Health & Medicine

A neoteric’s view

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To date, none of the available vaccines prevent transmission from one individual to another. Most focus on decreasing the severity of symptoms. In the short term, that is a very effective strategy. In the longer term it can turn into a double-edged sword.  Evolving new strains of COVID may be more beneficial than detrimental. Consider […]

In one in three primary care consultations more than one problem is managed. The average number of problems managed is two, but as we get older or if we include mental health problems, closer to five problems are addressed per consultation and at least the same number of medications prescribed. COVID has been blamed for virtually anything that can […]

COVID-19 continues to ravage the world in waves and ways that are seemingly unstoppable. Even now, the unresolved debates about vaccination and herd immunity will ensure that the virus will affect us long into the future. And then there is the unspeakable discourse that centres around the possibility that the virus is a Darwinian cull […]

With the advent of antibiotics in the first half of the last century, traditional public health went into hibernation.  Communicable or infectious diseases surfaced only occasionally, and usually only in small outbreaks of old foes such as TB, leprosy and polio. Most of these outbreaks were contained and in relatively inaccessible locations subject to a small […]

Since March 2020, most places in the world have been through several versions of CoVID-19 lockdown. The most extreme level, currently in force in several cities in the USA, prohibits social contact beyond the immediate household throughout the rest of the year. Those who can work from home are expected to do so. Those who […]

CoVID has brought the age-old problem of containing infectious diseases back into the limelight. To date, clinicians and patients have focussed on the individual and human aspects of infectious containment, but the spread of infections in our built environment must become a priority. Humid environments mean less viral spread in air. Take hospital architecture. Like […]

As the world battles with localised CoVID-19 outbreaks, it is now clear that a major source of transmission of infection is no longer from the influx of expatriates nor travellers. CoVID-19 is now a community problem. The politicizing of the pandemic has obfuscated the fact that, in most countries, communities and family groups have been […]

(This blog is the Gordon Reid MacDonald Memorial Lecture which I have been asked to deliver in Edmonton Alberta this month. It is much longer than my usual blogs) If there is one thing that the pandemic has shown us, it is that modern healthcare is undemocratic, antisocial and thus largely unresponsive to its patients’ […]

Absolute risk is the likelihood an event will occur. Relative risk is the likelihood an event will occur in one group compared to another. In CoVID-19 terms, the absolute risk of dying from the disease is low. However, if we look at very old residents of care facilities who have multiple health problems compared with […]

Over the past two decades, three human coronaviruses (SARS-CoV, MERS-CoV, and SARS-CoV-2) have emerged worldwide and there is still no approved vaccine for any of them. Greedy nations race each other in a drug-ridden CoVID Olympics, spending billions to find the gold medal vaccine. Yet we are told the greatest elite performer on earth – […]

A new epidemic has broken out, and it’s not CoVID-19.  The symptoms are an inability to subtract, and a tendency just to add.  It’s sweeping through physicians around the world who, instead of weaning patients off antidepressants, continue to layer on two or even more psychoactive drugs, despite evidence that this strategy is ineffective. Depression […]

Hospitals are full of sick people and not all of them are patients. More and more staff in hospitals are turning up for work that they are unable to do. They are present, but not working at their best, due to the impact of COVID-19 on their health and well-being. Every week there is another […]

Every couple of years a group of experts lowers the level of blood pressure required to diagnose and treat hypertension. On the face of it, the advice seems reasonable: obesity and diabetes are on the increase across the globe and both are related to hypertension and its result, cardiovascular disease. So, dropping the upper limits […]

Hospitals are full of people sick with CoVID but not all of them are patients. More and more staff in our hospitals are turning up for work that they are unable to do. They are present, but not working at their best, either due to their own health problems, increased CoVID-related workload, or CoVID anxiety. […]

CoVID is no longer just a health concern. As clinicians we now understand the disease a little better, are comforted that most cases are mild and self-limiting, and relieved that the intensive care resources are becoming equipped to manage the increase in patient numbers. Even the danger to health care workers of too much exposure […]

What will happen to our healthcare services once the acute phase of CoVID-19 has passed is anyone’s guess. The backlog of non-urgent surgery and medical treatment grows daily as physicians not involved in acute life-threatening care are furloughed and patients are reticent to see clinicians for fear of catching CoVID-19, if their offices are even […]

Even before the CoVID-19 pandemic, more and more people were working remotely. Between 2012 to 2016, the number of people working remotely rose by four percent globally. In the US, 43% of workers spend some of their time working remotely. In countries such as Finland, Japan, Netherlands and Sweden, more than half the population work […]

In times of overwhelming disaster and limited resources, ingenuity and repurposing can save lives.  For example, the use of stapling wounds on the suture-poor battle fields more than a century ago was game changer. It worked because the purpose of a suture and a staple were similar – to hold two opposing surfaces together. Wrap […]

As most of us become as paranoid as Lady Macbeth about handwashing, dodging infected droplet spread of CoVID-19 is equally important. So, let’s talk about sneezing and coughing. To avoid potentially infecting others, hold something you can clean or dispose of safely to sneeze or cough into at all times. Sneezing or coughing into your […]

CoVID-19 is all about lungs and breathing. As the infection increases in seriousness so the need for breathing assistance becomes greater. Critical and intensive care units (ICUs) provide the optimal support for these life-threatening breathing problems. But are they ready for the expected surge in cases? There will never be enough ICU beds. Overall, critical […]