percent of the federal stockpile will be deployed to the states while 10 percent will be held in reserve “for critical needs of frontline healthcare workers serving in federal response efforts” per Health and Human Services spokesman Katie McKeogh. The government has already shipped out more than 11 million N95 masks and 7,000 ventilators, but the remaining contents of the stockpile is not enough to meet current requests from the states, many of which are expecting surges in hospital demand in coming weeks.

“The stockpile was designed to respond to a handful of cities. It was never built or designed to fight a 50-state pandemic,” an anonymous Homeland Security official told the Washington Post last week. “This is not only a U.S. government problem. The supply chain for PPE worldwide has broken down, and there is a lot of price-gouging happening.”

The government is attempting to refill the stockpile with items produced under the Defense Production Act. President Trump invoked the Act back on March 18 but the first contracts for ventilators were only signed yesterday. Phillips will produce 2,500 ventilators by the end of May and 43,000 by the end of the year while GM will deliver 6,132 ventilators by June 1 and 30,000 by the end of August.  The Trump Adminstration canceled a pending ventilator contract with GM back on March 26 citing cost concerns.

The stockpile shortage may also play into reports that the federal government is seizing medical supplies from hospitals and state agencies. The Los Angeles Times reported on Monday that hospitals in seven states reported that FEMA had commandeered shipments of medical supplies that they had ordered. Spokesmen for the hospitals said that the government had not given them any guidance about how to access the supplies that they had requested and there was no information about how the government intended to distribute the seized shipments. Presumably, the supplies are being fed into the national stockpile but that has not been confirmed.

President Trump has attempted to shift the blame for the partially empty medical stockpile on Barack Obama, but the problem goes even deeper. An analysis by Hot Air found that Presidents Obama and George W. Bush had both used stockpiled supplies without replenishing them. President Trump also neglected to restock the cache in his first three years. It was a failure of both parties that, in a time of record-breaking federal spending, no one thought to refill the emergency medical stockpile.

While troubling, the situation could be much worse if social distancing steps had not been implemented when they were. If the exponential growth in COVID-19 cases had continued, the situation would be even more dire. By flattening the curve, we have more time to prepare for a possible onslaught of new cases. If the critics of the economic pause and self-isolation had their way, there would be many more cases in the near term with a corresponding shortage of supplies that would dramatically increase the ultimate death toll.

Originally published on The Resurgent

Pediatrician: Transgender Treatments Are 'Child Abuse'

The movement to normalize transgender medical treatments for children has seemingly come out of nowhere. In the course of a few short years, cases of gender-confused children, some in kindergarten, seeking medical treatment to alter their sexual characteristics have become commonplace. Today, at least one pediatrician is speaking out to call the practice “child abuse.”

In an op-ed for the Daily Signal, Dr. Michelle Cretella writes that the treatments advocated by many in the “transgender affirming movement” can cause severe damage to children and “constitute nothing less than institutionalized child abuse.”

“Today’s institutions that promote transition affirmation,” Cretella says, “are pushing children to impersonate the opposite sex, sending many of them down the path of puberty blockers, sterilization, the removal of healthy body parts, and untold psychological damage.”

Michelle Cretella is no stranger to controversy and criticism from the left. A graduate of the University of Connecticut School of Medicine in 1994, she practiced pediatric medicine for 15 years before becoming president of the American College of Pediatricians (ACPeds) in 2015, a group that the Southern Poverty Law Center labels “an anti-LGBT hate group.”

Cretella attacks the sacred cows of the gay rights movement with science and logic. She points out that scientific studies of identical twins prove that gay and transgender identities are not a product of genetics since in 72 percent of cases of a transgender twin, the other twin’s sexual orientation is different. If sexual orientation were purely genetic, correlation would be 100 percent in identical twins.

She also points out that gender identity is very malleable in young children. Cretella cites the American Psychological Association’s Handbook of Sexuality and Psychology which acknowledges that 75 to 95 percent of children eventually come to accept their biological gender. In most cases, puberty is the cure for a confused gender identity.

Unfortunately, a new trend is preventing many sufferers of gender dysphoria, the new medical term for the problem, from going through puberty. A treatment that is becoming more common is the prescription of puberty blockers. Cretella writes that there have been no studies that prove these drugs are safe for the treatment of gender dysphoria. She writes that a new study of the treatments shows “evidence for decreased bone mineralization, meaning an increased risk of bone fractures as young adults, potential increased risk of obesity and testicular cancer in boys, and an unknown impact upon psychological and cognitive development.”

Perhaps even more disturbing, Cretella points out that there is not a single case in the scientific literature of transgender children choosing to discontinue the puberty blockers. “The only study to date to have followed pre-pubertal children who were socially affirmed and placed on blockers at a young age found that 100 percent of them claimed a transgender identity and chose cross-sex hormones,” says Cretella. Cross-sex hormones are associated with health risks including cardiac disease, high blood pressure, blood clots, strokes, diabetes, and cancers.

“There is an obvious self-fulfilling effect in helping children impersonate the opposite sex both biologically and socially,” writes Cretella. “This is far from benign, since taking puberty blockers at age 12 or younger, followed by cross-sex hormones, sterilizes a child.”

Cretella also debunks the liberal claims that therapies affirming gender identities will result in fewer suicides of transgender children. “Adults who undergo sex reassignment—even in Sweden, which is among the most LGBT-affirming countries—have a suicide rate nearly 20 times greater than that of the general population,” Cretella says.

The fundamental problem is that the transgender politics have outstripped medical studies and laws. The controversy over bathroom policies shows how difficult it can be to enact laws that restrict perceived transgender rights. Restrictions on the ability to administer puberty-blocking drugs to children or even commit children to gender-reassignment surgery would be no different. In the end, it will be the children who suffer.

Originally published on The Resurgent

Winning Republican strategies for 2015

Since the recent failure of the Republican attempt to defund President Obama’s executive immigration amnesty, much has been written, most of if it unflattering, about the future of the Republican Party. Many on the Tea Party right doubt the “backbone” of the Republican leadership and question their commitment to opposing President Obama’s policies.

What these critics do not provide is an answer to how the Republicans can overcome the Democratic filibuster that derailed the attempt to defund the amnesty. The problem was not “lack of backbone” on the part of the Republican leadership. The problem was mathematics. The Republicans lacked the 60 votes required by Senate procedural rules to end a filibuster.

The Republicans have a majority in both houses of Congress, but the majority is only meaningful if conservatives understand that it is a limited majority. Voters vested control of the Senate and House of Representatives with the Republicans, but they did not issue them a carte blanche to impose a conservative agenda.

The Republican majority is limited in two important ways. First, Senate rules require 60 votes for cloture to end debate on a bill. The Republicans have only 54 votes so it is axiomatic that a cloture vote will require at least six Democrats. Second, the Republicans are limited by President Obama’s veto. Even if a bill passes both houses of Congress, the president can veto it. Congress can override a presidential veto, but this requires 67 votes in the Senate and 288 in the House. Democratic votes (13 in the Senate and 41 in the House) would be required. To avoid wasting two years of a majority, Republicans need to take these limitations to heart and adapt a strategy to defeat them.

The first step is in casting aside unworkable strategies of the past. Defunding is a dead idea that should not be considered in the future. As with any other legislation, the idea is unworkable without a bipartisan majority. If Republicans have the votes to defund something, it would be better to simply repeal it outright.

Shutting the government down as a consequence of the House’s “power of the purse” has also proved unsuccessful in the past. A government shutdown is useful only as leverage if Democrats want to keep the government open. With a president who relishes the idea of using a shutdown to pummel Republicans, the strategy of a shutdown is pointless masochism. Republican leaders have quite sensibly rejected this course.

A successful Republican strategy will require one thing above all: a bipartisan majority. No conservative legislation can become law without Democratic votes. Republicans must peel off at least six Democratic senators for cloture and 13 to override Obama’s veto. This is a mathematical and constitutional fact. The question is how to do so.

The answer is to learn from the Democrats themselves. The Democrats in Congress have been successful because they stay united and split the Republicans over divisive issues like immigration. Republicans should ask themselves what issues can be used to divide the Democrats.

One such issue is the medical device tax imposed by Obamacare. This very unpopular tax is imposed on the manufacturers of such items as prosthetic limbs and pacemakers. It threatens thousands of American jobs as well as hurting the sick and disabled. There is bipartisan support for a repeal of the medical device tax, if not for Obamacare in its entirety.

If Republicans bring a repeal of the medical device tax to vote in Congress, Democrats would be forced to choose between voting to tax the sick or deserting to the Republican side. If the vote passes, Obama must allow it or publicly defend a veto. In either case, a vote to sustain the tax would be fodder for campaign ads by Republican challengers.

A second method for creating a bipartisan majority is to sweeten the pot with a compromise. Bill Clinton famously said that the Constitution could be subtitled “let’s make a deal.” If Republicans want to pass their agenda, they must induce the Democrats to vote with them, rather than simply expecting them to bow down before superior numbers.

One area where such a concession could be made is on the minimum wage. The minimum wage is an issue where the public supports the Democratic position. Recent polling has found strong support for raising the minimum wage, even in red states. In the 2014 elections, voters in four states that sent Republicans to the Senate enacted increases to their state minimum wages.

Trading a modest increase in the federal minimum wage for Democratic votes on Republican bills is a compromise that would defuse a popular Democratic issue while, at the same time, helping to advance conservative policies. The Republicans should not give in to a sharp increase in the minimum wage to $10 or $15 per hour, but a modest increase to the $8 to $9 range could be phased in over time.
Numerous studies, including one that looks at unemployment during the Great Recession, have shown that raising the minimum wage hurts low-skilled workers, but the economic effects of a modest increase to the minimum wage would be negligible. Thirty states already have minimum wages that are higher than the federal minimum wage according to the National Conference on State Legislatures. At least 14 states have already enacted or scheduled minimum wages that are $9.00 per hour or higher. Further, a 2013 study of minimum wage earners by the Bureau of Labor Statistics found that only 4.3 percent of workers earn the minimum wage. An increase to the minimum wage would affect few workers in a small number of states.

Negative effects on the economy could be further minimized by incorporating a separate minimum wage for teenagers. The BLS study reports that only three percent of workers over age 25 earn the minimum wage, compared with 20 percent of teenagers. Instituting a lower minimum wage for teens would protect their ability to find entry-level, part-time jobs.

For Obama’s executive immigration amnesty, the contentious issue that led to the almost-shutdown of the Department of Homeland Security, there is the low-yield nuclear option. In the Wall St. Journal, Curt Levey, a constitutional attorney with the Committee for Justice, called on Republicans to block Mr. Obama’s judicial nominees until he reneges on his executive action.

Blocking Obama’s appointees has many advantages that defunding lacked. First, it is possible. The Democrats cannot block the Republicans from blocking confirmations. There is no cloture or veto of a blocked confirmation. This strategy negates the two weapons that the Democrats hold.

Second, blocking confirmations is a win-win for Republicans. The optimal outcome would be that Obama reverses his executive action, which would be tantamount to surrender. If he stands firm, however, his nominees will never be seated as judges. This means that there will be more judicial openings for the next president, hopefully a Republican, to fill.

Finally, the potential for blowback is small. With a government shutdown, Republicans always take a hit in public opinion and lose support. That’s why Democrats try to goad them into that course of action. Blocking nominees is much lower profile and would not be noticed by most Americans. There would be no closed offices or parks and no furloughed workers to show on television. Lawyers who cannot get appointed to cushy jobs in federal courts are not sympathetic figures.

Many critics of the Republicans ask, “What was the point of winning the election?” if the Republicans can’t enact their agenda. The election gave the Republicans an advantage; it did not give them the ability to dictate terms to the Democrats.

The Republicans can use their majority over the next two years to further the conservative agenda and roll back pieces of Obama’s legacy, but to do so they must adopt realistic strategies that play to their strengths and work around those of the Democrats. Winning Republican strategies divide the Democrats, not themselves.

 

Read the full article on Examiner.com

Medical marijuana bill might pass in Georgia this session

On February 1, Jim Galloway of the Atlanta Journal-Consitution reported that Rep. Allen Peake (R-Macon) has introduced a bill in the General Assembly that would legalize a medical form of marijuana for use in treating epileptic seizures in children. Even more surprising is that Peake hopes to have the bill become law within a matter of weeks.

The bill, dubbed H.B. 885, has been given the nickname of “Haleigh’s Hope Act” for Haleigh Cox, a Monroe County four-year-old who suffers from severe seizures. Children’s Healthcare of Atlanta spokeswoman Patti Gregory told the Macon Telegraph that hospital sees hundreds of children like Haleigh who have as many as 100 seizures each day and who don’t respond to other medications.

The bill would allow cannabis extracts and compounds such as cannabidiol (CBD) to be recommended by doctors at academic research hospitals. CBD is a non-hallucinogenic oil derived from the cannabis plant. Although there has been little research so far, there is anecdotal evidence that CBD can help some young victims of acute epilepsy.

Rep. Ben Watson (R-Savannah) told the Telegraph, “The evidence that’s there relating to seizure disorders looks like when it is added on, it sometimes has very dramatic results.” Watson, a medical doctor, was the first cosponsor of Peake’s bill. Galloway reports that about 90 members of the 180 seat House of Representatives have also signed on to cosponsor the bill.

“At present, there has not been enough evidence-based research around the use of CBD studying its safety and tolerability in children with seizure disorders, and thus should not be used generally,” CHOA’s Gregory said. “However, we are in support of legislation that would allow clinical research by academic institutions.”

The Georgia bill would not be an attempt to usher in de facto recreational use of marijuana as medical marijuana bills have been in some states. The text of the bill contains a clause that explicitly rejects the recreational use of the drug. The proposed law would not allow stoners to self-medicate by smoking a joint.

“What I kept hearing when I jumped into this thing is that (the bill) needed to be tightly restricted, very regulated, managed by doctors, limited in scope, in oil-based form. That’s what we drew up,” Peake told the AJC. “We had to fight the perception from some of my colleagues that we were going to go down a path allowing 6-year-olds to smoke a joint and that we were going to have pot shops on every corner. Or that any physician in the state could prescribe it.”

Marijuana for research and prescription would come from the National Institute on Drug Abuse if the law is passed. This federal agency, a part of the National Institutes of Health, grows a limited amount of marijuana for research purposes. Research facilities would apply to the Georgia Composite Medical Board for authorization to conduct cannabis research and the Georgia Drugs and Narcotics Agency would create rules for storing and distributing the drug.

The bill will likely be assigned to the Health and Human Services Committee in the House. To become law, it must pass both the House and Senate before the current General Assembly session ends in March.

Originally published in Atlanta Conservative Examiner

Med Express now required for FAA pilot medicals

The next time you go for a flight physical, you will be required to fill out the application online at MedExpress.FAA.gov. The old paper application for an FAA medical certificate is no longer being used. The site is now also used by student pilots who wish to apply for a combination student pilot certificate and medical.

To apply for an FAA medical certificate, pilots must first create an account. To do this, go to the Med Express home page and click the button in the grey box that says “request an account.” This opens a page that asks for the user’s name and email address. After filling out the form, click “submit” and a temporary password will be sent to your email address.

The email from the FAA contains a link back to the site. Click the link and you will be prompted to select a new password. Once the new password is set, you will be taken to the home screen.

From the menu on the left side of the home screen, select “Form 8500-8” to access the medical application. The application screen asks for the same information that was required on the paper form. Note that the list of medical history questions covers your whole life, asking “have you ever had” any of the following conditions.

Any yes answers require an explanation. To provide an explanation, click the “add comment” button. This opens fields for each of the required explanations. If the condition has been reported on an older medical application and there has been no change, you can click the “PRNC” button at the right to indicate “previously reported, no change.”

As on the paper application, you must list any medications and doctor visits. It would be helpful to gather your medicines and doctor’s addresses when you fill out the application. The form requests dosages and the frequency of medicines. For doctor visits, the name, date and address of the visit are required as well as the reason. To add medicines and doctors, simply fill out the appropriate blanks and then click the “add” button.

When the application is completed, click the button at the bottom to validate it. The application will be checked for errors and unanswered questions. If any problems are found, the user will be directed to correct them.

A “save” button is also found at the bottom of the page. I recommend that you save the application frequently. When I completed my application, I was disconnected several times and had to start the application from scratch.

As you navigate through the application, there are question mark icons that are supposed to open help screens for different fields. In practice, when I clicked the help icons, they took me to the login screen. More helpful was the Med Express Users Guide, which contains step by step instructions for registering with Med Express and completing the application. A link to the user guide is on the home page.

When the application is complete and validated, enter your password at the bottom to submit the application to the FAA. No changes can be made to the application after you submit it until you are with your doctor. When an application is saved, the FAA will store it for 30 days. After the application is submitted to the FAA, you have 60 days to visit an Aviation Medical Examiner for your physical exam.

After the application is submitted, you will receive a confirmation number. Write this number down and take it with you when you go for your physical. The AME will use this number to access your medical application. An email will be sent to you with the confirmation number as well. If you lose the number, you can find it again by logging into Med Express and viewing your application. The confirmation number is at the top.

The FAA suggests that you print out the application and take it with you to your physical. Some doctors only want the confirmation number, so check with yours to find out what they want you to do.

If you have problems with website or the application, the FAA provides support via telephone and email. The telephone number, 1-877-AVS-NSD1 (1-877-287-6731), is monitored continuously. The email address for support, 9-NATL-AVS-IT-ServiceDesk@faa.gov, is only monitored from Monday through Friday during business hours.

Originally published at Examiner.com

 

http://www.examiner.com/article/med-express-now-required-for-pilot-medical-certificates?cid=db_articles