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Cancer Diagnoses Declining as COVID-19 Fears Rise

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Generally, to find cancer diagnoses declining would be good news, but this decline is due to fewer people willing to risk COVID-19 for a doctor visit. Six common cancers and their diagnoses were studied: breast, colorectal, lung, pancreatic, gastric and esophageal. A 46% decrease was found between March 1 and April 18 – the same time period the public was warned to stay away from doctors’ offices and emergency departments unless it was a true emergency.

safe doctor office practices to change cancer diagnoses declining

Since that time, safety procedures were put in place that lessened worry about these visits. Even though the warnings about visits are much fewer, the initial fear of visits – leading to diagnoses – are still less than pre-Pandemic.

How was the study conducted?

Quest analyzed tests ordered by doctors who entered the code for ‘new cancer diagnosis’. They began with a baseline covering January 2019 through February 2020. In the following seven weeks, March 1 through April 18, the mean weekly number for all six types of cancer diagnoses decreased 46.4% for those newly diagnosed with cancer. Quest found that in the baseline and pandemic studies, women with a mean age of 66 comprised 75% of their patients.

What does cancer diagnoses declining mean to patients?

Ned Sharpless, director of the National Cancer Institiute, stated this delay of diagnoses could mean 10,000 unnecessary deaths from breast and colorectal cancer over the next ten years. He also said, “We’re very worried about the consequences of … delaying therapy on our patients. We can’t delay cancer care forever.” This could be trading the COVID-19 crisis for a late cancer diagnosis crisis. The United States now has 163, 651 deaths from COVID-19 as of August 11, 2020. This is a huge number.

Other effects of COVID-19

The purpose of the National Syndromic Surveillance Program (NSSP) is to collect electronic health data in real time. They found that visits to emergency departments declined by 42% comparing March 31 – April 27, 2019  to March 29 – April 25, 2020.  This data covered visits from a subset of hospitals in 47 states. This led to acquiring data from approximately 73% of emergency department visits in the United States.

This demonstrates that patients afraid of going to the doctor’s office, also were slow to go to the emergency room. A person with arm or chest pain may decide it’s better to wait and see what happens than go to the emergency room, leading to a potential heart attack. Visits for nonspecific chest pain decreased by over 24,000 during the early pandemic.

They may try to ignore a severe headache and treat with OTC remedies when it could be a treatable stroke. They also may hesitate to go with abdominal pain, musculoskeletal pain, high blood pressure, and nausea and vomiting, respiratory infections – as well as sprains and strains. While some of these might be minor, others could lead to serious illness or death.

Those who use emergency departments as their primary healthcare – usually because of lack of access to primary care – may be significantly affected, leading to avoidance of their normal safety net.

What to do?

Authorities, and the media, must stress doctor visits, regular checkups and needed tests are still necessary to stop the number of cancer diagnoses declining. They must also reassure the public that health facilities have guidelines in place for monitoring entrance to facilities, mandatory face masks, and social distancing. All facilities need frequent access to approved hand sanitizers and hand washing stations. Good use of phone and video calls for triage can quickly assess emergency situations and limit crowds. For those afraid that telemedicine may not be covered with their insurance, check with providers. Currently, because of the emergency status, most insurances are paying as if in-person. In most cases, that also includes Medicare.

While COVID-19 is serious and can be deadly, so can ignoring early detection of cancer and other health risks.

Cancer diagnoses declining is the canary in the mine warning everyone that this is not a time to neglect health care.

Some Hand Sanitizers May Prove Dangerous

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Though hand sanitizers are widely used to prevent the spread of COVID19, some hand sanitizers may prove dangerous.

The Food and Drug Administration (FDA) discovered an increase in sanitizer products labeled to contain ethanol (ethyl alcohol) may, instead, contain methanol, a possibly fatal ingredient. Below are hand sanitizers to avoid completely. The FDA investigation continues for other problems. In general, use no hand sanitizer products manufactured by Eskbiochem.

What is methanol and what are the effects?

It is also called wood alcohol. According to the Centers for Disease Control and Prevention (CDC), it is present in industrial products as a solvent, pesticide, and alternative fuel source. When exposed to methanol – such as when cleaning hands – nausea and vomiting, headache, seizures, coma, blurred vision, permanent blindness, permanent nervous system damage and even death can result.

Products manufactured by Eskbiochem

These have been recalled:

•   Saniderm Advanced Hand Sanitizer which comes in 1-liter plastic bottles labeled “Made in Mexico” and “Produced by: Eskbiochem SA de CV” distributed by Saniderm Products and UVT.

  • The UVT hand sanitizer is labeled with lot number 0530 and an expiration date of 04/2022.
  • The Saniderm Products hand sanitizer is labeled with lot number 53131626 and “Manufactured on April/1/20.”

•  ITECH 361’s All Clean Hand Sanitizer, Moisturizer and Disinfectant: UPC code 628055370130.

•  Transliquid Technologies’ Mystic Shield Protection hand sanitizer: NDC numbers include 75477-435-02, 75477-435-10, 75477-435-12, 75477-435-25, 75477-435-50 and 75477-534-10.

These Eskbiochem products, to date, are not removed from the marketplace. Products to avoid include:

  • All-Clean Hand Sanitizer (NDC: 74589-002-01)
  • Esk Biochem Hand Sanitizer (NDC: 74589-007-01)
  • CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-008-04)
  • Lavar 70 Gel Hand Sanitizer (NDC: 74589-006-01)
  • The Good Gel Antibacterial Gel Hand Sanitizer (NDC: 74589-010-10)
  • CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-005-03)
  • CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-009-01)
  • CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-003-01)
  • Saniderm Advanced Hand Sanitizer (NDC: 74589-001-01)

The FDA also tested the following products and found they contained methanol or were “purportedly made at the same facility as products in which FDA has tested and confirmed methanol contamination.”

  • Grupo Insoma’s Hand Sanitizer Gel Unscented 70% Alcohol: NDC numbers include 75744-0200-3, 75744-0200-4, 75744-0201-5, 75744-0202-1, 75744-0250-1, 75744-0250-2, 75744-0500-1, 75744-1000-1, 75744-1000-3 and 75744-1001-1.
  • Soluciones Cosmeticas’ Bersih Hand Sanitizer Gel Fragrance Free: NDC numbers include 75165-003-02, 75165-004-01, 75165-005-01, 75165-006-01, 75165-008-01, 75165-250-01 and 75165-600-01.
  • Soluciones Cosmeticas’ Antiseptic Alcohol 70% Topical Solution hand sanitizer: No NDC numbers listed.
  • Tropicosmeticos’ Britz Hand Sanitizer Ethyl Alcohol 70%: NCD numbers include 76676-402-01, 77676-402-02, 77676-402-03, 77676-402-04, 77676-402-05, 77676-402-06, 77676-402-07, 77676-402-08, 77676-402-09, 77676-402-10, 77676-402-11, 77676-402-12, 77676-402-13, 77676-402-14, 77676-402-16, 77676-402-17, 77676-402-18, 77676-402-19 and 77676-402-20.

What should you do if you used or possess any of these products?

It is critical to get immediate treatment if you, or someone you know, was exposed to a hand sanitizer containing methanol. This can allow possible reversal of the toxic effects of methanol poisoning, but must be done as soon as possible.

Children who accidentally swallow these sanitizers are at greater risk, as is anyone who drinks these as a substitute for alcohol (ethanol.)

To dispose of these products, put them in hazardous waste containers immediately and take to a disposal site. Do not put them in recycling. Do not flush or pour them down a drain.

Remember, though some hand sanitizers may prove dangerous, the best sanitizing defense is to wash hands with soap and water for at least 20 seconds.

The Life or Death Decisions of Autonomous Vehicles

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Though not seen often – yet – autonomous vehicles are on the streets bringing the advantages of artificial intelligence (AI). The goal is to make driving decisions without the human tendencies toward distraction or impaired driving. These autonomous vehicles also must make life or death decisions when an unexpected event occurs. On what basis are these critical decisions made? Can this be programmed into a software driven car or truck?

Autonomous Vehicles Making Life or Death Decisions

Can moral decisions be programmed? If a self-driven car judges a potentially fatal accident is imminent, does it choose to sacrifice passengers or pedestrians? Does the number in each group matter; two passengers or five pedestrians? What if the passengers include a child and the pedestrians comprise a group of elderly citizens? Should it endanger passengers to avoid hitting an animal? These and millions of other difficult scenarios have been discussed for years. There is even a website platform, the Moral Machine, created by MIT Media Labs where anyone is invited to make judgements in these situations. So far, people in over 200 countries have contributed.

What does data show?

Interesting data has been uncovered from the Moral Machine regarding the decisions people would make. In general, there is a consensus to save children over adults. Yet, in Far Eastern countries, the elderly would be saved first. So, even areas of the world come to different decisions – Western, Eastern, Southern – especially in complex situations.

Nicholas Evans, philosophy professor at the University of Massachusetts, writes, “You could program a car to minimize the number of deaths or life-years lost in any situation, but then something counter-intuitive happens. When there’s a choice between a two-person car and you alone in your self-driving car, the result would be to run you off the road. People are much less likely to buy self-driving vehicles if they think theirs might kill them on purpose and be programmed to do so.” What people say in surveys versus what they would want to happen if they, or loved ones, are involved varies greatly.

Though extremely difficult to program to fit so many scenarios, there must be moral programming for the AI to make the autonomous vehicles accepted. This is especially true since there is not a global consensus for the morality of any given situation. In addition to life or death decisions, the vehicle is computing routes, traffic, obstacles, speed, condition of vehicle and countless other parameters.

What is next?

The ultimate goal is reducing accidents exponentially. Until almost all vehicles are controlled by AI and can interact, that will not happen. Even then, everyone who has anything electronic knows that there can be bugs and glitches, service going down, hackers, and the unknown.

Once there is an accident, there will need to be a decision on liability. These computer-driven vehicles will be equipped with essentially “black boxes” that record the previous 30 seconds or so of data. This information will make it easier to reconstruct what occurred, but who is to blame? What stage of the vehicle’s development created this accident: software developer, vehicle manufacturer, communication provider, or one of the other multiple vendors supplying parts?

Much is still unknown as this is a huge change in transportation globally. As more and more of these vehicles are introduced to our streets and highways, data collected will lead to more answers and probably more questions as well.  

Statistics on Vaping-related Diseases and Deaths Rise

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Statistics on vaping-related diseases and deaths rise almost daily, it seems.

  • On August 23, the first vape-related death was found. This patient used vaping for the nicotine content.
  • Another five deaths were reported within a month – some using vapes containing THC, others nicotine.
  • On September 11, the Trump Administration pushed for a ban on all flavored e-cigarettes in the US because of the attraction to under-aged youth.
  • By September 12, The Centers for Disease Control (CDC) reported a confirmed 26 states reported 380 cases of illness from vaping in addition to the six deaths.
  • September 15, Governor Andrew Cuomo of New York announced the first state ban on all flavored e-cigarettes, except tobacco and menthol. Michigan followed with their statewide ban.
  • By September 26, The CDC stats rose to 805 cases of lung injury in 46 states and one territory. The death toll was 12 people.
  • By October 4, the FDA published a statement, “[T]he agency believes it is prudent to stop using vaping products that contain THC or that have had any substances added to them, including those purchased from retail establishments. Simply put, inhaling harmful contaminants in the lungs could put a patient’s health at risk and should be avoided.” The FDA warning included purchasing vapes containing THC from retail stores or on the street.

Vaping-related diseases and deaths in Texas

These confirmed cases may be the first wave of a tsunami of illness and death from these innocent-appearing and marketed devices. It is notable that September 25th, the CEO of Juul, Kevin Bruns, stepped down from his position. Juul launched in 2015 and by 2017 had a larger e-cigarette market share than any other competitor, including the major tobacco companies. At the time Bruns resigned, Juul published a release stating Juul “suspended all broadcast, print and digital product advertising in the US.”

As of October 9th, 95 cases of severe lung diseases were reported by Texas health officials. These patients reported vaping before symptoms began. One person died as a result according to the Texas Department of State Health Services (TDHS). Another 28 deaths possibly involving vaping are under investigation. These patients are between 13 and 75 years of age, with a median age of 22. One quarter of patients are minors. TDHS reported approximately 9 in 10 cases vaped marijuana or THC, though the dangers of nicotine are not insignificant and much is still to be researched.

Texas is a big state, with many students in the vulnerable ages of the vaping trend. The Texas A&M University system now bans e-cigarettes and vaping in every “building, outside space, parking lot, garage and laboratory” according to John Sharp, chancellor of the Texas A&M system – this means all properties, not just the 11 universities. The University of Texas system also banned vaping in an overall tobacco ban in 2017, however, the American College Health Association recommends institutions go further. Since the wording might be misconstrued as applying only to traditional tobacco products, the association believes the wording must reflect strict no-tobacco language and include all methods of smoking, including e-cigarettes and vaping. 

Will the bans help?

A USA TODAY/Ipsos poll showed 80% of people agree purchasing of vaping devices should not be allowed for people under 21. 59% of respondents believe the ban will lead users to the black market, while 82% of vapers think that is true. Users also say government regulations will not reduce users, according to another survey.

If you are vaping, consider your health and that of those around you. Statistics are not in your favor.

Texas Wrongful Death and Survival Claims Explained

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There is often confusion about Texas wrongful death and survival claims, but Dallas serious personal injury attorney, Ben DuBose, explains, “When tragedy strikes and a person dies because of someone’s negligent conduct, Texas law provides for two general types of recovery in our civil court system: wrongful death and survival claims.”

Survival claims

Survival claims are those personal injury claims the deceased individual would have if they were living. The individual’s death does not extinguish these claims. Rather, they “survive” their death and belong to the estate of the decedent. Survival claims include claims for pain, suffering, mental anguish, lost wages, as well as medical expenses related to treatment of the injury that caused the death.

Wrongful death claims

In addition, claims can be brought by the family of the decedent for wrongful death. Wrongful death claims exist by statute in Texas and belong to the family members of the decedent for the loss of their spouse, parent, or child.

How wrongful death and survival claims work together

DuBose points out that “while wrongful death and survival claims are separate claims, they are brought in the same lawsuit.”

A surviving spouse, parent or child may bring the wrongful death action. However, if none of those individuals have brought the claim within three months of the death of their loved one, the executor of the estate may bring the claim.

Surviving siblings do not have standing to bring a wrongful death action in Texas. However, most states have a wrongful death statute and the classes of relatives with standing to bring a claim vary from state to state.

In some Texas wrongful death claims, exemplary damages are available. Exemplary damages are permitted if the jury finds a wrongful death is caused by a willful act or omission, or by gross negligence. The purpose of exemplary damages is not to compensate the family, but to punish a wrongdoer and to make an example that willful or grossly negligent behavior will not be tolerated.

The award of damages in a Texas wrongful death claim is typically made by a jury. The jury allocates the damage award among the surviving family members in proportion to the injury they suffered as a result of the untimely death.

The Texas wrongful death statute can be found here.