MERS Outbreak in South Korea Hits Record High, 3 New Cases, 2 More Die

who says south koreas mers outbreak large and complex, photo courtesy of ritika patel

who says south koreas mers outbreak large and complex, photo courtesy of ritika patel

SOUTH KOREA - An outbreak of MERS (Middle East Respiratory Syndrome) in South Korea has led to 138 confirmed cases and 14 deaths, according to the World Health Organization (WHO). Just 17 hours ago news outlets reported 3 new cases with 2 more deaths.

A single traveler brought the disease to South Korea last month and since then it has spread exponentially overwhelming the healthcare system. Contributing factors include overcrowded emergency rooms, the sick and worried returning numerous times to hospitals, additional delays as medical professionals seek second opinions, coupled with an ill-trained medical community unfamiliar with the disease.

Currently, all cases have occurred have been traced back to a hospital where patient zero contracted the disease. Many citizens have started wearing surgical masks to protect themselves from infection. However, the larger community isn't taking any chances either and have subsequently closed more than 2,900 schools and quarantined 3,680 people. (Source: BBC).

An early setback has been a lack of government transparency. President Park Geun-hye has been accused of not being pro-active in his response and of withholding information about who has been infected. The mayor of Seoul, Park Won-soon, said that a now quarantined doctor attended a gathering of more than 1,500 people the day before he was diagnosed with the disease. (Source: New York Times)

However, the WHO has issued a statement that human-to-human transmission of the virus is only possible through very close contact. As long as reasonable measures are taken there is no need for panic. Currently, the WHO is working with scientists to better understand the disease, develop treatment strategies, and determine the best way to respond to the outbreak.

Although the disease is not well understood and has no cure, the spread of it has thus far been predictable. Most contagious diseases are opportunistic and are most easily incubated and spread in hospitals and other healthcare facilities due to close proximity of the infected. Although doctors and scientists are struggling to find a way to treat the infected, predictive and statistical models have proved invaluable in anticipating what part of the population is at greatest risks and thus help communities implement proactive precautions.

The disease originated in Saudi Arabia in 2012, and according to the Center for Disease Control (CDC) there is currently no vaccine to prevent MERS-CoV infection, but the South Korea outbreak is the largest outbreak outside of the Middle East. “MERS-CoV is thought to spread from an infected person to others through respiratory secretions, such as coughing. In other countries, the virus has spread from person to person through close contact, such as caring for or living with an infected person. (Source: CDC)

Contributing Journalist: @SJJakubowski
Facebook: Sarah Joanne Jakubowski

Live Like You Were Dying | Tim McGraw

Tim McGraw's song 'Live Like You Were Dying,' serves as yet another reminder that each of us is allotted a certain amount of time here on earth. None of us knows the date or hour that we will be called home, which is why we should live as if we were dying.

We often pity people with terminal illnesses, but in truth we all have a terminal illness because living is a terminal illness. We all are born and will die, it is just that some are more acutely aware of their impending demise. How would you live if you knew you would die soon?

Wouldn't you take the time to touch other people's lives in a more positive manner? Would you hold back from cursing out a driver who cut you off? Perhaps they just received a report from their doctor that so preoccupied them that they didn't even notice.

Would you care so much about office politics, celebrity gossip, jealousy, or despair over worldly or other ephemeral concerns? This was a wake-up call for me, and a remembrance to not judge others nor ourselves, but to start from where we are to live and to love!

Editor-in-Chief: @AyannaNahmias
LinkedIn: Ayanna Nahmias

United States Leads in Stealing Africa's Doctors

Pediatric doctors at Donka Hospital in Conakry, Guinea

Pediatric doctors at Donka Hospital in Conakry, Guinea

The United States is stealing the world’s doctors — and from the very places that need doctors the most. Dubbed the “international brain drain,” the United States leads the way in attracting international doctors, especially those from Africa.

The United States, with its high salaries, attracts more international doctors every year than Britain, Canada and Australia combined. However, for every 1000 people, Africa has only 2.3 health care workers, while the United States has almost 25. Doctors emigrating in droves from developing countries for “greener pastures” are making an already critical health worker shortage ever more dire.

But this brain drain is not new. In countries like Ghana, some 61% of doctors produced in the country between 1986 and 1994 had already left the country by 1999. The financial loss from emigration like this has been extremely detrimental. The loss from this period of emigration in Ghana alone is estimated at over 5.9 million dollars.

Foreign MDs
Foreign MDs

Not surprising, foreign medical doctors make up a substantial proportion of the doctors workforce in some of the most affluent countries in the world. More than 34% of doctors practicing in New Zealand were from overseas in 2000.  And according to a 2010 report in the Economie Internationale other developed countries have extremely high proportions of foreign doctors, including the United-Kingdom with 31%, the United-States with 26%, and Australia and Canada with more than 20%.

This is in part the result of initiatives like the 1994 U.S. legislation proposed to allow foreign doctors on student visas access to stay in the U.S. if they agreed to work in some of the poorest places in the United States. Since then, over 8,500 African doctors have left Africa and gained jobs at American hospitals that were in short supply.

A sneaky initiative. It looks great from the outside from its ability to give African medical students the chance to work in the U.S. for higher wages but it does nothing but continue to keep those living in “periphery” countries ever more dependent on “core” countries.

This is described by most scholars as the dependency theory — an economic model that became popular in the 1960s as a critic of the way the United States, along with many western countries, exploits those in the “periphery” for their own gain.

Poor countries provide resources, in the form of raw materials, cheap labor, and a market to those countries in the core. While wealthy countries in the core perpetuate their dependence in every way possible — through control of the media, economic politics, banks and finance insinuations like the International Monetary Fund (IMF) and the World Bank, educational initiatives, cultural exploitation, and even sporting events like the World Cup.

Indeed, this exploitation is clearly exemplified by the emigration policies facilitating the exodus of medical doctors from Africa over the past decade. Of the 12 African countries producing the most medical graduates, 8 have seen a 50% increase from 2002 - 2011 in all graduates appearing in the U.S. physician workforce. Cameroon, Sudan, and Ethiopia each had over a 100% increase since 2002.

These policies in place, that are sucking up some of Africa’s greatest doctors, are just further methods of perpetuating the poorest country’s dependence on the wealthiest.

It becomes clear then that while the United States benefits, Africa only appears to benefit. The U.S. gains excess doctors, while Africa looses the few it barely has.

While the United Sates grows its ratio of 2.45 doctors for every 1000 people, countries like Mozambique see a decrease in the already alarming rate of .04 doctors for every 1000 people.

Health professionals around the world agree that human resources is the most key component to solving problems in global health. But it is often one of the most neglected components, with much more emphasis focused on managing disease outbreaks and not the people actually preventing diseases.

Oliver Bakewel, of the International Migration Institute, agrees with this logic in writing that “development practice has commonly seen a reduction in migration as either an (implicit or explicit) aim of intervention or an indicator of a programme’s success" in an 2007 report.

However some scholars at the World Bank disagree with the notion that migration is inversely proportional to success in African development. A 2014 article in The Atlantic headlined "Why the brain drain can actually benefit African countries," outlined their findings that suggest "one additional migrant creates about 2,100 dollars a year in additional exports for his/her country of origin.”

However, this argument does not look closely enough at the brain drain for specifically medical doctors.

The brain drain intersects more than just the medial field — it cross cuts every highly skilled profession. But the effects of the brain drain on the status of health care in Africa is much more harmful than that of the brain drain of — for example — African professors. The average increase of 2,100 dollars in exports will do nothing to solve the critical and immediate lack of medical doctors in almost every African country.

The time is here more than ever for the international community to play a more proactive role in addressing the international medical brain drain. Affluent countries like the United States should be held accountable for exploiting Africa for its doctors, while international policies should be put in place to help African governments increase wages for health workers and retain their much needed doctors.

Contributing Editor: @AustinBryan
LinkedIn: Austin Drake Bryan

To Spite Obama Health Insurance Companies and Pharmaceuticals Choose to Kill Citizens

a-child-wishing-for-health-photo-by-all-childrens-hospital.jpg

WASHINGTON, D.C. – At midnight on December 31st the world retired 2014 to make way for 2015. For many it marked a night of festivities, parties, and insouciance. For others, like me, it was the day which marked the resetting of health insurance premiums, deductibles, and prescription coverages which would inevitably result in increased costs.

In the days prior, I frantically traveled to doctor's offices and pharmacies to get all of our prescriptions refilled before January 1st. In one instance, my son's pediatrician wouldn't authorize refills for his asthma medications without an appointment. Thankfully we were able to be seen by him on an emergency basis on the morning of December 31st. It was with grateful relief that he wrote all of the prescriptions needed and that I was able to get them filled before the pharmacy closed.

Unfortunately the insurance company would not authorize the refill of one of my son's most expensive medications until after the new year. One might think, with the figures I am about to report, that the medications to which I am referring are 'Brand Named' versus 'Generic.' However, this is not the case. In 2014, before I met my plan deductible, the generic version of one of his medications was $250 for a 30-day supply, while the cost for the brand name was $491. After I met my annual deductible, the costs of this medicine was reduced significantly to $50 for a 30-day supply of the generic which was a great costs savings for our household.

This reduction from my perspective directly correlated with the enactment of The Affordable Care Act (ACA) which was passed in 2010. The ACA, also known as 'Obamacare' made health coverage mandatory and also provided the means for the uninsured to purchase affordable insurance through exchanges which would help regulate the market prices. For me it was a blessing because it reduced my premiums and enabled me to purchase 'individual/self-pay' insurance without having to pay exorbitant premium fees because of 'preexisting' condition as defined by insurance companies such as Asthma, Cancer, Heart Disease, etc.

The cost to maintain this insurance is expensive, but compared to what I paid for COBRA Continuation Health Coverage in 2012, the 33 percent reduction in premium costs was a welcomed relief. I went from paying $1,660 per month to just over $550 per month for better coverage. The only catch was that my prescription costs increased significantly and thus the net/net was actually more like a 20 percent reduction in costs once this was factored in. However, providing the best healthcare for my son was non-negotiable and often meant that bills remain unpaid, and in some instances I didn't refill my medication or go to see the doctor when I needed.

Then, on November 14, 2014, The New York Times reported that "The Obama administration on Friday unveiled data showing that many Americans with health insurance bought under the Affordable Care Act could face substantial price increases next year — in some cases as much as 20 percent — unless they switch plans." Proponents of ACA asserted that this demonstrated that the legislation was working while Republican opponents pointed to these increases as proof that it is not.

As a parent and someone who is directly impacted by the ACA, I can categorically state that without it neither my son nor I would have insurance coverage. I couldn't have afforded to pay $3,000 a month in premiums and prescription costs because of 'preexisting conditions.' From my perspective the 2015 rate increases coupled with inflation in costs for generic medicines is a ploy devised by the insurance companies and pharmaceuticals to incite an already cash strapped American consumer to work against their own best interest. The premise that healthcare for average Americans was better prior to the passing of the ACA is ludicrous.

Me and millions of other Americans remember the heartache and pain of having to watch one's child suffer because an insurance company informed you that your child's healthcare costs would no longer be covered because of an "annual or lifetime" dollar limit. Other parents were faced with the necessity of mortgaging their homes, working several jobs, and making other sacrifices so that they could pay for expensive cancer or heart disease medicines. We all thought these days were behind us, but it turns out that 'we' have become collateral damage in what has been advertised as a war between the Republicans and President Obama.

In reality it is about greed. Providing access to affordable healthcare and prescriptions is not a luxury, it is a need. Parents like me are not 'lazy ne'er-do-wells' seeking to sponge off of the government. We are hard-working individuals who make difficult choices so that our children may live and grow up to be healthy contributors to society. The ACA provided us with hope for such a future, but insurance companies and pharmaceuticals have found a new way to game the system.

Anecdotally, it appears that since insurance companies are forced to insure people who may cost them money, they will make insurance available but the quality of that service is dependent on one's ability to pay for it. Thus, the better the insurance the greater the costs. However, this doesn't help them to recoup their losses (i.e. executives can't buy a new yacht, jet, exotic car, or mansion), so they turn to the pharmaceutical companies to further pressure consumers into lobbying for the dissolution of Obamacare.

When the media first began to report that generic medicine prices would increase substantially I worried but not much. Then, The Chicago Tribune reported on the rising cost of generic drug prices, and I became concerned but couldn't imagine an increase greater than a few percentage points. Then on January 3rd when I asked the pharmacists to fill the one prescription remaining from 2014, I was shocked to learn that the price increased from $50 for a 30-day supply to $391 for a 30-day supply. That was for GENERIC not brand name! I contacted my insurance company and was given a clearly ridiculous story that the cost of manufacturing the drug had increased.

Asthma can be a life-threatening condition and not taking his medication for a few days though not recommended, is not going to kill him. The same cannot be said of parents who have children with a terminal illness like cancer, in which treatment consists of multiple medications and a single prescription can cost upwards of $1,500 per month. Thus, the title of this article seeks not only to grab your attention, but also to help people understand that by taking away our ability to purchase life-saving medicine so that a pharmaceutical company can increase it's profit margin is immoral, reprehensible, and absolutely inhuman; and like it or not the choice to drastically increase the cost of generic drugs is tantamount to 'killing citizens.'

Follow Nahmias Cipher Report on Twitter Twitter: @nahmias_report Editor-in-Chief: @ayannanahmias

Related articles

Human Trials to Test Ebola Vaccine Begin

flu-vaccinations-in-europe-photo-by-u-s-army-corp-of-engineers.jpg

WASHINGTON, D.C. - The National Institute of Health (NIH) has received approval from the U.S. Food and Drug Administration (FDA) to begin human testing of a new Ebola vaccine. This will be welcome news for the millions of Americans who now face the very real possibility of encountering someone with the disease or contracting it themselves.

Currently, 357 people are being monitored in New York for possible exposure to the deadly virus, and Texas which was the epicenter for the first mortality from Ebola in the U.S. has been declared Ebola free.

According to the Los Angeles Times, "Nine people have been treated in the U.S. for Ebola, including Thomas Eric Duncan, a Liberian who died last month. One doctor, Craig Spencer, remains hospitalized in stable condition in New York."

The vaccine is undergoing a "human safety trial," which means it will be tested on "healthy human subjects to evaluate the immune response, identify any side effects and determine the appropriate dosage." (Source: NewLink Genetics)

The vaccine was developed by the pharmaceutical company Glaxosmithkline and the National Institute of Allergy and Infectious Diseases (NIAID), and is one of several being developed worldwide.

Earlier in the outbreak, the drug Zmapp was administered to seven aid workers. Five of the workers survived, though it's unclear how large a role the drug played in their survival. Due to the emergency status of the outbreak, treatments are not being monitored and tested as thoroughly as they would be if there was more time. Nevertheless, the U.S. Department of Health and Human Services has granted an $24.9 million 18-month contract with the manufacturer of Zmapp to expedite the development process.

VSV-EBOV is another experimental vaccine for the Ebola filovirus, developed by scientists at the Canadian National Microbiology Laboratory and is currently being tested in clinical trials in the U.S. at the Walter Reed Army Institute of Research in Silver Spring, Md. This vaccination purportedly does not induce any fever or other symptoms of illness. There is also evidence that this type of vaccine which can be administered orally or intranassaly as nose-drops may have potential as a treatment for those already infected. (Source: Wikipedia)

In Canada, permission has been granted for the vaccine VSV EBOV to be sent to Africa, but problems such as refrigeration during transport and storage have come up. Many of the villages that are most in need are in remote areas with bad roads, infrequent electricity, and and treatment is further hindered by the citizens mistrust of new technologies. It's clear that while developing a vaccine is an enormous step forward in the Ebola fight, there are still many political and practical obstacles to overcome.

Follow Sarah on Twitter Twitter: @nahmias_report Contributing Journalist: @SJJakubowski

Related articles

Generation Z, Tobacco Free?

smoking-dude-photo-by-michiel-s.jpg

Michael Ransom, Contributing EditorLast Modified: 11:45 p.m. DST, 8 July 2014

Butts2, Photo by Dave Hull UNITED KINGDOM -- Could the generation born after the year 2000 be the first generation in the Western world to be cigarette free? Doctors throughout the United Kingdom are hoping so.

The British Medical Association (BMA) has voted in favor of a law that would ban the sale of cigarettes to the newest generations, while grandfathering-in older age groups, who would still have legal access to the tobacco product.

The effort is extremely controversial, and would effectively signal the beginning of the end of cigarette production. The curbed cigarette consumer market would continue to age, and cigarette companies would slowly close up shop.

But, could this move have negative consequences? Many people are saying so. With any sort of prohibition, such as the alcohol prohibition in United States during the 1920s and 30s, people do not give up habits and addictions overnight in response to the legal status of the product in question.

Some groups are warning that this measure could backfire, and tobacco sales could explode on the black market. And in these underground markets, there would be no way to deny cigarette sales to minors.

Critics claim that youth smoking rates could actually increase, maybe even by drastic proportions. But this fear is not enough to change the recent strategy of the BMA. If the British Parliament agrees with this prestigious medical organization's take on nicotine addiction, then serious changes could be forthcoming.

The BMA does not recommend the prohibition without some quantitative backing. The association of doctors cite a study in which two out of every three people interviewed wished they had not begun smoking in the first place. According to the BMA, the proposed initiative could help Generation Z avoid the deadly habit, before they pick up their first cigarette.

Follow Michael on Twitter Twitter: @nahmias_report Contributing Editor: @MAndrewRansom

WHO, West African Ministers of Health Develop Ebola Strategy

public-safety-ebola-campaign-photo-by-unicef-liberia.jpg

Sarah Joanne Jakubowski, Ghana CorrespondentLast Modified: 13:50 p.m. DST, 07 July 2014

Ebola outbreak in Guinea, Photo by Photo by International Federation of Red Cross and Red Crescent Societies

ACCRA, Ghana -- Last week an Emergency Ministerial Meeting was held in Accra to discuss the growing Ebola epidemic.

The disease, which can have up to a 90% fatality rate, started in rural Guinea then spread to neighboring Liberia and Sierra Leone. Without intervention, it will continue its international invasion.

The World Health Organization (WHO) says the proposed strategy to treat, control and prevent Ebola will cost $10 million and would need to be put into place within the next six months.

Representatives called on the African Union and The Economic Community of West African States (ECOWAS) for the funds.

The plan would set up an Ebola treatment and research center in Guinea as well as smaller centers in other affected areas. Funds will go to training and deploying staff, providing medical equipment and supplies to affected or at-risk regions and educating the public.

An emphasis was placed on research, both to develop treatments and cures and also social research to gauge public understanding and reaction to the disease. However, Africa's research facilities were described as "weak" and a request for global collaboration among scientists was issued.

When asked if border control was a viable solution to control the spread of the disease, the idea of country-wide quarantines was shot down.

Ministry of Health & Social Welfare (MOHSW) Liberia explained that there were so many border crossing points it would be impractical to watch all of them. The Minister went on to say that while his country was able to stop several travelers who were carrying the disease, there were many false positives and possibly cases where infected travelers were not yet showing symptoms and so got through. A key problem was that Ebola can incubate unnoticed for up to 21-days in a seemingly healthy person.

Some traditional practices can help spread diseases, and doctors across the region are urging people to seek assistance from trained doctors or one of the international organizations that are on the ground providing help, education, and intervention. Organizations such as UNICEF Liberia, The International Federation of Red Cross and Red Crescent Societies (IFRC), and Medicins Sans Frontieres.

These organizations in conjunction with local doctors and government health officials urged all West African citizens to take precautions when handling the sick and deceased. Practices involving delayed burials and prolonged contact with the dead facilitate disease spread.

"People don't know what they're dealing with" explained, emphasizing the need to especially educate churches, those whose jobs involve handling the dead, as well as the need to educate family members about Ebola so that the sick can seek immediate treatment to avoid infecting others.

This is a very urgent issue, and though citizens in the West may feel that they are immune from this disease, it takes just one person to breach the borders of any Asia, Middle East, European Union, or North/South American countries for the deadly virus to become a global pandemic.

Follow Sarah on Twitter Twitter: @nahmias_report Africa Correspondent: @SJJakubowski