May is Skin Cancer Awareness Month and Melanoma Monday occurs this month as well. Prior to Memorial Day and the beginning of summer is Dermatology’s most active time for public service education regarding sun protection and warning signs of skin cancer. Our QDP communications staff have developed a great message to patients regarding the ABCDEs of melanoma and encouraging regular skin exams for those at risk or with any new, changing or worrisome lesions.
Patients frequently present to our offices with selfies of skin lesions, send us photos to review for complications, and other times desire to take their own photos of their skin cancer defect or repair. In this modern age of ubiquitous smartphones and social media it is easy to forget that QDP and all medical practices nationwide should be enforcing the HIPAA policy that prohibits this practice. While seemingly harmless, there are well documented instances of another patient’s private health information (PHI) being visible in the background and compromising their privacy and breaking the HIPAA law. Serious fines and penalties occur in these circumstances. There are also potential medico-legal and malpractice issues. I am sure we have all forgotten this at some point, so please remind all QDP staff that they must advise patients and family members that self-photos and/or videos are prohibited in the practice. If signage is preferred by providers to help educate and enforce the policy, the practice managers are welcome do so. Patients interested in their surgical photos can be sent a copy in the mail or given one same day if time allows by completing a simple authorization form. These procedural images taken by clinical staff utilize backgrounds and are reviewed to ensure no PHI is visible.
COVID-19 Reinfections Becoming Increasingly Common
- Current Omicron variants have become more adept at reinfecting people, who may go on to have third or fourth infections; some small fraction may suffer from long COVID.
- QDP impact remains high with numerous providers suffering COVID infections, although fortunately recovery has been good
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Omicron subvariant BA.2.12.1 now dominant among new U.S. COVID-19 cases
- Testing is much lower than early in the pandemic, but still cases are surging now
- Assume that this current and most highly contagious variant is present in any social gathering with those outside your family unit
- For indoor crowded settings, public transportation, – protect yourself and your close contacts with strategic use of simple distancing, masking (n95/KN95), hygiene
- Rapid tests remain widely available and free from the government
- https://www.covid.gov/tests
- Use a rapid test for even mild symptoms, before attending events or visiting with at risk people like elderly family, friends, nursing home
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As the US marks 1 million confirmed COVID deaths, a quick comparison:
Now vs June 30, 2021 - arguably the low point of the pandemic so far.
Bottom line:
Remarkable shift toward milder but common illness for most. But still deadly for those at risk.
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FDA authorizes Pfizer booster for kids ages 5 to 11
The Food and Drug Administration on Tuesday authorized giving the Pfizer-BioNTech COVID-19 vaccine booster to children ages 5 to 11. Children in that age group will be eligible for the third dose of the vaccine five months after they received the second shot. The companies asked the FDA to approve the booster, the first available to children that young, based on a small study they said indicated it was safe and effective in boosting antibody levels to counter waning immunity. Previously, only people 12 or older were able to get booster shots. The companies said the booster increased protection against the coronavirus, including the highly infectious Omicron variant, which has increased the number of children hospitalized with COVID-19.
Here is a great detailed Q&A by a respected epidemiologist and mother of 2 little girls regarding vaccines and boosters in children. https://yourlocalepidemiologist.
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MonkeyPox cases have arisen worldwide although do not appear to be a major cause of concern in the US. A CDC report concluded the general public is at “low risk” as the probability of exposure is very low.
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MPX is spread through many modes, like viral transmission on clothing or respiratory droplets during prolonged periods of contact. MPX is not a sexually transmitted disease. The public can’t lose sight of this, as we will likely see cases beyond interconnected sexual networks.
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MPX is more severe for vulnerable populations, like young children, pregnant people, and immunosuppressed, or those who don’t seek care. So, while general risk is low, this won’t be the case if MPX starts infiltrating vulnerable pockets.
There are significant implications if the virus jumps from humans to animals. If the virus finds a new animal host, like squirrels, this disease could easily become endemic in other places around the world. (The transmission from humans to pet animals is theoretically possible.) We’ve seen reverse zoonosis is possible, like among mink farms and white tailed deer during the SARS-CoV-2 pandemic
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Bottom line
The MPX outbreak continues to unfold as more and more cases are identified and confirmed. It’s crucial that cases and contacts continue to come forward for treatment and quarantine without prejudice and stigma. Thanks to quickly shared genomic surveillance, we know the virus has changed since 2018, but we don’t know what it really means yet.
While we get answers, the best thing we can do is quickly identify cases, inform close contacts, and contain the virus. This will force MPX to fizzle out as soon as possible and ensure no new animal reservoirs emerge.
Resources for dermatology clinicians regarding Monkeypox
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Please have a wonderful Memorial Day weekend and remember the significance of this national holiday; honoring the men and women who died while serving in the U.S. military. We have so much to be grateful for in this country and please take a moment during the holiday to think about our collective blessings.
Stay safe and be well.
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