COVID-19 Positive cases: 241,005
COVID-19 related deaths: 2841
Recovered COVID-19 cases: 220,726*
Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Saturday, February 27, 2021. Find more COVID-19 information from TCPH here.
COVID-19 Positive cases: 240,416
COVID-19 related deaths: 2818
Recovered COVID-19 cases: 219,208*
Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Thursday, February 25, 2021. Find more COVID-19 information from TCPH here.
Advanced practice registered nurses (APRNs) are asking legislators for full practice authority that would allow for essentially independent diagnosis and prescribing without any collaboration with a licensed physician
Rep. Stephanie Klick (R-Fort Worth) filed House Bill 2029, which if passed will allow APRNs to: independently prescribe dangerous drugs and controlled substances (up to Schedule III with some Schedule II privileges in inpatient facilities and hospice); order and interpret diagnostic testing; and prescribe DME and devices – all without any relationship with a physician. The bill is expected to be referred to the House Public Health Committee which is Chaired by Representative Klick. We need every Texas physician’s voice to help us.
Please contact your state lawmakers today. Let them know why it’s important to support physician-led, team-based care. Texas patients deserve the highest quality health care possible.
Tell them how much you learned in your years of medical school, residency, and beyond. Let them know you are calling on behalf of the patients of Texas, and how your education is much different from that of APRNs and other nonphysicians. Ask them to say “No” to the APRNs and HB 2029, and to help the Texas Medical Association advocate for what is best for patients: a physician-led, team-based care model.
You can use the new TMA Grassroots Action Center to share that message quickly and easily with your representatives.
by David Lam, OMS-IV
This piece was originally published in the January/February issue of the Tarrant County Physician. You can read find the full magazine here.
The residency application process has changed significantly over the past several decades. I remember a grey-haired attending telling me that when he applied to residency, it consisted of hopping in a car, driving down the freeway, and requesting meetings at hospitals he encountered along the way. A strong handshake later, and the promise of training in the specialty of his choice was secured. Since then, the Match process has been transformed with the stratification of candidates by board examinations which dictate competitiveness for certain specialties. We are under pressure to shine starting on day one, with no assurance that our labors will be rewarded by placement into a residency program.
The class before mine underwent the pomp and circumstance of their Match days at home, sidelined by the COVID-19 pandemic. My class is interviewing for residencies through virtual platforms. We do our best to capture the vibe of a program through an online tour of a hospital recorded on a GoPro camera attached to a resident’s forehead. Our webcams are always on, and we exercise our zygomatic muscles to maintain a soft smile throughout the events of the day. We try our hardest to convey ourselves in the best light possible, both figuratively and literally (many of us have invested in elaborate lighting set-ups).
This is not an indictment of the residency programs whose attention we are vying for. These are unique times, and residencies face similar obstacles to those encountered by the applicants being interviewed. As we evaluate a place we may call home for the next three to six years, residency programs are navigating how to choose a class of interns without meeting them in person. Then there is the additional challenge of representing the program’s values and culture on a screen. Many have attempted to replicate pre-interview dinners with meal delivery gift cards or virtual resident speed-dating. One residency even sent a care package with personalized memorabilia from their city.
Although we have lost the ability to explore our future landing spots during the “golden year” of medical school, there are still many silver linings to consider. Instead of having to coordinate plane rides and lodging, applicants can interview from coast to coast in the comfort of a home setting. For students under financial strain, there are fewer restraints on our ability to consider programs that are farther away. Then there’s the benefit that few will admit—wearing shorts or yoga pants out of view of the camera frame during your interview.
While this certainly is not how I dreamed my fourth year would go, I nevertheless feel grateful. Leaders in graduate medical education are creatively finding ways to help us make informed decisions about the next step of our training. As we interview with leaders in our respective specialties, we reflect on the rollercoaster journey of medical school and the plethora of lessons learned. In the process of making our rank list, we ask ourselves hard questions about what our priorities are. How do we envision our professional identities and who are the people we want to be around during the formative years of residency training? I look forward to the day when I can be the grey-haired attending who wistfully shares stories of virtually interviewing in the midst of a global pandemic.
by Catherine Colquitt, MD
This piece was originally published in the January/February issue of the Tarrant County Physician. You can read find the full magazine here.
In the midst of the worst pandemic in over a hundred years, it’s easy to overlook vaccine-preventable seasonal influenza.
According to the Centers for Disease Control and Prevention, as of December 28, 2020, COVID-19 has already accounted for 336,761 deaths and 19,297,396 cases in the U.S. since its first appearance in early 2020. Tarrant County has reported more than 135,793 confirmed cases (TCPH data) and 1,425 deaths so far (https://covid.cdc.gov.covid-data-tracker). The current percent positivity (percent positive tests/all tests performed) for Tarrant County is a staggering 17 percent (also from CDC COVID Data Tracker).1
For reference, the 1918 influenza pandemic is reported to have killed 21,000,000 people including 549,000 Americans.2
Our most recent prior pandemic, the influenza experience between April 2009 and April 2010, H1N1pdm09, accounted for 60.8 million U.S. cases, 274,304 hospitalizations, and 12,469 U.S. deaths. H1N1 continues to circulate and is still included in the seasonal flu vaccine. A monovalent vaccination produced in response to the H1N1pdm09 pandemic after this strain emerged in 4/2009 wasn’t distributed widely until 11/2009.3
H1N1pdm09 was unique in causing more severe outcomes in younger persons. Approximately 30 percent of persons over 60 in 2009 were thought to have some immunity to H1N1pdm09 conferred by exposure in the past to another H1N1 strain.
As we make our way through the 2020-2021 flu season while in the throes of the highly politicized COVID-19 pandemic, how will we fare at vaccinating Americans against seasonal flu, and will flu vaccination rates provide some hint at public acceptance of, or enthusiasm for, COVID-19 vaccines?
According the CDC’s FluVaxView, during the 2019-2020 flu season, 80.6 percent of healthcare personnel received flu vaccines, with 94.4 percent vaccination in healthcare settings which required it and 69.6 percent in healthcare settings which did not make it mandatory.4
In the U.S., for the 2019-2020 flu season, CDC Influenza data are still preliminary but provide a range in numbers of influenza cases from 39,000,000 to 56,000,000, flu medical visits from 18,000,000 to 26,000,000, flu hospitalizations from 410,000 to 740,000, and flu deaths from 24,000 to 62,000. Even using the highest estimate for flu deaths from last season, COVID-19 deaths have already quadrupled the total number of flu deaths last season (https://www.cdc.gov/flu/about/burden/past-seasons.html).5
However, according to Flu Surv-NET (the Influenza Hospitalization Surveillance Network), the number of influenza-associated hospitalizations from 10/01/2020 to 12/05/2020 only totals 61 in the U.S. thus far (compared with prior seasons this is an unseasonably low number). There is not yet efficacy data for the 2020-2021 seasonal influenza vaccine because of low case counts so far, but most influenza experts expect a mild flu season due to COVID-19 practices of masking, social distancing, hand sanitization, and cough and sneeze hygiene.
As communities struggle to control the catastrophic consequences of COVID-19, getting our flu vaccines and encouraging all of our eligible patients to do the same demonstrates leadership and concern for the most vulnerable among those we serve. Discussing the flu vaccine with our patients also offers context for discussing the COVID-19 vaccines.
References
1 https://covid.cdc.gov.covid-data-tracker.
2 Epidemiology and Prevention of Vaccine-Preventable Diseases,
13th Edition, p 187
3 https://www.cdc.gov/flu/pandemic-resources/2009-h1n1- pandemic.html
4 https://www.cdc.gov/flu/fluvaxview/hcp- coverage_1920estimates.html.
For residents in West Fort Worth are still affected by boil water notices, as well as others who might be experiencing water shutoffs because of water main breaks and repairs, here is some information about water resources in Tarrant County.
The below locations and times are for Monday. Be aware that water may run out before closing time.
All locations will have bottled water as well as water to fill containers.
They include four locations that will operate hand out water from 11 a.m. to 6 p.m.
Those locations include:
Open from 8 a.m. to 6 p.m. is Birchman Baptist Church, 9100 N. Normandale St., 76116.
Disclaimer: Water is being provided to you by the City of Fort Worth in a disaster-recovery situation. It is the responsibility of the individual to ensure that containers being used for water collection are clean, free of contaminates and are a proper water storage container. The City of Fort Worth will not inspect the containers and will not accept responsibility for illness or other any damages that occurs from the service.
In addition to the city-operated sites, some breweries are offering water to residents. Please call to confirm hours.
Resident need to bring their own containers for all breweries.
The Water Department realizes many affected customers have no water to boil and others have no power to boil the water. They are working to secure additional water for distribution as quickly as possible. Additional locations will be added. Continue to check the city’s website for updates. You can also call 817-392-1234 for additional water distribution locations; because supplies are limited, each household is limited to one case.
COVID-19 Positive cases: 230,088
COVID-19 related deaths: 2473
Recovered COVID-19 cases: 189,861
Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Monday, February 8, 2021. Find more COVID-19 information from TCPH here.
Tarrant County Physician Online 