Houston Medical Times by Rick Delarosa

Serving Harris, Brazoria, Fort Bend and Montgomery Counties

HOUSTON

Volume 10 | Issue 4

Inside This Issue

April Edition 2020

The Growing Role of Telehealth During Covid-19 Outbreak By Mary Leigh Meyer

T Soap vs. Antibacterial Soap See pg. 7

INDEX Legal Matters........................ pg.3 Mental Health...................... pg.4 Financial Forecast.............. pg.5 Oncology Research......... pg.6 Healthy Heart..................... pg.13

he coronavirus, COVID-19, is rapidly spreading across the globe. Those individuals with a suspected case of COVID-19 are being asked to self-quarantine for up to two weeks. Similarly, more and more health care providers are coming into routine contact with infected individuals, putting them at risk for contracting the disease themselves. “With the restrictions this virus is putting on people and required quarantines, the medical and mental health fields are searching for creative solutions to care for COVID-19 patients while protecting communities from widespread exposure,” said Carly McCord, PhD, director of Telebehavioral Care at the Texas A&M University Health Science Center (Texas A&M Health) and clinical assistant professor in the Texas A&M

College of Medicine and Texas A&M College of Education and Human Development. “Already, telehealth and telebehavioral health is being seen as part of the solution to some of the COVID-19 specific barriers to care.” Telehealth during times of crisis “Telehealth has always been a

great option, but COVID-19 is now forcing the option for a lot of providers across the nation,” said Katie Console, program coordinator at Texas A&M Telebehavioral Care and counseling doctoral psychology student in the see Telehealth... page 12

Rice Develops $300 Ventilator to Help Fight Coronavirus By Mike Williams

UH Optometrist Sewing Masks for Health Workers See pg. 10

ice University and Canadian global health design firm Metric Technologies have developed an automated bag valve mask ventilation unit that can be built for less than $300 worth of parts and help patients in treatment for COVID-19. The

collaboration expects to share the plans for the ventilator by making them freely available online to anyone in the world. Faculty and students went into overdrive several weeks ago Automated bag valve mask ventilator unit that can help when requests began pouring critically ill COVID-19 patients help get air into the lungs of people into the university seeking plans for an early prototype developed in having difficulty breathing on their own. But the masks are difficult to 2019 by Rice engineering seniors. That now-alumni team of squeeze by hand for more than a few Madison Nasteff, Carolina De minutes at a time. Dr. Rohith Malya, an assistant Santiago, Aravind Sundaramraj, Natalie Dickman, Tim Nonet professor of emergency medicine and Karen Vasquez Ruiz, calling at Baylor College of Medicine, themselves Take a Breather, designed an adjunct assistant professor of and built a programmable device bioengineering at Rice and associate able to squeeze a bag valve mask. of the Rice 360° Institute for Global These masks are typically carried Health and a principal at Metric by emergency medical personnel to see Ventilator... page 14

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Houston Medical Times

CARING TAKES TRUE COURAGE. THANK YOU FOR YOUR SACRIFICE.

THANK YOU TO EVERY PHYSICIAN, NURSE, FIRST RESPONDER AND HEALTHCARE WORKER IN THE GREATER HOUSTON AREA. Thanks to those being called away from their own families to be of service to yours. And we thank the people of the Greater Houston area for taking every step possible to safeguard your own health. Thank you for the sacrifices you’re making. And for the impact you’re having on all our lives.

Advancing health. Personalizing care.

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Legal Matters Responding to Covid-19 In the Workplace: Five Things an Employer Should Do By Lindsay Ryan, J.D. Polsinelli, PC

in response to an infected or exposed employee: • Isolate Affected Employee: If an employee has reported a confirmed case of or exposure to COVID-19, the employer should immediately isolate the affected employee and take steps to limit the spread of he rapidly developing COVID-19 the person’s infectious respiratory pandemic has left many health secretions, including by providing care providers carefully balancing them with a facemask. In contrast the sometimes competing concerns to Personal Protective Equipment of maintaining a safe and healthy (“PPE”) intended for workers, the workplace and retaining sufficient mask acts to contain any infectious staffing to care for patients during a secretions from the individual’s period of high demand. nose or mouth. Unless urgent As the country confirms an medical attention is required, increasing number of COVID-19 cases, the employee should ultimately employers must prepare for the probable self-quarantine at home and scenario where one of their employees consult their health care provider. contracts COVID-19 or reports that • Investigate and Assess Potential he or she has been exposed. Health Exposure to Others: Employers care providers will be expected to act should promptly investigate and quickly to protect the health and safety determine who may have been of their employees, patients and visitors in close or direct contact with and should have a response plan ready the affected employee and who to execute. The following outlines the may need to self-quarantine. Hou_Med_times_ad_3_2020.pdf 1 3/11/20 5:25 PM critical steps any facility should follow Pursuant to CDC guidance, “close

contact” includes “being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time” or “having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on).” [https://www.cdc. gov/coronavirus/2019-ncov/hcp/ clinical-criteria.html] In making this assessment, employers should consider both duration of exposure, the clinical symptoms of the person with COVID-19, and whether potentially exposed individuals were wearing PPE at all relevant times. Close contact generally does not include brief interactions, such as walking past a person. • Identify and Decontaminate Impacted Workspaces: In addition to identifying exposed individuals, employers should investigate and identify workspaces occupied by the affected employee (or others who may have been exposed to the virus), as well as surfaces, tools and equipment utilized by affected employees, and take measures to thoroughly decontaminate such

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areas and objects. Health care facilities should consult the CDC for specific guidance on cleaning and disinfecting work areas. Importantly, employers must also comply with all OSHA regulations applicable to workers engaged in these cleaning efforts to ensure they are properly protected from exposure to blood, certain bodily fluids, and other potentially infectious materials or hazardous chemicals. • Report and Provide Appropriate Notice of Exposure: Health care providers should notify local health authorities of any instance of exposure to enable an epidemiological investigation. Additionally, employers should notify any employees of their potential exposure to the virus. In doing so, employers should be see Legal Matters...page 14

CMY

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Mental Health Managing Stress During The COVID-19 Pandemic By Simone Sonnier

hile we are all focusing on taking care of our physical health as the outbreak of COVID-19 develops, it’s also important to keep our mental health a priority. When there is a major concern for ourselves or our loved ones falling ill, the emotional impact of that can be great. It’s human nature to want to stay informed, however it is important that overexposure of media coverage can cause more stress. “Many people will turn to social media or the news to learn more about what’s happening, thinking that this will help. While being informed is important, continuously checking the news and seeing repeated images and reports about the virus can provoke more anxiety without necessarily increasing knowledge about virus transmission,” said Leslie K. Taylor, PhD, an assistant professor in the Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern

April 2020

Medical School at UTHealth. Instead of information overload, consider designating specific time to check reliable sources such as the Centers for Disease Control and Prevention and the World Health Organization. Both organizations give regular updates on COVID-19 and share methods for coping with the outbreak. Individuals with preexisting mental health conditions, including substance use, may be more vulnerable to stress. “Keeping a routine, eating healthy, and resting will help alleviate stress. If self-quarantining, maintaining a sense of connection with friends, family and community is also important. Isolation from others can result in feeling sad or hopeless,” said Taylor, who is also a psychologist specializing in post-disaster behavioral health functioning at UT Physicians Psychiatry Outpatient Clinic. Taking time for ourselves by

doing things that we enjoy or keep us calm can help us get through this difficult time. Create a list of practical relaxation activities and perform them a few times a day. This can be meditating, deep breathing, stretching or even just sitting quietly and mindfully. “It’s okay to be upset, but we should all stay hopeful. Experts in public health are working across the world to deliver high-quality care and

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ensure everyone’s safety,” said Taylor. Prolonged isolation and separation as a result of quarantine or illness could have a traumatic impact on families as a whole. UT Physicians patients who are experiencing emotional distress due to COVID-19, may consider booking an appointment at the UTHealth Trauma and Resilience Center, which can be reached at 713-486-2630.

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Financial Forecast Tax Traps to Avoid when Using Life Insurance as a Financial Planning Tool By Grace S. Yung, CFP Managing Director Midtown Financial Group, LLC

Be Careful If You Use Life Insurance

ollowing the passage of the SECURE Act, life insurance has become even more attractive as an estate planning tool. For example, with the elimination of the “stretch IRA” – which allowed traditional IRA beneficiaries to access funds over a long period of time (and in turn, reduce the impact of taxation) – life insurance proceeds can help replace this lost wealth. A life insurance retirement plan, or “LIRP,” can provide another benefit in your strategy, via tax-free income that is accessed as a policy loan rather than a taxable withdrawal. Likewise, this cash could also be used for paying off debt and/or financing large purchases like a new vehicle. But while life insurance can offer

many tax-advantaged opportunities, it is critical that the policy is properly structured. Otherwise, it could end up losing its enticing tax benefit, and you could find yourself (and/or your beneficiaries) still having to pay taxes. How to Ensure that the Life Insurance Tax Benefits in Your Estate Plan Don’t Backfire Throughout the years, more advanced life insurance strategies have been implemented, primarily because they can provide some significant tax-related advantages. For example, death benefits are received income tax free to beneficiaries. In addition, cash value on permanent life insurance policies allow tax-deferred build-up of the funds inside the policy, meaning that no taxes are due each year on the gain in the account. This can equate to a substantial, compounded increase in the cash value over time. But using such strategies can end up backfiring if they are not properly structured. So, it is important to follow the rules pertaining to using

this coverage in your overall planning. Otherwise, you could find that can cause some unpleasant tax-related issues. Even with the right policy in place, you could face issues that can turn a policy with numerous tax advantages into a taxable situation. For example, “overfunding” a permanent life insurance policy, could turn it into a Modified Endowment Contract. This is a life insurance plan where the cumulative premiums that have been paid into it during the first seven years are more than the amount that is necessary for providing a “paid up” policy, based on seven “statutorily defined” level annual premiums. This therefore would make withdrawals taxable. There are other life insurance “tax traps” to be mindful of, too, which could even deem the policy’s death benefit as taxable. For instance, “the

Goodman Triangle” can arise when three different people / entities play the roles of the insured, beneficiary, and policy owner. In this case, if Person A (the owner) owns a life insurance policy on Person B (the insured), and names Person C as the beneficiary, if the insured dies and the beneficiary receives the death benefit proceeds, these funds can be viewed as a taxable gift from the owner to the beneficiary, and can subject the owner to gift taxes (on the amount that is over the $15,000 gift tax exemption in 2020). It is also important not to pull out all of the policy’s cash value, as this could trigger a taxable event. With that in mind, working with a financial advisor who is well-versed in life insurance strategies as a risk management tool, as well as how to best structure a plan to help reduce, or even eliminate taxes, is essential. 

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Oncology Research Never Too Young: What Adults Under 50 Need to Know About Colorectal Cancer By Cesar K. Tin-U, M.D., Texas Oncology Sugar Land

h, youth! A time of mostly carefree, exuberant living, right? That’s what it should be. But the truth is unexpected health concerns can cloud that ideal vision. Recent research indicates that colorectal cancer is on the rise in younger adults, an emerging and troubling trend for oncologists like me. In the past 25 years, cases of colorectal cancer in those under the age of 50 have increased by 51 percent, according to the National Cancer Institute. While the direct cause of this increase varies by patient, one thing is clear: cancer knows no age restrictions. That’s why it’s crucial for adults of all ages to become more informed about their colorectal health and learn to recognize cancer signs and

symptoms. The good news is that colorectal cancer death rates continue to drop due to advancements in screening, prevention, and treatment. The questions and answers below can help you better understand how to take control of your health. Am I at risk? Age is just one of many risk factors related to colorectal cancer. It’s vital for people for people under the age of 50 to become familiar with the other risk factors. Diets heavy in red and processed meats have been linked to increased risk, as has obesity, diabetes, and inactivity. Those with a history of polyps or inflammatory bowel disease may also be at higher risk. Risk is also tied to family history or inherited syndromes, such as Lynch Syndrome. When should I get screened? If you were born around 1990, you have double the risk of colon cancer and quadruple the risk of rectal cancer compared to people born around 1950, when risk was lowest, according to the American Cancer Society. This trend led the ACS to revise its colorectal

cancer screenings guidelines to recommend most people begin regularly screening at the age of 45, instead of 50. Those with increased risk factors should consult their physician about whether to begin screenings earlier than age 45. What signs and symptoms should I watch for? Even those under the age of 45 should pay close attention to the signs and symptoms of colorectal cancer – and so should their doctors. While colorectal cancer often doesn’t have symptoms until later stages, the most common signs include changes in bowel habits, rectal bleeding, dark or bloody stool, cramping or abdominal pain, weakness and fatigue, and unexplained weight loss. No matter your age, don’t hesitate to see a doctor. What are the key challenges? The Colorectal Cancer Alliance found that 85 percent of young adults with early-onset colorectal cancer experienced anxiety or depression, 64 percent took a leave of absence from work or school, and 62 percent experienced financial difficulties.

Young adults living with colorectal cancer shouldn’t be afraid to seek help. Many resources, such as counseling and social work, tips for managing cancer in the workplace, and guidance on family planning, are available through providers like Texas Oncology. When it comes to colorectal cancer, the facts tell the story. The five-year survival rate for colorectal cancer discovered early and before the cancer spreads is 90 percent, but only 39 percent of colorectal cancer cases are identified in this early stage, according to the ACS. Even as we see more younger patients with colorectal cancer at Texas Oncology, there is plenty of reason to have hope for positive outcomes as treatment advances. 

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Soap Is Soap! And Other Ideas on Staying Germ Free

an’t find antibacterial soap at the store these days? No need to worry, any type of hand soap can rid hands of germs and viruses such as COVID-19. That’s according to an expert at Baylor College of Medicine who has more tips on what to do to stay virus free. Soap vs. antibacterial soap “There doesn’t need to be any additives in soap to clean your hands of germs and viruses. Soap works by removing germs from your hands, and the antibacterial soap contains chemicals that may also kill the bacteria, but both result in germ-free hands,” said Isabel Valdez, a physician assistant and instructor of general internal medicine at Baylor Medicine. The rule of thumb is to make sure you wash hands for at least 20 seconds before rinsing and to wash your hands often. The reason to wash hands often is because most people are not aware of how much they actually touch

throughout the day, and they don’t know if someone with COVID-19 has been touching those same items and surfaces. If soap and water isn’t available, then hand sanitizer is a good alternative. Hand sanitizer “When it comes to hand sanitizer, you do need to make sure what the ingredients consist of, because you’re not washing off the germs like you do with soap and water but are instead inactivating the viruses that could be on your hands,” she said. Hand sanitizer ingredients should include at least 60% ethanol, a type of alcohol. But what if you can’t find hand sanitizer either? “You can find some recipes online that explain how to make your own; however, it is easy to get the proportions wrong, which lessens the antimicrobial effect,” Valdez said. The standard recipe found online includes 2/3 cups of 91%

isopropyl alcohol, commonly found at drug stores, and 1/3 cup of aloe gel. Some recipes call for essential oils, but this is where Valdez says people can go wrong. “Once you start adding ingredients, or perhaps get the proportions off here or there, you start to dilute the effectiveness of the homemade hand sanitizer,” she said. Ultimately the recommendations are to use alcohol based products to

What to disinfect Here is a reminder of just a few common items to disinfect, but don’t forget to be aware of what you touch and continue to add to this list.

• Keys • Wallet • Purse or bag handles • Credit cards • Stair railings • Doorknobs and/or turn keys • Light switches and/or pulls • Steering wheel & other knobs and handles in your vehicle

• Cell phone • Keyboard & mouse • Charging cables • Work phone • Makeup and brushes • Eye glasses/ Sunglasses • Remote controls • Wash bedsheets & towels

see Soap...page 10

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Retired Physician Volunteers Receive No-Cost Malpractice Coverage during COVID-19 Pandemic

s U.S. healthcare systems are being tested to the limit during the COVID-19 pandemic, The Doctors Company has announced that it will provide free medical professional liability coverage to retired physicians formerly insured by the company who volunteer during the crisis. “Today, our mission to advance, protect, and reward the practice of good medicine is more important than ever. We appreciate our members’ lifesaving work during this crisis and want to make it as easy as possible for our retired members to assist,” said Richard E. Anderson, MD, FACP, chairman

and chief executive officer of The Doctors Company. If retired former members of The Doctors Company return to practice as volunteers, this decision will not impact their extended reporting period, or tail, coverage. Additionally, there will be no impact on previous Tribute® Plan awards received for their loyalty and commitment to superior patient care. To qualify, a retired healthcare professional must be providing professional

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University of Texas Medical Branch Developing Tool To Streamline COVID-19 Vaccine Development

esearchers at The University of Texas Medical Branch are collaborating with the clinical trial laboratory services organization Q2 Solutions to make a new assay test available that will streamline the development of a COVID-19 vaccine. Once UTMB completes the testing kit, Q2 Solutions labs will produce it for use in clinical trials so that researchers can more quickly and accurately judge how well a developing COVID-19 vaccine is working in people. When compared with the tests currently available to test the potency of developing vaccines, UTMB’s new test is more sensitive and works much faster. The new test yields results in a single day rather than taking several days to complete and can process more samples simultaneously.

“We have successfully produced a reporter virus system engineered with either luciferase (the same chemical that gives fireflies their signature glow) or fluorescent tags to enable quantitative determination of vaccine effectiveness,” said Pei-Yong Shi, I.H Kempner professor of Human Genetics at UTMB. “This test will enable Q2 Solutions to analyze blood samples from individuals participating in vaccine clinical trials see Vaccine...page 14

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UH Cougars Helping the Community At Home, UH Optometrist Sewing Masks for Health Workers

or 15 years, Moriah Chandler has been a sewing and quilting enthusiast. Now, the clinical assistant professor at the UH College of Optometry has found a way to put her hobby to good use. She’s dusted off the sewing machine, pulled out the fabric, looked up a couple online tutorials, and she’s creating masks – personal protection equipment – to give away to front line responders and medical personnel treating patients during the COVID-19 pandemic.

“As an optometrist, my job is to help people and right now I can’t really do that, so this is one way to help people and feel like I’m contributing,” said Chandler, who is working from home where her two children, ages 5 and 9, are participating in online classes. Chandler’s sewing is not only good for those who receive her largesse, but also in line with what psychologists say are good ways to fill down time: taking on neglected projects and seeking creative

projects. Ultimately, Chandler said, she benefits from sharing her work, and her sewing closet gets organized at the same time. “We all have household tasks such as decluttering, donating unused clothing and household objects, home improvement projects and deep cleaning,” said John P. Vincent, director of the Center for Forensic Psychology and co-director of the Center for Couple’s Therapy at the University of Houston. “It is best to break down bigger projects into bite-sized chunks. We get a small burst of the neurotransmitter dopamine in our brain’s reward center when we complete small tasks.” Chandler’s contribution may be cottage-industry sized small compared to companies who mass produce protective gear, but it is important. “I like serving a purpose, it helps calm me down,” said Chandler. “With so many things out of our control, when I’m sewing, I can be in the moment and be present with the project, but also get to think of how it’s helping others. It’s a win-win.”

Soap

Continued from page 7 sanitizer the hands. Hydrogen peroxide is not as effective as alcohol. Cleaning surfaces To disinfect items, make sure your cleaner contains bleach. If you cannot find disinfecting solution, the CDC recommends 1 cup of household bleach in 5 gallons of clean water. This will make a lot of solution that you can pour into multiple spray bottles to keep throughout your home. High-touch areas should be cleaned often but don’t forget about all the extra items and areas you might touch without realizing. Pay attention to what you touch in a small time frame and this will help you realize that you might be touching things throughout the day that you are not aware of. “Right now we don’t know exactly how long COVID-19 stays on surfaces. It is believed to stay anywhere from a few hours to a few days. I’ve even read some studies that suggest up to 9 days,” Valdez said. Bottom line, Valdez said, is wash your hands and clean everything often.

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Telehealth

Continued from page 1

PlAN WISElY. YOU

WON'T GET A

College of Education and Human Development. “Everyone is now asking the question if health care and society as a whole is ready for a potential viral outbreak of this scale.” If a health care provider is believed to be exposed to COVID-19 while treating a patient, they are required to self-quarantine. This means providers will be unable to see patients in-person until they are proven to be free of the disease, a problem amid an already strained health care system. Similarly, patients may feel hesitant to seek help due to the fear of spreading the coronavirus to their community. Officials advise those who believe they may have the virus to call ahead to their health care providers to limit contact with others in waiting rooms. Telehealth and telebehavioral care could take these precautions to the next level. Telehealth considerations and best practices “Right now, we have seen a surge of health care providers seeking to add the telehealth model to their practice. We recommend they first consider proper training and learn best practices to provide highest-quality services possible to their patients,” McCord said. “Providers should not rush into the telehealth model without the proper supports. We offer online trainings and resources to help.” All health care providers have laws and codes of ethics to abide by during practice. “These rules still apply if you change your method of health care delivery,” said Alexander Giovanetti, program coordinator at Texas A&M Telebehavioral Care and counseling doctoral psychology student at the College of Education and Human Development. “For example, providers adopting the telehealth model should make sure the video-conference program is HIPAA-compliant; otherwise they may violate laws, guidelines or professional ethics codes. Furthermore, if they do not know

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how this new, secure software works and are unable to help the patient troubleshoot from a distance, then they may be unable to successfully deliver services, and patients could go without much-needed care.” McCord, Console and Giovanetti emphasized the importance of learning best practices and receiving telehealth-specific training. There are a lot of things you have to think about before you transition to the telehealth and telebehavioral care model. “You do not know what you do not know,” they said. The fundamentals of telehealth For those who do not know, telehealth uses technology for direct service or as an adjunct to health care services. For example, the telehealth model uses video conferencing, wireless communications, remote data collection and image streaming, so health care professionals can reach patients who cannot make it to a clinic. This model mitigates the potential health care barriers of distance, lack of transportation, cost and a lack of providers. Furthermore, this model works especially well with chronic disease management—both physical and mental. McCord and the rest of the Texas A&M Health Telebehavioral Care program provide grant-funded telehealth counseling to underserved residents across Texas. The clinic also sells time blocks to organizations across the state including institutions like the Washington County Jail, so they can offer mental health services “in-house.” Texas A&M has led the movement towards telehealth through programs like this one and the Center for Excellence in Forensic Nursing, a program designed to develop and implement a telehealth program to bring forensic nurse expertise to areas that may not have a forensic nurse available.

Coverage

Continued from page 8

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Retired members considering volunteering can find more information at “COVID-19 Malpractice Coverage FAQs.” All healthcare providers can visit “COVID-19 Resource Cewnter for Healthcare Professionals” to keep up to date on the pandemic.

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Healthy Heart Kids Heart Challenge: Getting Active, Having Fun, Saving Lives By The American Heart Association

he American Heart Association’s Kids Heart Challenge is an innovative and fun program that prepares elementary school students for a healthier future at campuses all across the country. It allows students to learn healthy lifestyle habits for emotional and physical well-being and the value of community service by raising funds to help kids with special hearts. “The American Heart Association strongly believes in the important role schools and educators share in shaping future generations by providing a strong foundation of health and physical activity through the Kids Heart Challenge,” said Tanya Edwards, Southwest Executive Vice President for the American Heart Association. The program includes cardio-pumping activities that go beyond the simple joy of exercise and has kids pledge to be more physically active, drink more water, and do a good deed. Kids learn about the importance of physical activity and how it helps their bodies.

WHAT WE OFFER:

“A component to Kids Heart Challenge that makes the program so meaningful is the opportunity to honor and recognize students and staff who have been impacted by heart disease. So many people are not aware that 1 in 100 babies is born with a congenital heart defect and that could mean multiple children in an average school that we can honor,” said Samantha Fewell, the American Heart Association Vice President of Youth Market in Houston. This is especially important during April, which is Move More Month, but also an important lifelong lesson; kids understanding heart health early can help prevent myriad health problems, including heart disease and stroke – the two leading causes of death in the world. For teachers, the Kids Heart Challenge offers four activations to get students’ hearts pumping. Program activities include: • Jump: Students compete to see who can jump the most times in a minute, while learning about how it burns calories, builds agility, and

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increases bone density. • Hoops: A heart-pumping basketball-based activity that challenges students to work as a team. • Dance: Students burn calories and build confidence as they collaborate and express their creativity with dance moves to the “Cha Cha Slide” or “Space Jam.” • Warrior: Students build strength and confidence as they crawl, run, and leap navigating the obstacle course’s cones, hurdles, and balance beam. The program is celebrating the Association’s 41st year working in schools with exciting new content that meets the changing needs of today’s youth and educators and helps prepare kids for success through physical and emotional well-being, all while fundraising for the American Heart Association. The National Kids Heart Challenge Ambassador lives in

• Integrating the Montessori method into the public school curriculum • Currently offering Pre-K thru 4th • Open enrollment until positions ﬁll

Houston and is a great example of the local impact of this program. “We met Alexa through one of our Heart Survivor cape ceremonies in Cy-Fair ISD. She is an incredible 8-year-old student who has had multiple heart procedures including two open heart surgeries,” said Fewell. More information about the Kids Heart Challenge is available online at heart.org/kidsheartchallenge. To learn more about other school programs, or to make a donation to the American Heart Association, please visit www.heart.org.

• Comprehension Stem Program • Character & Leadership Development • High Tech – 7 computers per classroom

2319 N. GRAND BLVD., PEARLAND, TX. 77581 www.hmps.net | 281-485-2500 medicaltimesnews.com

April 2020

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Ventilator

Continued from page 1 Technologies, recognized the need to automate the masks not only for emergencies where hospital ventilators are in short supply but also for developing nations where such equipment is not available at all. The first criterion certainly applies now, with a global shortage of ventilators threatening the population as the novel coronavirus spreads. Rice administrators, staff and students gathered to see how quickly they could develop a more robust prototype built primarily of 3D-printed and laser-cut parts. Their solution, designed and prototyped within a week, is a reconfiguration of the original rack-and-pinion device and designed to be not only medical grade, but also inexpensive enough to be considered disposable. The small team worked in the Brown School of Engineering’s Oshman Engineering Design Kitchen (OEDK), where the original project came together last spring. The OEDK is usually hopping at this time of year as Rice senior engineering students race to finish their capstone design requirements. With students hunkered down and taking their

Legal Matters

Continued from page 3 careful to avoid identifying any infected employee (or providing information from which the employee could be readily identified), and instead disclose only sufficient information to enable employees to assess and address their own exposure risk to protect themselves, their family and community. If an employer suspects that COVID-19 was transmitted in the workplace, additional notice may be required to OSHA, workers’ compensation

Vaccine

Continued from page 8 to see whether the vaccine has induced antibodies that block infection of the virus and thereby answer critical questions in the vaccine development process.” The COVID-19 diagnostic tests available through governments and commercial laboratories are used to reveal whether a person is infected by April 2020

Houston Medical Times

classes online, the facility provided a quiet refuge for the ApolloBVM team as it worked around the clock to build the device. The Department of Defense is one of the groups interested in ApolloBVM. The U.S. Navy invited several institutions to submit proposals to develop a low-cost, mechanical ventilation support system that can be rapidly produced with widely available resources. “This is as simple as it can get, with all readily available parts,” said Danny Blacker, the OEDK’s engineering design supervisor. The prototype uses an Arduino board to facilitate programming that allows users to adjust the rate of air delivery to the lungs of patients depending on their conditions, but the team expects a custom integrated circuit will eventually be available to replace the board at a lower cost. The device will also employ feedback sensors that help fine-tune the flow of air to the lungs, as well as motors of the same type that power 3D printers for hours on end. In its documentation, the team characterizes ApolloBVM as a “high-acuity limited-operability (HALO) ventilator solution with an a priori design to produce volumeand pressure-cycled ventilation that includes positive end-expiratory pressure and the inclusion of

enriched oxygen sources.” Malya inspired the Rice project two years ago after seeing families try to keep critically ill loved ones at the Kwai River Christian Hospital in Thailand alive by bag-ventilating them for hours on end. He expects the new ApolloBVM to serve that purpose eventually, but the need is now worldwide. “This is a clinician-informed end-to-end design that repurposes the existing BVM global inventory toward widespread and safe access to mechanical ventilation,” Malya said, noting that more than 100 million bag valve masks are manufactured around the world each year. “The immediate goal is a device that works well enough to keep noncritical COVID-19 patients stable and frees up larger ventilators for more critical patients,” added Amy Kavalewitz, executive director of the OEDK. Malya said the name is a tribute to Rice’s history with NASA and President John F. Kennedy’s famous speech kicking off the nation’s efforts to go to the moon. “This project appeals to our ingenuity, it’s a Rice-based project and it’s for all of humanity,” he said. “And we’re on an urgent timescale. We decided to throw it all on the table and see how far we go.” 

or others. • Review Exposure Controls: Health care employers are generally expected to maintain appropriate exposure controls, including engineering controls, administrative controls, safe work practices and PPE. However, when an employee reports an incident of exposure, employers should review these controls and ensure that all appropriate precautions are in place and operating properly. Health care providers should also train workers with reasonably anticipated occupational exposure to COVID-19 about appropriate workplace protocols in place to

prevent or reduce the likelihood of exposure. Although these steps should serve as a helpful checklist to guide an employer’s immediate response to a case of COVID-19 in their workplace, they must be considered in conjunction with the employer’s obligations under all applicable OSHA regulations. Given the unprecedented circumstances presented by COVID-19, employers should consult legal counsel and OSHA’s Guidance on Preparing Workplaces for COVID-19 [https://www.osha.gov/Publications/ OSHA3990.pdf] to ensure compliance with the quickly evolving standards and expectations placed on employers.

the virus. The UTMB test focuses on preventing infections through vaccine development by creating a technology that helps determine how well a developing vaccine protects a person from COVID-19. The team’s goal is to develop a quicker and more efficient method of measuring neutralizing antibody concentrations, the gold standard method for determining vaccine effectiveness. “We are pleased to support UTMB in this important research to

develop the COVID-19 assay that, once available, may help accelerate vaccine development,” said Kevin Jones, vice president and general manager, Bioanalytical, ADME, and Vaccine Laboratories for Q2 Solutions. “We are excited to take the assay developed from this research collaboration to production in our labs and enable vaccine developers to use it for largescale human clinical trial testing to drive toward an effective COVID-19 vaccine.” 

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