The word “health” instantly brings images to mind of getting your temperature checked, visiting your doctor’s office, maybe the last meal you ate, or a New Year’s resolution to start getting more exercise. There are also millions of other possibilities to consider when exploring the topic. We are aware that we make choices that impact our health, just as genetic or family health issues affect our overall wellness. Health encompasses the most personal, private decisions that we, as individuals, make every day. In a nation of over 328 million people, it can be overwhelming to consider the unbelievable number of choices Americans make that affect our healthcare system. Yet, managing the health of all people and their communities is the main role of public health professionals.

Dr. Alleyne describes public health as a team sport. Collaboration and cooperation are the two methods pubic health uses to save millions of lives at a time and improve our life expectancy by twenty-five years. Early in his career, he was an epidemiologist at the Rockland County Health Department. During these years, he was part of a local team that responded to Anthrax, Lyme disease, and fast-food industry service issues. “We would meet with other regional health departments to share experience and knowledge. We then worked with health departments in other areas of the country to create a network to share best practices, information, and ideas to support each other in addressing the health and safety of our nation’s communities.” This experience set Dr. Alleyne on the path to advocate for a strong network, operating on the latest technology, to provide instant access to health officials during manmade threats or natural disasters.

Public health during COVID

At the outset of the pandemic, local health departments and local health officials became the source of information and direction on the guidelines established to keep our communities safe. There are nearly 3,000 local health departments in the United States; many lack resources or funding to operate fully. The CARES Act was a $2 trillion coronavirus response bill passed by Congress in March. The aid package was emergency relief funding to help citizens, small businesses, corporations, hospitals and public health, local and state governments, and education. For example, $100 billion was for hospitals responding to the pandemic. $4.3 billion went to the CDC programs and response efforts. Almost $340 billion was designated for local and state governments; more than half was reported toward specific COVID projects, with the remaining $150 billion as direct aid to state and local governments requiring emergency funding to operate. Dr. Alleyne advocates for counties who “have not seen federal dollars.”

On a basic level, local health departments are charged with slowing the spread of COVID-19 by testing, tracking, and tracing area infection rates. During this process, the data collected is then shared on a state level, incorporated into the national health system. This work is where Dr. Alleyne shared his favorite analogy. “I often joke that the healthcare infrastructure investments, like health information technology, did not reach public health departments. Public health is sitting on the information superhighway with a bus pass because they were not eligible for these investments. We have antiquated systems to process information. We still have health departments that are still delivering their reports by fax.”

After months of speculation, a safe, effective COVID vaccine from Pfizer/BioNTech is now available in the United Kingdom. The UK reportedly ordered 40 million doses, enough to vaccinate 20 million people. UK health officials are implementing a vaccine rollout plan, similar to what US officials have stated, targeted at administering doses to frontline healthcare workers and the elderly. The US Food and Drug Administration approved emergency use authorization for Pfizer and BioNTech’s vaccine this week, after an all-day meeting that formalized distribution logistics and the national vaccination plan. Shots will not be available for administration until the CDC officially recommends the vaccine to the American public. The CDC’s Advisory Committee on Immunization Practices has scheduled emergency meetings for this weekend. As our nation’s leaders formulate a strategy for vaccinating Americans, the planning process must include the role of public health.

Local health departments will need to work with community health care providers to deliver COVID vaccines and communicate the effectiveness and importance of vaccination. Public trust has wained this year due to conflicting messages and misinformation shared through social discourse. In their Recommendations for the Biden-Harris Transition and the 117th Congress, NACCHO recognized that public health must abstain from promoting any political agendas. “Even perceived political interference with public health guidance and mixed messages at the federal level greatly impact the ability of our members to protect their communities.” Dr. Alleyne addressed that a safe, effective COVID vaccine is the beginning of a long-term timeline in improving public health. “The next phase is critical; what can we expect in the future? That is the overall impact on mental and physical health, as well as the elements of the economy and society. How are we going to reset to return to a sense of normalcy? We will need adequate resources to create significant and long-lasting progress in behavioral health and social concerns. We are not in for a sprint but a very long marathon!”

Written by: Michael Arce, host of HeartTalk presented by Capital Cardiology Associates. HeartTalk airs Sunday at 1PM on NewsRadio 810 and 103.1 WGY. You can listen anytime on iHeartRadio.

The Centers for Disease Control and Prevention (CDC) established National Influenza Vaccination Week (NIVW) in 2005 to highlight the importance of continuing flu vaccination through the holiday season and beyond. Every year, it seems we deal with a devastating strain of the flu. This year, the term “twindemic” captures the overlap of the flu and COVID pandemic. With that said, only 48% of adults were vaccinated last year. Healthcare providers insist that this year, it is more important to get a flu shot than ever.

“I am cautiously optimistic that vaccination rates will be higher this season,” states Dr. Brion Winston, a board-certified cardiologist at Capital Cardiology Associates. Along with his specialty as an interventional cardiologist, Dr. Winston also holds a Master of Public Health (MPH) from Columbia University. He has keenly observed the coordination and communication of federal, state, and local guidelines and pandemic response to keep the public safe. “Certainly what we are concerned about is the twindemic, that cases of both influenza and COVID present in the same person. That would be quite devastating.” The flu, by itself, led to 400,000 hospitalizations and 22,000 deaths, according to the CDC estimates for 2019-2020.

Dr. Winston added that while the vaccine is quite effective, it’s not a guarantee that you will not contract the virus. “It does reduce cases by almost 50% for those who receive the shot. That is quite remarkable. For those that do get the flu, the general rule is a much more mild case despite the vaccination,” adds Winston. The National Foundation for Infectious Diseases reported that flu vaccines prevented 7.5 million flu cases, 3.7 million flu-associated medical visits, 105,000 flu hospitalizations, and 6,300 flu deaths last year. The flu shot has proven to lower cardiac arrest rates in heart patients, reduce admissions for stroke or heart failure, and reduce death rates in adults with Type 2 diabetes. For those who have received the vaccine and still get infected, their body can better fight the flu, lessening the intensity of symptoms and shortening the duration of illness. Plus, for Americans with a health insurance plan (private or public), your provider will cover the cost of the flu shot entirely. Outside of visiting your doctor, there are also more options, like pharmacies allowing you to schedule an appointment.

The flu forecast for 2021

The New York Department of Health has a flu tracker on their website, updated weekly on Thursday evening. Last year’s flu season (2018-2019) was the longest in a decade, lasting 21 weeks. It wasn’t as brutal with illnesses, hospitalizations, and deaths as previous years, but for those who visited a Capital Region hospital in mid-February through April, it seemed like waiting rooms and patient areas were filled with people seeking relief from their infection. A predictor for the American flu season is the largest continent in the Southern Hemisphere: Australia. The flu season south of the equator generally runs from April to October, peaking in August. Health officials and epidemiologists monitoring Australia’s season this year noted two factors: unusually low numbers of cases and an unprecedented demand for flu shots. Australia reported just over 21,000 confirmed flu cases and administered a record 18 million flu vaccines this year.

Experts are encouraged with Australia’s diminished season but cautioned that what happens in other parts of the world doesn’t guarantee success in the United States. “How we can predict the effectiveness of the flu vaccine six months in advance is impressive. Our flu vaccine is based on two antigens; they look at the circulating flu levels in Asia and North America. From that, they come up with a cocktail, for lack of a better term, of antigens that will elicit the antibody response. It’s a probability model in terms of predicting which strain we are likely to see,” noted Winston. There is also the theory that more people practicing COVID guidelines (wearing a mask, social distancing, and frequent hand washing) could sustain the flu virus’s spreading. “I am impressed with the way that New Yorkers have responded to the pandemic,” said Winston.

Written by: Michael Arce, host of HeartTalk presented by Capital Cardiology Associates. HeartTalk airs Sunday at 1PM on NewsRadio 810 and 103.1 WGY. You can listen anytime on iHeartRadio.

Forecasting healthcare trends for the ensuing year in standard times usually considers examing the current focus’s effect while balancing future needs. But we do not live in normal times. Forecasting during a global health pandemic is driven by one constant need: a safe, effective coronavirus vaccine delivered to a massive population. COVID will continue to be a massive demand for 2021, but two other major areas will most likely emerge — one that affects how healthcare is delivered, the other on how care is administered.

The hope in the coronavirus research is that mRNA would turn the healthy body cells into hunters, almost an anti-virus force preventing those receiving the vaccine dose from becoming infected with SARS-CoV-2, the virus that causes COVID-19. Another sign of encouragement with an mRNA vaccine is that it is easier to mass-produce than traditional vaccines. Scientific experts estimate just a few months instead of the standard 1-2 years for manufacturing.

Lost in the excitement of the first COVID vaccine candidate’s advancement to market where the challenges with the distribution issues. For one, the Pfizer vaccines must be administered within five days after being thawed from their subzero storage temperatures. If not, the shots go bad. This creates a logistics challenge, not only in creating a deep-freeze storage/transfer network to transport the drug but also vaccination centers that have the proper storage equipment. The World Health Organization has stated their goal to raise almost $20 billion to purchase vaccines for poorer countries. Even with assistance funds, there will be many areas that cannot afford to build proper facilities or are simply too distant for safe, reliable transport. Moderna, one of the many other possible COVID vaccine candidate drugmakers, shared that it expects to have news on the data of the first analysis of its testing by the end of the month. As the picture clears on the effectiveness of possible vaccines and how the drugs are adminstered, we can understand the point made by health experts that there will mostly be multiple vaccines for COVID.

New healthcare horizons

Searching for the possible silver lining during the pandemic points to the expanded role of technology in healthcare. “This will be a growing part of how we bring care to more people,” states Dr. Connor Healey, a board-certified cardiologist with Capital Cardiology Associates. “While telehealth is great for primary providers, it can be a challenge for specialty physicians. In cardiology, it’s difficult to provide virtual type meetings without having access to EKG or vital information on patients if they are at home.” However, like many healthcare providers in the United States, Capital Cardiology shifted our focus to include virtual visits as an option for patients during the pandemic. This will continue to grow as telehealth services improve to include features like Bluetooth stethoscopes and diagnostic equipment that can be administered by a technician or provider working with the patient and simultaneously reviewed by a physician connected at a remote location.

Mobile health has emerged in the form of wearable activity & fitness trackers and remote monitoring, which offers physicians and healthcare providers the opportunity to watch patient health data in real-time. Mobile health also incorporates Health Apps, user-centric programs, and software installed on smartphones, tablets, and wearables that connect a vast amount of data into one reporting module. The Apple Health app, for example, takes information from devices and displays them in one place. We live in a time where your healthcare provider can quickly glance at the Health app on your iPhone to get information on changes in your activity, cholesterol or blood pressure, or sleeping patterns.

The downside of collecting health data is privacy and security issues. Many legal experts predict that with integrated data collection, like the Apple Health app, the same devices used in smart home technology to turn on lights or the heating and air conditioning place our data at-risk to hackers. As it is referred to by tech giants (Apple, Google, and Microsoft), Big Data puts millions of personally identifiable health records on servers and storage devices out of reach of the individual user. The collection and usage of this user’s data will continue to be a legal and policy concern until there are clear regulations on how much medical information is covered under user agreements in the fine print on the apps and devices we use. American consumers are pushing for more control over how our data is used, who has access to it and want to be able to make decisions on how a company can interact with us in advertising and marketing generated from using their product.

Healthcare reform

While the Affordable Care Act (ACA) is the law of the land, there continue to be legal challenges on the largest healthcare legislation that impacts over 23 million Americans. Currently, the future of the ACA is before the United States Supreme Court in the case California vs. Texas, an argument to overturn the ACA in its entirety. “That will have long-term consequences beyond the presidential election cycle,” pointed out Dr. Healey. President-elect Biden called for building on the ACA during his recent campaign, vowing to continue to give Americans a public option to affordable health insurance, increasing tax credits to lower premiums, and expand coverage to low-income Americans. “It’s imperfect; I get that. There are a lot of bipartisan accomplishments that everyone agrees on. Allowing young people to keep their parents’ coverage until they are 26. Eliminating pre-existing conditions. Problems with transparency in health care plans and coverage. These are all excellent moves. I don’t see any strong impotence to change them. If you make the ACA in general illegal or reverse it, you are rolling back those advances. Furthermore, what is the alternative plan?”

Ultimately, the future of healthcare in 2021 and beyond revolves around offering patient-focused care that improves health and quality of life. As a physician engaged in actively improving his patients’ outcomes, Dr. Healey points to an important lesson he learned during the COVID pandemic. “Social determinants of health should not be barriers to healthcare. Many of us see this on a day-to-day basis and can at least enact some form of change, even if it’s just simply having the conversation. If we are still having this talk in ten years, then what have we done?” The entire healthcare system is committed to advancing awareness and education initiatives that create healthier citizens and communities. From adding sidewalks in our neighborhoods to smoking cessation programs to promoting annual health visits and flu vaccinations, public health officials, healthcare providers, and health insurance are investing resources in creating value in individual citizens taking an active role in their daily health.

Written by: Michael Arce, host of HeartTalk presented by Capital Cardiology Associates. HeartTalk airs Sunday at 1PM on NewsRadio 810 and 103.1 WGY. You can listen anytime on iHeartRadio.

Sudden Cardiac Arrest Awareness Month is a vital initiative set forth by the Heart Rhythm Society to educate the public and raise awareness for sudden cardiac arrest. Sudden Cardiac Arrest (SCA) can lead to death within just minutes of the event if the victim doesn’t receive immediate medical attention or help. These episodes are aptly named as they happen suddenly, “meaning that there is often no warning ahead of time that there could be a problem,” adds Dr. Kevin Woods, a board-certified cardiologist at Capital Cardiology Associates. He explained how SCA is the leading cause of death, taking more lives than breast cancer, lung cancer, or AIDS in the United States. How the most important person during an SCA event is YOU.

Not a heart attack or stroke

SCA is often confused for a heart attack because they share a cardiac connection due to the instant onset that can strike without warning. What makes cardiac arrest dangerous is that there are underlying causes that trigger the heart to beat out of rhythm or sync. “Usually, it’s a problem when the heart rate beats very fast, not as you see in movies where someone flatlines or needs to be shocked,” explained Dr. Woods. SCA typically originates as an electrical problem, an arrhythmia. When the lower chamber of your heart (ventricle) receives erratic signals, it will throw off the heart from beating and pumping blood efficiently. When an event occurs, the victim may complain of chest pain, discomfort, heart palpitations, shortness or difficulty breathing, feeling faint, lightheaded, or dizzy. Sudden cardiac arrest will cause the heart to beat out of sync, robbing the brain of blood flow, leading to unconsciousness.

The breakdown of a sudden cardiac event sounds very much like a heart attack, but it’s important to note the main difference: SAC is an electrical issue where heart attack is a plumbing problem. In a heart attack, we see blood flow interruptions due to plaque (a fatty substance) clogging arteries. “When plaque ruptures, a blood clot forms that robs the heart muscle of oxygen, inducing a heart attack. That can precipitate sudden cardiac death, which is where a heart attack can overlap with sudden cardiac arrest,” noted Dr. Woods. In both cases, when the heart stops beating, the loss of blood can cause permanent brain or heart muscle damage or death after as few as 10 minutes.

Another distinguishing fact is that sudden cardiac arrest can strike anyone, at any age. Thankfully, cardiac arrest events are rare in children between the ages of 5-19 years old, claiming the lives of over 2,000 children a year. When these deaths are reported, they are tragic, leaving communities to seek what can prevent future loss. Parent Heart Watch is a national organization that strives to protect youth from sudden cardiac arrest. Their website states that 72% of students who suffered from SCA were reported by their parents to have had at least one cardiovascular symptom before the event. They didn’t recognize it as life-threatening. Many young people don’t speak up about possible symptoms because they are not aware of their unusual condition, are afraid of being different, or fear losing playing time.

What can be done

Communication with your teenager is key in creating awareness. As a physician and father, Dr. Woods understands the challenge of talking with teens about their health. “The important point is when you are aware of a family history of heart problems, that is definitely a reason to be specific with your children and your health care provider. With teens, you will have to engage them in the conversation. You should also have an open dialogue with your provider on your concerns.” A grandparent or parent that had a heart attack at a young age, like 50, is information you should share with your children and doctor. “People are labeled as having a heart attack frequently when it might not be exactly what happened. It could be a cardiac symptom or seizure that was misdiagnosed at the time. If it’s an event that happens at 50 or younger, that results in death, that is a major red flag.” You also play a major role in your health. Self-prevention includes regular checkups with your healthcare provider, being screened for heart disease, and making good lifestyle choices.

Quickly reacting to a sudden cardiac arrest can dramatically increase the chance of survival. For every minute in SCA, the chance of survival decreases by about 10%. Health experts point out that calling 9-1-1 isn’t enough to provide support during this health emergency. The amount of time it typically takes emergency medical services to arrive, around 10 minutes in the best estimates, affects survival chances. In his initial setting with patients, Dr. Woods experiences best and worst-case scenarios. “There are patients who come in unconscious due to treatment on the way to the emergency department. Some we have to induce a coma as part of a protocol to cool down their core temperature to improve the chance of having fewer neurological defects or brain damage after their event.” Since an SCA episode contains sudden collapse, unresponsiveness, or loss of breathing, CPR is a life-saver. Beginning hard and face chest compressions at the center of the chest can stimulate the heart to start working again.

The shock of an automated external defibrillator (AED) can re-establish an effective heart rhythm. The American Red Cross is one of many organizations that offer AED training. These small, portable devices deliver a strong shock while waiting for emergency responders. The sooner the AED shock is given, the better the outcome as these devices are most effective if used within three minutes after cardiac arrest. In New York State, every school must have an AED – especially at sports/athletic activities. High school seniors are now required to learn how to administer an AED or CPR. AEDs are also required at beaches, pools, trampoline parks, and state buildings. “The good news is that we do save people. Those numbers are on the rise due to awareness in the general population, the availability of AED’s, more people getting certified in CPR, and new protocols that we follow in the hospital to help people recover. It’s amazing to see how far people can go after an event of this magnitude,” Dr. Woods optimistically added.

Written by: Michael Arce, host of HeartTalk presented by Capital Cardiology Associates. HeartTalk airs Sunday at 1PM on NewsRadio 810 and 103.1 WGY. You can listen anytime on iHeartRadio.