Dec. 28, 2020

COVID-19: A New Year with More Meaningful Resolutions
By Glenn Ellis

(TriceEdneyWire.com) - According to a new survey from CIT Bank conducted by The Harris Poll, despite the turbulence of 2020, Americans are not turning their backs on making goals for the year ahead. In fact, more Americans are planning to make New Year's resolutions for 2021 (43%) than did so for this year (35%).

As we near the end of 2020, many of us are looking to 2021 as a fresh start. Do you have a New Year’s resolution or goal for the new year? Did you have to put off your 2020 goals because of COVID-19? Has the pandemic given you a new perspective that makes your resolutions - or how you plan to achieve them - different than what you might have done in the past? How have your goals for the future changed in our “new normal”?

After almost the entirety of 2020, we are learning more about COVID-19 every day. Much of what we have learned should factor in each of our list of New Year’s Resolutions. These lessons are relevant for children as well as adults of all ages. While children have been less affected by COVID-19 compared to adults, children can be infected with the virus that causes COVID-19 and some children develop severe illness. By now it should be clear that COVID-19 is an equal opportunity killer. 

What we have witnessed and learned from COVID-19 in 2020 should inform us on making New Year’s resolutions that matter, and ones that we should be committed to keeping moving forward. Here are some of the key takeaways: chronic disease and vaccines.

Chronic Diseases: The COVID-19 health crisis has caused massive disruptions in diagnosing and treating people with deadly but preventable diseases, such as diabetes; high blood pressure; obesity, etc.. People with chronic conditions are more vulnerable to catching and dying from COVID-19. In addition, their exposure to risk factors - such as substance abuse, social isolation and unhealthy diets - has dramatically increased during the pandemic.

Because of this insight, it is imperative that all resolutions for the New Year include particular attention to limits or restrictive availability of food supplies, so careful planning on how to maintain a good, consistently healthy diet. Care must also be given to considerations on physical activity and exercise. Regular physical activity helps improve your overall health, fitness, and quality of life. It also helps reduce your risk of chronic conditions like type 2 diabetes, heart disease, many types of cancer, depression and anxiety, and dementia.

Finally, a word about chronic conditions and medical care. Pharmacies and community clinics are less able to handle the demands than ever. Make sure your resolutions include a promise (to yourself) to be as compliant as possible with the treatment plans and/or medications prescribed for your condition(s). Commit to monitoring your blood pressure and/or blood sugar at home on a daily basis. Bottomline? The New Year must find folks with chronic conditions making resolutions around lowering blood pressure and/or blood sugar; reducing BMI; and maintaining a healthy daily calorie intake.

Vaccines: The recent Kaiser Family Foundation study found that 35% of Black Americans would probably or definitely not get the vaccine if it was determined to be safe by scientists and widely available for free. Washington Post columnist Michele Norris captured the essence of this phenomenon. “Vaccine hesitancy from Black Americans is different from an “anti-vaxxer” stance. It’s not that Black Americans don’t believe in vaccines. They don’t trust a public health system that has in too many cases engaged in grievous harm by experimenting on Black bodies without consent or ignoring the specific needs of Black people.

What’s the solution for your resolution? Information is the best medicine. Add to your list a determination to improve your health literacy. Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions.

Do you have any questions related to the coronavirus vaccine? Do the vaccines protect against both severe and mild illness? Can the vaccines stop virus transmission? How long will the vaccines be protective? Most of us won’t have access to the vaccine anytime soon. Some of the “experts” are saying that by Memorial Day, end of June, any Americans who want a vaccine will have their hands on a vaccine. Use the time wisely and find out all you can about vaccines. If improving your health literacy is one of your New Year’s resolutions, whatever you decide about taking the vaccine will not be based on fear and suspicion.

In closing, let me remind us that at the heart of our New year’s resolutions should be ample opportunity on us to work on our humanity. We see suffering and hardship brought on by the pandemic, all around us. Almost overnight we’ve become more and more, a nation of have’s and have nots. There's a lot of distress out there: If we can set goals that aim to help others, those kinds of goals will, in turn, also add to our own well-being. Think about the ways in which you can contribute to your family, your community, and to the world.

Remember, I’m not a doctor. I just sound like one, Take good care of yourself and live the best life possible!

 The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Fellow in Research Bioethics and Writing. He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com

 Dec. 7, 2020

Are You Taking the COVID-19 Vaccine?
By Glenn Ellis

(TriceEdneyWire.com) - Now comes the moment of truth. The time has come when each of us will have to make a personal decision about whether to take the COVID-19 vaccine or not. Following months of the most unimageable experience of living in the midst of a global pandemic, the promise of the vaccine hoped for is finally at hand. Within days or weeks, people are going to start receiving the first of a two-dose vaccine. As opposed to influencing your decision or telling you what you should do; this column will contribute to making sure that your decision is an informed decision.

Making sure that you have asked the right questions, especially about the stuff you don’t understand, is the important thing you can do to guarantee that the decision you make is one that you can live with.

Here are a few areas that look at some of the most common questions that folks have posed to me. I thought you might find them helpful:

What’s different about this vaccine? The COVID-19 vaccines are different because they use a “new” technology called mRNA. The CDC describes how it works by saying, “To trigger an immune response, many vaccines put a weakened or inactivated germ into our bodies. Not mRNA vaccines. Instead, they teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies”.  

This vaccine works by providing a “genetic code” for our cells to produce viral proteins. Once the proteins (which don’t cause disease) are produced, the body launches an immune response against the virus, enabling ta person to develop immunity to that virus should it ever show up again. This is a new technology with vaccines in humans. Even though there has been research in the past, it has not been successful until now.

Whereas in the past, vaccines worked by introducing small parts of either live or inactive viruses, in order to create a “memory” in the immune system against a future invader of the same type of virus; mRNA works in a whole different way. They actually introduced a protein in the injection, which causes the immune system to react and attack it as an invader. The protein then has a “plan” programmed (so to speak) inside to instruct the immune system to create antibodies for the COVID-19 virus, should it ever show up.

Clearly, this is a remarkable breakthrough in the world of vaccines! However, there are some concerns that worry some experts. mRNA’s protein is a foreign invader, and there is the possibility, albeit it slight, that it could trigger a immune response separate from the one intended, and cause an inflammatory response from the immune system. This was at the heart of some of the unsuccessful attempts with mRNA as a vaccine.

There is also the question of the effectiveness and safety in those people with chronic medical conditions. Is there data on how it works in those populations and communities? Almost 60 percent of American adults have at least one chronic medical condition. 40 percent of U.S. adults are obese; one of the most common underlying conditions that increases one’s risk for severe illness.  The more underlying medical conditions people have, the higher their risk. What percentage of the study population reflected people with pre-existing chronic conditions?

And then there are our seniors and elderly. Elderly and older adults are at greatest risk of severe disease and death from COVID-19. People older than 65 years makeup 9% of the world’s population, and yet they account for 30% to 40% of cases and more than 80% of deaths. A review of recent research literature shows that older adults were excluded from more than 50% of COVID-19 clinical drug trials and 100% of vaccine trials. Again, what percentage of the study population reflected people who were older?

According to the CDC, all but one of the COVID-19 vaccines that are currently in Phase 3 clinical trials in the United States use two shots. The first shot starts building protection. A second shot a few weeks later is needed to get the most protection the vaccine has to offer. What this means is that most of shouldn’t expect to receive and see protection from the vaccine (assuming it works, and enough people take it) until late spring or early Summer 2021. This means that the best thing all of us can do, regardless of our decision on taking the vaccine, is to remain vigilant in keeping up the protective measures of sanitation, physical distancing, and wearing face masks.

Finally, keep in mind that what we know so far about the vaccines is based on preliminary data. To date, there have been no peer-reviewed published studies. If it walks like a duck, and quacks like a duck, it’s a duck. This is still a clinical trial. Learn all you can; educate yourself and your family; make an informed decision. Don’t forget that Information is the Best Medicine”.

Remember, I’m not a doctor. I. just sound like one. Take good care of yourself and live the best life possible!

The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Fellow in Research Bioethics (2018) and Narrative Bioethics (2020). He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com

Nov. 23, 2020

COVID-19: A Real Different Holiday Season
By Glenn Ellis

(TriceEdneyWire.com) - As if losing the ability to gather for each of our traditional forms and places of worship, as well as mourning and burying our dead according to our customs wasn’t all we thought we could bear, COVID-19 continues to take its’ toll in unexpected ways. For most, this is the first time that we have to make a decision to forgo the annual holiday trip or skip the family gathering. No seeing the joyful faces of families and friends, as we have all come to expect and enjoy.

For some of us, this is the time to make amends for yearlong petty disputes; for others it’s a season to introduce new babies or significant others to the family; and then there are those for whom it is the therapeutic intervention we need to return us to our “roots’, and be infused with the familial and ancestral spirit that enables us to cope with the challenges of our daily lives.

It’s time for us to start to pay attention to the emotional and mental toll that the pandemic is causing in all of our lives; and whether we like it or not, we’re going to have to cope not just with our own emotions, but our family’s emotions, too.

Let me acknowledge that I am under no illusion that everyone doesn’t share this degree of caution or concern. We’ve seen a wide range of reactions to the pandemic, from those who take it very seriously to those who treat it like it’s not such a big deal. We have seen every day for the past six or seven months, that there are millions of people in this country who could care less about allowing this virus to interfere with their lives, especially during this holiday season. Even though the TSA screen over 2 million people at airports over a 48 hour period last week, I’d like to believe that most of us are like me, being cautious and following all of the CDC’s guidelines for preventive measures…like not traveling for the holidays. However, like me, many of you also have family and friends who are dismissive of the danger; and if so, you need to deal with the conflict if you have decided to skip the festivities. If your family and friends don’t think like you about the threat that this virus brings, then they absolutely won’t understand your decision not to celebrate your holiday season in a totally distant, but safe, way.

A couple of facts pointed out in research from the Kaiser Family Foundation makes clear why this concern is of particular importance for Black folks. We are “at an increased risk for serious illness if they contract COVID-19 due to higher rates of underlying health conditions, such as diabetes, asthma, hypertension, and obesity compared to whites; more likely to work in the service industries such as restaurants, retail, and hospitality that are particularly at risk for loss of income during the pandemic; more likely to live in housing situations, such as multigenerational families or low-income and public housing that make it difficult to social distance or self-isolate; and often working in jobs that are not amenable to teleworking and use public transportation that puts them at risk for exposure to COVID-19.

I don’t know about you, but every Black person I know either fits this profile or have a friend or relative who is a part of their normal holiday celebrations that they would contact if things go on as they have in holidays past. If you’ve made a decision to do things differently this year, remember that these people won’t understand, and you could find yourself in the throes of some deep resentment. Are you ready for that from the people you love and care about the most? How are you planning to approach these conversations? You might want to put some thought into it so that you will be prepared for the inevitable. The last thing any of us want is to cuase damage in our most meaningful relationships.

Always remember your responsibility to your friends and family, always make the goal to set a boundary and stick up for yourself and your family. Of course, food is a meaningful part of our cultural and history for our holiday experiences. If you live in close proximity to your family, consider a socially-distanced food exchange. So if you are not comfortable going to a family member’s house for a long sit-down meal, you can cook various dishes and drop them off.

It’s okay to admit that you’re sad and disappointed and that you’ll miss these events. But, it’s entirely possible to still turn the holidays into a positive experience with alternative plans, even if they’re not the plans you’d hoped for.

When you’re thinking about holiday rituals and adapting to new or different circumstances, ask yourself, again, if it’s something meaningful to you or something that feels like an obligation.

If it’s meaningful, think about how you can do the things to be safe, so that you can still recreate the experiences in the holidays to come.

Remember I’m not a doctor. I just sound like one! Take good care of yourself and live the best life possible! 

The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Fellow in Research Bioethics and Writing. He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com

Nov. 2, 2020

COVID-19: Structural Racism and Black Health
By Glenn Ellis

(TriceEdneyWire.com) - Throughout modern U.S. medical history, official reports and statistics have documented, and confirmed, the disproportionate burden of health carried by the Black community. Now, COVID-19 has not only brought incredible attention to myriad of chronic diseases and social determinants that lead to those health

outcomes but has made clear and indisputable how systemic racism works.

For all of us in the United States, the phrase “health disparities” or “health inequities” has never been made clearer than what are seeing with the impact of the COVID-19 pandemic on Black communities. For what is arguably the first time in this nation’s history, the entire country is witnessing exactly what has been historically denied the Blacks in healthcare. For generations, health disparities were thrust on us as though it was something “biologically wrong” with us.

Many of us, and the rest of America, actually believed that we were supposed to have higher rates of high blood pressure; diabetes; obesity; asthma; and many other chronic diseases. that had led to societal acceptance of the rate with which we die so prematurely; without any true medical or public health intervention.

High blood pressure is one of those “Black” diseases that is not only a chronic condition itself, but also is linked to heart attacks and strokes. For Blacks, the risk of being diagnosed with diabetes is 77 percent higher than for whites. A similar gap, with poor outcomes in equity, follows with all other chronic conditions.

It was an acceptable fact that mistrust in Blacks is something we are boing with that gets triggered by a memory or experience of an event or incident that we should “get over it, that was a long time ago!” Blacks, and mistrust were thought to be as inseparable as hand in glove. It was accepted as “fact” by many of us, and the entire healthcare system. Finally, because of COVID-19, all of America is feeling (and seeing) our pain!

For Blacks, the good news is that there is an underlying factor in these inequities that is seldom, if ever, mentioned in the scientific and medical reports that we get consistently in the media that “normalize” the notion of Blacks having higher rates of chronic diseases.

Turns out, we are the victims of an absence of a piece of vital information when it comes to understanding why we are “cursed” with so many chronic diseases that seem to affect generation after generation! Studies have shown that a term, first coined in 1993, called allostatic load is a huge factor in the unequal prevalence of chronic diseases between whites and Blacks in this country. Allostatic load is "the wear and tear on the body" which accumulates as an individual is exposed to repeated or chronic stress.

Your brain interprets and responds to environmental challenges that we all face in our lives. It manifests as anxiety disorders, depressive illness, hostile and aggressive states, substance abuse, and post-traumatic stress disorder (PTSD). There is growing evidence that depression and hostility are both associated with chronic diseases. this plays out as a product of the risk factors associated with early childhood experiences of abuse and neglect, which in turn increases their allostatic load later in life and lead many people into social isolation, hostility, depression, and subsequently to higher rates of chronic conditions than others.

Those individuals with a history of childhood abuse suffer greater early death and sickness from a range of chronic diseases. We find the same principle in those elderly who have had a lifetime of economic hardship ending up experiencing a more rapid decline of physical and mental functioning

All of this previously unknown information is a clarion call for Blacks to be vigilant in chronic disease management and pay close attention to diet, lifestyle, and primary healthcare. We all know that, “when America catches a cold, Black people get pneumonia. Whether it’s COIVD-19; chronic diseases, HIV/AIDS, or any of the other health issues that wreak havoc on us, we’ve got to realize that only we can save ourselves, and live healthy, productive lives.

Chronic diseases represent 75% of all health care costs in the United States and are 60 percent of all Americans have at least one chronic disease, representing 70% of all deaths. By 2030 that the total number of Americans will exceed 170 million.

Chronic diseases are linked strongly to the effects of structural racism on Blacks, but we don’t have the luxury of waiting for the system to change. We are not capable, on our own, of eliminating structural racism in our society; particularly in healthcare and medicine. What we can do is take care of ourselves as best of our abilities. Diet; lifestyle; stress management; and physical activity are things that help us all people protect their health, particularly from chronic diseases. It is even more important to be behaviors that Blacks have to pay even closer attention. There is much more to be done, as great disparities in this country in wealth, income, and education continue to plague our community.

Remember, I’m not a doctor. I just sound like one! Take good care of yourself and live the best life possible!

The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Research Bioethics Fellow. He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com