Although Latinos account for 38.9% of the state’s population, they represent a whopping 55.1% of positive cases and almost half of all deaths. In Los Angeles county, where more than 850,000 infections have been recorded, Latinos are succumbing to the virus at 2.5 times the rate of their white counterparts, the LA Times reported.
But “it’s really not about race and ethnicity”, cautioned Yvonne Maldonado, a professor of global health and infectious diseases at the Stanford University School of Medicine. “It’s about race and ethnicity as a surrogate for poverty and inequity.”
If clinical trials for COVID-19 vaccines aren’t expanded soon to include children, it’s unlikely that even kids in their teens will be vaccinated in time for the next school year.
The hurdle is that COVID vaccine makers are only in the early stages of testing their products on children. The Pfizer vaccine authorized for use by the Food and Drug Administration on Friday was greenlighted only for people ages 16 and up. Moderna just started trials for 12- to 17-year-olds for its vaccine, likely to be authorized later this month.
“The longer we take to start kids in trials, the longer it will take them to get vaccinated and to break the chains of transmission,” said Dr. Yvonne Maldonado, a professor of pediatrics at Stanford University who chairs the AAP’s infectious disease committee. “If you want kids to go back to school and not have the teachers union terrified, you have to make sure they aren’t a risk.”
Stanford Medicine expects to receive the first shipment of a coronavirus vaccine on Dec. 18 and start inoculating health care workers the next day.
The plan to vaccinate health care workers first aligns with federal recommendations shaped by two national committees whose members include Stanford Medicine faculty.
Besides ensuring that health care workers are inoculated against COVID-19, the Stanford vaccine committee is also focused on building trust in the vaccines.
Committee member Grace Lee, MD, associate chief medical officer for practice innovation at Stanford Children’s Health and a professor of pediatrics, said people worried about vaccine safety can rest assured that, despite how quickly coronavirus vaccines have been developed, federal regulators are rigorously reviewing them.
Tad and Dianne Taube Establish Endowed Professorship in Global Health; Yvonne Maldonado, MD, is appointed first holder
Tad and Dianne Taube have made a generous $2 million gift to establish the Taube Professorship in Global Health and Infectious Diseases at Stanford University School of Medicine. It was matched with an additional $2 million from Andi Okamura and Jeff Chambers, chair of the Board of Directors for Lucile Packard Children’s Hospital Stanford. The first holder of this prestigious endowed professorship is pediatrician Yvonne “Bonnie” Maldonado, MD, one of the world’s top experts in infectious diseases.
“The current pandemic underscores the importance of strong leadership and world-class scientific research, as well as the critical need to invest in this work to be prepared for future pandemics,” says Tad Taube, chairman of Taube Philanthropies. “We are proud to establish this professorship to advance care for children everywhere and to advance science. Dianne and I are thrilled that Dr. Maldonado, a world-class researcher, will be the initial holder of the Taube Endowed Professorship."
COVID-19 has had a devastating impact across the country, but not all populations have felt its effect equally: Members of the Black and Latinx communities have had a disproportionate number of cases and deaths from COVID-19.
"This pandemic is a real wake-up call for us," says Yvonne Maldonado, MD, Stanford senior associate dean of faculty development and diversity and professor of pediatrics and of health research and policy. "Rather than cursing the darkness, we need to light a candle. And we have plenty of candles at Stanford."
In a Q&A for Stanford Medicine's Recover, Restore and Reopen project, Maldonado and Melissa Bondy, PhD, professor and chair of the department of epidemiology and public health, discuss how COVID-19 has shaped Stanford Medicine's understanding of health disparities and how the institution is responding.
Latino communities around the Bay Area have been hit by the coronavirus harder than most and yet there seems to be conflicting opinions among them about whether or not a vaccine should be mandatory.
Stanford epidemiologist Dr. Yvonne Maldonado says there’s more than one reason Latinos are getting sick at a higher rate.
"We need to get the Latino community, they are just not paying attention," Maldonado said. "Part of it is that they have to work, and they don’t think they’re going to get that sick. What we’re seeing is whole families are getting sick."
And COVID-19 isn’t the same for everyone. Younger patients may get less sick or experience less severe symptoms. But in a lot of Latino families, several generations live in the same home. And some have limited access to health care.
California is expected to receive more than 2 million COVID-19 vaccine doses this month, but there are still questions about where the vaccines intersect with the law.
Once approved by the FDA, the first Californians to receive a vaccine will likely receive the one manufactured by Pfizer.
Dr. Grace Lee, professor of pediatrics at Stanford University School of Medicine, was part of the CDC advisory panel that recommended frontline medical teams and residents and employees of nursing homes be the first to receive vaccines.
"We included the long-term care facility residents because while they make up 6% of the U.S. population, COVID-19 cases in long-term care facility residents have been associated with 40% of the cases of death in the U.S.," Lee said.
Seven to 10 days. That’s how long it took Stanford Children’s Health to pull together a master plan to respond to the pandemic in March 2020. Yet in all that rush, no one lost sight of what was most important: patients and families.
“Our response was driven by a primary focus of keeping patients and families safe,” says Luanne Smedley, executive director and associate chief nursing officer of women and infant services. “Each day brought something new to our attention, but we developed the bulk of our initial protocols in less than 10 days.”
Soon after the COVID-19 pandemic struck, experts at Stanford Medicine realized that organizations and communities -- along with individuals -- would need scientifically based guidance to help them navigate the health crisis and eventually return to normal.
They created a framework, known as Recover, Restore and Re-open, or R3, to provide information and insights for government agencies, health care organizations and other institutions. The collection of resources represents a culmination of lessons learned while delivering patient care, conducting research and forming policy recommendations over the course of the pandemic.
Last spring, as office buildings emptied and local governments ordered residents to shelter in place, Stanford Medicine faculty members and executives sprang into action to understand more about the mysterious new coronavirus.
Even in the early months of the pandemic, it was clear that a return to normal — bringing students back to classrooms, workers back to offices and travelers back to airlines — would take complex and scientifically grounded policies and guidance.
Now, Stanford Medicine has launched a website to advise various segments of society on getting back to healthy functioning. The effort is called Recover, Restore and Re-open, or R3.
The Black In Cardio Week ran from 19 to 25 October 2020, where eight researchers organized a series of virtual activities and panels to both celebrate Black scientists in the cardiovascular field and raise awareness about the risks of cardiovascular diseases in the Black community.
With supporters including the American Heart Association (AHA), the American Association for the Advancement of Science (AAAS) and the Cardiovascular Research Institute of Vermont, the Black In Cardio Week events covered several topics, including career advice, destigmatizing cardiovascular research in Black communities, and the future of the field.
“Black people have been involved in the evolution of science and medicine for a long time, but they haven’t been heard of,” says co-organizer Catherine Tcheandjieu, who is a post-doctoral fellow at the Stanford School of Medicine. “The more you see yourself in people that did great, the more you can relate.”
SACRAMENTO – Governor Gavin Newsom today named a group of nationally acclaimed California physician scientists with expertise in immunization and public health to the state’s COVID-19 Scientific Safety Review Workgroup that will independently review the safety and efficacy of any vaccine that receives FDA approval for distribution. While there is no proven vaccine for COVID-19 yet, these top health experts – guided by the principles of safety, equity and transparency – will review any vaccine that receives federal approval and verify its safety, before California makes a COVID-19 vaccine available to those most at risk.
The Scientific Safety Review Workgroup is a key piece of the state’s initial COVID-19 vaccine distribution plan, which was submitted to the Centers for Disease Control and Prevention on Friday. Many vaccine candidates are in clinical trials currently, and California is putting a system in place for the distribution and administration of vaccine as supply becomes available.
When it comes to measuring the prevalence of the coronavirus, one term frequently comes up: community spread.
"The likelihood of (community spread) is much higher in communities where there are more cases and where there is less mask-wearing, where there's more mingling of humans in higher-risk situations," she said.
Though the pandemic has affected every family differently and presents numerous challenges to all, special needs families are now experiencing an entirely different pandemic than the rest of us.
"Children with special needs, are experiencing similar challenges (as their peers) but with greater intensity and with fewer personal resources to manage the stress of these challenges," explains Heidi Feldman, a professor of Developmental and Behavioral Pediatrics at Stanford University's School of Medicine. No child likes to wear a face mask or spend hours a day learning in front of a screen, she observes, but such circumstances are worse for children with special needs who may lack the ability to comprehend why they have to make such changes in the first place.
People with type 1 diabetes must check their blood sugar levels several times per day, including before eating, then calculate how much insulin to inject. Handheld glucometers require frequent, painful finger pricks to get a drop of blood for testing. Also, because middle-of-the-night checks are needed to catch dangerously low sugar levels, it's difficult for patients and their parents to get a good night's sleep.
The newest continuous glucose monitoring systems rely on a wearable sensor with a thin platinum wire inserted just under the patient's skin, so patients don't have to prick their fingers.
C. Jason Wang, MD, PhD, is leading efforts in response to the coronavirus by developing research projects related to reopening the U.S. economy, improving the safety of air travel during the pandemic, and getting kids back into classrooms.
Associate Professor of Pediatrics C. Jason Wang, MD, PhD, thinks the messaging around mask wearing could use a makeover. He cites a recent study from researchers at Temple University and the University of Pennsylvania that found faces with masks were rated as more attractive than those unobstructed by fabric.
“Hey, if you wear a mask, people think you're more attractive,” says Dr. Wang, suggesting that this new announcement amplified with the right advertising could work well, particularly on teenagers.
Appealing to people’s vanity is one of the more playful ideas Dr. Wang has about how to reduce the spread of the coronavirus. As the former project manager of Taiwan’s National Health Insurance Reform Task-force, he in fact spends much of his time studying global responses to the coronavirus in order to make recommendations about what to do here in the United States. He is forthcoming with his knowledge and advice, which is grounded in his expertise as a pediatrician, policy analyst, and health services researcher.
In the eye of the pandemic, viral disease expert Bonnie Maldonado, MD still has hope.
More than six months into the pandemic, her optimism has not waned. “I was always hopeful, and I still have hope,” she said. “We can conquer this disease. We’ve conquered other diseases like this or worse.
“It’s scary and horrifying that we have to learn about this virus through this living experiment that we are undergoing. But I really think that, in the end, I’ve learned more in the past seven months than I’ve learned about anything else over my lifetime. It’s really moved very quickly.”
As the global number of confirmed Covid-19 cases surpasses 30 million, residents of Taipei seem relaxed in the knowledge there has been only one suspected case linked to local transmission in the city since mid-April.
And in Taiwan as a whole, an island with a population of approximately 23 million people, there have been around 500 confirmed cases and just 7 deaths since the beginning of the pandemic.
And that's despite it being located just 130 kilometers (81 miles) from China, the country where the virus was first detected.
One of the main reasons for Taiwan's success in containing the virus is speed.
The island's leaders were quick to act as rumors spread online of an unidentified virus in the Chinese city of Wuhan and unconfirmed reports of patients having to isolate.
It's still unknown when a COVID-19 vaccine might be available in the United States. But when one is first approved, there may only be 10 million to 15 million doses available, which may be enough to cover around 3% to 5% of the U.S. population. That's according to estimates from Operation Warp Speed, the government's vaccine project, published in a draft framework from the National Academies of Sciences, Engineering and Medicine.
There are many who would benefit from the protection a safe and effective vaccine would afford; policymakers must decide who gets the vaccine first.
A vaccine advisory group to the Centers for Disease Control and Prevention is meeting Tuesday to consider how to prioritize distribution of a future COVID-19 vaccine. But a vote on who will get a vaccine first, originally planned for Tuesday, has been delayed.
Priority groups include "those who have the highest risk of exposure, those who are at risk for severe morbidity and mortality ... [and also] the workforce that's needed for us to maintain our both health and economic status," said Dr. Grace Lee, a pediatrics professor at Stanford Children's Hospital and a member of the CDC's Advisory Committee on Immunization Practices or ACIP. Lee spoke for herself, not the committee.
Educators across the country are making tough choices when planning for this school year. Many are extending virtual learning plans launched when the COVID-19 pandemic arrived in the spring, while others are reopening classrooms for in-person instruction or doing some combination of the two.
Stanford Medicine pediatrician Jason Wang, MD, PhD, reviewed the American Academy of Pediatrics guidelines for schools choosing to reopen, analyzing the academy's recommendations to provide a realistic view of the costs involved in sending children back to school safely.
For more than two decades, the Stanford Children’s Health Teen Van has been a vital resource for underserved youth across the Bay Area. During the COVID-19 pandemic, it has stepped up in an even bigger way—providing testing, food and supplies for local families, many of whom live in communities hit hardest by the virus.
Today, the Van is run by Arash Anoshiravani, MD, who once completed an adolescent medicine fellowship under now-retired Ammerman, along with a nurse practitioner, a social worker, a dietician, and a registrar/driver. The Van travels to nine sites across Santa Clara and San Mateo County, including local high schools and youth centers, providing no-cost vaccines, mental health care, contraceptives, physical exams, nutritional counseling and more to patients ages 10 to 25.
Sounding the mental health alarm: the psychological distress of living through a pandemic, and how to build resilience
For many Americans, aspects of ordinary life — working in an office, going to school, eating inside a restaurant, hugging a friend — still feel impossibly unsafe. Amid continued uncertainty about when the COVID-19 pandemic will be brought under control, Stanford mental health experts are planning for the psychological fallout of having an entire population under prolonged stress.
“We’ve all been talking about virus surges. What we’ve been preparing for in psychiatry is a surge in mental health problems,” said child and adolescent psychiatrist Victor Carrion, MD, director of the Stanford Early Life Stress and Resilience Program.