Results from the Phase I trial in humans of a recombinant adenovirus type-5 vectored COVID-19 vaccine: a Synopsis

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One of the vaccine candidates for COVID-19 at the Phase I stage is the non-replicating adenovirus type-5 (Ad5) vectored COVID-19 vaccine developed by the Beijing Institute of Biotechnology (Beijing, China) and CanSino Biologics (Tianjin, China). Three days ago, the results of the Phase I trial of the vaccine in humans was published in the Lancet. (Zhu, Feng-Cai et al. Lancet Online. May 22, 2020). The vaccine is very similar to the one being developed by the Oxford group. Both use adenoviRead More…

Did Coronavirus turn the US into a third-world country?

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As a surgeon who has been working in the US healthcare system for the last twenty years. I never imagined I would ever see what has transpired in the first quarter of the year 2020. Never in my wildest imagination did I think I would experience such a retrogression in the delivery of healthcare. Let me explain. In over 20 years of surgical missions across Africa I have seen and experienced how lack of resources can influence healthcare delivery. Typically, on our trips, we bring along suppliRead More…

Something must kill a man!

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In the past few days, the internet has been abuzz with the story of a nurse in a hospital in Tula, Russia. She showed up for her shift in the all-male COVID-19 patient ward with no clothing save for her underwear under her transparent PPE.A picture posted online by one of the patients shows an older gentleman in the background staring at the nurse with a delightful look on his face. The look on the older man’s face reminded me of an incident involving an older male and a beautiful woman ovRead More…

A Solutions Based Approach to Problem Solving

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For many years I have lamented the lack of trained health workers in Ghana to treat precancerous lesions of the cervix. A handful of gynecologists in Ghana are equipped with the skill to treat precancerous lesions of the cervix with Loop Electrosurgical Excision Procedure (LEEP). This is an essential component if Ghana will win the fight against cervical cancer. Precancerous lesions of the cervix need to be treated so that they don’t develop into cancer. In January 2020 (celebrated as cervicRead More…

Covid-19 Pediatric Multi-System Inflammatory Syndrome

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Since COVID-19 broke out, the data has shown relatively fewer children getting infected or severely ill. 2% of cases described in patients under age 20 (Wu et al. JAMA. 2020). The pediatric deaths from COVID-19 have been few and far between (Dong et al. Pediatrics. 2020) In March, Dr. Veena Goel Jones, a pediatrician with Palo Alto Medical Foundation in California, treated a 6-month-old baby girl with the rare Kawasaki’s Disease. Following hospital protocol, she tested the bay for COVI-19.Read More…

Race and Ethnicity in the Era of Covid-19

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Racial and ethnic disparities in healthcare has always been a feature of the American health system. This is an issue that all minorities in the healthcare field address in their own way. Some get embroiled in this, others stay cognizant but accept it as just one of the things you have to deal with as an American, others just totally attempt to ignore it or in extreme circumstances deny of its existence. I believe my response has traversed many of these different approaches because in a way thiRead More…

A Post-Covid-19 World; What’s Expected?

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Dr. Anthony Fauci said this, “Anything could, but I must say that the degree of efficiency of transmissibility of this virus is really unprecedented in anything that I’ve seen. It’s an extraordinarily efficient virus in transmitting from one person to another. These kinds of viruses don’t just disappear.” These worlds by the great physician should literally introduce us to the new post-covid-19 world. Those were not his exact words but that captured his message to Americans and the worRead More…

Lockdown & its Aftermath in Accra, Ghana, By Teddy Totimeh

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Lock down ends. The streets are already beginning to fill again. There is a new item of color on the landscape of faces now: masks. I am learning to recognize people by the pattern on the masks they wear. It is a different world now. I don’t think things will ever be the same again. This virus has ravaged through the very fabric of our societies. We are living through historic times. This is a transition nobody could have seen coming. The syllabus for life’s textbook has undergone a major rRead More…

Covid-19: A Systemic Scourge, By Nana Dadzie Ghansah

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Unlike initially thought, the lungs are not the only victims of the SARS-CoV-2 virus. By combing through the myriad reports out there, it is getting evident that this virus can attack other organ systems. This is leading to an ever-changing disease picture of how COVID-19 presents. This also means that even when the patients who get critically-ill from COVID-19 recover, they could have long-lasting sequelae of this infection. Below are some of the pathology seen in the different organ systemRead More…

The Land of Three No’s, By Nana Dadzie Ghansah

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In the early 1990s, HIV spread like wildfire in the Chinese provinces of Henan, Hebei, Anhui, Shaanxi, and Shanxi. Between 200,000 and 300,000 were infected because of the trade in blood and blood products by thousands of public and commercial blood and plasma collection centers.These centers, whose actions were poorly policed and controlled, led to the infection of thousands with HIV and other blood-borne pathogens. A lot of them reused needles. Plasma was often pooled and red cells mixed up wRead More…

Is There a Disparity in Covid-19 Incidence and Mortality by Sex? By Nana Kwame Ghansah

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One very noticeable thing about COVID-19 is the disparity in mortality between men and women. First noticed by the Chinese, it seems to be playing out in other countries too.According to a meta-analysis by Mohammad Javad Nasiri from the University of Miami and his group, even though both sexes are infected at close rates, men have three times the risk from dying versus women. In Italy for instance, close to 75% of all those who have died from COVID-19 are men.The CDC has yet to release detailedRead More…

Covid-19: Lessons from Autopsies & Biopsies, By Nana Dadzie Ghansah

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Autopsies of dead patients and biopsies of diseased organs are a great way to learn about a disease’s pathology. Unfortunately, due to the highly contagious nature of COVID-19, not a lot of them have been done on victims. As of the end of March, Chinese pathologists had sectioned 12 bodies.(This number may be higher now). Liu Liang and his group from the Tongji Medical College at the Huazhong University of Science and Technology in Wuhan, China have done nine. They published their findingsRead More…

Social Distancing and Abortion Ban in the Time of Covid-19, Dr. Leonard Sowah

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Social distancing & Abortion Restrictions With roll out of social distancing rules across the country some states are facing problems likely created by anti-reproductive choice activists. This problem is driving a wedge across State legislatures. The situation is driving some socially liberal legislators to the point of madness and doctors claim some women to desperation. The question at hand is whether abortion should be considered an essential procedure. States like Oklahoma, Alabama,Read More…

Common Atypical Presentations of Covid-19, By Nana Dadzie Ghansah

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As COVID-19 broke out, several of the authoritative bodies like the WHO and the CDC as well as clinicians from China listed three common presenting symptoms: fever, cough, and shortness of breath.However, as the disease has continued to spread worldwide, reports are rampant of atypical presentations. Diarrhea seems one of the more common atypical presenting signs. Guan in their paper in the NEJM that looked at 1009 Chinese patients found an incidence of 3.8%. In a paper to be published soon,Read More…

Covid-19 Response in Accra, Ghana: The Perspective of a Citizen and Physician, By Dr. Teddy Totimeh

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Lock down begins. I thought, going to work that I would see a ghost town. I did not. The traffic has definitely reduced, but there are still people on the streets. The shops are closed, or closing. The police stops are increasing. The first day, I was underwhelmed. I did not meet a single policeman on my way to work. Today, I was stopped more times. The grip is tightening slowly, but maybe not fast enough. I met a police woman this morning who did not have a mask on when she stopped me. I waRead More…

Summary of Updated data from the French Chloroquine/Azithromycin Study for Covid-19, Summarized by Nana Dadzie Ghansah

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The French group in Marseille whose small study really got the ball rolling on using hydroxychloroquine and azithromycin to treat COVID-19 released data on 80 more patients. Six of those were from the first cohort of 20 patients. Important findings: The study is really an observational one and not a randomized controlled trial. The aims of the study were threefold – if aggressive treatment with the combo of drugs could reduce the need for oxygen therapy of transfer to the ICU, if treatRead More…

Covid-19 Pandemic in Africa, The Facts, Myths and The Unknowns, By Dr. Leonard Sowah

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There have been multiple Coronavirus outbreaks in the pasts, SARS-CoV-1 was first reported in Asia in February 2003, though cases subsequently were tracked to late 2002. This virus quickly spread to about 26 countries mostly in the Far East and Toronto, Canada before being contained after about four months. Epidemiologists localized its source to Guangdong Province in China where it was believed to have originated from bats. Another coronavirus MERS-CoV was first reported in Saudi Arabia in 201Read More…

Unforgettable Lessons from the Frontlines in Healthcare? By Dr. Leonard Sowah

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There are certain lessons in life that are difficult to forget. Unfortunately, some of these lessons are very costly, and in the medical field the costs is usually counted in human lives. I still remember this day like it was yesterday. The lone house officer on the medical floor on a Saturday morning after a call in Accra, Ghana. We had a lot of admissions and the ward was completely full. Rounding for me in those days was an ordeal that could be likened to an obstacle course with patient pRead More…

How Would Posterity Grade Us on our Handling of COVID-19, By Nana Dadzie Ghansah

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There are subjects you study in med school that are meant as instruments of torture. One of these is “Embryology” – the study of how the fetus forms from the fusion of the female egg and the male sperm and how all the organs develop and end up at their final spots. I bet you didn’t know that the heart started off as a tube! With that intro, let’s go back in time to 1989…back to the University of Leipzig. It was one night in the winter, the night before an all-important embryology exaRead More…

Global Health & Pandemic Preparedness: A Key Piece of American Diplomacy, By Dr. Leonard Sowah

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When it comes to infectious diseases national boundaries have never been a useful means of control. This is one very important reason why the World Health Organization (WHO) is so important. There is another organization that has done so much to support the WHO called the Center for Disease Control and Prevention (CDC). The CDC is virtually an Agency of the US Department of Health and Human Services but is recognized globally in its role in Pandemic Mitigation and Control. Before I got some Read More…

COVID-19 ON OUR MINDS: PERSONAL ADVICE FOR EVERYONE, BY NANA DADZIE GHANSAH

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Surely the COVID-19 pandemic is on a lot of minds lately. The news from places like Northern Italy and Washington State are worrisome but there are examples of other communities that have stood up to it. If we all do the little things that matter, I believe we can help make our respective communities one of those with low mortalities and great outcomes. Now, to the matter at hand: A few things that make COVID-19 special:It is a novel virus so there is no immunity against it out there. Even a fRead More…

RNA VIRUSES & HUMAN SPILLOVER INFECTIONS, BY NANA DADZIE GHANSAH

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Note: this is a really basic discussion of a very complex and still-evolving topic. The genetic information that codes for traits in all living organisms are found in DNA or RNA or a combination of the two. Even viruses, not really seen as living organisms, have genetic material. They either code them in RNA (RNA viruses) eg. Influenza or DNA (DNA viruses) eg. Herpes.Where DNA viruses are quite big, RNA ones are much smaller. Also, RNA viruses replicate (multiply) way more than DNA virusRead More…

A Tribute to Mr. Rudolf Darko, Are We Witnessing The Passing of an Era, By Dr. Leonard Sowah

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I have a lot of memories of medical school, some pleasant and some that I would rather not remember. Most of these memories are associated with faculty who have had some impact or other on my time in training. After all what is the purpose of medical school and residency but a highly structured apprenticeship program, and what good is an apprentice who fails to take a piece of the master with them.
I know very well that most of my colleagues who have all gone on into different fields of medicineRead More…

On the HPV Vaccine Debate; What I Learned About Sexual Risk from a Colleague in Medical School, By Dr. Leonard Sowah

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Anytime I hear any debate on the HPV vaccine Gardasil, I remember a fact that most of us tend to forget.  This simple piece of common sense was brought to my attention by a classmate in a class on sexual risk and cervical cancer. I can still hear his voice ringing in my ears; “Sowee; de ting ino bi how many people the chick sleep with, sometimes all you need is one bad dick” He went on to explain this with an analogy using cars, he compared 50,000 miles on the German Autobahn to Read More…

Addressing the Risk of Anal Cancer in Baltimore City, By Dr. Leonard Sowah

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On the first approach by our division chief to work on a project to develop an anal cancer screening program I must admit I was a skeptic. Like most physicians I believed high resolution anoscopies were not really supported by any good evidence and did not support the need for the procedure. Over the course of several months however a close evaluation of the medical literature left me with more questions than answers.
In 2014 as it is now there was no clear evidence supporting the benefit of anaRead More…