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The photos from doctors came quickly and in succession: blood-stained operating rooms, blood-covered scrubs and shoes, bullets piercing body parts and organs.The pictures on Twitter were an emotional response to a smackdown by the powerful gun industry lobby, which took issue with the American College of Physicians' call late last month for tighter gun control laws. The recommendations included bans on "assault weapons," large capacity magazines and 3D-printed firearms."Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves," the National Rifle Association tweeted.Physicians across the United States seized on the phrasing, taking to Twitter with 22,000 comments and the hashtags #thisismylane and #thisisourlane, posting photos of their encounters with gun violence and offering their own personal stories of treating such wounds.The debate gained new urgency this week with the shooting death of an emergency room doctor outside the hospital where she worked, as physicians argue shootings are a public health crisis that they must play a key role in trying to stem. Dr. Tamara O'Neal was killed Monday outside a hospital in Chicago in what police say was a dispute with her ex-fiance. The shooter and two other people — a responding police officer and a resident in the hospital's pharmacy — also died."It just shows that not only is this is in our lane, but this happens to us," said Dr. Joseph Sakran, a trauma surgeon at Johns Hopkins Medicine in Baltimore who as a 17-year-old was shot in the throat by a stray bullet fired during a dispute at a high school football game.Sakran created a Twitter account @ThisIsOurLane which in just two weeks has attracted nearly 15,000 followers. They include Dr. Peter Masiakos, a pediatric trauma surgeon in Boston, who wrote "The Quiet Room" just hours after the mass shooting at a church in Sutherland Springs, Texas, about breaking the news that a loved one has died."We need to start talking about this as a public health issue. Politics aside, we have a problem that no other country has, and we shouldn't," Masiakos said.About 35,000 people each year are killed by guns in the United States, and about two-thirds are suicides. That's about 670 people per week and among the largest number of civilian gun deaths in the world.The world's highest rate of gun deaths is in El Salvador with a rate of 72.5 per 100,00; the rate in the U.S. is 3.1 per 100,000. Among all European countries, the rate never breaks 1 gun death per 100,000, according to Small Arms Survey, a Switzerland-based research organization that examines firearms and violence."These are not just statistics. These are people, mothers, fathers, brothers, sisters that are being killed," Sakran said. "The worst part of my job is having to go out and talk to these families and to tell them that their loved one is never coming home."It's not the first time that medical professionals have taken on powerful industries: auto companies over seat belts, Big Tobacco over cigarettes and toys that posed choking hazards. It's also not the first time that the gun lobby has pushed back against the medical community or researchers it considers to be biased. In the 1990s, Congress barred the Centers for Disease Control from conducting research that advocated or pushed for gun control; while it didn't ban research from being conducted, it did have a chilling effect.More recently, the NRA backed legislation in Florida — eventually overturned in court — that would have barred doctors from asking patients about guns in the home.Dr. Stephanie Bonne, a trauma surgeon in New Jersey, was in the hospital when she saw the dispute playing out on Twitter."I was reading this, and I was like 'Stay in my lane', are you kidding me? Gun violence is something I deal with every day. We're mopping it up in the hospital every day," she said. "My second sort of reaction is maybe people ought to see what this lane is really all about."Bonne works at a Level I trauma center — the top-level hospital for treating the most serious cases. Her hospital sees about 600 gunshot wounds each year, and she described the toll that unfolds: medically, psychologically and financially."It's always tragic and it's always preventable," Bonne said.Dr. Judy Melinek, a forensic pathologist in the San Francisco Bay area, examines the dead. She took to Twitter to push back at the gun lobby, posting: "Do you have any idea how many bullets I pull out of corpses weekly? This isn't just my lane. It's my (expletive) highway.""The chutzpah, the gall is what really got to me," Melinek told The Associated Press. "The NRA seems to think they've cornered the market on expertise when it comes to guns. And that's not correct."She's conducted about 300 autopsies involving gunshot wounds, about half of those suicides. She's seen the damage from bullets and believes more and better research would help prevent gun violence.Would GPS tracking on firearms or high-tech trigger locks make firearms safer, for example?Dr. Arthur Przebinda, director of the gun rights advocacy group Doctors for Responsible Gun Ownership, said the pushback from physicians is largely driven by more liberal forces within medical academia and based on ignorance about firearms.He described it as old, tired debate that shows a knee-jerk bias against firearms. Rather than stripping away constitutional rights, physicians should focus on finding ways to study the underlying causes of violence, he noted."These virtue-signaling physicians would be in their lane if they pursued better surgical techniques, better postoperative treatments. They are in the wrong profession if they want to cure society's ills," Przebinda said. "If that was their life's calling, they should have pursued a career path in psychology, criminology or the clergy."___This story has been amended to correct the first name of Dr. Judy Melinek. 6087

The pandemic is coinciding with flu season, which is a potentially dangerous scenario doctors and nurses have given much thought to as the winter months approach.“How much is [the flu] going to play into things, and is it just going to make everything worse?” said Dr. Michelle Barron. “Is it going to comingle with COVID, and actually make people double sick or doubly ill?”Dr. Barron is the senior medical director of infection prevention and control at one of Colorado’s largest hospitals. She says staff has come up with contingency plans to deal with an influx of patients who might be battling serious flu symptoms.“We’ve been really encouraging our patients to get their flu shots and make sure they have that on their list,” she said. “We understand that there are some years that you’re debating whether or not it’s worth it, and we’re like this is the year you need to get it.”The CDC estimates around 196 million flu shots are available this year, a 13 percent increase from last year’s record-setting dosage of 175 million. It is an important number as last year 400,000 people were hospitalized for the flu, a potential burden hospitals have prepared for as bed space is now at a premium.“We’ve already surpassed the numbers of the first surge, so now, we’re like what’s next,” said Maddie Smith, a nurse at UCHealth in Colorado.Smith works in the hospital’s COVID ICU. She says while her unit has not reached a tipping point, it is expecting more flu patients to come in. Her unit has made plans to allocate more bed space to the seriously ill, regardless of cause, and treat them with whatever drugs are necessary. The good news, she says, is the flu has been treated for years, so doctors have a good plan of attack, and the measures we have taken to reduce the spread of COVID-19 are having a positive effect on the spread of the flu.“We usually are able to use the southern hemisphere as a good way to figure out what our flu season is going to look like,” said Dr. Barron. “They actually had a pretty mild flu season but COVID hit at the exact same time.”Dr. Barron says 3 to 5 percent of COVID-19 patients have had co-infection with another virus, showing complications are possible as flu season hits its stride, but not guaranteed.“I don’t think it’s anything that we can’t manage that we already haven’t thought about,” said Dr. Barron. 2367

The Indianapolis 500 will be held without fans in attendance on Aug. 23 due to escalating concerns over the coronavirus pandemic in Marion County, the Indianapolis Motor Speedway announced Tuesday.It will mark the first time in the 109-year history of the Indy 500 that it will be run in front of empty stands at the 2.5-mile oval track.“As dedicated as we were to running the race this year with 25 percent attendance at our large outdoor facility, even with meaningful and careful precautions implemented by the city and state, the COVID-19 trends in Marion County and Indiana have worsened," a news release from IMS said.First held in 1911, the Indianapolis 500 is the largest single-day sporting event in the world with approximately 350,000 people annually packing the track's grandstands and infield to watch "The Greatest Spectacle in Racing." Running the race without fans prevents the seventh cancellation in Indy 500 history. The race was not held in 1917-18 during World War I, and from 1942-45 during World War II.In late March, IMS leaders rescheduled the race from May 24 to Aug. 23. Officials said on June 26 that Indy 500 attendance would be limited to no more than 50%.That number was further decreased on July 22 when plans were scaled back to host the race at 25% capacity. Face coverings would be required, and the Speedway released an 88-page health and safety plan that provided guidelines and protocols for how the race would be run in 2020.Even at 25% capacity, the race would have been the largest event held in the United States since the beginning of the coronavirus pandemic.IndyCar and IMS owner Roger Penske previously said he wouldn't run the race without fans, but the realities of the pandemic prevailed.“We need to be safe and smart about this,” Penske told the Associated Press. “Obviously we want full attendance, but we don’t want to jeopardize the health and safety of our fans and the community. We also don’t want to jeopardize the ability to hold a successful race.”In a news release, IMS said in the weeks since the June 26 announcement of 50% capacity, the number of COVID-19 cases in Marion County has tripled while the positivity rate has doubled."We said from the beginning of the pandemic we would put the health and safety of our community first, and while hosting spectators at limited capacity with our robust plan in place was appropriate in late June, it is not the right path forward based on the current environment," the release said.How fans will be impactedThe announcement of no fans on race day also means all on-track activity during the month of August, including practice and qualifications, will be closed to the public. The first practice will take place on Aug. 12.Fans who still have tickets to the 2020 Indy 500 will be credited for the 2021 race and retain their seniority and originally assigned seats.Additionally, as announced in July, the race will be broadcast live on TV in Central Indiana for the first time since 2016.State and city leaders react to Speedway's decisionIndiana Gov. Eric Holcomb issued a statement following the announcement thanking Penske and IMS leadership and encouraging Hoosiers to do what they can to prevent the spread of COVID-19. 3239

The president has signed the covid relief/government funding bill, several sources told me.— Jake Sherman (@JakeSherman) December 28, 2020 152

The number of people killed in wildfires burning in California has risen to 50 -- including 48 from northern California's Camp Fire, already the most destructive and deadly blaze in state history.As firefighters battle that fire Wednesday in Butte County north of Sacramento, authorities fear more human remains will be found as searchers comb through rubble and ashes in Paradise, the ravaged town of about 27,000 residents."I want to tell you, though, this is a very, very difficult process," Butte County Sheriff and Coroner Kory L. Honea told reporters. "There's certainly the unfortunate possibility that even after we search an area, once we get people back in there, it's possible that human remains can be found."PHOTOS: Wildfires devastationAuthorities have requested that 100 National Guard troops join cadaver dogs, mobile morgues and anthropology teams in the grim search and recovery of human remains.In Southern California, firefighters still are battling the Woolsey Fire, which so far has left two people dead in Malibu.They've also been fighting a new blaze, the Sierra Fire, in San Bernardino County. It started late Tuesday about 50 miles east of Los Angeles near Rialto and Fontana, and by Wednesday morning had burned 147 acres, though no evacuations have been ordered, the San Bernardino County Fire District said.Fire officials said the Sierra Fire was fanned by the Santa Ana winds -- strong, dry winds that high-pressure systems push from east to west, from the mountains and desert areas down into the Los Angeles area.Winds will be "particularly strong" Wednesday morning but are expected to weaken by evening, the National Weather Service said.Meanwhile in Northern California, forecasters have said the winds fueling the Camp Fire would slowly begin to decrease Wednesday and give firefighters a reprieve. 1842

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