President’s Message

A Message from the President

by Cindy L. Russell, MD

SCCMA President

The Environment and Covid-19

Summertime… and like a lazy dog day afternoon the pandemic seems quiet. A little over a year after the onset of COVID we now are able to attend graduations that can be outdoors, and travel to vacation destinations with “precautions”. The pandemic, however, is still not over. COVID-19 is still rumbling around and causing smaller third surges in other states and countries, with an unprecedented and puzzling reemergence in India. This could be due to highly transmissible variants in combination with large crowds in celebration resulting in tragic consequences. As of this date vaccines have now been administered to about 42% of the population of the U.S., with 135 million fully vaccinated. John Hopkins reports that about 33 million people in the U.S. have had confirmed cases of COVID-19 with many others unconfirmed and thus immune from the virus. Herd immunity is now apparent.

New interim guidance by the CDC as of May 28, 2021, stated that because hospital and death rates are so low now, fully vaccinated people can “resume activities without wearing masks or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules and regulations, including local business and workplace guidance; and resume domestic travel and refrain from testing before or after travel or self-quarantine after travel.” Planes and trains and other forms of transportation still require masks as do physician’s offices.

Not all agree with shedding our masks and argue the incidence of COVID-19 is still higher in communities of color where vaccination rates are lower. In addition, there are still a small number of people who are getting COVID-19 after being fully vaccinated. A study of 6,710 health care workers in Israel found that eight had symptomatic and 38 had asymptomatic breakthrough COVID infections after being fully vaccinated. The CDC reported a total of 10,262 SARS-CoV-2 vaccine breakthrough infections from 46 U.S. states and territories as of April 30, 2021, where 27% were asymptomatic, 10 % were hospitalized and 2% died. Small numbers indeed but it still highlights that a level of precaution still seems warranted.

Academic data show that about 3-4% of the population has an impaired immune system, due to disease or organ transplants or cancer treatment or immune suppressive medications. Research has shown that a significant number of these patients do not mount an immune response and others may safe harbor the virus which can multiply and evolve, as was found in the New York B.1.256 variant in a patient with advanced AIDS. Research continues to reveal the mysteries of COVID-19, long haul and vaccinations. It will be a while before we know all the answers. In the meantime, appropriate and considerate masking and social distancing seem sensible.

The Environment and COVID-19

The COVID pandemic has underscored the environmental impacts of human activities, from air pollution to climate change to chemicals in consumer products that can cause immune suppression (PFAS). Environmental issues still loom large. This issue of the Bulletin highlights the SCCMA Environmental Health Series 2021 with discussions by experts in climate change, children and technology, children’s environmental health, and food and the environment. All of these webinars have been recorded and are available on the SCCMA. org website and You Tube. All are supremely educational, inspirational and worth watching and sharing.

Environmental Health Series 2021

Climate Change: Our series began on Earth Day, April 22, 2021, with the topic of climate change, featuring Dr. Santosh Pandipati, a fetal maternal specialist, and Amory Lovins, a leading international advisor to governments on addressing climate change. Dr. Pandipati provided a riv-

eting discussion of the effects of climate change on women’s health and reproduction, followed by an equally captivating and hopeful talk on energy efficiencies and new technologies by internationally recognized expert Amory Lovins, of the acclaimed Rocky Mountain Institute.

Children and Technology: On May 6 we had compelling and engaging presentations on Children and Technology: Schools, Screens and COVID-19 with psychologist and author of “Glow Kids”, Nicholas Kardaras, PhD, who discussed the pervasive issue of internet addiction; integrative psychiatrist and author of “Reset Your Child’s Brain,” Dr. Victoria Dunckley masterfully explained the dysregulation of children’s emotions with screen time; and two unapologetic honest veteran teachers, and authors of “Screen Schooled,” Joe Clement and Matt Miles, discussed the effects (and failure) of Zoom School on learning during the pandemic. A must see for teachers and parents who are concerned about this issue.

Children’s Environmental Health: May 20 gifted us with a special presentation by Dr. Philip Landrigan, one of a handful of global experts on Children’s Environmental Health, who literally wrote the seminal “Textbook on Children’s Environmental Health,” a chapter of which will be posted on our website. The question and answer period proved equally as revealing as the talk. The newest article he co-authored, “Public policy and health in the Trump era” (Woolhandler S et al 2021) is a candid blueprint for a sustainable future for all of us, as well as a good read. Dr. Gina Solomon, Clinical Professor at UCSF and co-author of “Generations at Risk,” provided a glimpse into her long-term work on children’s health and now community engagement, examining the cause of benzene-laden drinking water last year from the taps of fire-ravaged Northern California. We must all know this information.

Food and the Environment: The series ended on June 3 with Dr. Ted Schettler discussing “How Our Modern Food System Affects Our Health, Planetary Health and Opportunities for Change.” Dr. Schettler is co-author of “The Ecology of Breast Cancer,” “Generations at Risk,” and “In Harm’s Way,” publications that shake our conventional thinking about the modern convenient “forever” chemicals we so readily embrace to line our coffee cups and protect our shoes from stains. He was joined by Courtney Crenshaw of Health Care Without Harm, who inspired us with physician and community actions to move a new generation into equitable and healthy foods for all of us while preserving the critters we share the earth with. The discussion highlighted the direct and indirect consequences of large-scale factory farming on soil, water, air pollution, greenhouse gases and climate change, and how hospitals across the country have been changing their menu to support sustainable and nutritious meals.

We are lucky to have such skilled and caring individuals advocating on our behalf and on behalf of our children who will lead the future. Read more about them in this issue and be sure to visit SCCMA.org to link to the videos which I am sure will be shared and enjoyed by physicians and leaders alike. Think about getting involved. We need you.

Be informed, be kind, be hopeful, be safe.

Dr. Cindy Russell

About the Author

Dr. Cindy Russell is a board-certified plastic surgeon with the Palo Alto Medical Foundation, and the current Santa Clara County Medical Association President. She has also served as the Chair of the SCCMA Environmental Health Committee, and as a Delegate in the CMA’s House of Delegates. Dr. Russell is the Executive Director of Physicians for Safe Technology and is determined to bring environmental health issues and concerns to the attention of both physicians and the public.