All articles by Venugopal immadi
Venugopal immadi
Double jeopardy
Like they do every winter, health services across the northern hemisphere are gearing up for flu season – though this year, of course, they have to cope with rather more. With cases of coronavirus peaking and repeaking across Europe and North America, doctors risk being hit with a double emergency. Yet look to more southern climes, and the situation seems less hopeless. Andrea Valentino talks to experts on both sides of the equator to find out how southern hemisphere nations have fared with the two-pronged challenge, and what lessons, from vaccines to diagnostic testing, their northern neighbours could learn.
Put the world to the test
In a bleak milestone, the global death toll for Covid-19 has passed one million people. It’s impossible to say how many of these deaths could have been prevented, but it is clear that testing has a crucial role to play in stopping the count getting higher. Irenie Forshaw talks to Steven Woloshin, co-director of the Center for Medicine and Media at The Dartmouth Institute, and Bruce Tromberg, director of the National Institute of Biomedical Imaging and Bioengineering at the National Institutes of Health, about the lessons learned so far and what future testing strategies may look like.
The path to recovery
With the lung-protective ventilation used to treat severe cases of Covid-19 associated with an ‘air hunger’ similar to that experienced by victims of waterboarding, and patients suffering from delirium, the pandemic is placing a strain on facilities specifi cally designed to treat post-intensive care syndrome. Will Moffi tt speaks to James Jackson of Vanderbilt University Medical Centre and Richard M Schwartzstein from Beth Israel Deaconess Medical Centre about how critical care teams can protect patients from mental, as well as physical, damage.
Web-side manner
US Medicare claims for telemedicine jumped from ten thousand a week in March to well over a million a week in April. Most doctors weren’t trained for this. Tim Gunn asks Kevin Curtis and Matt Mackwood, telemedicine specialists at the Dartmouth-Hitchcock Health System, and Graham Kendall, head of the UK’s Digital Healthcare Council, how healthcare can best adapt to the remote world while maintaining its connection with patients.
Sharp relief
Needlestick accidents are a common cause of injury and can lead to psychological distress for healthcare workers. Natalie Healey explores the measures some hospitals are taking to bring down the rate of sharps mishaps, from emphasising the importance of PPE to taking trainees into virtual reality.
Heroes cleaned these
Before Covid-19, life down in the world’s sterile processing departments (SPDs) felt like a lot of pressure for little reward. Could the pandemic change that? Tim Gunn asks SPD directors Sharon Greene-Golden and Tony Thurmond what they’ve learned about working across their facilities and supply chains to help hospitals cope with the strain of keeping patients safe in the most difficult circumstances. Deep in the disinfected bowels of the hospital, far from patients’ eyes – behind airlocks and shoe covers – and further from their minds; go as low as the lifts go, lower than acclaim will follow: down to the nooks and gleaming crannies where nary a doctor dared before to venture; find the bardo where their instruments are purged. For there, someone whispers, they’ve still got PPE
Skin in the game
Burns have traditionally been treated with skin grafts, but some burns are so extensive that it can be hard to find enough healthy skin for the procedure. At the University of Toronto, researchers Axel Guenther and Marc Jeschke have developed a 3D bio-ink printer that can print new skin directly onto the wound. Kim Thomas talks to Guenther and Jeschke to find out more. Worldwide, more than 11 million people require medical treatment for burns every year. The traditional treatment for burns covering a large area is to carry out a skin graft, transferring healthy skin from another part of the patient’s body. It’s a process that involves creating another wound in the patient – and the greater the area of the burn, the more skin needs to be taken to cover it. As Marc Jeschke, director of the Ross Tilley Burn Centre at Sunnybrook Health Sciences Centre in Toronto, points out, “If you have a 10% wound, you create a 20% overall wound.”
In with both feet
Until recently, research into chronic wound care was small scale, localised and largely uncoordinated. The Diabetic Foot Consortium (DFC) is looking to change that. With an initial focus on bringing more advanced biomarkers for predicting wound healing and recurrence into the clinic, the DFC is the first ever research network of its kind. Tim Gunn speaks to Dr Teresa Jones, the National Institute of Diabetes and Digestive and Kidney Diseases’ project scientist for the group, and Professor Chandan Sen, the principal investigator for its first protocol.