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The use of telehealth has become a common practice during the pandemic. Now, some doctors hope it continues to be an important tool in the healthcare industry."There are a number of bills have been proposed," said Dr. Tesh Monteith, a neurologist and fellow with the American Academy of Neurology.Dr. Monteith says Congress is considering several bills to keep telehealth, which allows patients to video conference with a doctor instead of going in for a physical appointment, around for the long run.When the pandemic hit, rules regarding telehealth changed, allowing for doctors to be financially reimbursed for the virtual appointments."It's allowed patients to access care. They're patients that would normally have to take days off, or to keep providers, multiple providers, and if they can do that, they may have childcare issues and not be able to get to a clinic," said Dr. Monteith.The bills would allow for everything from permanent reimbursement for physicians to allowing doctors to virtually see patients across state lines."Some of these bills are proposing that there are not limitations within states. For example, there are issues of licensing. A doctor licensed in New York should they be able to see a patient with a specialized disorder in Minnesota or does that patient have to come in Minnesota," explained Dr. Monteith.While telemedicine has been an important part of making sure people received medical care and diagnoses during the pandemic, doctors agree that the virtual visits in no way can replace seeing your physician in person."Because I know my patients well, I’m a pediatrician, I can do so much over telehealth with the kids I know. When they're sick I can look at them. I can watch them breathe. I can ask them to jump up and down and have the parents press on their tummy, but I can’t look in their ears. I can’t listen to their heart, and if it’s a family that I don’t know, there is concern that I might miss something," said Dr. Tanya Altmann, a pediatrician in California.Dr. Altmann says telehealth can also be a very valuable tool.As for reimbursement for physicians, Dr. Altmann says, "anyway that a physician or healthcare provider reaches out to a family to help with anything medical, it should be compensated."Dr. Altmann says pediatricians can sometimes spend hours on the phone with patients at night, work they don't get paid for. Getting reimbursed for telehealth visits with patients would be a plus."Patients need to empower themselves to learn about telemedicine, to learn what questions to ask a doctor. Have an advocate or family member there to even help with the physical examination," suggested Dr. Monteith.Dr. Monteith says medical professionals estimate there have been more than one billion telemedicine appointments since the pandemic began. She hopes Congress passes the telehealth-related bills to further expand medical access to people across the country. 2932

The United States is at the beginning of a second wave of significant job loss.“We are seeing a resurgence in layoffs that has been quite clearly indicated in the last couple of weeks,” said Daniel Alpert, an adjunct professor and senior fellow at Cornell University.Cornell University recently published a study showing about a third of the people who went back to work during the pandemic have now been laid off for a second time. Another 26 percent of workers have been warned by their employers that future furloughs and layoffs may soon come.“The problem is that you get an echo,” said Alpert. “So, if you have a resurgence in layoffs, a decrease in spending, that creates more contraction on the part of businesses, which creates more layoffs. The question is, when can you put a floor under this spiraling situation? It is a classic economic spiral.”The cycle--of job loss eventually leading to more job loss--is causing some to fear it could lead to a third wave of unemployment in a few months. Experts, like Alpert, believe the only way to stop the cycle would be a vaccine or for Congress to come together on another stimulus bill that props up households and businesses until a vaccine is released.“We are very concerned about the current rollercoaster effect on resumed layoffs, but longer term, we are really scared about seeing huge numbers, tens of millions of businesses vanish,” said Alpert.The more waves of unemployment we see, the higher likelihood of that. 1486

The smoke from dozens of wildfires in the western United States is stretching clear across the country — and even pushing into Mexico, Canada and Europe. While the dangerous plumes are forcing people inside along the West Coast, residents thousands of miles away in the East are seeing unusually hazy skies and remarkable sunsets.The wildfires racing across tinder-dry landscape in California, Idaho, Oregon and Washington are extraordinary, but the long reach of their smoke isn’t unprecedented. While there are only small pockets in the southeastern U.S. that are haze free, experts say the smoke poses less of a health concern for those who are farther away.The sun was transformed into a perfect orange orb as it set over New York City on Tuesday. Photographs of it sinking behind the skyline and glinting through tree leaves flooded social media. On Wednesday, New Jersey residents described a yellow tinge to the overcast skies, and weather forecasters were kept busy explaining the phenomenon and making predictions as to how long the conditions would last.On the opposite coast, air quality conditions were among some of the worst ever recorded. Smoke cloaked the Golden Gate Bridge and left Portland and Seattle in an ashy fog, as crews have exhausted themselves trying to keep the flames from consuming more homes and even wider swaths of forest.Satellite images showed that smoke from the wildfires has traveled almost 5,000 miles (8,000 kilometers) to Britain and other parts of northern Europe, scientists said Wednesday.The current weather system, which favors a westerly wind across the higher levels of the atmosphere, is to blame for the reach of the smoke, experts explained.“We always seem, at times, to get the right combination of enough smoke and the upper level jet stream to line up to bring that across the country, so we’re just seeing this again,” said Matt Solum with the National Weather Service’s regional operations center in Salt Lake City, Utah. “It’s definitely not the first time this has happened.”There could be some easing of the haze this weekend as a storm system is expected to move into the Pacific Northwest and could affect the conditions that helped the smoke travel across the country. But Solum said there’s always a chance for more smoke and haze to shift around.“Just due to all the wildfires that are going on, this is likely going to continue for a while,” he said. “You might have ebbs and flows of that smoke just depending on how the upper level winds set up.”Kim Knowlton, a senior scientist with the Natural Resources Defense Council in New York City, said she woke up Wednesday to a red sunrise and more haze.She said millions of people who live beyond the flames can end up dealing with diminished air quality as it’s not uncommon for wildfire smoke to travel hundreds of miles.Although the health impacts are reduced the farther and higher into the atmosphere the smoke travels, Knowlton and her colleagues said the resulting haze can exacerbate existing problems like asthma and add to ozone pollution. 3070

The US surgeon general issued an advisory Thursday recommending that more Americans carry the opioid overdose-reversing drug, naloxone.The drug, commonly known as Narcan, can very quickly restore normal breathing in someone suspected of overdosing on opioids, including heroin and prescription pain medications.Dr. Jerome Adams emphasized that "knowing how to use naloxone and keeping it within reach can save a life." To make his point, Adams relied on a rarely used tool: the surgeon general's advisory. The last such advisory was issued more than a decade ago and focused on drinking during pregnancy.Adams noted that the number of overdose deaths from prescription and illicit opioids doubled in recent years: from 21,089 deaths across the nation in 2010 to 42,249 in 2016.America's top doctor attributed this "steep increase" to several contributing factors, including "the rapid proliferation of illicitly made fentanyl and other highly potent synthetic opioids" and "an increasing number of individuals receiving higher doses of prescription opioids for long-term management of chronic pain.""Research shows that when naloxone and overdose education are available to community members, overdose deaths decrease in those communities," Adams said. Naloxone is used by police officers, first responders and emergency medical techs to reverse opioid overdoses. Adams added that increasing both the availability of naloxone and effective treatment is critical to ending the opioid epidemic.Speaking at the National Prescription Drug Abuse & Heroin Summit in Atlanta on Thursday morning, Adams addressed the potential "moral conflict" felt by some people who believe that providing naloxone "doesn't make a difference," since many people with drug addictions will just "go on and misuse substances again.""Well, that would be like me saying 'I'm not gonna go do surgery on this trauma patient because they're just gonna go out and speed again,' " he said.Adams noted that in most states, people who are or who know someone at risk for opioid overdose can get trained to use naloxone properly and also may receive naloxone by "standing order" -- without a prescription -- from pharmacies or some community-based programs."No mother should have to bury their child ,and especially not when there's a life-saving medication that virtually anyone can access," Adams said. "It is for this reason that I am issuing the first Surgeon General's Advisory in 13 years."The-CNN-Wire 2484

The United States and China are acting tough over trade, but they're also busy talking to try to stop the situation spiraling out of control.President Donald Trump ramped up tensions last week by ordering tariffs on about billion worth of Chinese goods just weeks after announcing of sanctions on steel and aluminum imports. Beijing has responded with plans to target billion worth of US products and warnings that it's ready to inflict more pain.The moves have fueled fears that the situation could escalate into a full-blown trade war between the world's two largest economies. But Treasury Secretary Steven Mnuchin said Sunday that he's been talking to Chinese officials in an effort to prevent that."We're not afraid of a trade war, but that's not our objective," he said in an interview on Fox News."We are going to proceed with our tariffs ... we're also working on investment restrictions," Mnuchin said. "But we are simultaneously having negotiations with the Chinese to see if we can reach an agreement."The US government wants China to do a lot more to open up its vast economy to US businesses and bring down the massive trade deficit between the two countries.Trump has set a target of cutting the deficit in goods with China by 0 billion. It soared to 5 billion last year, according to US figures.Mnuchin said the United States wants China to do away with rules that require foreign companies to set up joint ventures with Chinese firms in many industries, such as automobiles, and to stop forcing American businesses to hand over valuable intellectual property in order to operate in China. Intellectual property theft is the reason the Trump administration gave for the planned billion in tariffs on Chinese goods.Mnuchin and US Trade Representative Robert Lighthizer detailed the US requests in a letter to a top Chinese economic official late last week, according to the Wall Street Journal. They included asking Beijing to reduce tariffs on American cars, increase spending on US semiconductors and provide greater access to the Chinese financial sector, the Journal reported, citing unidentified people with knowledge of the matter.A Treasury Department spokesperson declined to confirm the report."We are having very productive conversations with them," Mnuchin told Fox, adding that he was "cautiously hopeful" that the two sides could reach a deal. But in the absence of "an acceptable agreement that the president signs off on," the Trump administration will press ahead with the tariffs and other measures, he warned.China's point man for the talks is Liu He, a Harvard graduate who is one of President Xi Jinping's most trusted advisers. Liu was in Washington for talks with US officials the week that Trump announced plans for the tariffs on steel and aluminum and was recently appointed to the position of vice premier.Mnuchin and Liu spoke as recently as this weekend."Secretary Mnuchin called Liu He to congratulate him on the official announcement of his new role," the Treasury spokesperson said. "They also discussed the trade deficit between our two countries and committed to continuing the dialogue to find a mutually agreeable way to reduce it."China's official news agency Xinhua also reported the conversation, saying that Liu criticized the US allegations of Chinese intellectual property theft and warned Mnuchin that China "has the capability to safeguard its national interest."But Liu also said that China "hopes to see both sides remain sensible and work together to preserve the overall stability of China-US trade relations," according to the Xinhua report.Some experts are skeptical that Beijing will give Trump what he wants."China may be able to come up with some big ticket imports to allow it to appear to be trying to reduce the bilateral trade imbalance," Mark Williams, chief Asia economist at research firm Capital Economics, wrote in a note to clients on Friday. "But China won't be able to reduce the annual imbalance by 0bn as Mr Trump has demanded."And "the chances of China making substantive changes to its practices on intellectual property are also low," Williams said, adding that the practices are seen in Beijing as "a key element" of efforts to develop the Chinese economy.  4274

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