2021 Edition
“A strong woman is a woman determined to do something others are determined not to be done.”
- Marge Piercy
ABOUT US Here at AMWA UTD, we want to do our very best to inform you of all of the issues relevant to women and healthcare, together and separately. We hope that our monthly newsletter becomes an enlightening source to you all as we learn about the multitudes of important topics and issues that we all need to be aware of.
The Editor’s Take: The First In-Person Semester Complete
By: Shraddha Trehan
Look at that AMWA, it would seem our first semester in-person together is complete. What an idea! Over these last 15 weeks, I have gotten to know some of you brilliant girls face-to-face, and it has made my medical journey all the sweeter. I could not be more grateful to be graduating this semester knowing that this club is here to last at UTD. Though I will be your editor next semester as well (looking forward to a spring of barista-ing at Starbucks and reading even more intriguing news about this crazy, beautiful, blue world), October-December 2021 will always hold a special place in my heart.
The newsletter has brought you exciting, memorable, and interesting pieces thus far, and we plan to end this year with a bang. Finishing off 2021, we’re going to talk about Mental Health, Cybermedicine, the Omicron variant, Microarray Technology, HIV/AIDS, and what the UTD AMWA community thinks about the socioeconomic world under COVID-19.
Please feel free to email me at shraddha.trehan@utdallas.edu about any topic you feel needs to be included in future newsletters. Editing the articles you see here, the articles from October & November, and the articles to come, will always be a humbling privilege.
Until the next one, Shraddha :)
Mind Over Matter: De-Stressors for Finals
By: Zoe Du and Megan Zachariah
mental health /men-tal health/, n. something that sorely needs to be taken care of and loved, even though some may tell you differently.
Zoe:
The college experience looks different for everyone, but a universal experience is stress. We have a lot on our plates, and most, if not all, of us, have probably felt overwhelmed or anxious at some point this semester. With final exams and grades looming over many of us, our mental health is more important than ever. Mental health is health, and just as we need to nourish our bodies to stay physically healthy, we need to take care of our mind and its needs. Here are some of my favorite ways to de-stress and relax!
Megan:
No matter how many exams you have under your belt, testing anxiety never really goes away. The only thing that you do have control over, however, is how you cope with it. Whether it be studying with friends or having a self-care day, nurturing your mental wellness is just as important for consolidating information and being a more effective test taker. Here are some of the ways I practice self-care!
Cybermedicine
By: Megan Zachariah
The strains placed on our healthcare system by the COVID-19 pandemic have changed the way we practice healthcare forever. The transition into telemedicine and emphasis on at-home care has been on the rise since the pandemic first hit. With stress to develop ever-more effective modes of telehealth, many hospital systems have found partnerships with major tech companies in order to facilitate this transition.
This month, Cerner, an electronic health records platform, partnered with Zoom to provide patients with a more seamless tele-visit experience. Now, built-in features allow patients and physicians access to medical documentation and the ability to invite interpreters into the session. Further, multiple physicians can now access a session without the hassle of generating new links. In the future, Global Healthcare Lead from Zoom Communications, Ron Emerson hopes to create a way in which in-person appointments may be reserved through Zoom to those in critical need.
Another exciting collaboration that took place earlier this month was between Microsoft and CVS Health in order to further streamline the pharmaceutical industry. Microsoft’s strategy includes the digitization of records, incorporating machine learning to tailor patient care, and expanding online ecosystems like Cloud and Remote Assist to keep patient information within a closed-loop and simplify patient access by providing a “one-stop solution”. CVS Health points to the “40 percent of prescriptions that arrive as paper or fax” as a marker of the inefficiency highlighted by the pandemic stressors that delay critical care to patients. With a new emphasis on increasing the rate of service, this particular collaboration is indicative of the direction healthcare is taking by the time we enter the field as professionals.
Despite all this exciting progress, the transition to virtual-based medical practice also invites a whole new host of threats, many of which we have already seen. Ransomware attacks occur in which corrupted files or applications are loaded onto devices hosting medical platforms and patient information that, upon access, freeze these systems and generate an arbitrary paywall prompting the victims to pay to regain access to the stolen information. Though these forms of cyberattacks are not unique to healthcare, with the strains imposed onto hospital computer systems, the threat of ransomware has more devastating implications. In October 2021, the University of Vermont Medical Center found ransomware on their systems, eventually being blocked from accessing emails, patient information, or records. In order to resolve this issue, they chose to replace their entire system rather than pay the attackers. This resulted in nearly $50 million in losses due to canceled appointments, rescheduled surgeries, and referrals for radiation treatments.
As we can see, preventative measures protecting hospitals and patients from cyberattacks should be of the utmost priority as we move into this technology-based world. By ensuring that medical staff is informed about the dangers of malware and common modes of infiltration, healthcare systems can focus on providing the most efficient and effective care for patients.
What do we know about Omicron?
By: Amulya Bhaskara
As the fall comes to an end and the world learns how to live with the Delta strain of the COVID-19 virus, we are forced to face a new strain: Omicron. The South African variant has spread through Europe and recently reached the US, so it is clear that we need to learn how infectious and dangerous this strain is, and whether our current precautions are enough to keep numbers low.
Besides the fact that it sounds like a malicious organization from a Marvel movie, what exactly do we know about Omicron? While it got on our national radar near the beginning of December, it turns out Omicron has been circulating since the beginning of November. One of the most concerning parts about the new strain is how fast it was able to circulate since its origin. Experts predict Omicron can infect up to 6 times as many people as Delta, making it appear to have a transmission advantage. Therefore, the next concern is how dangerous this virus is. That, unfortunately, is a more difficult question to answer.
There are some claims that Omicron is milder than Delta, but there is just not enough data to make any clear conclusions. There are many factors to consider when looking at severity, such as age, gender, pre-existing conditions, and even economic status. As a result, it will take some time before we know how dangerous this strain is. As we wait, it’s important to know how effective our current vaccines are against Omicron. It turns out that this new strain has the ability to evade immunity provided by the vaccine to a certain extent. As a result, it is possible that the vaccine alone, even with its boosters, is not enough to curb infection rates. Experts say a mix of vaccination and other control measures, such as limited indoor gatherings and mask-wearing, is the most effective way to stop the spread of the strain. This is something that many doctors and healthcare workers are concerned about, given the relaxation of mask mandates in many states. They fear that the spread of the virus will be falsely attributed to the vaccine not working and will decrease vaccination rates.
Like with all the other strains, education and preventative measures are the top priority, and being cautious is always the best protection.
Microarray Technology and COVID-19
By: Tanya Baiju
Over the last year and a half, the pandemic has become the new norm. With that is COVID-19 testing. The three common tests are Polymerase Chain Reaction (PCR), Lateral Flow Tests (LFTs), and Antibody tests. PCR, is an antigen test that is used to directly “screen for the presence of viral RNA” (Kent). An LFT is similar to a PCR test, though they provide faster results. Antibody tests are used to evaluate “the immune response in people who have been vaccinated” (Kent).
Another type of diagnostic testing, recently seen with COVID-19 testing, is the microarray. A microarray is a lab test that displays numerous genes at once and is used to identify a mutation. The most common type of microarray is DNA microarray. In the beginning, DNA microarrays were used purely for research. Scientists would use this technology, for instance, to see how those with a “particular mutation develop breast cancer” or how differences in gene sequences lead to particular diseases (NIH). This technology is also used to see how various genes are turned on or off. As microarrays become more common, they are often seen in diagnostic testing.
In 2004, an article published in the Journal of Virological methods discuss the use of microarray technology with the SARS-CoV genome sequences. Since microarrays deal with mutations, the SARS-CoV study would have helped apply the same technology to other diseases. In this article, they mention a “universal microarray” that can detect SARS-CoV and “six mutated bases related to the different phases of the SARS epidemic” (Long et. al.). The article states that this microarray system is “more economical and labor-saving than that of the SARS-CoV resequencing microarray for complete sequence analysis” (Long et. al.). Now, during the pandemic, the use of microarray testing for COVID-19 has been more prevalent. An article in the journal Sensors by Francesco Damin and Silvia Galbiati et. al. introduces the CovidArray. The article states that the CovidArray is a “microarray-based assay, to detect SARS-CoV-2 markers N1 and N2 in the nasopharyngeal swabs” (Damin et. al.). The CovidArray would be the first DNA microarray-based assay to “detect viral genes” in the nasopharyngeal swabs (Damin et. al.). The method of this microarray is based on “solid-phase hybridization of fluorescently labeled amplicons upon RNA extraction and reverse transcription” (Damin et. al.). The study goes more into its benefits. For instance, the CovidArray would be able to reduce the total analysis time to two hours, unlike the RT-qPCR test which takes about three to six hours (Damin et. al.).
The CovidArray is a novel microarray assay but it shows how far diagnostic testing based on a microarray system has come since 2004. The ongoing research within this type of testing can eventually lead to more frequent use of the microarray assay within all sorts of diagnostic testing.
HIV/AIDS in America: An Anthropological Perspective
By: Zoe Du
December is HIV/AIDS Awareness month, and it serves as a reminder that conversations need to take place about not only the prevention of HIV/AIDS but also the social history of HIV/AIDS and how it has and continues to impact underprivileged communities.
When the COVID-19 Pandemic arrived in the United States, VP Mike Pence was appointed head of the Coronavirus Taskforce. Pence’s appointment was met with outrage and fear because he infamously exacerbated the HIV-AIDS outbreak in Indiana during his stint as state governor. A Yale study found that through inaction, citing moral objections to providing needles to drug users, Pence was responsible for HIV infecting up to 20 times more people than the virus would have, had Pence acted sooner. Pence’s reaction to HIV-AIDS is indicative of the pervasive stigmatized status of HIV-AIDS that persists today and must be overcome.
Human immunodeficiency virus (HIV) is a retrovirus spread through bodily fluids and it attacks the immune system, compromising the body’s ability to fight infection. HIV left untreated can develop into acquired immunodeficiency syndrome (AIDS), the last stage of HIV characterized by low blood counts and/or the development of an opportunistic infection. There is no known cure for HIV, but it is treatable via antiretroviral therapy (ART) and preventable through a variety of practices and treatments, including PrEP, pre-exposure prophylaxis.
When HIV was first discovered in the United States, it predominantly affected gay men, spawning a wave of homophobia. The virus was initially named “gay-related immune deficiency” (GRID), feeding the misconception that it only affected gay people. This had the dual effect of both people downplaying the seriousness of the virus and the growing epidemic, and it demonized the LGBTQ community, especially men who have sex with men (MSM). Too often MSM is treated as if they are somehow aberrations, and this oppression and discrimination are only exacerbated by the stigma of HIV, with headlines citing the “Gay Plague.” Even now, MSM is singled out by FDA guidelines for blood donations that require all blood collection organizations to defer any man who has had sex with men in the last three months.
The discussion and misconceptions about HIV are also fueled by racism. When HIV was reported in Haitians, Americans immediately began pointing fingers at Haiti as the place of origin. A physician at the National Cancer Institute claimed that HIV was suspected to be a Haitian virus brought to the “homosexual population in the United States” and physicians associated with MIT went so far as to blame “voodoo practices.” In reality, HIV likely arrived in Haiti from the United States and Europe, transmitted by “tourists or returning Haitians.”
The social aspects of the HIV/AIDS epidemic in America are only the tip of the iceberg, but they are still powerful reminders for us as aspiring physicians. The way in which we discuss diseases and the people they affect, and the way in which we prevent and treat diseases have real impacts on health. Humanity and compassion, and along with them cultural humility and inclusion, should be at the core of medicine.
Ask AWMA: The Socioeconomic World under COVID-19 and Mental Health
By: Amulya Bhaskara & Tanya Baiju
As the COVID-19 pandemic continues to plague our society, the number of hospitalizations and deaths continues to rise, putting immense strain on our healthcare systems. But as it turns out, it’s not just healthcare that has taken a hit. The pandemic conditions have also brought attention to numerous socio-economic issues. The International Law Organization (ILO) reports that over 200 million jobs were lost worldwide in 2020 alone. Furthermore, despite world governments spending over $16 trillion to bolster their economies, the poverty rate has risen to 7.1%. While it is easy to blame these effects on the pandemic, these issues have been going on for several decades, and they have also been brought to the limelight due to their exacerbation during the pandemic. Since the Great Depression, wage inequality has been steadily increasing, with the top 10% getting richer while the lower 90% have had little wage growth. As a result, homelessness and poverty have also increased, with there being more than a million homeless Americans pre-pandemic times. These numbers don’t even begin to touch on how women and people of color are disproportionately impacted by any sort of economic recession.
In November, we polled the AMWA community over the socioeconomic determinants of COVID-19 and Mental Health treatment. We asked our members if they believed socio-economic class played a pivotal role in patient treatment. A whopping 86% of our pollsters agreed with this statement, and they are unfortunately correct. Being a lower economic class or a more disadvantaged social group makes reliable healthcare too expensive or inaccessible. Sadly, many of the people who occupy one of these groups also occupy the other, meaning inequitable healthcare access is propagated among the same communities.
In light of the pandemic, one of the taglines was, ‘COVID-19 does not discriminate.’ In the poll, we asked the AMWA members to decide if this was true or false. In the Google form that we sent out, there was a tie in this answer. 46.7% of the members chose true while another chose false. In the Instagram poll we sent out 35.6% chose true while 64.38% chose false. This statement is not as simple as it sounds. Though the virus may not discriminate, treatment and access to that treatment do. In the early days of the pandemic, during lockdowns, working from home wasn’t a privilege given to the lower economic class. The article, “Class and COVID: How the less affluent face double risks” by Richard Reeves and Johnathan Rothwell, discusses the early struggles faced by the less affluent. From access to a good internet connection to being able to afford to work at home, these inequalities became more visible during the pandemic. The article also states that “the chances of having a health condition that amplifies the impact of the virus…is more prevalent among the [lower economic class]” (Reeves). Therefore, not only do those who are less affluent can’t afford social distance, but they also have a higher risk.
This inequality does not stop there. When an individual shows symptoms of COVID, it may be much later. According to a Harvard review, those “with health insurance are more likely to have a primary care doctor they can call about COVID-19 concerns” and go to for medical attention when they show the symptoms (Rollston). This delayed response or lack of response can lead to more detrimental effects that don't rely on the virus but on how healthcare itself operates. In a sense, COVID-19 may not discriminate but the obstacles in place cause the less affluent to have a higher risk and disadvantaged access to the proper medical attention they deserve.
Along with COVID-19 treatment, in the AMWA poll, we also asked if ‘Mental Health does not discriminate when it comes to socio-economic class.’ In the Google form, 53.3% of the pollsters chose false while 40% chose true. On our Instagram poll, 56.6% chose false while 43.4% chose true. According to the American Psychological Association, in a study that examined the socioeconomic status of patients with psychiatric hospitalizations, “unemployment, poverty and housing unaffordability were correlated with a risk of mental illness” (Hudson). Though the chance of having a mental illness is higher in the less affluent, according to an article in the Social Psychiatry and Psychiatric Epidemiology Journal, the only difference for mental health treatment is that those in a higher socioeconomic class are given less “specialized healthcare and combined psychiatric medication” than their counterparts (Dorner). This divide overall leads to varied treatment among the economic classes.
The socioeconomic factors that play into healthcare are not new information, however, the pandemic has brought this divide into the open. Over the course of the last two years, there have been more reforms to improve this issue. But overall, the main concern is equal access to healthcare. The last question we polled was, ‘Which of these areas do you believe is most in need of improvement?’ Out of mental health services, economic welfare, access to medical care, and equality in research, ‘Access to Medical Care’ has the majority of votes. This shows that all people deserve the right to access healthcare despite their socioeconomic class.
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