MSSNY eNews: July 21, 2021 – Member Dr. Ariel Nassim Heads to Tokyo to Treat US Olympic Athletes

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MSSNY Member Dr. Ariel Nassim Heads to Tokyo to Treat US Olympic Athletes
When American athletes gather in Tokyo for the Summer Olympics, they will be joined by seven physicians, including MSSNY member Dr. Ariel Nassim, a specialist in internal and sports medicine with offices in Great Neck and Flushing.

Dr. Nassim will be stationed in the Olympic Village with 80% of the U.S. athletes. His typical day will start at about 8 a.m. with a medical team meeting to discuss health issues, such as upper respiratory tract infections, and whether any doctors need to attend that day’s matches.

“They invited me to the Pan Am Games, so I guess they appreciated the work I did,” Dr. Nassim, a member of the Medical Society of the State of New York [MSSNY], tells Newsday.  “I think my internal medicine background really came in handy for them as they often don’t have internists on staff.”

Read more in Newsday’s article, An Olympian Task Awaits Great Neck Physician for U.S. Team in Tokyo.


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AMA to Congress: Wake Up to Financial Peril Facing Medicare Payment System
The American Medical Association (AMA) raised concerns today that Congress seems “indifferent” to the fiscal uncertainty facing the Medicare physician payment system.

In a letter to congressional leaders, the AMA pointed out that physician practices face a 9.75 percent cut on January 1. Not only was Congress not taking up legislation to prevent this, but proposals are being floated that aim to wring out more money from payments to fund an infrastructure package.

“All this financial uncertainty comes at a time when physician practices are still recovering from the financial impact of the COVID-19 public health emergency, including continued infection control protocols that, while necessary, have increased the costs of providing care,” the AMA wrote in its letter. “The combination of all these policies would be challenging to endure in normal times. Yet, physician practices continue to be stretched to their limits clinically, emotionally, and financially as the pandemic persists well beyond 15 months. The enactment of further Medicare payment cuts will undoubtedly threaten patient access to care, especially considering the stark reality that, adjusted for inflation in practice costs, Medicare physician payment actually declined 22 percent from 2001 to 2020, or by 1.3 percent per year on average.”

The letter urged Congress to pass legislation to prevent the fiscal cliff awaiting on January 1 and to hold hearings on how to permanently improve the Medicare physician payment system, noting, “The state of the program is increasingly dysfunctional and, ultimately, it will be patients who suffer.”

Read the full text of the letter from AMA CEO James L. Madara, M.D. here.


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American Academy of Pediatrics Calls for Prioritizing In-Person Learning and Advises Schools to Prepare to Address Students’ Mental Health Needs
In updated guidance for the 2021-22 school year, the American Academy of Pediatrics strongly recommends in-person learning and urges all who are eligible to be vaccinated to protect against COVID-19.

In addition to vaccinations, the AAP recommends a layered approach to make school safe for all students, teachers and staff in the guidance here. That includes a recommendation that everyone older than age 2 wear masks, regardless of vaccination status. The AAP also amplifies the Centers for Disease Control and Prevention’s recommendations for building ventilation, testing, quarantining, cleaning and disinfection in the updated guidance.

AAP recommends universal masking because a significant portion of the student population is not yet eligible for vaccines, and masking is proven to reduce transmission of the virus and to protect those who are not vaccinated. Many schools will not have a system to monitor vaccine status of students, teachers, and staff, and some communities overall have low vaccination uptake where the virus may be circulating more prominently.

Research has shown that opening schools generally does not significantly increase community transmission with masking and other safety measures in place. Recently, COVID-19 variants have emerged that may increase the risk of transmission and result in worsening illness. Given the effectiveness of safety precautions when used consistently, children are at higher risk of suffering mental health issues and developmental setbacks if they miss out on in-school learning, according to AAP.

Other recommendations included in the AAP guidance are:

  • Schools should be prepared to adopt an all-encompassing approach for mental health support.
  • Adequate and timely COVID-19 testing resources must be available and accessible.
  • Strategies should be revised and adapted depending on the level of viral transmission and test positivity rate throughout the community and schools.
  • School policies should be adjusted to align with new information about the pandemic; administrators should refine approaches when specific policies are not working.[i]
  • School districts must be in close communication and coordinate with state and/or local public health authorities, school nurses, local pediatric practitioners, and other medical experts.

AAP also urges families to call their pediatrician and have children caught up on all vaccines they may have missed during the pandemic. This includes getting a vaccine to protect against influenza, which, like COVID-19, can cause severe illness and death.


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Important Information Regarding Johnson & Johnson COVID-19 Vaccine
On July 13, the U.S. Food and Drug Administration (FDA) announced revisions to the Emergency Use Authorization (EUA) fact sheets for the Janssen/Johnson & Johnson (J&J) COVID-19 vaccine to include information regarding an observed increased risk of Guillain-Barre Syndrome (GBS) after administration of the vaccine.  Based on an analysis of data from the Vaccine Adverse Event Reporting System (VAERS), there have been 100 preliminary reports nationwide of GBS following vaccination with the Janssen vaccine after approximately 12.5 million doses administered.

Although the available evidence suggests an increased risk of GBS after vaccination with J&J vaccine, there is not enough evidence to establish a causal relationship at present.  No similar signal has been identified for either the Pfizer or Moderna COVID-19 vaccines.

Updates to the EUA fact sheet for health care providers include a warning about GBS and information regarding the adverse event reports suggesting an increased risk for GBS.  The fact sheet for vaccine recipients has been updated to include information about GBS and explains that those who receive the Janssen vaccine should seek medical attention right away if they develop any of the following symptoms:

  • weakness or tingling sensations, especially in the legs or arms, that’s worsening and spreading to other parts of the body
  • difficulty walking
  • difficulty with facial movements, including speaking, chewing, or swallowing
  • double vision or inability to move eyes
  • difficulty with bladder control or bowel function.

Department of Health Advisory: New York State Has High Burden of Legionellosis
In 2018 New York reported more cases of legionellosis than any other state and twice the national incidence. Medical provider recognition of the possibility of Legionnaires’ disease (in persons with pneumonia), Pontiac fever (in persons without pneumonia) or Extrapulmonary Legionellosis (in persons with Legionella in sites outside of the lungs) coupled with appropriate diagnostic testing is critical to the identification and investigation of community clusters.

While legionellosis occurs year-round, the incidence of illness usually increases during the summer and early fall. Local health departments (LHDs), with the assistance of the NYSDOH, investigate potential timespace clusters of cases as they are recognized.

Legionnaires’ disease (LD) cannot be distinguished from other causes of pneumonia on clinical or radiologic grounds, including the virus that causes COVID-19. LD and COVID-19 both cause fever, fatigue, and respiratory illness (including pneumonia). In hospitalized or at-risk patients with suspected pneumonia, test for Legionella infection especially if testing for COVID-19 has been negative.

Read the full NYS DOH Advisory here.


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AIDS Institute’s Office of the Medical Director for a Public Health Physician II
Health Research, Inc. (HRI) has a job opening within the AIDS Institute’s Office of the Medical Director for a Public Health Physician II. Please distribute this announcement widely through your networks. Interested individuals can apply for this position through the HRI website.

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