Canadian Healthcare Technology eMessenger - COVID-19

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March 26, 2020 - Volume 17, Number 7 Welcome to The CHT e-Messenger: A summary of key I.T.-related news from Canadian Healthcare Technology. COVID-19 New solution for rapidly screening, managing patients TORONTO – InputHealth, a Canadian healthcare software company known for their Collaborative Health Record (CHR) platform, has signed a contract to supply the Ontario Health West region with a newly devised solution for rapidly screening, triaging and treating patients according to the urgency of their care. More   Innovation Orion Health offers IT solution for current pandemic  TORONTO – A computerized system for remote patient management, developed by Orion Health, is now being used in New Zealand, France and elsewhere to monitor patients who have tested positive for COVID-19, enabling them to remain in their own homes. The solution could be quickly adapted in Canada, too, and extended to homes to help monitor patients in this country, the company said. More   Telehealth Alberta increases doctor’s fees for virtual visits EDMONTON – The Alberta government has approved new, temporary billing codes to compensate doctors for providing virtual care. The new health service codes allow physicians to be paid at the same rate as if the medical services were provided face-to-face. Previously, Alberta doctors were paid only $20 for a virtual visit, compared with $38 for an in-person visit. More   Education & training CAE Healthcare and iRIS share coronavirus scenario  MONTREAL – CAE Healthcare and UK-based iRIS Health Solutions announced that CAE’s COVID-19 Simulated Clinical Experience (SCE) for healthcare is now available and free of charge to the global iRIS community. iRIS and the SCE will shortly be made available free of charge to the full membership of the Society for Simulation in Healthcare (SSH), which has 4,200 members in 60 countries, to aid collaboration and sharing between members at this time. More   Research & development AWS announces $20 million for COVID-19 diagnostics  WASHINGTON, DC – Amazon Web Services has launched the AWS Diagnostic Development Initiative – a program to support customers who are working to bring better, more accurate, diagnostics solutions to market faster and promote better collaboration across organizations that are working on similar problems. More   Telehealth Sask now covering cost of virtual visits with doctors REGINA – With the growing concern around COVID-19, Saskatchewan is taking steps to enhance access to healthcare by providing support for physicians to offer virtual appointments to patients. The new virtual services, which will be supported through a new payment code for physicians, will enable patients to connect with physicians by telephone. More   Innovation Ottawa company readies a quick COVID-19 test OTTAWA – Spartan Bioscience is weeks away from producing a mobile, hand-held testing kit that can tell people quickly if they have COVID-19, according to company CEO Paul Lem. The biotechnology company is now working with the Canadian Government to help combat the spread of novel coronavirus by developing the new testing tool. More   Got a story idea? Contact the Editor at jerryz@canhealth.com or phone: 905-709-2330.

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Anxiety about coronavirus can increase the risk of infection — but exercise can help

Stress about the coronavirus pandemic can actually increase your risk of infection, but exercise can alleviate the immune system’s stress response. Above, a lone jogger in Ottawa, on March 17, 2020. THE CANADIAN PRESS/Adrian Wyld

Jennifer J. Heisz, McMaster University
Worried about COVID-19? You may be putting yourself at undue risk, because chronic anxiety suppresses the immune system and increases our risk for infection.
The psychological impact of the COVID-19 pandemic is causing incredible distress. I ran into a friend at the grocery store the other day. She was wiping down her cart with antiseptic. Under normal circumstance, this behaviour would seem bizarre, but in the current COVID-19 climate, it has become acceptable.
Although it is important to be prepared during this pandemic, we do not need to panic. Physical activity can help protect the immune system from the effects of stress.

Fear of the unknown

As an associate professor in the department of kinesiology at McMaster University, I direct a team of researchers in the NeuroFit Lab, where we’ve shown that psychological distress can compromise mental health.
Anxiety about the unknown (such as our risk of COVID-19) can hyperactivate the fear centre in the brain called the amygdala. In terms of evolution, this is one of the oldest parts of the brain and its operations are quite primitive; it acts like a trigger-happy alarm that interfaces with the stress system to keep our body and mind on high alert for as long as we are feeling anxious. Research shows that the mere suggestion of danger, even if it never is experienced, is enough to trigger the amygdala and activate the stress response. This is what keeps people awake at night, lying in bed worrying about COVID-19.
The problem is that chronic activation of the stress systems can damage our cells and upset many of the body’s functions. Our immune system bears the brunt. Although psychological stress is not pathogenic per se, the damage it causes to the body’s cells triggers an immune response that makes us more susceptible to a foreign pathogen. This may increase our risk for infection with SARS-CoV-2, the coronavirus that causes COVID-19.

Worried sick

The immune system acts like border security, patrolling the body for cells that are foreign and harmful to it. It works a lot like the Nexus or Global Entry programs for pre-approved travellers; anyone enrolled in the program has their iris scanned to quickly confirm their identity for fast border crossing. But instead of iris scanning, the immune system scans the outer surface of a cell for its biological passport, or what scientists call a motif.
The body’s cells have a motif (a “self” motif) that’s different from the “non-self” motif of foreign cells and pathogens, like SARS-CoV-2. This non-self motif is known as a pathogen-associated molecular pattern (PAMP).

Concerns about COVID-19 led crowds to stock up on supplies. Here, people line up at a Costco in Ottawa on March 13, 2020. THE CANADIAN PRESS/Justin Tang

Another type of motif is the “damaged self” motif, known as a damage-associated molecular pattern, or DAMP. This motif is expressed by a damaged or dying cell that no longer serves the body. Stress damages the body’s cells, transfiguring self motifs into damaged self motifs. This elevates inflammation throughout the body in a similar way as if it were infected. This response, in the absence of an actual infection, is called a sterile immune response.
Chronic over-worrying about COVID-19 can intensify our vulnerability to viruses by creating an imbalance in immune function. This is because the immune system reacts to multiple breaches in immunity in a similar way that airport security reacts to multiple breaches in safety, by escalating the response. Think back to how vigilant airport security became after 9/11, implementing the strictest screening procedures for all passengers and luggage.

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Read more: Coronavirus weekly: expert analysis from The Conversation global network

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Excessive anxiety about COVID-19 can trigger an immune response that increases inflammation and readies the immune system’s equivalent of special forces, known as inflammasomes. If SARS-CoV-2 acts like other viruses, then upon infection the inflammasomes will be called to action to escalate inflammation even further. But too much inflammation does more harm than good; it deregulates immune function, increasing our risk of a viral infection.
My lab recently demonstrated how quickly our health declines under chronic stress. We tracked sedentary but otherwise healthy students during the weeks leading up to their final exams, and we observed how six weeks of stress gave rise to the symptoms of depression.

Resisting the effects of anxiety

What can we do to prevent panic and bolster immune protection?
Physical activity can protect your body from chronic stress-induced inflammation.
In our study, during that same stressful six-week period, we enrolled some of the students in a new exercise program in which they cycled on a stationary bike at moderate intensity for approximately 30 minutes, three times per week. Moderate intensity exercise is about 40 per cent of maximum workload: the point at which someone can still talk, but can’t sing.
Blood samples were collected to track changes in inflammation. Although the exercisers were exposed to the same psychological stressors as the sedentary students, their inflammation remained low and their mood remained high with no increase in symptoms of anxiety or depression.
But the intensity of the exercise mattered. Higher intensity exercise was not as effective at protecting mental health or reducing inflammation. The vigorous nature of the intense exercise may have exacerbated an already stressed-out system, especially in individuals who were not accustomed to exercise.
The key take-away from our research: a brisk walk, jog or bike ride can help keep you calm and healthy during these uncertain times so you can be prepared without the panic.
Jennifer J. Heisz, Associate Professor in Kinesiology and Associate Director (Seniors) of the Physical Activity Centre of Excellence, McMaster University
This article is republished from The Conversation under a Creative Commons license. Read the original article.

Bill Gates - Global Health - Blog

The Insider Edition February 10, 2020

Why Melinda and I swing for the fences

By Bill Gates

When Warren Buffett donated the majority of his wealth to our foundation, he told Melinda and me to “swing for the fences.”

That’s a phrase many Americans will recognize from baseball. When you swing for the fences, you’re putting every ounce of strength into hitting the ball as far as possible. You know that your bat might miss the ball entirely—but that if you succeed in making contact, the rewards can be huge.

That’s how we think about our philanthropy, too. The goal isn’t just incremental progress. It’s to put the full force of our efforts and resources behind the big bets that, if successful, will save and improve lives.

Our annual letter this year is all about those big bets. We write about the work our foundation has done on health and education over the last twenty years and why we think the risks we’ve taken have set us up for future progress. We also write about two issues that have emerged as priorities for us—the climate crisis and gender equality—and how they will factor into our next 20 years.

Read our 2020 annual letter here.

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