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The forensic pathology industry is facing a workforce shortage. These are the men and women who determine how and why a death happens. They are being overwhelmed, and the pandemic has only made things worse.“What you’re seeing now is part of our autopsy examination room,” said Francisco Diaz as he walked around the Office of the Chief Medical Examiner in Washington D.C. He is the deputy chief medical examiner.“The purpose of the medical examiner is to do two things, to determine why people die and to classify the manor of death,” he said.Diaz and his team have their hands full. Here, bodies are brought in, x-rayed, and analyzed every day. Most of them are bodies of those who have died of unnatural causes, like homicide, suicide, and certain accidents.They’re brought here, where seven forensic pathologists work.“As medical examiners and forensic pathologists you are dealing with death and tragedy every single day,” he said.This year the volume has been higher than usual, in large part because of the COVID-19 outbreak. “The peak of our pandemic was April, May. At that time we had that emergency morgue off campus,” Diaz explained. “We handled approximately 400 descendants or dead bodies.”The increase in autopsies needed is not only due to COVID-19 directly, but other ripple effects.“What I see as a consequence of the pandemic is a lot of people are dying at home because they choose not to seek medical attention because they may have concerns that they may get contaminated at hospitals,” Diaz said.If they die at home, they’re sent straight to D.C.’s Medical Examiner’s Office. Most people who die in a hospital are handled by the hospital, except for in certain jurisdictions like D.C. where they will help out with the hospital's cases as well.Regardless of where the cases are coming from, jurisdictions are strapped for resources. It’s a problem across the industry right now -- one that’s been facing a workforce shortage for years.“A lot of the policy makers think that it's a waste of money. You're just spending money on the dead, but everything we do is for the living,” said Victor Weedn, Forensic Science Professor at George Washington University. He’s an expert in the forensic pathology industry.“We are terribly undermanned, under served these days. It is thought we have 500 to 600 board certified forensic pathologists working in the field across the United States and that's simply not enough. It’s estimated we really ought to have 1,200 to 1,500 forensic pathologists.”The lack of workers has become more evident due to the pandemic, and also a growing epidemic. “And then the opioid crisis hit. That immediately caused 10% to 30% more cases because of all the overdose deaths,” Weedn said. “On top of that you have the COVID pandemic. The overdose cases have not declined, in fact they've continued to increase. And now we’re seeing a wave of homicides increasing our caseload still further. We are facing a true workforce shortage.”Weedn also talked about how some of their investigations on COVID-19 patients who passed helped answer some questions we had early on in the pandemic.Increasing a workers caseload is not a great option, according to Weedn. The National Association of Medical Examiners has accreditation standards.“A forensic pathologist really isn't supposed to do more than 250 autopsies a year. If you have more than that it’s considered an infraction of the standard,” he said. “When you start doing more than that, things get lost. Details get lost.”This puts many offices in a bind. “In the face of such a severe workforce shortage you find that people have changed the criteria for what deaths they will investigate and that means there are certain deaths that will go uninvestigated. A murderer could get away with murder. That’s certainly a possibility,” Weedn explained.As the workload remains heavy for many jurisdictions, Diaz said education and exposure for the industry might be their best bet in getting more interest.“I think every crisis brings an opportunity. And I think this is an opportunity for forensic pathology to be on the forefront and let the public at large know what we do, how we do it, and to encourage young people to pursue a career in forensic pathology,” Diaz said. 4266

The Federal Communications Commission voted and approved Thursday that the new National Suicide Hotline number beginning in July 2022 will be 988. 154

The Centers for Disease Control and Prevention is asking people who take a COVID-19 vaccine to download a smartphone app so it can continue to track side effects.The app, called V-Safe, uses text messages and web surveys from the CDC to check in with patients who have gotten a COVID-19 vaccine.The app will also remind patients when it's time to go back for a second shot.Patients can expect to experience mild symptoms like fever, headache and muscle aches after taking the vaccine. But doctors, like Dr. Grace Lee — the associate chief medical officer for practice innovation at Stanford Children's Health and a member of the CDC's vaccine advisory panel — say those side effects don't tend to last very long."We hope that patients will be willing to engage in the system, recognizing it does take some time," Lee said. "But it's really important for all of us in the U.S. to make sure that we are helping to create a robust vaccine safety monitoring system for all COVID vaccines."Lee says that because clinical trials for COVID-19 vaccines have been so large — with 30,000 to 60,000 people in each trial, compared to just several thousand for a typical trial — there's already a lot known about the vaccines.The trials have shown no major safety risks thus far, but Lee says rare adverse events can happen — like the two healthcare workers in Alaska earlier this week who suffered anaphylactic allergic reactions with the Pfizer vaccine. The side effects reported by those two patients were similar to the ones suffered by two people in the U.K. earlier this month.Lee says that's why the CDC is counting on as many people as possible to use V-Safe."My hope is that if the numbers are high," Lee said. "It just means it gives us more information more quickly, and so for anything rare that might occur, we would be able to pick it up much more quickly."V-Safe send text messages to patients, asking them how they are feeling for up to six weeks after their shots. The CDC says the questions take less than five minutes to answer and that the information patients provide will be confidential and private. 2117

The Centers for Disease Control and Prevention is now publicly acknowledging people can be infected with the coronavirus through airborne transmission, especially in enclosed spaces with inadequate ventilation.The update embraces growing evidence and international research showing the coronavirus can linger in the air longer - for minutes and hours - and travel farther than six feet.The update comes two weeks after the official CDC website was updated to reflect this, only to be removed a few days later with the agency saying it was “posted in error” before it was fully reviewed.The draft language seemed to imply aerosol or airborne transmission was the main way the coronavirus spreads, and the CDC says that is not the case.“Infections occur mainly through exposure to respiratory droplets when a person is in close contact with someone who has COVID-19,” the CDC states.Their added section is titled “COVID-19 can sometimes be spread by airborne transmission,” and includes information about smaller particles lingering in the air after an infected person had left the space. "Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours," it reads.“There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising,” the new section on the CDC’s website reads. “These transmissions occurred within enclosed spaces that had inadequate ventilation.”The World Health Organization changed their guidance in July and noted the prevalence of airborne transmission of coronavirus and particles lingering in the air. Hundreds of scientists encouraged the WHO to make the acknowledgement following research and studies. 1943

The COVID-19 pandemic is teaching us important lessons about the next potential infectious disease threat.“That includes things like dealing with the problems that are before us now, things like antibiotic resistance that kills too many Americans every day and preparing for things we don't know about by having good surveillance programs and public health infrastructure,” said Dr. Helen Boucher, Infectious Diseases Chief at Tufts Medical Center.The Centers for Disease Control and Prevention (CDC) says antibiotic-resistant infections impact nearly 3 million people a year and are responsible for 35,000 deaths. That's less than COVID-19, but there is new evidence the two are colliding.A new CDC report points to an outbreak of a multiple drug-resistant bacteria at a New Jersey hospital already dealing with a surge of COVID-19 patients. From February through July, there were 34 of the bacteria cases. Half were in COVID-19 patients and 10 of them died.At the time, the hospital wasn't able to use the same standard of infection control practices due to capacity, shortages in PPE, medical equipment and staff.“Certainly, having health care workers healthy so they can take care of patients is very important,” said Boucher. “You might have seen that there had been some outbreaks, places across the country that have really impacted the ability to have adequate health care workers take care of patients, and that is the worst thing that could happen. And we know leads to unnecessary deaths.”COVID-19 hospitalizations are higher now than the previous two peaks in April and July.Recruiting additional medical staff is also more difficult now as more hospitals are seeing surges. In the spring, some medical facilities were laying staff off due to fewer patients.The CDC says drug-resistant infections decreased when COVID cases dropped. Basic hand hygiene can help prevent the spread of both. 1908

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