Addressing childhood obesity also supports US military readiness (The Hill)

THE HILL | Our childhood obesity epidemic here in the U.S. is as concerning as it is well-documented.  It’s no secret that obesity trends have been on the rise for the last 20 years. In fact, in 2016, 18.5 percent of youth ages 2-19 were classified as obese. And it’s only getting worse. 

The implications of these data and the impact of poor nutrition on our overall health and well-being are disheartening and demand action. And while the broad strokes of this challenge may be familiar to you, what is less well known is the way childhood obesity is inextricably linked to our country’s long-term national security.

Nationwide, 11 percent of our 17- to 24-year-olds do not qualify for military service strictly due to excess weight. If you combine this with other eligibility factors such as crime or drug abuse or even academic issues, this shocking ineligibility figure has held steady at 71 percent for years.  

However, the Department of Defense’s most recent figures show that an astonishing 77 percent of Americans of prime recruiting age would be ineligible for military service. This is a massive increase. Over three-quarters of American young people are ineligible due to some combination of factors, chief among them obesity.

Read the full article here: https://thehill.com/opinion/national-security/3774831-addressing-childhood-obesity-also-supports-us-military-readiness/

Tennessee must refocus our education system to help more students succeed (The Tennessean)

THE TENNESSEAN | For the better part of two decades, Tennessee has been on a journey to significantly improve public education and workforce opportunities for all Tennesseans.

And by working together, we have made significant progress, moving from the back of the pack to one of the most improved and innovative states in the country on multiple K-12 and higher education measures.  

However, as we emerge from the global pandemic and head into 2023, it is clear we still have much more work to do if we are to build a strong bridge between our education and workforce systems and truly create a lifetime of opportunity for all Tennesseans.

Education opens doors to economic independence, and we must rally around the goal of ensuring our students are part of the best-prepared and best-educated workforce in the nation.

Read the full article here: https://www.tennessean.com/story/opinion/contributors/2022/12/08/tennessee-must-refocus-education-system-to-help-more-students-succeed/69703226007/

Congress: Close the gap between funding for nutrition research and the toll diet-related disease takes on Americans (Stat)

STAT | You are what you eat. Every year, new scientific discoveries make clear that food is critical to health. In recent years, nutrition research trials have shown that a Mediterranean diet reduces cardiovascular disease; ultra-processed foods increase weight gain; omega-3 fatty acids improve IQ in preterm babies; cocoa prevents heart attacks; and vitamin D supplements do — well, almost nothing.

But many questions remain: What’s the best diet for weight loss? Do supplements really work? Can certain foods or better nutrition help cancer treatment, maintain brain health, treat autism, or improve immunity? What’s the best way to nurture the gut microbiome?

It will take years before answers to these and many other questions emerge — time the U.S. does not have as obesity and diet-related diseases rise at alarming rates. What’s needed right now is a national nutrition science moonshot.

Diet-related conditions are the leading cause of death and disability in the U.S. Not only is poor nutrition deadly, it’s expensive: The combined health care spending and lost productivity from suboptimal eating costs the economy $1.1 trillion each year. Obesity alone has far-reaching consequences for the education system, American workplace, and national defense, with 1 in 3 young adults disqualified to serve in the military because of excess weight. Americans who live in rural areas, have lower incomes, or are part of certain racial or ethnic groups often face higher rates of diet-related diseases like diabetes, obesity, stroke, and heart disease. The combined toll of poor nutrition is astronomical.

Read the full article here: https://www.statnews.com/2022/12/02/congress-close-the-gap-funding-nutrition-research-toll-diet-related-disease/

How A Rock Star, A Physician-Legislator, And An Evangelical Senator Bonded To Help End The Global AIDS Pandemic: A Backstory (Forbes)

FORBES | In 1998 before I was Senate Majority Leader, and before Bono’s name became synonymous with addressing the AIDS pandemic and the RED campaign, he visited my Senate office to lobby me, and then collaborate with me, on the Heavily Indebted Poor Country (HIPC) initiative to provide debt relief to the world’s poorest nations, in exchange for the nations investing in clean water and public health initiatives at home.

This early, successful collaboration led us to many later conversations, including in 2002 discussing how to change conservative and evangelical hearts and minds to see the moral imperative of addressing AIDS globally.

I suggested to Bono at the time, “to move policy into legislation, you have to capture the views of mainstream, Middle America. If you as a rock star, who speaks so effectively to hearts of millions around the world through music, can do that, then you will demonstrate that we can move the U.S. Congress to support legislation to address global HIV/AIDS in a big way,” which at that time was killing 3 million people a year globally.

Bono took those words to heart – and months later on World AIDS Day (December 1, 2002) he embarked on his “Heart of America Tour.” Different than his dazzling rock concerts, Bono personally spent eight days on the ground directly engaging people on their home turf with his message of how America can lead the world in reversing the relentless, global scourge of HIV/AIDS. He made stops in Nebraska, Iowa, Illinois, Indiana, Ohio, and Kentucky, culminating on December 8,2002 with a final event in Nashville, Tennessee. I joined him as he spent two hours raising awareness about AIDS, played a few songs, and visibly moved the audience. Earlier on his tour at a stop at the University of Iowa, he had shared, “I’m told you can grow anything here. We’re here to grow a movement.”

Read the full article here: https://www.forbes.com/sites/billfrist/2022/12/01/how-a-rock-star-a-physician-legislator-and-an-evangelical-senator-bonded-to-help-end-the-global-aids-pandemic-a-backstory/?sh=77b05f292fdd

Let’s harness our heritage to revitalize Tennessee main streets and communities (The Tennessean)

THE TENNESSEAN |Tennessee is rich in history, but the physical evidence of our heritage is increasingly threatened by our state’s dramatic growth. The structures that have served for generations as the center of spiritual, social, cultural and economic vitality are being torn down or left in disrepair because of the misguided notion that it’s always cheaper to build something new rather than restore and preserve the old.

For example, in rural areas across the state the inability to save important historic structures or landscapes that once played a vital role in the success and identity of those communities is widespread. Buildings around our many courthouse squares, within “Main Street” districts or places that were once farming homesteads are disappearing due to neglect, the lack of adequate financial resources or, like our cities, threatened by uncontrolled development.

Just in my hometown of Nashville, the nationally celebrated Music Row, which tells the story of country music and planted the seeds that built Music City USA, is being demolished at an alarming rate. Between 2013 and 2019, at least 55 music-related buildings were torn down, replaced by apartment and condominium buildings. The places that defined the heart and soul of Nashville, and of Tennessee, are quickly disappearing.

There is a way to save and revitalize the storied buildings of our downtowns and communities while repurposing them to spur economic growth at the local level. The answer is enacting a state historic preservation tax credit. The credit works by incentivizing substantial rehabilitation of historic buildings for income-producing or business use. It requires preservation of the historic character of the property and makes it feasible to preserve older structures that would otherwise be too cost-prohibitive to renovate or restore. Simultaneously, it can save our state’s tangible past in a way that conserves resources, reduces waste and creates jobs.

Read the full article here: https://www.tennessean.com/story/opinion/contributors/2022/12/01/opinion-harness-heritage-to-revitalize-our-main-streets-communities/69687722007/

Tracy R. Frist Establishes Fund To Support Ferrum College and Blue Ridge Institute’s Preservation of Appalachian Literature and Folktales

This November, former Ferrum College student and longtime supporter of the College, Tracy R. Frist, made a generous gift to Ferrum College to support the College’s Appalachian Literature project (AppLit) and the digitizing and archiving needs of the Blue Ridge Institute & Museum (BRIM).

Tracy Frist at Ferrum’s annual folklife festival in Ferrum, Virginia

“Tracy’s generous gift to the BRIM archive will provide us with the resources we need to digitize collections of folktales and songs so that they will be easily available for public use,” affirmed Bethany Worley, director of the Blue Ridge Institute & Museum.

AppLit is an online resource created by Tina L. Hanlon, professor of English at Ferrum College, to serve as an archive of Appalachian literature for children and young adults. Frist’s own original animal tale, “Mountain Marbles: An Appalachian Tale,” is archived on the site and is an example of how the project includes student and faculty authored works as well those gathered from oral traditions.

Frist’s support will help in preserving folk literature of the region and enhance the educational resources available to students.

“One of the magical threads in the tale of my three decades in Virginia has allowed me to cross paths with Tracy Roberts Frist periodically: from studying Appalachian folktales in a graduate course in the 1990s, to publishing Tracy’s original animal tale and teaching materials in our website AppLit, collaborating in Ferrum’s Teaching Appalachian Literature project, discussing Appalachian books at conferences, and bumping into Tracy and her sweet mother at Ferrum’s folklife festival over the years,” Hanlon recalled. “I’m so grateful Tracy has established this fund that will enable us to upgrade AppLit as well as continuing to engage students and alumni in the important work of preserving and sharing folklore and literature of the region.”  

The AppLit project was originally funded in 2000 by the National Endowment for the Humanities and serves as a resource for educators and dramatists. Reflecting Hanlon’s background as a librarian, it features a rich bibliography of works as well.

In addition to Frist’s gift, Ferrum College received a Humanities Research for the Public Good grant from The Council of Independent Colleges to fund student work on the project. Abigail McGovern, a senior majoring in English with a concentration in Creative Writing, is one of four Ferrum College students whose work with the Blue Ridge Institute digitization as well as AppLit has been critical to these preservation projects. McGovern was invited to present at the Appalachian College Association Summit in September highlighting the college-community collaboration. 

“One of the things I learned from working on this project is how folklore can connect community. Folklore is perceived as historic and no longer relevant, but in reality, we create folklore daily – it represents values and culture that connect us all together from the past into the present,” said McGovern.

“The value of the AppLit resource and the BRIM archive is the themes and stories. What makes Ferrum College unique is the local culture and these resources celebrate it and drive engagement with it. Appalachian folklore is part of our story as students,” McGovern continued.

Frist shared how Hanlon’s course enlightened her about the value of folktales and inspired her to support the ongoing preservation work through Ferrum College.

“Dr. Tina Hanlon taught me preservation of culture, history and diversity lies in storytelling. Ferrum College and the greater Appalachian community is full of powerful and transformative stories. I wanted to be a part of saving these stories with this rich cultural evidence and making them accessible to everyone,” stated Frist.

To support the AppLit and digitizing efforts of Dr. Hanlon and the Blue Ridge Institute and Museum, select “Other” in the drop down menu and type “Tracy R Frist Fund” on Ferrum’s giving form here.

Bill and Tracy Frist enjoying Ferrum’s annual folklife festival in Ferrum, Virginia

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Can Nature Be Our Climate Defender? Adaptive Strategies Lead To A Sustainable Future Where People And Nature Thrive (Forbes)

FORBES | Friday, November 18th marks the final day of COP27 – the United Nations 27th annual Climate Change conference. Each year this conference convenes leaders from nearly 200 nations. And each year, the stakes are higher.

This year seems especially poignant. The global community is under tremendous pressure to achieve the goals outlined in COP21’s Paris Agreement where nations pledged to limit global warming to 1.5 degrees Celsius (2.7 degrees Fahrenheit). Since then, nations have been working to drastically reduce greenhouse gas emissions to protect the health of our environment, natural resources, and people.

Reducing emissions alone, though, will not be enough. Indeed, we will not be able meet our climate action goals without also transitioning to cleaner and more sustainable energy sources and doubling down on investing in nature.

Nature-centric solutions – such as restoring, protecting, and managing our lands and wetlands — allow our natural environment to be our climate defender. This is better for the health of our ecosystems, our communities, and our planet. It is also a core value of The Nature Conservancy (TNC), the world’s largest conservation organization dedicated to creating a future where people and nature thrive.

Read the full article here: https://www.forbes.com/sites/billfrist/2022/11/16/can-nature-be-our-climate-defender-adaptive-strategies-lead-to-a-sustainable-future-where-people-and-nature-thrive/?sh=6684265b434a

How the ‘red ripple’ could impact health policy in 2023 and beyond (The Hill)

THE HILL | Rather than a red wave, the 2022 congressional midterms brought a ‘red ripple’. 

With races still being decided and votes counted, Democrats have won control of the Senate, despite a runoff in Georgia. It looks like Republicans will take back the House — albeit with a much smaller majority than they had hoped. 

What does this all mean for health policy? With a divided Congress, President Biden’s ability to pass major, sweeping legislation along party lines (like the Inflation Reduction Act) falls to the wayside. But it doesn’t mean legislating comes to a standstill. Contrary to popular opinion, Congress has passed major health-related legislation with bipartisan support in recent years. This includes:

  • The No Surprises Act, which passed as part of 2020 appropriations legislation, established new federal protections against surprise medical bills;
  • Major opioid legislation of 2018, the SUPPORT for Patients and Communities Act;
  • The 21st Century Cures Act of 2016, which modernized the development and delivery of drugs and medical devices and advanced research into serious illness;
  • And the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which repealed the Medicare Sustainable Growth Rate formula and changed the way that Medicare rewards clinicians for value over volume.

Read the full article here: https://thehill.com/opinion/healthcare/3734558-how-the-red-ripple-could-impact-health-policy-in-2023-and-beyond/

Congress must not miss the chance to reform the Electoral Count Act (The Hill)

THE HILL | It was Jan. 6, and a United States Senator and a member of the House of Representatives had just issued a formal challenge to the electoral votes from one state — halting congressional ratification of the presidential election results. It was nearly unprecedented, and turned a civilized ceremony into what one publication referred to as “a political and historical drama.”

This moment in time was not Jan. 6, 2021, as one might assume, but rather Jan. 6, 2005. I was the Senate Majority Leader, and Sen. Barbara Boxer (D-Calif) and Rep. Stephanie Tubbs Jones (D-Ohio) had just launched an objection to President George W. Bush’s reelection, claiming Ohio’s results were tainted. 

While this challenge was rightly voted down, and President Bush’s victory certified, it set an unfortunate precedent where each party has begun to exploit ambiguities in the 1887 Electoral Count Act. This 136-year-old law established the process by which Congress certifies presidential elections, and while effective for a century, vague language in its drafting has led to challenges that increasingly undermine public confidence in our elections.

Despite extreme partisanship in the Capitol today, this is an area where both sides of the aisle agree: The Electoral Count Act must be modernized and dangerous loopholes that threaten the organized transfer of power in our democracy must be addressed. 

Read the full article here: https://thehill.com/opinion/campaign/3720056-congress-must-not-miss-the-chance-to-reform-the-electoral-count-act/

It’s Time To Prioritize Nutrition: Better Diet Quality Leads To Better Health And Wellbeing For Americans (Forbes)

FORBES | September should be a big month for nutrition. For too long, we have struggled and failed to curb food and nutrition insecurity, to mitigate rising rates of obesity, and to reduce the prevalence of diet-related chronic illnesses such as diabetes, hypertension, and coronary artery disease.

This issue is very real to many of us, but it is especially real to me.

For nearly 12 years as a cardiac surgeon, I operated five days a week on people’s hearts, palpating and coming face to face with fatty, calcified, and hardened coronary artery disease caused in large part by bad nutrition. I saw firsthand how, despite growing up hearing that “you are what you eat,” many of us fail to consume nutritious foods fundamental to promoting health and wellness. We know better.

Our nutrition – or lack thereof—has thwarted our nation’s health and wellbeing. And it’s costing many Americans their lives and their savings. It is time we act on what science, clinical medicine, and public health experts have long understood: our country must prioritize better nutrition policy.

Read the full article here: https://www.forbes.com/sites/billfrist/2022/09/23/its-time-to-prioritize-nutrition-better-diet-quality-leads-to-better-health-and-wellbeing-for-americans/?sh=3f65a8ed2ea3

65 Years Later: A School Bombing, A Steady Leader, And A Message Of Hope (Forbes)

FORBES | In times of uncertainty, we know leadership matters more than ever. I see this from leaders firsthand every day – leadership in improving health outcomes, in driving better policy, in rising to the moment to solve tough challenges – from conservation to economic mobility. Recently, I have been reflecting on the power and importance of great leadership in education, and marking the anniversary of a painful event in Nashville where leadership mattered.

This Saturday, September 10th, 2022 marks the 65th anniversary of the tragic bombing of the Hattie Cotton School, which occurred just after midnight following the very first day of mandated integration at six elementary schools in Nashville in 1957. This major cultural advance was spurred by the landmark Supreme Court decision in 1954, Brown v. Board of Education.

On that first day of school, Hattie Cotton had just one six-year-old black girl enrolled, Patricia Watson. My aunt Margaret Cate, who we lovingly called Aunt Bonnie, was the principal at Hattie Cotton and she had led the school since the day it opened seven years prior in 1950. Never married, her life was centered entirely around educating children, teaching with high values and high expectations, always gently and humbly — and later leading as principal in the style of servant leader. She was gentle but strong. Her convictions were ahead of the times.

From old letters, we know a close friend sensed an air of worry and concern when visiting with Aunt Bonnie the day before the opening of school because of planned, organized, community-wide protests. Little did she know that soon her beloved, tiny school would be making national headlines, and she would be called upon to unify and courageously lead the Hattie Cotton community after a vicious, violent attack.

Read the full article here: https://www.forbes.com/sites/billfrist/2022/09/09/65-years-later-a-school-bombing-a-steady-leader-and-a-message-of-hope/?sh=5bb97298c792

Cultivating A Culture Of Health: How Comprehensive Community-Wide Hypertension Data Are Inspiring Heath Equity (Forbes)

FORBES | It’s no secret that the best data often begets the best policy, especially when it comes to community health and wellness. Having accurate, timely, and well-informed data is often the difference maker that allows communities to dramatically move the needle on health disparities.

When it comes to health disparities, the city of Nashville can – and must – do better. Nashville is known nationally as a health services capital, yet our own community health and well-being statistics rank far worse than the cities we compete with on a daily basis.

For many, this comes as a surprise. Nashville is filled with top-level academic institutions, nationally renowned hospitals, and tremendous economic growth, and it is home to some of the largest health and hospital systems in the country. But when compared to cities like Austin, Charlotte, Denver, and Dallas, we have the worst life expectancy and highest rates of infant mortality, smoking, and number of poor mental health days by far.

How can Nashville, an otherwise thriving city, work to ensure that every single one of our community members has an opportunity for a healthy life?

Read more at Forbes: https://www.forbes.com/sites/billfrist/2022/08/18/cultivating-a-culture-of-health-how-comprehensive-community-wide-hypertension-data-are-inspiring-heath-equity/?sh=388ce0817018

The White House Conference on Hunger, Nutrition and Health is an opportunity for transformational change (Nature Food)

NATURE FOOD | More than 50 years ago, President Richard Nixon convened the 1969 White House Conference on Food, Nutrition and Health, bringing together all the agencies of the US government, Congress and other stakeholders to address widespread hunger in the United States. That conference — chaired and organized by Dr Jean Mayer, the founder of the Tufts Friedman School of Nutrition Science and Policy — was historic in its vision, bipartisanship and impact. The insights and recommendations of the 1969 conference established nearly all of the major US food and nutrition programmes that are in place today. This included major expansion and harmonization of the National School Lunch Program; major expansion and harmonization of the Food Stamp programme (now the Supplemental Nutrition Assistance Program (SNAP)); creation of the School Breakfast Program and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC); and development of a new focus on food-based dietary guidelines and new consumer protections such as nutrition facts labelling2. Together, these policies achieved success in their major goal: to reduce caloric hunger nationally.

However, much has changed since 1969, and the United States and global community face stark new food and nutrition challenges. Chief among these are the intertwined pandemics of obesity and type 2 diabetes, as well as globally rising cardiovascular diseases, cancers and other diet-related diseases. In the United States, half of all adults have diabetes or prediabetes, while 3 in 4 are overweight or have obesity. In addition, undernutrition has still not been eradicated globally — a dire double burden of malnutrition. In 2020, about 3.9% of US households experienced very low food security, and an additional 6.6% experienced low food security.

In our nation and around the world, nutrition insecurity and diet-related chronic diseases also disproportionately afflict racial and ethnic minorities and lower income, rural and other underserved populations. At the same time, the industrialization of food, from the Green Revolution to food science, successfully mitigated the leading nutritional concerns of the twentieth century: mass starvation due to a soaring world population, endemic vitamin deficiency diseases, and common foodborne pathogens; however, it is not well designed for the needs of the twenty-first century: a fully healthy, just and sustainable food system. Together, these burdens on human health and natural resources are also producing tremendous economic losses in the United States and worldwide. The COVID-19 pandemic and the Russia–Ukraine war have further underscored fundamental weaknesses across our food systems, including fragile supply chains, persistent food and nutrition insecurity, and increasing inequities. COVID-19 also intersects directly with obesity, diabetes and hypertension, which are the top risk factors, beyond age, for poor outcomes from infection.

Read the full article here: https://www.nature.com/articles/s43016-022-00568-x

Twenty-Five Years After My House Call To Dolly: What Have We Learned About Cloning And How Did We Learn It? (Forbes)

FORBES | Twenty-five years ago, the scientific breakthrough of mammalian cloning marked a monumental moment in medicine and science. Anticipating the collision it would have with ethical decision making in medicine, I, the only physician-scientist in the U.S. Senate at the time, journeyed to the University of Edinburgh in Scotland to personally visit Sir Ian Wilmut at his research lab at the Roslin Institute.

Professor Wilmut just months before in 1996 had cloned a sheep from an adult somatic cell, shocking the world. This was the first successful attempt of its kind. All over the world people were wondering: would we be cloning a human being next? We talked science, we talked ethics, and we talked about his creation’s potential impact on altering the course of human history. I also met and examined the cloned sheep, Dolly, in her stall.

Dolly, named after Tennessee’s own Dolly Parton, was a Finnish Dorset sheep cloned from a single, adult mammary gland cell. Her creation, birth, and short life were scientific feats that immediately sparked global concern and discourse on the increasingly complex moral and ethical dilemmas posed by a sudden discovery of life-manipulating science.

Wilmut and colleagues published their achievement in February 1997, having kept Dolly secret for seven months. We, as a society, were quickly forced to answer difficult, probing questions. A few months later on the Senate floor, I borrowed a question that the Washington Post editorial board had posed a few years before: “Is there a line that should not be crossed even for scientific or other gain, and if so where is it?”

Read more at Forbes: https://www.forbes.com/sites/billfrist/2022/08/02/twenty-five-years-after-my-house-call-to-dolly-what-have-we-learned-about-cloning-and-how-did-we-learn-it/?sh=7e0ff3c759c0

Changed Hearts And Minds – A Personal (Ongoing) Journey To Better Understanding LGBTQ+ Equity Issues (Forbes)

FORBES | Last week, Supreme Court Justice Clarence Thomas opined that we should revisit several major Supreme Court decisions, including Obergefell v. Hodges, which legalized same-sex marriage. This startled me. But it also moved me to reflect on my own past. And some of these recollections are painful to look back upon.

Two decades ago I supported the official Republican platform and President George W. Bush’s public call for a constitutional amendment defining marriage as between one man and one woman. I can firmly say I was wrong then, and it would be a major step backwards for this country to even consider relitigating that issue in the future. Indeed, we have seen major, positive cultural and attitudinal shifts on LGBTQ+ issues for the country — and a parallel personal journey of awareness, enlightenment, and growth for me.

As Americans, we can all agree there’s been sizable cultural change in our nation over the last 20 years. Looking back on my time as a member of the United States Senate at the turn of the century, and later as its Majority Leader from 2003–2006, many of the issues we voted on and beliefs we held then – including my own – are totally out of step with today’s more enlightened understanding and prevailing viewpoints. And while many feel today’s culture wars may be reaching a boiling point, we should recognize that amidst current partisan infighting, we have also made huge, generational progress, always recognizing that much more must be done.

Read the full story here: https://www.forbes.com/sites/billfrist/2022/07/01/changed-hearts-and-minds–a-personal-ongoing-journey-to-better-understanding-lgbtq-equity-issues/?sh=402462b55737

Can We Unite Around Gun Safety? Yes, Think Local And Get The Data (Forbes)

FORBES | Earlier this week, as I was checking in at the Aspen Ideas Festival, a man approached me unexpectedly. He said, “Excuse me, Dr.-Senator Frist. I am a pastor in North Carolina. I want to bring people together on gun issues, right and left, Republican and Democrat, rural and urban. Is it possible? And how can I do it?”

Already late to my first meeting, I gave him my short, but direct, answer: “Yes. You must start locally. Most important, you must open the conversation with specific data that accurately describes their local community, information that they can relate to. Bring eight or ten people to the table and begin simply by asking specific, thought-provoking questions about gun safety in their own neighborhood. Likely they will not know the answers, but you will quickly establish a rapport and common foundation for a civil, mutually respectful discussion that can lead to deeper understanding, possibly even a change in culture and attitude, and, eventually, progress.”

I left him with these four, specific questions that I successfully use in starting similar conversations:

  • “Are any firearms kept in or around your home?”
  • “If so, are these firearms now loaded?”
  • “Are any of these loaded firearms unlocked?”
  • “Do you feel safer or less safe when there are firearms in your home or vehicle?”

Read the full article here: https://www.forbes.com/sites/billfrist/2022/06/24/can-we-unite-around-gun-safety-yes-think-local-and-get-the-data/?sh=5a67d5f8118e

Reducing The Health Harms Of Incarceration: Five Big Ideas From The Aspen Health Strategy Group (Forbes)

FORBES | Our nation has the highest incarceration rate in the world with 10 million people incarcerated each year, yet the health of these individuals is truly an afterthought. We must recognize that their experiences and their health outcomes are not contained in a vacuum. These individuals are often struggling with undiagnosed or untreated behavioral health issues and chronic illnesses prior to being jailed or imprisoned, and their health challenges before and after incarceration have a ripple effect that substantially impacts the health and well-being of their families and communities, and ultimately our country.

We know incarcerated Americans are sicker – those who have been jailed or imprisoned are associated with having an elevated risk for nearly all diseases, and they touch a much larger percentage of our population than many realize. In fact, 45% percent of Americans have had an immediate family member who has been incarcerated, and for these Americans, this connection to an incarcerated individual is correlated to a life expectancy that is two years less than for those without a family member who has been incarcerated. The carceral system is taking years off Americans’ lives, even if they haven’t served time.

For these reasons, we at the Aspen Health Strategy Group (AHSG) – which I co-chair with former U.S. Health and Human Services Secretary Kathleen Sebelius – have determined, “Incarceration is a primary source of poor health for individuals, families, communities, and our nation as a whole.” This is the issue AHSG’s 24 multi-sectoral leaders chose to study in 2021 as part of the Health, Medicine & Society program at the Aspen Institute. Tasked with exploring some of our nation’s greatest health challenges and preparing actionable solutions, we lay out five big ideas on “Reducing the Healthy Harms of Incarceration,” which we arrived at after extensive consultation with experts in the field, as well as with those who have personally experienced the health impacts of incarceration.

Our “five big ideas” center around expanding health coverage, providing coordinated care, implementing quality standards, and rethinking certain justice system approaches to prioritize health.

Read more here: https://www.forbes.com/sites/billfrist/2022/06/15/reducing-the-health-harms-of-incarceration-five-big-ideas-from-the-aspen-health-strategy-group/?sh=4d676b27156c

Nature And People Positive Solutions: The Nature Conservancy In Belize (Forbes)

FORBES | The Nature Conservancy (TNC) has a storied history of local, regional, and global environmental protection and conservation efforts centered on sound principles and comprehensive solutions. Since 1951, TNC has used a collaborative approach that engages communities, governments, the private sector, and other partners to combat some of our world’s toughest challenges like climate change and food and water sustainability.

TNC’s mission is centered on the fact that all life is connected and supported by land and water and, when these resources benefit, so do people. This duality of purpose in focusing on solutions that benefit nature and people alike, separates TNC from many other environmentally focused groups. Without a doubt, this has been key to TNC’s successes in 76 countries and territories: 37 by direct conservation impact and 39 through partnership.

Recently, Tracy—my wife and a member of the Tennessee TNC Board—and I traveled to the eastern coast of Central America to visit the on-the-ground team leading TNC’s Belize chapter. This chapter has played an active role in protecting the country’s vital ecosystems for 31 years and, more recently, the country’s economy.

Always eager to immerse ourselves in the fascinating conservation work being done globally, Tracy and I jumped at the opportunity to join a Belize TNC team retreat to learn more about innovative solutions underway, from Blue Bonds to sustainable seaweed farming, and how local conservation efforts in Belize are indeed having a powerful global impact. Here are some of the remarkable and eye-opening things we learned over our two-day visit:

Continue reading here: https://www.forbes.com/sites/billfrist/2022/06/09/nature-and-people-positive-solutions-the-nature-conservancy-in-belize/?sh=1d4b66225b24

Reevaluating, Reimagining, And Reinventing Healthcare: Innovation In A Post-Pandemic World (Forbes)

FORBES | Since its onset, COVID-19 has been the focal point of recent healthcare innovation and advancement. Though the past couple of years have been filled with innumerable advancements of health technologies, much opportunity for reevaluating, reimagining, and reinventing the future of healthcare remains. The next two years will set the scope for what is to come.

As our world successfully transitions from a pandemic to endemic stage, the landscape of healthcare innovation is wide-open for disruption, as health, wellness, and healthcare are taken more fundamentally into the digital age. Advancing technology will be the vigorous driver behind a much needed refocusing of healthcare delivery to put the patient experience and navigation of health services back where it belongs front and center.

What we can expect—at least in the near-term future—is more digital transformation, more cloud, more integration, more automation, and overall a more coherent, consistent, and comprehensive delivery of healthcare.

Though the endless number of possibilities are inspiring, here are six areas where I foresee the most disruption occurring:

Read the full article here: https://www.forbes.com/sites/billfrist/2022/05/04/reevaluating-reimaging-and-reinventing-healthcare-innovation-in-a-post-pandemic-world/?sh=22feaffd1bc8

Tennesseans Answer The Call: Volunteer State Leads Rapid Response Efforts For Ukrainian Requested Medical Supplies (Forbes)

FORBES | We have watched the tragedy in Ukraine unfold with a continual stream of shocking live video footage. Many of us seeing the struggle on our screens have been left wondering how something like this could possibly happen during this day and age. It seems so foreign, so distant, yet—at the same time—so close. Our natural impulse is to ask, how can I help? Is there something that I, as an individual or a family or a business, can do to lend a helping hand?

We each answer this question in our own way. But what I share today is the story of how a small group of concerned Tennesseans responded to this question, rallying their connections among friends, businesses, nonprofits, government, and public entities. All these groups and people came together to act quickly, creatively piecing the puzzle of logistics together, to generously provide critical, life-saving medical equipment and supplies directly to the Ukrainian people suffering from daily atrocities.

The first call for help came at midnight on March 2: a message from my friend, Kenney Isaacs, with whom I have traveled extensively over the past twenty-five years doing urgent international relief in response to natural and man-made disasters. Together, we traveled to sites within days of onset of multiple catastrophic events around the world, he with logistics and me, as a physician, with medical and surgical teams. We were in Sri Lanka immediately after the Indian Ocean tsunami in 2004, in New Orleans forty-eight hours after Katrina in 2005, in Haiti within thirty-six hours after the 2010 earthquake, and in Sudan on multiple occasions during the ongoing civil war in the late 1990s and early 2000s.

Read the full article here: https://www.forbes.com/sites/billfrist/2022/04/26/tennesseans-answer-the-call-volunteer-state-leads-rapid-response-efforts-for-ukrainian-requested-medical-supplies/?sh=4b10efb01238

The global crisis of COVID orphanhood (The Hill)

THE HILL | The flood of Ukrainian refugees fleeing Russia’s brutal invasion reminds us that the pain of war often falls most heavily on those with the least ability to cope, especially children.

The same is true of our battle with COVID-19, which has now left over 7 million children worldwide suffering from the loss of a loving parent or grandparent caregiver. Urgent action is needed to protect these children from the many threats they face. The Biden-Harris administration can lead by using the U.S.-hosted Global COVID-19 Summit this spring to rally the world to care for the hidden victims of the pandemic.

COVID-19-associated orphanhood and caregiver loss are increasing at unparalleled speed, with one new child affected every six seconds. It took the HIV-AIDS pandemic 10 years for 5 million children to become orphaned; it’s taken COVID-19 just two years to top that tragedy.

While equitable vaccine coverage can slow the rates of caregiver deaths, the numbers of children affected by COVID-19 orphanhood will continue to rise, especially in Africa where less than 10 percent of the population has been fully vaccinated. The lack of strong social safety nets exposes these children to extreme threats, including abuse, violence, high-risk sexual behavior, and institutionalization. These risks increase when breadwinners die — a sobering fact given that 75 percent of COVID-19 orphanhood involves paternal death.

Most children losing a parent or primary caregiver to COVID-19 have a living relative who, with adequate support, could care for them. But the time to act is now. Early intervention with educational, economic, and parenting support is needed to ensure that each affected child benefits from the healing hands of a safe and nurturing family — and does not end up in institutional care.

Read the full article here: https://thehill.com/blogs/congress-blog/healthcare/600129-the-global-crisis-of-covid-orphanhood/

Commissioner Califf needs to put the F back in FDA (Stat)

STAT | Robert Califf is taking the reins as commissioner of the Food and Drug Administration with the nation in a nutrition crisis. Americans are living shorter, less-healthy lives due to the foods they are being sold. The new commissioner can meet this challenge by harnessing the FDA’s effective but underused food-related regulatory powers, which were created with FDA itself for a similar food crisis more than 100 years ago.

At the turn of the 20th century, food was making Americans sick. Illnesses due to chemical and microbiological contaminants were among the top 10 causes of death. Food producers, eager to meet consumer demand for cheap, quick, appealing, and tasty food, were adding harmful ingredients without concern for people’s safety and were intentionally mislabeling food. Milk contained chalk and formaldehyde; canned foods had salicylic acid, borax, and copper sulfate; corn syrup was sold as honey; and colored animal fat from pig stomachs sold as butter. Food manufacturers were unchecked by government regulation, basic food safety, or labelling requirements.

Under the leadership of President Theodore Roosevelt and Harvey Wiley, a chemist working for the U.S. Department of Agriculture, the federal government was able to make the country’s food supply safer through research and policy. Wiley conducted groundbreaking research on food additives by testing them on a group of men that came to be known as “the poison guard.” This research culminated in sweeping food safety laws — and the founding of the FDA — through the 1906 Pure Food and Drug Act.

Read the full article here: https://www.statnews.com/2022/03/14/commissioner-califf-needs-to-put-the-f-back-in-fda/

Congress should create a national board on pandemic preparedness (The Hill)

THE HILL | As we approach the frightening, chilling milestone of nearly 1 million dead from COVID-19, it should go without question that preventing this loss of life again should be a top priority of our United States Congress, regardless of party affiliation.   

The recent release of a discussion draft of the bipartisan Prepare for and Respond to Existing Viruses, Emerging New Threats and Pandemics Act (PREVENT Pandemics Act) is a significant step forward toward enhancing our nation’s security. We applaud Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Senator Patty Murray (D-Wash.) and Ranking Member Richard Burr (R-N.C.) for putting forth critical policies that would strengthen federal and state preparedness, improve our response capacity through data systems modernization, accelerate research and countermeasure discovery, modernize the supply chain for vital medical products, and enhance development and combat shortages of medical products. 

While the PREVENT Pandemics Act proposes a short-term task force to examine the initial emergence of the pandemic and the nation’s response, we also believe that the legislation should include a permanent oversight mechanism so that the United States is equipped to respond to future threats. There is currently no congressionally chartered body for evaluating the state of America’s pandemic preparedness system, leaving the nation vulnerable to a suboptimal response to public health emergencies and future pandemics. For this reason, we and our colleagues on the Bipartisan Policy Center’s Future of Health Task Force call on Congress to create a national board on pandemic preparedness. The independent board would establish a set of metrics and benchmarks for evaluation of federal and state pandemic preparedness capacity and capability; gauge how the nation is faring against these metrics; and develop an annual report to Congress on the state of pandemic preparedness with specific recommendations.  

The board should consider some broad thematic areas while developing metrics including, nonpharmaceutical and pharmaceutical mitigation measures; public health, emergency management, and health care system coordination; equity in emergency response planning; exercising of response plans; standardized data collection and reporting along with data privacy and security standards; real-time surveillance and systems; vaccination infrastructure, distribution and uptake; and, stockpiling and supply chain resiliency. Throughout the metric development process, Congress should require that the board consult with stakeholders, including relevant federal agencies, private sector organizations, and subject matter experts.  

Read the full article here: https://thehill.com/blogs/congress-blog/healthcare/594438-congress-should-create-a-national-board-on-pandemic/

“A Storm For Which We Are Entirely Unprepared …”: A 2005 Pandemic Prophecy & Call For A “Manhattan Project” For The 21st Century (Forbes)

FORBES | Two years ago this week, the United States declared a public health emergency in response to what was then being referred to as the 2019 Novel Coronavirus, now widely known to all as COVID-19. Few envisioned how all-encompassing and destructive this virus would become. Few would have believed that two years later, it would have led to nearly 900,000 deaths in the United States, with thousands more still suffering the effects of long COVID, as well as the devastating financial repercussions the pandemic has sowed.

Yet, it was predicted. A coming pandemic was certain. Tragically, it was not adequately prepared for. And now as we continue to recover and slowly enter a stage of endemicity, we must increase our resolve to prepare for the next pandemic — for there will be another.  

Seventeen years ago, I, serving then as Majority Leader of the United States Senate and one of the few physician-scientists in Congress, wrote a formal Declaration to serve as the foundation for a nationwide call-to-action to what I and a few others saw as the inevitability of a coming catastrophic pandemic that would cause massive loss of life and destruction of livelihood: “But we will not be able to sleep through what is likely coming soon — a front of unchecked and virulent epidemics, the potential of which should rise above your every other concern.”

The Declaration, which I share in its entirety below, was the substance of a speech which I repeatedly delivered over the course of a year across the country in multiple venues, from large outdoor settings in San Francisco to the National Press Club in Washington, DC to the lecture halls at Harvard. The mission was urgent — to warn we were not prepared for what we would have to face and to lay out a proposal that would “dwarf the Manhattan Project.”  We knew that if left unprepared we would face a global pandemic that would devastate our economy, our livelihoods, our health systems, our way of life. We did not prepare.

Read the full article here: https://www.forbes.com/sites/billfrist/2022/02/02/a-storm-for-which-we-are-entirely-unprepared-a-2005-pandemic-prophecy–call-for-a-manhattan-project-for-the-21st-century/?sh=5452666513f2

Omicron And Our Economic Forecast: What’s Next For Fiscal And Monetary Policy? (Forbes)

FORBES | The COVID-19 pandemic has had significant impact on our domestic economy. It comes as no surprise that the ongoing pandemic will continue to influence our economic policies for years to come. The challenge lies, however, in predicting what this will look like and what the long-term ramifications will be.

At the start of the pandemic, I joined some of Princeton University’s brightest economic and health policy minds to attempt just this: to predict how a global pandemic would affect our country’s fiscal and monetary policy. It’s safe to say that in April 2020 when we first came together, we had no idea what our fight against COVID-19 would entail, nor would we have predicted we would be participating in our 5th iteration of this discussion just a couple weeks ago.

I recently sat down with Drs. Jessica Metcalf, Alan Blinder, and Bill Dudley to, once again, try and predict the future of our economy, to analyze how Omicron and future variants will impact our projected outlook, and to examine how our initial pandemic fiscal and monetary policy panned out.

Read the full article here: https://www.forbes.com/sites/billfrist/2022/01/25/omicron-and-our-economic-forecast-whats-next-for-fiscal-and-monetary-policy/?sh=505787264a2c

Your health (and you thought climate change was not about you) (The Hill)

THE HILL | New Year’s resolutions: chances are we’ve made — and broken — a few of them. And, chances are many of those resolutions have been related to our health: exercise more, eat better, stop smoking. But what if, in 2022, we resolved to improve our health by taking action against climate change?

According to recent data from National Oceanic and Atmospheric Administration (NOAA) and NASA, 2021 marked the sixth warmest year on record. Why does this matter? Well, a warming climate directly affects the health of individuals, communities, businesses and economies alike.

Climate change, if nothing else, is a background condition of our lives that shapes our health. As a social determinant of health, it is as much a public health crisis as it is an environmental and economic one. Things like access to clean air, clean and safe drinking water, healthy food supplies and housing are directly impacting our quality of life, as well as physical, mental and emotional health.

We’re seeing the effects of climate change on peoples’ health already — from increased cases of asthma in children to more heat-related illnesses like heat stroke and vector-borne diseases like malaria. If you’re not seeing these repercussions in your community now, chances are you will soon.  

Read the full article here: https://thehill.com/opinion/healthcare/590394-your-health-and-you-thought-climate-change-was-not-about-you/

Remembering Larry King: Master Of The Wise Interview, Who Cared To Listen (Forbes)

FORBES | I met Larry King for the first time over 33 years ago as an unknown heart transplant surgeon leading the Vanderbilt Multi-Organ Transplant Center in Nashville. Larry was just a few years into his hit show, “Larry King Live”, on CNN.  

He had invited my friend Barbara Mandrell, arguably the biggest female star in country music at that time, and me to the show to give us the opportunity to raise awareness about the shortage of organ donors. Those 30 minutes we spent together were plenty long enough for me to witness the profound skill, experience, and purpose of the “Master of the Interview.” 

While in the green room with Barbara just before going on air, the show’s producer abruptly announced that Larry’s questions would, to our surprise, all be focused on Barbara’s highly popular music career. We were stunned: Barbara’s whole purpose in setting up the interview and our trek to Los Angeles was to broadly educate others on the serious but commonly misunderstood issue of the national need for organ donors.  

On set—30 seconds before going on air—Barbara reminded Larry that we were there solely to highlight a life-changing message, not to aggrandize her career. Immediately, Larry tore up the prepared off-topic questions. He smoothly winged the entire interview, and still managed insightful, probing questions that allowed for thoughtful answers. Because of him, with his willingness to listen and his mastery of the interview process, we were able to help demystify the subject.

Read the full article here: https://www.forbes.com/sites/billfrist/2022/01/19/remembering-larry-king-master-of-the-wise-interview-who-cared-to-listen/?sh=1f6d00e47396

A Call For Data Equity: Using Pandemic Data Mishaps To Improve Health Outcomes (Forbes)

FORBES | Where we live determines how long we live. Read that again.

Health disparities, in large part, are determined by where we live. In Nashville—a city that prides itself on being a renowned healthcare hub—life expectancy increases 5 years by moving to the neighboring Williamson County. Similar patterns hold true in other cities all over the U.S.

For those of us in public health, this unfortunate reality is not surprising. Structural racism—the category of racism that stems from the very infrastructure of our communities—has long determined unjust resource allocation. Inequitable access to things like quality education, nutritional foods, and healthcare services can lead to poorer health outcomes.

Connecting the dots, it’s easy to see how ZIP code can be more predictive of health than genetic code.

Health disparities, especially those stemming from the location of our homes, were only heightened by the COVID-19 pandemic. Throughout the pandemic, ZIP code determined access to testing sites, personal protective equipment, and vaccine availability.

Read the full article here: https://www.forbes.com/sites/billfrist/2022/01/11/a-call-for-data-equity-using-pandemic-data-mishaps-to-improve-health-outcomes/?sh=4ba1f6485e65

Rethinking How And What We Eat With Dr. Mark Hyman (Forbes)

FORBES | If Dean Ornish is the father of lifestyle medicine, Dr. Mark Hyman is the food as medicine master. With his New York TimesNYT+1% best-selling books, a top-rated podcast, “The Doctor’s Farmacy,” and visionary leadership of the Center for Functional Medicine at Cleveland Clinic, Hyman is changing the conversation about the nation’s relationship with food to improve health—not just for brains and bodies, but for the planet.

I sat down with Hyman recently for my podcast, A Second Opinion, to talk about his latest book, “The Pegan Diet, 21 Practical Principles for Reclaiming your Health in a Nutritionally Confusing World.” As a heart surgeon who in the operating room daily witnessed the devastating consequences of diet-related disease, I truly appreciate Hyman’s no-nonsense and easily digestible guide to using food as a therapeutic tool for better health. And as a former policy maker in the Senate, I love his ability to connect the misaligned incentives of our government to the health of each of us—and what we can do about it.

Hyman’s innovative approach reminds me of the groundbreaking work of Ornish, who argued in our talk in 2020 that lifestyle change—including plant-based diets low in fat and sugar, regular moderate exercise, strength training, stress management and social support—can treat and often reverse life threatening conditions like heart disease and diabetes.

Read the full article here: https://www.forbes.com/sites/billfrist/2021/08/12/rethinking-how-and-what-we-eat-with-dr-mark-hyman/?sh=3d8b685dff23

Tennessean: In 1998, Tennessee Sen. Bill Frist ran to help during a deadly U.S. Capitol shooting

By Rachel Wegner | Published in the Tennessean on January 14, 2021

On July 24, 1998, a gunman went on a rampage through the halls of the U.S. Capitol, leaving two Capitol Police officers dead and a tourist seriously injured.

The gunman had been shot multiple times by an officer when then-Tennessee Sen. Bill Frist stepped in not as a senator, but a physician. 

Frist, a heart surgeon, said he ran two blocks to the Capitol building to help after a staffer told him what happened.

He first attended a wounded officer until emergency personnel arrived. Then he turned his attention to a second man, uncertain of his identity. That man turned out to be Russell Eugene Weston Jr., who police later named as the gunman. 

In the end, Frist resuscitated Weston. 

“It is not what a U.S. senator typically does, but it is what this senator has done all of his adult life,” Frist told reporters shortly after the shooting. “I didn’t do anything any other trauma surgeon wouldn’t have done.”

The 1998 shooting marked the last time a Capitol Police officer died in the line of duty before the deadly riot at the Capitol on Jan. 6 this year.

In a 2018 Forbes column, Frist said he had an informal agreement with the Capitol Physician’s office to notify him if there was a medical emergency on the grounds. He was the only doctor in the Senate at the time.

Frist was a heart transplant surgeon at Vanderbilt University Medical Center before entering politics four years before the shooting. The shooting marked the fourth time his medical training had come into play since becoming a senator. 

In 1995, Frist revived a 60-year-old constituent who collapsed inside a Senate office. In 1996, he tended to a woman who was choking while he was on vacation. In 1997, he came to the aid of Sen. Diane Feinstein when she became short of breath during an allergic reaction. 

In 2018, Frist wrote a column for Forbes on the anniversary of the Capitol shooting

“Twenty years ago tomorrow was one of the most memorable days in my U.S. Senate career. And it haunts me still,” Frist wrote. 

He detailed the harrowing events of the day and called for improvements in mental health care. The 1998 Capitol gunman was suffering from mental illness.

“On this anniversary, I reverentially reflect on the heroic sacrifices our men and women in uniform make every day,” Frist wrote. “And as a physician, I’m prompted again to consider the discouraging state of mental health in America, and especially the poor care too many of those who suffer from mental illness today receive.” 

Senator Frist Statement on the Failed Insurrection at the U.S. Capitol

January 6, 2021 | Our U.S. Capitol: “It was all so surreal. Everything was out of context and not the way it was supposed to be….  I looked upward and saw the majestic dome of the Capitol with the American flag, fluttering against the bright blue sky and blazing sun. How could this assault and death, senselessness and tragedy, occur here [the Capitol] at the heart of our democracy?” These words I wrote in a Forbes article in 2018 on the 20-year anniversary of the 1998 Capitol shooting. They just as well could depict today. 

President-elect Joe Biden, hours ago, similarly described the terrifying and shameful events of today created by pro-Trump rioters when he said, “Our democracy is under precedented assault, unlike anything we have seen in modern times … an assault on the citadel of liberty, the Capitol itself.”  

This is not peaceful freedom of speech, this is an attack that puts innocent people in danger and deserves to be prosecuted to the fullest extent of the law.   

Democracy is fragile. We must come together. We must not tolerate anarchy, mob-like mentality, violence, physical confrontation, and lawlessness.  Whatever our differences and beliefs, we must unite around the peaceful transfer of power. We must rise to the expectations of being the world’s beacon of democracy. 

We have witnessed loss of life in the Capitol building today.  In 1998 two brave, honorable heroes — Capitol Police Officer Jacob Chestnut and Special Agent John Gibson — lost their lives defending us against a mentally ill shooter who stormed the Capitol.  Our condolences to all those individuals and families who have been so deeply hurt by these tragedies. 

Below is my Forbes op-ed from 2018 describing the experience of the 1998 Capitol shooting: 

https://www.forbes.com/sites/billfrist/2018/07/23/murder-in-the-capitol-honor-the-fallen-and-improve-mental-health/?sh=75a7239425e3

60% Of Americans Say Government Making Pandemic Worse. Here’s How We Restore Trust In Government & Science (Forbes)

September 4, 2020

Forbes | President Trump has said a COVID-19 vaccine could be ready before Election Day on November 3, and the Centers for Disease Control (CDC) just advised state public health officials to prepare to distribute one to high-risk populations as soon as late October or early November.

This comes on the heels of FDA Commissioner Stephen Hahn saying a vaccine could receive Emergency Use Authorization before the end of Phase III clinical trials—a statement that drew an outcry from public health experts concerned vaccine approval could be rushed for political reasons.

Top U.S. infectious diseases expert Dr. Anthony Fauci points to a slightly different timeline, saying in a September 3 CNN interview that, “I think most of the people feel it’s going to be November, December,” when we’ll see a vaccine released. “It is conceivable that you can have it by October, though I don’t think that that’s likely.” This was echoed by the Administration’s scientific adviser heading Operation Warp Speed, Dr. Moncef Slaoui, who agreed that, “There is a very, very low chance that the trials that are running as we speak” could be ready by the end of October.

Science shouldn’t be political. Our nation’s greatest scientific minds are working overtime to speed treatments and vaccines for SARS-CoV-2 to turn the tide on the global pandemic. There is no question that they are working for the good of the country and to save lives around the world.

But there is growing public opinion that politics is entering the vaccine development process. Several recent missteps on behalf of our nation’s public health agencies give the impression that they are bowing to pressure from the White House.

Read the full article here: https://www.forbes.com/sites/billfrist/2020/09/04/60-of-americans-say-government-making-pandemic-worse-heres-how-we-restore-trust-in-government–science/#2a9de7d476a5

Health security is national security (The Dallas Morning News)

The global coronavirus pandemic compels us to rethink how we approach development assistance, cooperation, innovation and international organizations.

The Dallas Morning News is publishing a multi-part series on important issues for voters to consider as they decide who to vote for president this year. This is the second installment of our What’s at Stake series, and it focuses on foreign policy. Find the full series here.

There are three things that the COVID-19 pandemic has made clear about public health: it’s global; it’s intrinsically tied to economic prosperity; and it is a part of our national security.

While we annually pour billions into our national defense, federal support of public health has been stagnant. Centers for Disease Control and Prevention funding specific to state and local public health preparedness has been cut from $939 million in fiscal year 2003 to $675 million in 2020. Over the last decade, frontline state and local health departments have lost more than 56,000 positions due to funding cuts. Yet America has lost more lives to COVID-19 than we did in the Vietnam War or World War I. And in just a few short months, we have already spent more in COVID-19 relief packages than we have on the Iraq War.

The cost of our lack of preparedness has been staggering, with economic devastation surpassing the Great Recession and unemployment rates on par with the Great Depression. This life-altering event needs more than emergency spending bills to plug holes. We need to fundamentally alter our approach to public health.

Read the Full Article Here: https://www.dallasnews.com/opinion/commentary/2020/08/16/health-security-is-national-security/

The US food system is killing Americans (CNN)

Opinion by Akash Goel, Michel Nischan, Bill Frist and Tom Colicchio

CNN | This global pandemic has given a new meaning to the idea of American exceptionalism. The United States is faring far worse than other countries and shoulders a disproportionate share of global disease burden — with 4% of the global population, yet, at the time of writing, nearly a quarter of global Covid-19 fatalities.

While much of the rationale has focused on our government’s flat-footed response and poor public health infrastructure, this ignores a significant and underrecognized risk factor — the exceedingly poor baseline health of our country’s population. Among the most significant risk factors for hospitalization and death in Covid-19 are the presence of diet-related chronic diseases such as hypertension, heart disease and obesity. America’s starting point? Nearly three out of four American adults are overweight or obese.

And half of US adults have diabetes or pre-diabetes. A 2018 study found that only 12% of Americans are metabolically healthy, which is defined as having optimal levels of blood markers and pressures as well as waist circumference. Diet-related diseases are no longer the things you have to worry about down the road. In a pandemic environment, they could hasten death next week.

Read the full article here: https://www.cnn.com/2020/08/02/opinions/us-nutrition-insecurity-snap-goel-nischan-frist-coliccio/index.html

COVID-19 has left millions of Americans without enough food. Here’s how Senate can help. (USA Today)

Today’s environment is unlike anything our nation has ever experienced. We are on the brink of an economic and food security disaster.

Bill Frist and Mark K. Shriver

USA Today | As a nation, we have a moral and economic obligation to address child hunger, food insecurity and avoid economic collapse in the wake of COVID-19. While we have different political viewpoints, we strongly agree that the Supplemental Nutrition Assistance Program is one of the most effective tools we have to fight the looming health and economic crises facing our great country.

The Senate is at a critical decision point as to how we use this tool. That’s why together, we are calling for a temporary 15 percent increase in SNAP benefits, bound to economic indicators, in the next federal coronavirus relief package.

Even in the best of economic times, far too many Americans struggle to put food on the table. This is especially concerning for families, where children need nutritious food to grow up healthy and strong.

Today’s environment is unlike anything our nation has ever experienced. We are on the brink of an economic and food security disaster that will impact every citizen, but disproportionately affect vulnerable individuals including children, the elderly, rural Americans, Black, indigenous and people of color.

For years, the number of hungry children was declining. But, a new Save the Children report shows that many children now face even greater risk. New estimates from Northwestern University based on Census Bureau data indicate the percentage of families who are considered food insecure has increased during the pandemic, is much higher than during the Great Recession, and, of great concern, disproportionately affect children and families of color.

Read the full article here: https://www.usatoday.com/story/opinion/2020/08/05/covid-19-has-led-surge-child-hunger-heres-how-we-can-help-column/5580099002/

Discrimination and Disparities in Health: Examination of racial inequality in Nashville (The Tennessean)

Bill Frist, M.D. and Andre L. Churchwell, M.D.

The Tennessean | As city and community leaders across the country wrestle with their own roles and responsibilities in addressing racial inequality, we believe specific attention to health equity and health disparities will lead to dismantling structural racism and a roadmap for a healthier future for all.

An example of how we are beginning that focus and journey can be found in Nashville, Tennessee.  But it could just as well be any town or city in the nation. 

We’ve known for years that minorities face health disparities nationally, and in our own experiences as physicians, we’ve seen first-hand how health inequities unfairly persist in communities of color when it comes to access and quality.

In Nashville, the simple zip code of your residence could lead to a six-year decrement to life expectancy, twice the rate of unemployment and five times difference in poverty.

The challenges of unconscious bias and racism that enable health inequities must be addressed to improve health outcomes.

Thanks to the recent Nashville Community Health and Well-Being Survey, we have a clearer picture of the challenges facing vulnerable populations, especially African Americans here in Davidson County, for the first time in 20 years. 

Read the full article here: https://www.tennessean.com/story/opinion/2020/07/31/examination-racial-inequality-nashvilles-healthcare/5540680002/

Tennessee’s COVID-19 Update – A Weekly Analysis (Week of July 19 – 25, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  As our state begins to reopen businesses, restaurants, and lift restrictions on stay at home orders, the statistics for infection rates are vitally important. NashvilleHealth is sharing weekly tracking updates and insights based on Department of Health data.  We are also incorporating the latest figures for Davidson County from Nashville Mayor John Cooper’s office.

For the week of July 19 – 25 there were a total of 14,460 new cases. Comparing to the previous week, the average cases/day is 6% lower.

  • Davidson County – 1,782 new cases which is 30% lower than last week
  • Williamson County – 363 new cases which is 51% lower than last week
  • Other TN Counties – 12,315 cases which is 2% higher than last week

There were 126 fatalities. The previous week had 100. Hospitalizations are also at a new high averaging 78/day with a total of 547 for the week (65/day and 456 total for the week before). Testing for this week was 5% lower compared to last week. Average of 22,645/tests/day.


Virtual Care Advances Are The Silver Lining Of COVID-19. Here’s How We Make Them Permanent (Forbes)

Forbes | It is said that necessity is the mother of invention, and the explosion of telehealth and virtual care has been one of the most constructive advances to emerge from the COVID-19 crisis. The gains for the patient include convenience, affordability, and rapid access to quality care while eliminating the risk of viral spread. The field of virtual health care, delivered from a remote location by text, phone, or video, has been accelerated by five years or more.

But we must ensure our nation does not lose the gains made when this public health emergency comes to an end.

Indeed America’s health systems, notoriously slow to change, have transformed their approach to care with lightning speed. Prior to COVID, health systems saw telehealth use in a 3-4% range. Now, providers are planning and financially budgeting for a larger percentage of virtual care, at around 25 – 30%. Geisinger CEO Dr. Jaewon Ryu recently shared with me that as result of COVID, they have gone from perhaps a few hundred telemedicine visits a day to conducting 4,500 – 5,000 a day. Medicare-covered virtual visits have skyrocketed – jumping from 12,000 per week to a million per week. And Americans are increasingly comfortable with a virtual visit, with surveys showing 74% of consumers are comfortable using telemedicine to have a conversation with a doctor.

For years I have been heavily involved in virtual care, beginning with my days 30 years ago taking care of over a hundred transplant patients remotely. Today I serve on the board of two virtual health care companies, Teladoc Health (physical and mental health) and Smile Direct Club (dental health). I have seen firsthand how our recent policy changes at the federal and state levels have unleashed private sector innovation in an overwhelmingly positive way—stepping in to address care gaps created by the pandemic’s stay at home orders.

Read the full article here: https://www.forbes.com/sites/billfrist/2020/07/27/virtual-care-advances-are-the-silver-lining-of-covid-19-heres-how-we-make-them-permanent/#65fc0e2b2980

Science alone cannot beat the pandemic. We also need outreach about a Covid-19 vaccine (STAT)

By BILL FRIST, RICHARD PAN, and MAX G. BRONSTEIN

STAT | Americans anxiously await two key benefits that a Covid-19 vaccine will deliver: freedom from fear and a return to normal.

No single vaccine is likely to offer a panacea for this pandemic. And even if it did, it might not accomplish its job if we don’t deal with hesitance to get vaccinated and counter vaccine disinformation. By failing to do these things, we risk a perpetual cycle of infectious disease coupled with persistent economic decline.

Now is the time to make sure that all residents of the U.S. understand the value of a Covid-19 vaccine and the necessity of getting one.

Since the start of the Covid-19 pandemic, vaccination conspiracy theories have flourished, fueled by a potent combination of fear, misinformation, and social media amplification. According to new polling data, among adults who have heard of one or more Covid-19 conspiracy theories, 36% believe it to be probably or definitely true.

At first, many health professionals dismissed vaccine conspiracy theories as outlandish and unbelievable. Yet additional polling data indicates 20% of Americans would outright refuse a Covid-19 vaccine and 31% are unsure as to whether they would get vaccinated.

Read the full article here: https://www.statnews.com/2020/07/27/science-alone-cannot-beat-pandemic-need-outreach-about-covid-19vaccine/

COVID-19 Laid Bare America’s Need to Confront Its Racial Health Disparities (Morning Consult)

BY BILL FRIST & RHONDA MEDOWS

Morning Consult | Every one of us is feeling the stress of these uncertain times. For Black Americans, the pain of the past several months has been especially devastating. Two viruses have reared their ugly head: COVID-19 and racism — both of which are killing people of color at disproportionate rates. 

Although we may come to this conversation from different backgrounds — as physicians and leaders in the health care community — we both firmly believe that racism is detrimental to health in all its forms and that addressing the systemic devaluing of black lives is a moral imperative. 

Rev. Martin Luther King Jr. said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

While COVID-19 itself may not discriminate, Black Americans and other minorities have had to bear the greatest brunt of this pandemic due to generations of racial health disparities and inequities — related to poverty, education, housing, access to transportation, healthy food and health care.

Black Americans were already disproportionately suffering from a higher rate of underlying conditions and chronic illnesses — including diabetes, heart disease, and obesity — all conditions which increase susceptibility to the ravages of COVID-19.

Read the full article here: https://morningconsult.com/opinions/covid-19-laid-bare-americas-need-to-confront-its-racial-health-disparities/

Tennessee’s COVID-19 Update – A Weekly Analysis (Week of July 12 – 18, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  As our state begins to reopen businesses, restaurants, and lift restrictions on stay at home orders, the statistics for infection rates are vitally important. NashvilleHealth is sharing weekly tracking updates and insights based on Department of Health data.  We are also incorporating the latest figures for Davidson County from Nashville Mayor John Cooper’s office.

For the week of July 12 to July 18– There were a total of 15,330 new cases, which is a new high. Comparing to the previous week, the average cases/day is 41% higher.

  • Davidson County – 2,549 new cases which is 5% higher than last week
  • Williamson County – 741 new cases which is 68.4% higher than last week
  • Other TN Counties – 12,040 cases which is 51% higher than last week

There were 100 fatalities. The previous week had 101. Hospitalizations are also at a new high averaging 65/day with a total of 456 for the week (47.5/day and 333 total for the week before). Testing for this week was 30% higher compared to last week – average of 23,756/tests/day.

Let’s keep Tennessee in the forefront of telehealth advancement (The Tennessean)

The Tennessean | We must continue to lay the groundwork that will allow virtual care to flourish so all Tennesseans will benefit.

The physical distancing precautions Tennesseans have undertaken to slow the spread of the coronavirus has affected every aspect of our lives. These changes have necessitated hardships, especially in our workplaces, schools, and families.

All of us have had to innovate, whether working at home, educating students online, or gathering our families by teleconferencing across a computer screen.

Nowhere has innovation been more thorough, rapid, and important—literally, saving lives—than in the delivery of health care through telemedicine.

Prior to the onset of the pandemic in the United States, 11% of Americans told researchers they had used telemedicine. Since early March, McKinsey & Company consulting firm reports that number has soared to 46%, or 140 million Americans, who say they have used telemedicine in 2020.

Read the full article here: https://www.tennessean.com/story/opinion/2020/07/17/keep-tennessee-cutting-edge-virtual-care/5452878002/

Tennessee’s COVID-19 Update – A Weekly Analysis (Week of July 5 – 11, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  As our state begins to reopen businesses, restaurants, and lift restrictions on stay at home orders, the statistics for infection rates are vitally important. NashvilleHealth is sharing weekly tracking updates and insights based on Department of Health data.  We are also incorporating the latest figures for Davidson County from Nashville Mayor John Cooper’s office.

  • For the week of July 5 to July 11– There were a total of 10,866 new cases, which is a new high. Comparing to the previous week, the average cases/day is 9% higher.
    • Davidson County – 2,436 new cases which is 19% higher than last week
    • Williamson County – 44 new cases which is 36.2% higher than last week
    • Other TN Counties – 7,990 cases which is 5% higher than last week
  • There were 101 fatalities which a new high. (previous high was week starting 6.14 at 74)
  • Hospitalizations are also at a new high averaging 47.5/day with a total of 333 for the week (42.3/day and 296 total for the week before)
  • Testing for this week was flat compared to last week. Average of 18,341/tests/day

Tennessee’s COVID-19 Update – A Weekly Analysis (Week of June 28 – July 4, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  As our state begins to reopen businesses, restaurants, and lift restrictions on stay at home orders, the statistics for infection rates are vitally important. NashvilleHealth is sharing weekly tracking updates and insights based on Department of Health data.  We are also incorporating the latest figures for Davidson County from Nashville Mayor John Cooper’s office.

For the week of June 28 to July 4– There were a total of 9,968 new cases. Comparing to the previous week, the average cases/day is 74% higher.

  • Davidson County – 2,051 new cases which is 86% higher than last week
  • Williamson County – 323 new cases which is 90.0% higher than last week
  • Other TN Counties – 7,594 cases which is 71% higher than last week
  • There were 53 fatalities
  • Hospitalizations average 42.3/day with a total of 296 for the week (42.5/day and 198 total for the week before)
  • Testing for this week was 78% higher compared to last week. Average of 18,500/tests/day

2005: “Manhattan Project for the 21st Century” – Remarks Delivered at the Bohemian Grove

Remarks as Delivered by Majority Leader Bill Frist, M.D.

“Manhattan Project for the 21st Century”

July 28, 2005

It is an honor for me to return to the Fellowship of the Grove and in this spectacular setting — the still waters, the glorious light — to share a few thoughts.  To be honest, this setting — with so much attention — is humbling.  You don’t get it as Majority Leader in the Senate.

In fact, one political pundit accurately said: “Being Majority Leader is like being a grounds keeper at a cemetery.  You have a lot of people underneath you.  But not one of them is listening.”

Like everyone else, politicians tend to look away from danger, to hope for the best, and pray that disaster will not arrive on their watch even as they sleep through it. 

This is so much a part of human nature that it often goes unchallenged. 

But we will not be able to sleep through what is likely coming soon — a front of unchecked and virulent epidemics, the potential of which should rise above your every other concern.

For what the world now faces, it has not seen even in the most harrowing episodes of the Middle Ages or the great wars of the last century.

We are unprepared for rampant epidemics.  And even worse, we haven’t taken sufficient note of the fact that though individually each might be devastating, they are susceptible of either purposeful or accidental combination, —in which case they could be devastating almost beyond imagination.

The history of pathogens advances in parallel with and is no more static than our own — with which it is always intertwined, even if at times invisibly.

Sometimes it rushes forward with great speed and breathtaking evolutionary vigor — and sometimes it rests in slow backwaters.

When, in 1967, the U.S. Surgeon General declared that we were within site of winning the war on infectious diseases, we thought the slack water would last forever.

But that war never ended other than in wishful thinking. 

*

Today more than a quarter of all deaths — 15 million each year — are due to infectious diseases.

These include 4 million from respirator infections, 3 million from HIV/AIDS, and 2 million from waterborne diseases such as cholera.  This is a continuing and intolerable holocaust that, while sparing no class, strikes hardest at the weak, the impoverished, and the young.

Three million children die every year of malaria and diarrheal diseases alone — one child every 10 seconds.

As sobering as this may be, we’ve been nonetheless in a quiescent stage of the mutability of pathogens — a hiatus from which they are now poised to break out.

When viral diseases evolve normally — such as in the typical course of the human influenza virus undergoing small changes in its antigenicity, (and killing an average of 500,000 people annually throughout the world) — it is called an antigenic drift.

When they emerge with the immense power derivative of a jump from animal to human hosts followed by mutation or recombination with a human virus — as in the influenza pandemic of 1918 – 1919 (in which 500 million people were infected and 50 million died, including half a million in the United States) — it is called an antigenic shift.

Antigenic shifts are the result of random, fortuitous, and unavoidable changes.

Human population increase, concentration, and spread, intensification of animal husbandry, and greater wealth in developing countries brings animals (both wild and domestic) into closer contact with ever larger numbers of people.

War, economic catastrophe, and natural disasters subdue active measures of public health. The unprecedented societal overuse and misuse of antibiotics build unprecedented resistance within the microbial bug universe to our even most powerful ammunition.

Travel, trade, and climate change bring into contact disparate types and strains of disease.

And as a consequence of all this, microbes evolve, mutate, and find new lives in new hosts.

*

The evidence suggests that we could be at the threshold of a major shift in the antigenicity of not merely one but several categories of pathogens — for rarely if ever have we observed among them such variety, richness, opportunities for combination, and alacrity to combine and mutate.

You read the tid bits and pieces in the news.  HIV, variant Creutzfeldt-Jakob disease (mad cow), avian influenzas such as H5N1, and SARS — all are merely the advance patrols of a great army forming out of sight — the lightning that (however silent and distant) gives rise to the dread of an approaching storm — a storm for which we … are … unprepared. 

How can that be?  How can the richest country in the world, with its great institutions, experts, and learned commissions, have failed to make every preparation — when preparation is all — for epidemics with the potential of killing off large segments of its population?

*

To see what might lie on the horizon one need only look to the relatively recent past.  I have a photograph of an emergency hospital in Kansas during the 1918 influenza pandemic.

People lie miserably on cots in an enormous barn-like room with beams of sunlight streaming through high windows.  It seems more crowded than the main floor of Grand Central Station at five o’clock on a weekday.  In this one room several hundred people are in the throes of distress.

Think of two thousand such rooms filled with a crush of men, women, and children — 500,000 in all — and imagine that the shafts of sunlight that illuminate them for us almost a century later are the last light they will ever see.

Then bury them.

That is what happened.

How would a nation so greatly moved and touched by the 3,000 dead of September 11th react to half a million dead?

*

In 1918 – 1919 the mortality rate was 3 percent, which seems merciful in comparison to the 50 percent mortality rate of today’s highly pathogenic H5N1 avian flu.  In just the last 18 months, avian flu has caused the death or destruction of over 140 million birds in 11 Asian nations.

And, most alarmingly, in 3 of those nations, H5N1 has taken the worried jump from birds to infect humans.

Should the virus shift and human-to-human transmission become sustained, imagine how many human lives avian flu will take.

How, then, would a nation greatly moved and touched by three thousand dead, react to 5 or 50 million dead?

*

And the new realities of terrorism and suicide bombers pull us one step further.  How would we react to the devastation caused by a virus or bacteria or other pathogen unleashed not by the forces of nature, but intentionally by man?

*

During the Cold War, the Soviet Union, which stockpiled 5,000 tons annually of biowarfare-engineered anthrax (resistant to 16 antibiotics), also produced massive amounts of weaponized smallpox — just as the monumental effort to immunize the world’s children came to a successful close.

It is impossible to rule out that quantities of this or other deliberately manufactured pathogens such as pneumonic plague, tularemia, or botulinum toxin may find (or may have found) their ways into the possession of terrorists such as bin Laden and Zarqawi.

Although the United States now has enough smallpox vaccine for the entire population, we haves neither the means of distribution nor the immunized personnel to administer it in a generalized outbreak.  Nor the certainty that the vaccine we have would even be relevant to a specific weaponized strain of the virus.

Hospitals and our long neglected public health infrastructure would be quickly overwhelmed.

Panic, suffering, and the spread of the disease would intensify as — because people were dead, sick, or afraid — the economy ceased to function, electrical power flickered out, and food and medical supplies failed to move.

Over months or perhaps years, scores of millions might perish, with whole families dying in their houses and no one to memorialize them or remove their corpses.  Almost without doubt, the epidemic would spread to the rest of the world, for in biological warfare an attack upon one country is an attack upon all.

Every vestige of modernity would be overturned.  The continual and illusory flirtation with immortality that is a hallmark of our scientific civilization would shatter. 

And we would find ourselves looking back upon even the most difficult times of the last century as a golden age.

*

Despite the common wisdom, humanity has not moved beyond this kind of scenario.  No — of late it has moved unnecessarily and gratuitously toward it.

Any number of known and unknown viruses — for which at present there is neither immunization nor cure — are at this very moment cooking in Asia and Africa — where they arise in hotbeds of densely intermingled human and animal populations.

We are in unexplored territory.  The brew is stewing in a new, ideal mixing vessel.  Economic and environmental changes in Asia have forced wilderness-deprived waterfowl to alight to feed amid farm animals — in newly dense populations due to recently acquired wealth and dietary expectations and in a culture in which live poultry is brought to market.

The reassortment of viral DNA as a result of this mingling is so frenzied that it is only a matter of time until the emergence of a virus unequaled in transmissibility and virulence.

The epidemiological calculus of flu is notoriously volatile due to the unknowns of rapid reassortment.  We do know now, however, we are woefully under prepared even for a virus that we can today foresee — much less for one that we cannot.

No such viruses have yet reached critical mass, or leapt from the channels imposed by their inherent limitations, environmental obstacles, and deliberate actions to contain them.

But who is to say they cannot? 

I certainly won’t.  Not with what I’ve seen.

I was in China at the height of the SARS outbreak and witnessed the government’s confused, deceptive, and miserable initial cover-up and response.  As a doctor on annual medical mission trips, I have treated patients in the Sudan and, just two weeks ago, in Tanzania.  I have seen a determined epidemic — HIV/AIDS — kill millions and hollow out entire societies on the African continent.

The evidence I have seen as doctor, scientist, and policy maker, the patterns of history, and new facts — such as rapid, voluminous, and essential travel and trade; the decline of staffed hospital beds; and a now heavily urbanized and suburbanized American population dependent as never before upon “just in time” but easily disrupted networks of services and supply — lead me to believe that such pathogens could result in the immensely high death tolls to which I have alluded.

*

Take the virus that is today the gravest threat — avian flu.

A vaccine would not become available, at best, until 6 to 9 months after the outbreak of a pandemic.  Even then, the vaccine would not be available in mass quantities.

And even then we do not know if that vaccine would work.  It’s still experimental.

So, in essence, we have no vaccine for avian flu.  Nor do we have enough of the only effective anti-viral agent Tamiflu stockpiled to treat more than one percent of our population for avian flu.  Only 10 of you could be treated.

*

It’s true that neither Avian flu nor these other viruses have yet spread geometrically — instantly and irrevocably overcoming health care systems and pulling us backward across thresholds of darkness that we long hoped we would never cross again.

And yet this they might do — either entirely on their own in nature or as a result of deliberate, purposeful human intervention.

No intelligence agency (no matter how astute) and no military (no matter how powerful and dedicated) can assure that a few technicians of middling skill using a few thousand dollars worth of readily available equipment in a small and apparently innocuous setting cannot mount a first-order biological attack.

It’s possible today to synthesize virulent pathogens from scratch, or to engineer and manufacture prions that, introduced undetectably over time into a nation’s food supply, would after a long delay afflict millions with a terrible and often fatal disease.

It’s a new world. 

Unfortunately, the permutations are so various that the research establishment as now constituted cannot set up lines of investigation to anticipate even a small proportion of them. 

But is it really reasonable to assume that anyone might resort to biological warfare?

Indeed it is.

Though Al-Qaida’s leadership has been decimated, it has declared that, “We have the right to kill four million Americans — two million of them children . . . . [and] it is our right to fight them with chemical and biological weapons.” 

It’s hardly necessary, however, to rely upon stated intent.  One need only weigh the logic of terrorism, its evolution, its absolutist convictions, and the evidence in documents and materials found in terrorist redoubts.  

And though not as initially dramatic as a nuclear blast, biological warfare is potentially far more destructive than the kind of nuclear attack feasible at the operational level of the terrorist.

And biological war is itself distressingly easy to wage.

Never have we had to fight such a battle, to protect so many people against so many threats that are so silent and so lethal.

*

So, I ask again how it is that we are so unprepared either for naturally occurring epidemics of newly emergent diseases or those that will be deliberately and purposefully induced?

I propose that we take the measure of this threat and make preparations today to engage it with the force and knowledge adequate to throw it back wherever and however it may strike.

It need not be invincible and we need not fall to our knees before it.  Means adequate to the success of a defensive plan are present in great profusion.  Whereas the approaching biological shift is gathering force like a massing army, providence has massed an army to meet it.

Having themselves expanded geometrically, the life sciences have come to the threshold of a great age, and to cross it they need only encouragement and a signal from the body politic to put their resources in play.

*

We are not without weapons in this war.  They are present in the stupendous material and intellectual wealth of the civilized world, which, despite current divisions of action and opinion, has everything to lose in common.

They are present in the great stores of science and technology amassed over thousands of years of civilization — in the many hundreds of universities, advanced research institutions, and hospitals — yes, in the United States and Europe, but also in Latin America, India, China, and dozens of other countries on six continents.

They are present in the revolution spawned by information technology and our vast, instant and interconnected ability to communicate and share information.  They are present in the private sector’s ruthless focus, which, though frequently condemned for its lack of humanity, could well be the instrument that saves us in the end.

They are present in the special temperament and brilliance of individual scientists; in the magnificent light that comes of the surprising and ingenious application of new technologies; and in the vigor, intelligence, and decency of free and unoppressed peoples.

*

So what must we do?

I propose an unprecedented effort — a “Manhattan Project for the 21st Century” — not with the goal of creating a destructive new weapon, but to defend against destruction wreaked by infectious disease and biological weapons. 

I speak of substantial increases in support for fundamental research, medical education, emergency capacity, and public health infrastructure.  I speak of an unleashing of the private sector and unprecedented collaboration between government and industry and academia.  I speak of the creation of secure stores of treatments and vaccines and vast networks of distribution.

Above all, I speak not of the creation of a forest of bureaucratic organization charts and the repetition of a hundred million Latinate words in a hundred million meetings that substitute for action, but action itself — without excuses, without exceptions — with the goal of protecting every American and the capability to help protect the people of the world.

I call for the creation of the ability to detect, identify, and model any emerging or newly emerging infection (present or future) natural or otherwise — for the ability to engineer the immunization and cure, and to manufacture, distribute, and administer what we need to get it done and to get it done in time.

*

This is a bold vision.

But it is the kind of thing that, once accomplished, is done.  And it is the kind of thing that calls out to be done — and that, if not done, will indict us forever in the eyes of history.

In diverting a portion of our vast resources to protect nothing less than our lives, the lives of our children, and the life of our civilization, many benefits other than survival would follow in train — not least the satisfaction of having done right.

If the process of scientific discovery proceeds as usually it does, we will come to understand diseases that we do not now understand and find the cures for diseases that we cannot now cure.

And, as always, disciplined and decisive action in facing an emergency can, even in the short run, compensate for its costs — by adding to the economy both a potent principle of organization and a stimulus like war, but war’s opposite in effect.

This would power the productive life of the country into new fields, transforming the information age with unexpected rapidity into the biotechnical age that is to come. 

All this, if the nation can be properly inspired in its own defense and protection — perhaps just in time.

We must open our eyes to face the single greatest threat to our safety and security today, but also to seize our greatest single opportunity.

*

And allow a conservative Senator from Tennessee (who is by nature skeptical of overzealous government action) to affirm the root conservative principle that if the life of the nation is potentially at risk, no effort should be judged too ambitious, no price too high to pay, no division too wide to breach.

I’m aware of the difficulties.  But the United States is as blessed today as it has been since its beginnings.  We are: the wealthiest, free-est, and most scientifically advanced of all societies; the first republican democracy; and the first modern state.

And although we as a nation have suffered criticism of late, we’ve been willing since our Founding, and are willing still, to pursue certain ideals.

Though not infrequently condemned from the precincts of cynicism, America has mostly left cynics in its wake — sometimes after saving them from floods that they themselves have unleashed.

Today, in the majesty of this setting, I’ve tried to impress upon you the urgency I feel in a matter concerning not only America but the world — for pandemics (whether natural or intentional) know neither borders, nor race, nor who is rich nor who is poor. 

They know only what is human, and it is this that they strike, casting aside the vain definitions that otherwise divide us.

It is my pre-eminent obligation as a public servant and my sacred duty as a physician to ask you to support the essence of this proposal.

In respect of human mortality, for the sake of your own families and children, for the honor and satisfaction of doing right, I bid you join in this effort.

*

As we celebrate as Bohemians and guests in fellowship in this magnificent and glorious space, may God preserve us all, and may our actions and foresight make us worthy of His preservation.

***

2005: Frist Calls For Manhattan Project For The 21st Century

August 3rd, 2005U.S. Senate Majority Leader William H. Frist, M.D. delivered the following lecture at the Nantucket Atheneum. The talk titled “The Manhattan Project for the 21st Century” outlined the global threat of infectious disease and bioterrorism and the need to better prepare the United States and the world to respond to epidemics and outbreaks:

Like everyone else, politicians tend to look away from danger, to hope for the best, and pray that disaster will not arrive on their watch even as they sleep through it. This is so much a part of human nature that it often goes unchallenged.

But we will not be able to sleep through what is likely coming soon — a front of unchecked and virulent epidemics, the potential of which should rise above your every other concern. For what the world now faces, it has not seen even in the most harrowing episodes of the Middle Ages or the great wars of the last century.

We are unprepared for rampant epidemics. And even worse, we haven’t taken sufficient note of the fact that though individually each might be devastating, they are susceptible of either purposeful or accidental combination, in which case they could be devastating almost beyond imagination.

The history of pathogens advances in parallel with and is no more static than our own — with which it is always intertwined, even if at times invisibly. Sometimes it rushes forward with great speed and breathtaking evolutionary vigor — and sometimes it rests in slow backwaters.

When, in 1967, the U.S. Surgeon General declared that we were within site of winning the war on infectious diseases, we thought the slack water would last forever. But that war never ended other than in wishful thinking.

Today more than a quarter of all deaths — 15 million each year — are due to infectious diseases. These include 4 million from respiratory infections, 3 million from HIV/AIDS, and 2 million from waterborne diseases such as cholera. This is a continuing and intolerable holocaust that, while sparing no class, strikes hardest at the weak, the impoverished, and the young.

Three million children die every year of malaria and diarrheal diseases alone — one child every 10 seconds. As sobering as this may be, we’ve been nonetheless in a quiescent stage of the mutability of pathogens — a hiatus from which they are now poised to break out.

When viral diseases evolve normally — such as in the typical course of the human influenza virus undergoing small changes in its antigenicity and killing an average of 500,000 people annually throughout the world — it is called an antigenic drift.

When they emerge with the immense power derivative of a jump from animal to human hosts followed by mutation or recombination with a human virus — as in the influenza pandemic of 1918 – 1919 in which 500 million people were infected and 50 million died, including half a million in the United States — it is called an antigenic shift.

Antigenic shifts are the result of random, fortuitous, and unavoidable changes.

Human population increase, concentration, and spread, intensification of animal husbandry, and greater wealth in developing countries brings animals both wild and domestic into closer contact with ever larger numbers of people.

War, economic catastrophe, and natural disasters subdue active measures of public health. The unprecedented societal overuse and misuse of antibiotics build unprecedented resistance within the microbial bug universe to our even most powerful ammunition. Travel, trade, and climate change bring into contact disparate types and strains of disease.

And as a consequence of all this, microbes evolve, mutate, and find new lives in new hosts.

*

The evidence suggests that we could be at the threshold of a major shift in the antigenicity of not merely one but several categories of pathogens — for rarely if ever have we observed among them such variety, richness, opportunities for combination, and alacrity to combine and mutate.

You read the tidbits and pieces in the news. HIV, variant Creutzfeldt-Jakob disease (mad cow), avian influenzas such as H5N1, and SARS — all are merely the advance patrols of a great army forming out of sight, the lightning that however silent and distant gives rise to the dread of an approaching storm, a storm for which we are unprepared.

How can that be? How can the richest country in the world, with its great institutions, experts, and learned commissions, have failed to make every preparation — when preparation is all — for epidemics with the potential of killing off large segments of its population?

*

To see what might lie on the horizon one need only look to the relatively recent past. I have a photograph of an emergency hospital in Kansas during the 1918 influenza pandemic. People lie miserably on cots in an enormous barn-like room with beams of sunlight streaming through high windows. It seems more crowded than the main floor of Grand Central Station at five o’clock on a weekday. In this one room several hundred people are in the throes of distress.

Think of two thousand such rooms filled with a crush of men, women, and children — 500,000 in all — and imagine that the shafts of sunlight that illuminate them for us almost a century later are the last light they will ever see. Then bury them. That is what happened. How would a nation so greatly moved and touched by the 3,000 dead of September 11th react to half a million dead?

In 1918 – 1919 the mortality rate was 3 percent, which seems merciful in comparison to the 50 percent mortality rate of today’s highly pathogenic H5N1 avian flu. In just the last 18 months, avian flu has caused the death or destruction of over 140 million birds in 11 Asian nations. And, most alarmingly, in 4 of those nations, H5N1 has taken the worried jump from birds to infect humans.

Should the virus shift and human-to-human transmission become sustained, imagine how many human lives avian flu will take. How then would a nation greatly moved and touched by three thousand dead, react to 5 or 50 million dead?

*

The new realities of terrorism and suicide bombers pull us one step further. How would we react to the devastation caused by a virus or bacteria or other pathogen unleashed not by the forces of nature, but intentionally by man?

During the Cold War, the Soviet Union, which stockpiled 5,000 tons annually of biowarfare-engineered anthrax resistant to 16 antibiotics, also produced massive amounts of weaponized smallpox — just as the monumental effort to immunize the world’s children came to a successful close.

It is impossible to rule out that quantities of this or other deliberately manufactured pathogens such as pneumonic plague, tularemia, or botulinum toxin may find or may have found their ways into the possession of terrorists such as bin Laden and Zarqawi.

Although the United States now has enough smallpox vaccine for the entire population, we have neither the means of distribution nor the immunized personnel to administer it in a generalized outbreak nor the certainty that the vaccine we have would even be relevant to a specific weaponized strain of the virus.

Hospitals and our long neglected public health infrastructure would be quickly overwhelmed. Panic, suffering, and the spread of the disease would intensify as — because people were dead, sick, or afraid — the economy ceased to function, electrical power flickered out, and food and medical supplies failed to move.

Over months or perhaps years, scores of millions might perish, with whole families dying in their houses and no one to memorialize them or remove their corpses. Almost without doubt, the epidemic would spread to the rest of the world, for in biological warfare an attack upon one country is an attack upon all.

Every vestige of modernity would be overturned. The continual and illusory flirtation with immortality that is a hallmark of our scientific civilization would shatter. And we would find ourselves looking back upon even the most difficult times of the last century as a golden age.

*

Despite the common wisdom, humanity has not moved beyond this kind of scenario. No — of late it has moved unnecessarily and gratuitously toward it.

Any number of known and unknown viruses — for which at present there is neither immunization nor cure — are at this very moment cooking in Asia and Africa — where they arise in hotbeds of densely intermingled human and animal populations.

We are in unexplored territory. The brew is stewing in a new, ideal mixing vessel. Economic and environmental changes in Asia have forced wilderness-deprived waterfowl to alight to feed amid farm animals — in newly dense populations due to recently acquired wealth and dietary expectations and in a culture in which live poultry is brought to market.

The reassortment of viral DNA as a result of this mingling is so frenzied that it is only a matter of time until the emergence of a virus unequaled in transmissibility and virulence. The epidemiological calculus of flu is notoriously volatile due to the unknowns of rapid reassortment. We do know now, however, we are woefully under prepared even for a virus that we can today foresee — much less for one that we cannot.

No such viruses have yet reached critical mass, or leapt from the channels imposed by their inherent limitations, environmental obstacles, and deliberate actions to contain them. But who is to say they cannot? I certainly won’t. Not with what I’ve seen.

I was in China at the height of the SARS outbreak and witnessed the government’s confused, deceptive, and miserable initial cover-up and response. As a doctor on annual medical mission trips, I have treated patients in the Sudan and, just two weeks ago, in Tanzania. I have seen a determined epidemic — HIV/AIDS — kill millions and hollow out entire societies on the African continent.

The evidence I have seen as doctor, scientist, and policy maker, the patterns of history, and new facts — such as rapid, voluminous, and essential travel and trade; the decline of staffed hospital beds; and a now heavily urbanized and suburbanized American population dependent as never before upon “just in time” but easily disrupted networks of services and supply — lead me to believe that such pathogens could result in the immensely high death tolls to which I have alluded.

*

Take the virus that is today the gravest threat — avian flu. A vaccine would not become available, at best, until six to nine months after the outbreak of a pandemic. Even then, the vaccine would not be available in mass quantities. And even then, we do not know if that vaccine would work. It’s still experimental.

So, in essence, we have no vaccine for avian flu. Nor do we have enough of the only effective anti-viral agent Tamiflu stockpiled to treat more than one percent of our population for avian flu.

*

It’s true that neither Avian flu nor these other viruses have yet spread geometrically — instantly and irrevocably overcoming health care systems and pulling us backward across thresholds of darkness that we long hoped we would never cross again. And yet this they might do — either entirely on their own in nature or as a result of deliberate, purposeful human intervention.

No intelligence agency, no matter how astute, and no military, no matter how powerful and dedicated, can assure that a few technicians of middling skill using a few thousand dollars worth of readily available equipment in a small and apparently innocuous setting cannot mount a first-order biological attack.

It’s possible today to synthesize virulent pathogens from scratch, or to engineer and manufacture prions that, introduced undetectably over time into a nation’s food supply, would after a long delay afflict millions with a terrible and often fatal disease. It’s a new world.

Unfortunately, the permutations are so various that the research establishment as now constituted cannot set up lines of investigation to anticipate even a small proportion of them. But is it really reasonable to assume that anyone might resort to biological warfare? Indeed it is.

Though Al-Qaida’s leadership has been decimated, it has declared that, “We have the right to kill four million Americans — two million of them children . . . . [and] it is our right to fight them with chemical and biological weapons.”

It’s hardly necessary, however, to rely upon stated intent. One need only weigh the logic of terrorism, its evolution, its absolutist convictions, and the evidence in documents and materials found in terrorist redoubts.

Though not as initially dramatic as a nuclear blast, biological warfare is potentially far more destructive than the kind of nuclear attack feasible at the operational level of the terrorist. And biological war is itself distressingly easy to wage.

Never have we had to fight such a battle, to protect so many people against so many threats that are so silent and so lethal.

*

So I ask again how it is that we are so unprepared either for naturally occurring epidemics of newly emergent diseases or those that will be deliberately and purposefully induced?

I propose that we take the measure of this threat and make preparations today to engage it with the force and knowledge adequate to throw it back wherever and however it may strike.

It need not be invincible and we need not fall to our knees before it. Means adequate to the success of a defensive plan are present in great profusion. Whereas the approaching biological shift is gathering force like a massing army, providence has massed an army to meet it.

Having themselves expanded geometrically, the life sciences have come to the threshold of a great age, and to cross it they need only encouragement and a signal from the body politic to put their resources in play.

*

We are not without weapons in this war. They are present in the stupendous material and intellectual wealth of the civilized world, which, despite current divisions of action and opinion, has everything to lose in common.

They are present in the great stores of science and technology amassed over thousands of years of civilization — in the many hundreds of universities, advanced research institutions, and hospitals — yes, in the United States and Europe, but also in Latin America, India, China, and dozens of other countries on six continents.

They are present in the revolution spawned by information technology and our vast, instant and interconnected ability to communicate and share information. They are present in the private sector’s ruthless focus, which, though frequently condemned for its lack of humanity, could well be the instrument that saves us in the end.

They are present in the special temperament and brilliance of individual scientists; in the magnificent light that comes of the surprising and ingenious application of new technologies; and in the vigor, intelligence, and decency of free and unoppressed peoples.

*

So what must we do?

I propose an unprecedented effort — a “Manhattan Project for the 21st Century” — not with the goal of creating a destructive new weapon, but to defend against destruction wreaked by infectious disease and biological weapons.

I speak of substantial increases in support for fundamental research, medical education, emergency capacity, and public health infrastructure. I speak of an unleashing of the private sector and unprecedented collaboration between government and industry and academia. I speak of the creation of secure stores of treatments and vaccines and vast networks of distribution.

Above all, I speak not of the creation of a forest of bureaucratic organization charts and the repetition of a hundred million Latinate words in a hundred million meetings that substitute for action, but action itself — without excuses, without exceptions — with the goal of protecting every American and the capability to help protect the people of the world.

I call for the creation of the ability to detect, identify, and model any emerging or newly emerging infection, present or future, natural or otherwise — for the ability to engineer the immunization and cure, and to manufacture, distribute, and administer what we need to get it done and to get it done in time.

*

This is a bold vision. But it is the kind of thing that, once accomplished, is done. And it is the kind of thing that calls out to be done — and that, if not done, will indict us forever in the eyes of history.

In diverting a portion of our vast resources to protect nothing less than our lives, the lives of our children, and the life of our civilization, many benefits other than survival would follow in train — not least the satisfaction of having done right.

If the process of scientific discovery proceeds as usually it does, we will come to understand diseases that we do not now understand and find the cures for diseases that we cannot now cure.

And, as always, disciplined and decisive action in facing an emergency can, even in the short run, compensate for its costs — by adding to the economy both a potent principle of organization and a stimulus like war, but war’s opposite in effect.

This would power the productive life of the country into new fields, transforming the information age with unexpected rapidity into the biotechnical age that is to come. All this, if the nation can be properly inspired in its own defense and protection — perhaps just in time.

We must open our eyes to face the single greatest threat to our safety and security today, but also to seize our greatest single opportunity.

*

Allow a conservative Senator from Tennessee who is by nature skeptical of overzealous government action to affirm the root conservative principle that if the life of the nation is potentially at risk, no effort should be judged too ambitious, no price too high to pay, no division too wide to breach.

I’m aware of the difficulties. But the United States is as blessed today as it has been since its beginnings. We are the wealthiest, free-est, and most scientifically advanced of all societies, the first republican democracy, and the first modern state.

And although we as a nation have suffered criticism of late, we’ve been willing since our Founding, and are willing still, to pursue certain ideals. Though not infrequently condemned from the precincts of cynicism, America has mostly left cynics in its wake — sometimes after saving them from floods that they themselves have unleashed.

Today I’ve tried to impress upon you the urgency I feel in a matter concerning not only America but the world — for pandemics whether natural or intentional know neither borders, nor race, nor who is rich nor who is poor. They know only what is human, and it is this that they strike, casting aside the vain definitions that otherwise divide us.

It is my pre-eminent obligation as a public servant and my sacred duty as a physician to ask you to support the essence of this proposal. In respect of human mortality, for the sake of your own families and children, for the honor and satisfaction of doing right, I bid you join in this effort.

May God preserve us all, and may our actions and foresight make us worthy of His preservation.
 

Seniors are becoming COVID-19 collateral damage. They’re dying because of it, not of it. (USA Today)

Dr. Martha K. Presley and Dr. Bill Frist – Opinion contributors

USAToday.com | Coronavirus has led to social isolation and lack of caregiver support. That can be fatal for fragile elderly people who don’t have the virus.

Coronavirus has changed the way we see life and health care. The immediate focus has been on infected patients. However, the effects of the pandemic are more widespread. Here are two patient stories that emphasize the far-reaching impact of COVID-19:

Mr. Smith was an 83-year-old man who was in good physical and mental health, until he fell and broke his hip. He underwent surgery, but as many elderly patients do, suffered delirium from the surgical anesthesia. His delirium worsened with new medications and no family to help orient him to a normal daily routine. In bed with medical devices, new medications and no family is a recipe for disaster. But Mr. Smith could not have his family visit because of the appropriate visitation policies. He spent 30 days alone in the hospital. His delirium worsened, and eventually his wife chose to transition to hospice so she could be with him. He died a week later.

Ms. Jones was a 93-year-old with Alzheimer’s disease. She was living in a memory care unit and was social, interacting with others and enjoying activities. When she was isolated because of COVID-19 precautions, she became confused and anxious. She could only see her family through a window. Because of her increasing agitation, her medications were increased. The amount of nursing oversight was decreased. One morning, she was found on the floor with bruises to her chin, a broken hip and a bleed in her brain. Her family did not want to put her through the stress of a hospitalization and surgery. She was admitted to a hospice house so her family could visit. She died a week later.

Coronavirus is particularly deadly for the elderly. In 14 states, half of COVID-19 deaths are in long-term care facilities, and the deaths of the residents and workers account for a third of the national death toll. But those are just the deaths from infected patients. Mr. Smith and Ms. Jones did not die from COVID-19. They died because of it.

Read the full article here: https://www.usatoday.com/story/opinion/2020/06/15/coronavirus-dangerous-for-uninfected-elderly-column/5322589002/

The Value of Home Health Care (Morning Consult)

BY TOM DASCHLE & BILL FRIST

Morning Consult | For the first time in our modern history, staying at home has become a “new” normal. And with more than 1.5 million Americans now infected with COVID-19, never before in our lifetime has accessing care in a person’s home been so important.

Smartly, our federal and state policymakers quickly expanded reimbursement for telehealth and removed barriers that have now allowed more providers to care for patients virtually via video and phone, eliminating the risk of COVID-19 exposure during provider visits. But not all care can be provided through telehealth – and we would be shortsighted to not also address the growing need for home-based care.

Long before the COVID-19 emergency, health care policy experts have increasingly recognized the value of home-based health care. A recent AARP survey found that three in four adults 50 years and older would prefer to age in their homes and communities. And a growing body of evidence suggests it is less expensive to deliver care in the home. Indeed, for years we’ve seen hospitalized patients more quickly returning to their homes and communities to heal and recover safely, reducing costs for themselves and the health care system.

Read the full article here: https://morningconsult.com/opinions/the-value-of-home-health-care/

Health leaders: We stuck together to #StayHome, now we can start together to #OpenSafely | Opinion (USA Today)

USA Today | Americans want our country to open up safely.

We have been at this for a number of difficult weeks since the global coronavirus pandemic began, and it has taken a toll.

It has been a time of unprecedented challenge. To our health. To our jobs. To our social connections. To our health care communities.

We have sacrificed with great unity to #StayHome in order to reduce the infection rate and save lives.

We want a sense of normalcy back — to go to work, to go to restaurants, to see sports again, to send our kids to school, to hug our families — but not at the expense of the lives of our friends, families and neighbors.

We want a good economy and public safety, but we are afraid if we open too quickly, or don’t have plans to adjust if spread recurs, we will have neither.

Read the Full Article Here: https://www.usatoday.com/story/opinion/2020/05/20/coronavirus-still-spreading-america-must-open-safely-column/5216824002/

Health leaders: We stuck together to #StayHome, now we can start together to #OpenSafely (USA Today)

We don’t believe we need to wait until there is zero risk. Many states are already beginning to reopen and this must happen in the safest way possible.

USA Today | Americans want our country to open up safely. We have been at this for a number of difficult weeks since the global coronavirus pandemic began, and it has taken a toll. It has been a time of unprecedented challenge. To our health. To our jobs. To our social connections. To our health care communities.

Still growing, contagious and lethal

COVID-19 is still spreading, but at a steadier rate. While it is shrinking in places like New York, it is still growing rapidly in some areas where there had been fewer cases. The virus is still equally contagious. The virus is still lethal to many. The virus still spreads through unsuspecting asymptomatic people. Some places are especially hard hit: nursing homes, meatpacking plants, prisons, detention centers, public housing, and the communities around them as people move in and out. People are still dying at an alarming rate, and that will continue unless we follow the path like the one outlined by Dr. Deborah Birx at the White House: a steady, gated reopening that avoids accelerated growth in cases, hospitalizations and deaths.

Read the full article here: https://www.usatoday.com/story/opinion/2020/05/20/coronavirus-still-spreading-america-must-open-safely-column/5216824002/

To Prioritize Both Student Learning and Student Health, Schools Must Work Differently This Fall | Opinion (The Hill)

BY FORMER SEN. BILL FRIST (R-TENN.) AND DAVID MANSOURI, OPINION CONTRIBUTORS

The Hill | As states and communities across the nation address the significant public health and economic impacts of the COVID-19 crisis and begin the intentional reopening of our communities, it is important to also look ahead to an important benchmark: the return to school for the nation’s 51 million Pre-K — 12 students. 

COVID-19 has created not only a devastating public health crisis but a real crisis in learning, requiring its own intensive recovery planning.

Research by the respected NWEA, a global not-for-profit educational services organization, suggests that students will return in fall 2020 with only 70 percent of the learning gains in reading compared to a typical school year. In math, students are likely to return with less than 50 percent of the typical learning gains. 

In some grades and locations, students may return nearly a full year behind what we would normally see. In high poverty schools, students are already susceptible to higher levels of summer learning loss; this pandemic will likely exacerbate existing equity gaps.

As we look ahead to school buildings reopening, state and local leaders should be focused on three major areas:

  • Planning and preparing for a very different kind of school year.
  • Investing in the innovations and technologies needed for rapid learning recovery.
  • Holding the line on proven policies and investments that advance student achievement.

Read the full article here: https://thehill.com/opinion/healthcare/498418-to-prioritize-both-student-learning-and-student-health-schools-must-work

Tennessee’s Confirmed COVID-19 Cases – A Weekly Analysis (Week of May 10th, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  As our state begins to reopen businesses, restaurants, and lift restrictions on stay at home orders, the statistics for infection rates are vitally important. NashvilleHealth is sharing weekly tracking updates and insights based on Department of Health data.  We are also incorporating the latest figures for Davidson County from Nashville Mayor John Cooper’s office.

  • For the week of May 10, 2020 – There were a total of 2,520 new cases. Comparing to the week of May 3rd, the average cases/day are 20% higher. This could be correlated to the relaxation of restrictions concerning the virus from the previous week. For example, Davidson county is keeping more restrictions in place than other counties and the average cases/day rate dropped while Other TN Counties rose.
    • Davidson County – had a total of 514 new cases which is 12% less than last week
    • Williamson County – 30 new cases which is 36% more than last week
    • Other TN Counties – 1,976 cases which is 32% less than last week
  • There were 53 fatalities which is 61% higher than last week.
  • Hospitalizations average 22/day with a total of 155 for the week
  • Testing for this week has increased compared to last week by 20%

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

Tennessee’s Confirmed COVID-19 Cases – A Weekly Analysis (Week of May 3rd, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  As our state begins to reopen businesses, restaurants, and lift restrictions on stay at home orders, the statistics for infection rates are vitally important. NashvilleHealth is sharing weekly tracking updates and insights based on Department of Health data.  We are also incorporating the latest figures for Davidson County from Nashville Mayor John Cooper’s office.

  • For the week of May 3, 2020 – There were a total of 2,107 new cases. Comparing to the week of April 26th, the average cases/day are 39% lower.
    • Davidson County – had a total of 585 new cases which is 8% less than last week
    • Williamson County – 22 new cases which is 42% less than last week
    • Other TN Counties – 1,500 cases which is 46% less than last week
  • There were 33 fatalities which is about the same as last week
  • Even with the influx of new cases last week, it seems that hospitalizations did not spike along with new cases. We will continue to monitor the condition of those cases.
  • Testing for this week has increased compared to last week by 3%

Read Governor Lee’s latest COVID-19 Bulletin here.

For information specific to Nashville (Davidson County) please go to asafenashville.org and for specifics regarding the reopening of Nashville see this Roadmap.

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

The US should be a leader in the global fight against Covid-19 | Opinion (CNN)

CNN | Americans are staring down an unprecedented crisis. We’ve already lost more than 71,000 of our fellow citizens. Millions of families live in fear and uncertainty every second. And large swaths of our workforce are losing their jobs each week.

Together, we face a common, invisible enemy: the novel coronavirus, Covid-19.

As two former US Senate majority leaders, we didn’t always see eye to eye during our time together in Congress, but today, we certainly agree on at least two things: America must lead the rest of the world to defeat Covid-19. And if we take our eye off the ball, China will try to exploit this crisis to its own gain.

Once again, Covid-19 has taught us that what happens around the world matters and impacts us here at home. As the number of cases climbs every time we refresh our screens, we’re learning in real time that viral threats know no borders. After starting thousands of miles away in China late last year, Covid-19 has spread to virtually every continent.

Read More Here: https://www.cnn.com/2020/05/06/opinions/covid-19-fight-against-coronavirus-us-daschle-frist/index.html?fbclid=IwAR36sePigZgn1oq6xvK_xLORiWvZmkjogwAPc2b1PMB4VXB_nq0WZK2gFVI

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 29, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

State-level data as of 3pm CT on April 29th is as follows:  Tennessee confirmed COVID-19 cases increased by 314 for a total of 10,366. Hospitalizations are now at 1,013, and fatalities rose to 195. To see all of the Tennessee statistics for COVID-19 visit the state’s dashboard here.

President Trump announced this week that states should move to test 2% of their population each month. With almost 170,000 residents tested already, Tennessee has met this goal for April and is looking to continue that progress through May.

Governor Lee issued Executive Order 31 to extend the prohibition of non-emergency dental services to Wednesday, May 6, to allow more needed time for the Tennessee Dental Association, the Tennessee Dental Hygienist Association, and the Tennessee Board of Dentistry to continue their work on guidance for safe reopening and practice.

Gov. Lee also announced that close contact services, such as salons and barbershops, in 89 of Tennessee’s 95 counties will be able to reopen at limited capacity on May 6. Our Economic Recovery Group will release industry-specific guidance for those businesses before the end of this week.

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 25, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 25th.  Tennessee confirmed COVID-19 cases increased by 5% for a total of 9,189.  Hospitalizations are now at 821, and fatalities rose to 178.

As today is Saturday, there are no media updates from Governor Lee or Mayor Cooper.

End of week update: Average cases per day statewide increased by 47% at 347 cases per day. Total tests for the week were 50,820 which is more than double any other week in comparison. Hospitalizations per total cases is slowly dropping at a total of 9% of total cases.

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

Data acquired from Mayor John Cooper and the Davidson County Department of Health via the daily Covid-19 update.

Privatized contact tracing will help America safely reopen amid coronavirus pandemic | Opinion (The Tennessean)

THE TENNESSEAN | South Korea proved it could contain COVID-19 without a lockdown through aggressive contact tracing. That is what the U.S. must do to be successful too.

After implementing social distancing through a lockdown, but before deploying a vaccine, the single best tool we have to contain the COVID-19 pandemic is contact tracing. 

Countries that have been successful outliers in halting the virus’s spread, like South Korea, have deployed contact tracing early and extensively.

If we want to wisely reopen our state (and our nation), as quickly and safely as possible, we must aggressively implement this approach.  And for it to be successful, we must involve a public-private partnership, compensating private healthcare providers for sharing the work of public health delivery.

Read more here: https://www.tennessean.com/story/opinion/2020/04/22/coronavirus-privatize-contact-tracing-help-america-safely-reopen/3005516001/

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 22, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 22nd.  Tennessee confirmed COVID-19 cases increased by 6% for a total of 7,842.  Hospitalizations are now at 775, and fatalities rose to 166.

Gov. Lee highlighted key data points from the White House guidelines for Opening Up America Again, which highlight three key data buckets: symptoms, cases, and hospital capacity. He also reported Tennessee ranks 12th in the nation for total tests and 15th in the nation for tests per 100,000 people.

More information on Governor Lee’s daily updates can be found here.

The data for Nashville-Davidson County is current as of 9:30am CT on April 22.  The city has confirmed 1,962 cases of COVID-19, up from 1,936 on April 20, a 26-case increase. The confirmed cases range in age from 2 months to 99 years.

More information on Mayor Cooper’s daily updates can be found here.

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

Data acquired from Mayor John Cooper and the Davidson County Department of Health via the daily Covid-19 update.

What We Have Lost In Social Connections, We Can Gain In Nature (Forbes)

FORBES | What We Have Lost In Social Connections, We Can Gain In Nature

The coronavirus pandemic has stolen much from us: the company of our friends, the variety of our daily activity, the color of our social occasions, and—for too many—the stability of our livelihoods. It thrusts us into physical distancing, imposed isolation, and loneliness.

But one unexpected good fortune this crisis brings forth is the dramatic unveiling of nature as a powerful healer when isolation must be transiently the norm. Nature is the antidote to loneliness, the counter to dis-connectedness, and the haven beyond the confines of our homes. The springtime abounds with life and regeneration. What we have so painfully but dutifully (and temporarily) lost in our human social connections, we can gain in constructive solitude and wellbeing by purposefully wandering into the wonderment of the outdoors and nature.

I’m blessed that I am able to work from home and pack in a highly structured, much more efficient and more productive schedule than I had anticipated: full days of conference calls and writing and podcast generation. But my wife Tracy and I, like everyone else, are forcibly isolated from family and friends. The insidious stress slowly builds and the mind unpredictably plays confusing tricks.

Read more Forbeshttps://www.forbes.com/sites/billfrist/2020/04/22/what-we-have-lost-in-social-connections-we-can-gain-in-nature/#1af3be336bc3

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 21, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 21st.  Tennessee confirmed COVID-19 cases total 7,394.  Hospitalizations are now at 760, and fatalities rose to 157.

Governor Lee announced today that next week, 89 of Tennessee’s 95 counties will begin a phased reopening of the state’s economy as we work to bring industries like retail, restaurants, and close contact services to a safe and methodical opening. For the remaining six counties, Gov. Lee and the Economic Recovery Group are working directly with local officials and health departments in Tennessee’s major metropolitan areas (Shelby, Madison, Davidson, Hamilton, Knox, and Sullivan counties) as they plan their unique re-open strategies. Tennesseans must maintain habits like social distancing, working from home when possible, hand-washing, and utilizing cloth masks. Certain restrictions will remain in place to ensure we do this properly and safely, such as discouraging social gatherings of 10 or more and restricting visitors at nursing homes and hospitals until further notice.

More information on Governor Lee’s daily updates can be found here.

The data for Nashville-Davidson County is current as of 9:30am CT on April 21.  The city has confirmed 1,936 cases of COVID-19, up from 1,903 on April 20, a 33-case increase. The confirmed cases range in age from 2 months to 99 years. There were two additional deaths reported today, making the total death count 22.

More information on Mayor Cooper’s daily updates can be found here.

 

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 20, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 20th.  Tennessee confirmed COVID-19 cases total 7,238.  Hospitalizations now total 730, and fatalities rose to 152.

In an aggressive push to test outside of traditional symptoms, Gov. Lee announced that more than 11,000 Tennesseans received free COVID-19 tests through the weekend efforts of the Unified-Command Group. Expanded testing will continue for the next two weekends – April 25-26 and May 2-3. A full list of sites can be accessed here. In addition to drive-through sites, all rural county health departments across the state offer free COVID-19 testing 5 days a week. A full list of county health departments can be accessed here. To date, we have conducted 100,689 tests, with this weekend’s surge accounting for the largest number of tests conducted in our state over a two-day period.

  • For 17 consecutive days, we have seen only single-digit increases in the number of cases in our state.
  • Our hospitalization rate has consistently remained lower than national averages.
  • As of today, our number of recovered patients exceeds the number of active cases.

More information on Governor Lee’s daily updates can be found here.

The data for Nashville-Davidson County is current as of 9:30am CT on April 2oth.  The city has confirmed 1,903 cases of COVID-19, up from 1,751 on April 19th, a 152-case increase. The confirmed cases range in age from 2 months to 99 years. A total of 20 fatalities have been reported.

More information on Mayor Cooper’s daily updates can be found here.

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 15, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 15th.  Tennessee confirmed COVID-19 cases increased from 5,823 on Tuesday, April 14th to 6,079 on Wednesday, April 15th.  Hospitalizations are now at 663, a 5% increase from yesterday. Fatalities rose 1.22%, from 124 to 135.

Governor Lee announced today that he is recommending all schools in Tennessee remain closed for the duration of the 2019/2020 school year. The state has formed a Child Well-being Task Force to ensure at-risk children will be monitored and checked on in the interim. He also announced free COVID-19 testing will be available for any Tennessean, regardless of traditional symptoms, as the Unified-Command group ramps up an aggressive effort to expand testing capacity across the state.

The expanded testing effort launches this weekend, April 18-19, 2020, with the Tennessee National Guard popping up 15 drive-through testing sites across the state. Drive-through testing sites will also be available during the weekends of April 25-26 and May 2-3. A full list of sites can be accessed here or within the list below. In addition to drive-through sites, all rural county health departments across the state offer free COVID-19 testing 5 days a week.

The data for Nashville-Davidson County is current as of 9:30am CT on April 15.  The city has confirmed 1,492 cases of COVID-19, up from 1,457 on April 1, a 35-case increase. The confirmed cases range in age from 2 months to 94 years.

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

 

Data acquired from Mayor John Cooper and the Davidson County Department of Health via the daily Covid-19 update.

3 Ways Policymakers Could Help Our Nation’s Doctors And Nurses (TIME)

TIME | As a former heart-transplant surgeon and former U.S. Senator, I understand the frustrations many on the front lines of this pandemic are experiencing. Here are three things those doctors and nurses—dedicated but tired, anxious and feeling betrayed by government—wish policymakers would do:

First, strengthen supply chains of personal protective equipment (PPE) and diagnostic tests. We are in a battle with a cagey, deadly virus enemy, but we send our soldiers to war without armor and ammunition. The President should make the dire shortage of masks, shields, gowns and quick tests a national priority, beginning every press conference with a call to action. The tools are many; they should start with the Defense Production Act of 1950.

Second, create a single National Response Portal, conveniently accessible on a single iPad dashboard. To efficiently and wisely make life-or-death decisions in emergency situations, doctors need at their fingertips complete real-time information about the virus—where it is, how to test for it immediately, the timely return of test results, which proven treatments will work, what intensive-care-unit beds are nearby, the whereabouts of ventilators, how much disease is in the neighborhood. This virus is evolving fast. To win, we must evolve faster and smarter.

The portal, which would analyze public-health data, private-sector data, and mobility and traffic patterns, would also provide ongoing community monitoring that would speed the reopening of our schools and businesses as we relax social distancing—and again tighten it if COVID-19 begins to resurface. We’d know: Where is the enemy and where will it strike next?

Read more at TIMEhttps://time.com/5820662/bill-frist-washington-first-responders/

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 14, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 14th.  Tennessee confirmed COVID-19 cases increased from 5,610 on Monday, April 13th to 5,823 on Tuesday, April 14th.  Hospitalizations are now at 633, a 9% increase from yesterday. Fatalities rose 2.13%, from 109 to 124.

The data for Nashville-Davidson County is current as of 9:30am CT on April 14th.  The city has confirmed 1,457 cases of COVID-19, up from 1,385 on April 13, a 72-case increase.  We are still encouraged by the numbers of confirmed COVID-19 cases, but the increase today could be in part due to less people being tested over the holiday weekend. Please keep staying the course and stay at home unless going out for essential errands.

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

 

Data acquired from Mayor John Cooper and the Davidson County Department of Health via the daily Covid-19 update.

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 13, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 13th.  Tennessee confirmed COVID-19 cases increased from 5,308 on Sunday, April 12th to 5,610 on Monday, April 13th.  Hospitalizations are now at 579, a 2% increase from yesterday. Fatalities rose 1.94%, from 101 to 109.

The data for Nashville-Davidson County is current as of 9:30am CT on April 13th.  The city has confirmed 1,385 cases of COVID-19, up from 1,348 on April 12, a 37-case increase.  We are encouraged by the slowing down of the number of confirmed COVID-19 cases. This shows our curve is flattening and social distancing is working. Please keep staying the course and stay at home unless going out for essential errands.

A few important points to call out:

  • State wide average cases/day for the week of April 12th are on track to be down 8% when comparing to the week of April 5th
  • Williamson County added 4 cases to their total case count but day over day case growth remains low
  • Hospitalizations had a large influx of 54 new cases. This is the highest for the week of 4.12.2020. This may be due to people delaying going to the hospital because of the Easter holiday

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

 

Data acquired from Mayor John Cooper and the Davidson County Department of Health via the daily Covid-19 update.

A Storm for Which We Were Unprepared (Claremont Institute’s The American Mind)

Claremont Institute’s The American Mind | Senator Bill Frist saw it coming years ago.

Senator William Frist, M.D. is a nationally acclaimed heart and lung transplant surgeon and the former Majority Leader of the U.S. Senate. In 2005, during his tenure in Congress, he delivered the Marshall J. Seidman Lecture for the Department of Health Care Policy at Harvard University. In this strikingly prescient speech, he foretells the possibility of a viciously deadly pandemic and calls for action to defend against that eventuality on a vast scale. Though his warnings went unheeded, we are honored to publish his words now as part of our ongoing efforts to understand and counteract COVID-19 and its effects.

I am a physician and a surgeon who by accident of fate finds himself in the halls of power at a time of dangers for his country and the world, the most compelling of which are exactly those a physician is trained to recognize and fight. To me it seems no more natural to be a United States senator, and in my case the majority leader of the Senate, than it did to Harry Truman, who spent so many hard and unambitious years as a farmer and then found himself in such a place and at such a time as he did. And, like him, as someone who comes from the outside, and for whom the perquisites of power appear strange and irrelevant, I have asked myself what my purpose is as a public servant, what my obligations are, and what high precedents I should follow.

After some thought, I have determined my purpose, I know my duty and obligations, the precedents to honor, and why—neither history nor life itself being empty of example. Just as a surgeon must follow a purely objective course and a general must look at war with a cold and steady eye, a statesman must operate as if the world were free of emotion. And yet, to rise properly to the occasion, the surgeon must have the deepest compassion for his patient, the general must have the heart of an infantryman, and the statesman must know at every moment that the cost of his decisions is borne, often painfully, by the sovereign population he serves—all as if the world were nothing but emotion. The difficulty in this is what Churchill called the “continual stress of soul,” the rack upon which the adherents of these professions, if they meet their obligations well, will of necessity be broken.

Read More at Claremont Institute’s The American Mindhttps://americanmind.org/essays/a-storm-for-which-we-were-unprepared/

We Failed to Act on Pandemic Preparedness Before. Let’s not Make that Mistake Again. (LinkedIn)

LinkedIn | As the COVID-19 pandemic surge peaks and we begin to think about reopening our economy, our policy makers should immediately address how to prepare for the next one, for it is inevitable that a next one will occur.

I share with you my exact words from an address I gave at the National Press Club on December 8, 2005. Not because they were prescient of what was to come 15 years later, but because we as nation failed to act. Let’s not make that mistake again.

My exact words as delivered:

“But our hands are not tied. In fact, the policy implications become crystal clear. By immediately outlining and implementing a specific policy prescription, we can minimize not only the direct economic effects of a pandemic, but perhaps more significant, greatly reduce the costly indirect effects of panic, fear and paralysis.

There are 6 steps we must take. 

1. Communication

Number #1 is communicating with the public.

To allay irrational fear, communication must be the bedrock of every public policy response. Communication—of accurate, reliable, consistent information—isn’t an option—it is the antidote—the vaccine for irrational fear. (Think Katrina.) 

Failing to effectively communicate with the public—both before and during the pandemic—would be analogous to having a fire escape plan for your home, but neglecting to share the plan with your family. You don’t want your family jumping out the window when there’s a ladder under the bed. To minimize losses, you not only create an emergency plan, you tell people about it – again and again and again.”

Read More at LinkedInhttps://www.linkedin.com/pulse/we-failed-act-pandemic-preparedness-before-lets-make-bill-frist-m-d-/?trackingId=BfTPnAkRiybet%2FIJcz6kAg%3D%3D

Could Congress Vote by Zoom? (Forbes)

FORBES | The COVID-19 pandemic has rocketed the American workforce into the virtual space. Nearly any worker who can is working from home. Company boards are holding meetings and voting virtually. Physicians are seeing patients through telehealth.

What hasn’t changed? The United States Congress. Members must still travel to the floor of their Chamber to cast their vote in person, adhering to a strict dress code and a no cell phone policy. But as social distancing becomes the norm and in-person meetings have become a health hazard, why can’t Congress vote remotely?

The answer is more complex than you might think.

I spoke to my former parliamentary counselor who is working on this issue, and he said, “remote voting is probably the easy part.” Remote deliberations, such as debate and amendments are much more challenging, and “these contingencies have not yet sufficiently been thought through.”

Beyond the challenge of logistics, neither Leader Mitch McConnell nor Speaker Nancy Pelosi are keen on the idea of remote voting. As a former Senate Majority Leader, I understand how important it is to have your caucus in Washington, DC meeting and working together to move legislation. There’s a reason so many bills pass right before big holidays—keeping Members in Washington is one of the few tools leadership has to encourage cooperation and compromise. Giving that leverage up and allowing remote voting could hamstring leaders at a time when Congress is already notoriously divided.

Read more on Forbeshttps://www.forbes.com/sites/billfrist/2020/04/13/could-congress-vote-by-zoom/#522199ca6b4a

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 10 & 11, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 11th.  Tennessee confirmed COVID-19 cases increased from 4,862 on Friday, April 1oth to 5,114 on Saturday, April 11th.  Hospitalizations on Friday were 536 and rose 3% today, totaling 556. Fatalities rose 1.97%, from 98 to 101.

The data for Nashville-Davidson County is current as of 9:30am CT on April 11th.  The city has confirmed 1,256 cases of COVID-19, up from 1,224 on April 12, a 32-case increase.  We are encouraged by the slowing down of the number of confirmed COVID-19 cases. This shows our curve is flattening and social distancing is working. Please keep staying the course and stay at home unless going out for essential errands.

Mayor Cooper wanted to remind everyone about the Community Assessment Centers now open in the greater Nashville area. If you think you have symptoms or have been exposed to someone that has been diagnosed with COVID-19, please do the following:

First, call the Metro Public Health COVID-19 Information Hotline – 615-862-7777, 7 a.m-7 p.m. daily – to speak with a public health professional about your symptoms. If additional assessment is necessary, you will be directed to your provider or one of Metro’s Community Assessment Centers to be screened and, if necessary, tested for COVID-19. Centers are open at Nissan Stadium, Meharry Medical College and the former Kmart in Antioch. All centers will be open Monday, Wednesday and Friday, 9 a.m.-3 p.m. Testing is available, free of charge, for Nashville residents.

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

 

Data acquired from Mayor John Cooper and the Davidson County Department of Health via the daily Covid-19 update.

 

Our National Moment: How We Can Put Our Healthcare Heroes First (Forbes)

FORBES | As a transplant surgeon for years, we were forced to routinely make tough life and death decisions. With too few available donor hearts (limited supply) for the overwhelming number of patients waiting for a transplant (huge demand), allocation of the limited vital resource, the donor heart, left many to die within months while waiting for a heart transplant.

I’m no longer on the front line of that decision making, but today’s coronavirus pandemic similarly introduces the life and death decisions being made daily by our heroic health providers because of limited medical resources, whether it be too few ventilators or the lack of personal protective equipment for themselves.

It’s not the way it should be in American medicine today.

But because of inadequate preparation it’s the stark reality we have created for our nurses, and doctors, and caregivers, and support personnel as they fight and sacrifice on the frontlines for our safety and well-being. They are indeed our heroes.

A formidable surge in hospital admissions for COVID-19 patients is underway. Although communities across the country are successfully “flattening the curve” and spreading out the appearance of new cases across a longer span of time, it almost certainly will not be sufficient to prevent surges that will severely test clinical and hospital capacity. With 85,000 adult ICU beds available, even estimates of 960,000 to 3.8 million critically ill patients over the course of this pandemic would far outstrip our nation’s current capacity.

Read more at FORBEShttps://www.forbes.com/sites/billfrist/2020/04/08/our-national-moment-how-we-can-put-our-healthcare-heroes-first/#6b6e9fcb68db

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 2, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 2nd.  Tennessee confirmed COVID-19 cases increased from 2,683 on Wednesday, April 1st to 2,845 on Thursday, April 2nd.  Hospitalizations are now at 263, a 32% increase from yesterday. Fatalities rose 33%, from 24 to 32.

On April 2nd, Gov. Lee upgraded the statewide “safer at home” order to a “stay at home” mandate, through at least April 14.  This new order is enforceable.  Lee and his team had been tracking the level of activity our population was engaging in, and found through vehicle traffic and cell phone data that some residents were beginning to disregard the safer at home order.

The data for Nashville-Davidson County is current as of 9:30am CT on April 2.  The city has confirmed 785 cases of COVID-19, up from 673 on April 1, a 112-case increase.  We continue to stress that as testing capabilities expand, the number of confirmed COVID-19 cases will rapidly grow.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

 

 

 

 

 

 

 

 

 

 

 

 

Source: Mayor John Cooper’s Daily Press Briefing, https://www.asafenashville.org/updates/

Tennessee’s Confirmed COVID Cases – A Daily Analysis (April 1, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on April 1st.  Tennessee confirmed COVID-19 cases increased from 2,239 on Tuesday, March 31 to 2,683 on Wednesday, April 1st.  We’ve seen 1,310 new cases reported since Sunday (4 days), doubling our overall total. And it’s the second day in a row that we’ve seen a day-over-day increase of over 400 cases.

Hospitalizations are now at 200, up 14% from yesterday. COVID-related fatalities increased by 1 to 24.  Tests given per day (2.2K to 5K) and net new cases per day (164 to 444) have been steadily rising since Sunday.

The data for Nashville-Davidson County is current as of 9:30am CT on April 1.  The city has confirmed 673 cases of COVID-19, up from 541 on March 31st, and 4 deaths.  The three COVID-19 Assessment Centers established by Davidson County – which had been delayed in opening due to lack of testing kits – opened the first half of this week.  With more people able to get tested in Nashville, we should begin to see the uptick in confirmed cases from this increased capability next week.

We continue to stress that as testing capabilities expand, the number of confirmed COVID-19 cases will rapidly grow.

 

 

 

 

 

 

 

 

 

Source: Mayor John Cooper’s Daily Press Briefing, https://www.asafenashville.org/updates/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

 

Tennessee’s Confirmed COVID Cases – A Daily Analysis (March 31, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.  We are also incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on March 31st.  Tennessee confirmed COVID-19 cases increased from 1834 on Monday, March 30 to 2,239 on Tuesday, March 31. That’s a 405-case increase – the largest day-over-day increase we’ve seen to date since the Health Department began tracking confirmed cases.  Hospitalizations saw an 18% increase from yesterday totaling 175 in Tennessee.  COVID-related fatalities jumped to 23, which now equal 1% of confirmed cases (2,239).

Nearly 12,000 tests have been administered in the past two days, and will monitor over the next 7 days to see what the impact this will have on confirmed cases. We continue to stress that as testing capabilities expand, the number of confirmed COVID-19 cases will rapidly grow.

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tennessee’s Confirmed COVID Cases – A Daily Analysis (March 30, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.

Going forward, we will also be incorporating the latest daily figures for Davidson County from Nashville Mayor John Cooper’s office.

Here is the latest state-level data as of 3pm CT on March 30th.  Tennessee confirmed COVID-19 cases reached 1834 on Monday, March 30, nearly a 300-case increase since Friday, March 27’s total of 1537 total cases.  There are 148 COVID-19 hospitalizations and 13 reported fatalities.  Statewide, over 23,300 tests have been administered.

The data for Nashville-Davidson County is current as of 9:30am CT on March 31st.  The city has confirmed 541 cases of COVID-19, up from 443 on March 30th.   Week over week, we’ve seen a 214% increase in confirmed cases.  We have 14 confirmed hospitalizations and 3 fatalities.  Nashville’s figures are similar to several other metro regions: Dallas, TX (549 cases), Harris County/Houston, TX (563 cases), Fulton County/Atlanta, GA (503 cases), Cuyahoga County/Cleveland, OH (493 cases), Washington, DC (495 cases), and San Diego, CA (603 cases), according to a county-level tracker from the New York Times.

We continue to stress that as testing capabilities expand, the number of confirmed COVID-19 cases will rapidly grow.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Above data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

 

 

Tennessee’s Confirmed COVID Cases – A Daily Analysis (March 27, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.

Here is the latest data as of 3pm on March 27th.  Tennessee cases passed the 1000 mark, with an increase of 957 to 1203 confirmed COVID-19 cases over a 24-hour period.  In the past week, testing has increased dramatically, although we are seeing a several-day lag in tests being processed.  The increase in tests completed this week could mean we see a notable jump in confirmed cases next week once the results come in.  We continue to stress that as testing capabilities expand, the number of confirmed COVID-19 cases will inevitably grow.

The data continue to reflect that our confirmed cases skew towards a younger population, with more than a quarter (26%) of all TN confirmed cases in patients aged 21-30.  Only 8% of our cases have been in patients 71 and older.  Hospitalizations rose 36% from March 26 to 27, with over 100 cases or 8% of confirmed COVID-19 patients hospitalized.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member.

 

Tennessee’s Confirmed COVID-19 Cases – A Daily Analysis (March 26, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth is sharing daily tracking updates and insights based on Department of Health data.

Here is the latest data as of 3pm on March 26th.  Tennessee reported cases are still trending up, with a notable day-over-day increase from 784 to 957 confirmed COVID-19 cases. Tennessee Health Commissioner Lisa Piercey explained that this larger day-over-day increase was simply reflective of the time delay in testing, not a big spike in cases.  We should expect to see a substantial increase in documented cases as testing ramps up.  For example, in Davidson County they have set up three COVID-19 assessment sites with adequate staff and PPE to test Nashvillians, but to date have not been able to open the sites because of a shortage of testing kits.  As these testing sites come online, the documented cases will inevitably rise.

The data continues to reflect that our confirmed cases skew towards a younger population, with 75% of all TN confirmed cases in patients aged 21-60.  Governor Lee acknowledged this in his daily press briefing, saying, “To the young people in Tennessee, it matters what you do out there.”  It is likely why, to date, our hospitalizations remain lower than 10%.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Data acquired from the Tennessee Department of Health Website, analyzed by NashvilleHealth Board Member Sajid Khan

Tennessee’s Confirmed COVID-19 Cases – A Daily Analysis (March 25, 2020)

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – are impacting infection rates, NashvilleHealth will be sharing daily tracking updates and insights based on Department of Health data.

Here is the latest data as of 3pm on March 25th.  Tennessee reported cases continue to grow, with a current total of 784 confirmed COVID-19 cases, 53 hospitalizations, and 3 deaths.   Younger Tennesseans continue to have the majority of confirmed infections, with 34% of cases in ages 21 – 30 and 22% of infections in ages 31 – 40.  We noticed that some counties are reporting higher confirmed cases than are currently being displayed on the State Department of Health’s website, and in the Governor’s daily press briefing today, Health Commissioner Dr. Lisa Piercey confirmed that,  “There is a lag in reporting… I would caution you to actually expect some local numbers to be ahead of ours, but please be reassured we will get those in our numbers.”  As testing ramps up significantly over the next two weeks, we expect to see a substantial increase in documented cases.  Many other Tennesseans probably have the virus but still have not been able to get tested.

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member

What We Can Learn from Tennessee’s Confirmed COVID-19 Cases – A Daily Analysis

With the coronavirus pandemic, we are in unprecedented times, with governments having to use incomplete and rapidly evolving information to determine how to best keep their people safe as well as keep local economies afloat.  I want to commend Governor Bill Lee and the Tennessee Department of Health for the steps they have taken to date to strengthen our state in the fight against COVID-19.

Every day, the Tennessee Department of Health releases figures tracking the number of confirmed COVID-19 cases in each county and statewide.  In an effort to raise awareness about these figures and understand how our changes in behavior – including business closures, school closures, and sheltering in place for non-essential workers – is impacting infection rates, NashvilleHealth will be sharing daily tracking updates and insights based on Department of Health data.

Here is the latest data as of 3pm on March 24th.  Tennessee cases continue to grow.  We are still in the beginning stages of the pandemic – this will get worse before it gets better and will be a significant burden on vulnerable populations, families, small businesses, and our healthcare professionals. We must recognize that the personal choices we make today will have a direct impact on our state and our nation’s ability to weather this pandemic.

While it is still too early to determine how much behavior changes are “flattening the curve,” so far the data suggests that the majority of documented cases in Tennessee (69%) are ages 50 and under, which means we are doing a good job protecting our seniors to date.  But it does raise the question whether younger Tennesseans are taking the pandemic as seriously as they might.

As testing ramps up significantly over the next two weeks, we expect to see a substantial increase in documented cases.   As testing and social distancing continues, we hope to provide you with an increasingly clearer picture of the impact the steps our state and our counties are taking, and what we as Volunteers can do to stem the tide of coronavirus in our communities.

Senator Bill Frist, MD

Chairman, NashvilleHealth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Data acquired from the Tennessee Department of Health Website, analyzed by Sajid Khan, SVP at Change Healthcare and a NashvilleHealth board member

We May Have 72 Hours To Address The COVID-19 Protective Equipment Shortage (FORBES)

FORBES |

I write today to describe an urgent issue that must be addressed by federal leadership in the next 72 hours. In conversations this week with two highly respected leaders representing hospitals in different parts of the country, I received the same vital message: we must organize a national effort to develop personal protective equipment (PPE), which constitutes the protective masks, face shields, gowns, gloves, and other coverings worn to protect health care personnel from contracting infections like the current novel coronavirus.

One of these health system leaders, a chief medical officer in the western United States with extensive experience responding to the past SARS and Ebola outbreaks, described to me the predicament of countless hospitals across the country. With gaps in COVID-19 testing causing patients in hospitals to wait up to five days for results, PPE is being expended by personnel caring for every individual patient waiting for a test result because the assumption must be made that they are COVID-19 positive until proven otherwise.

In fact, the majority are likely not infected and this PPE is being wasted unnecessarily due to the unusually long wait times to receive and complete testing. And with untimely testing causing patients to wait in the hospital, those who could be discharged to home, nursing facilities, and other locations are forced to wait until a negative result is confirmed. Although hospitals have postponed elective surgery to help conserve PPE, this has not been enough for the spike in demand that has been caused in this crisis.

Read More at FORBES: https://www.forbes.com/sites/billfrist/2020/03/20/a-call-for-national-leadership-to-stop-the-protective-equipment-shortage/#3b8b52722d9a

America’s public health infrastructure needs consistent funding (Roll Call)

Roll Call | As our nation confronts the COVID-19 pandemic, we have once again become aware of the critical importance of our state and local health departments. They are the backbone of our nation’s response system.

This is not a new story: Just in this century, we have confronted major infectious disease outbreaks — SARS, H1N1, MERS, Ebola, Zika and dengue. Now COVID-19. Every president, every governor and every city and county chief elected official has had to mobilize their public health systems to respond to each of these crises. These challenges seem to be occurring with greater frequency due to climate change, animal-human interaction, a growing world population and antimicrobial resistance.

But local and state leaders have responded with one hand tied behind their backs. It’s because we, as a nation, have chosen not to consistently fund a strong public health system that can quickly alert us to new problems, build resilient communities that are healthy and socially connected, and create a reserve capacity to respond to an emergency of any kind.

Read More at Roll Call: https://www.rollcall.com/2020/03/14/americas-public-health-infrastructure-needs-consistent-funding/

How Changing Tobacco Laws Can Save Thousands Of Lives, Billions Of Tax Dollars (Forbes)

FORBES | Today we have a massive and growing public health challenge that is substantially shortening the lives of millions, negatively impacting the health of our children, and adding an astounding $170 billion in health care costs to our nation annually. Unknown to most, it has been for years the leading cause of preventable death in the United States. But a new policy approach that 11 states and over 450 cities and counties have adopted is making promising inroads in this health challenge.

The challenge we are facing is tobacco and nicotine use. Smoking kills more people each year than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined. And while the number of youth tobacco smokers had been declining for decades, it has recently plateaued and many health officials believe the explosion in vaping is to blame. Nicotine-rich e-cigarette devices were designed to help adult smokers quit, but they have increasingly attracted adolescents and children using candy and fruit flavors with devastating long-term consequences. Indeed, Rite Aid, one of the country’s biggest pharmacy chains, just announced it was discontinuing the sale of e-cigarettes and vaping products because of “the alarming statistics regarding the use… by children and teens.”

We have a solution. Research has shown that nearly 95% of adults who smoke started smoking before the age of 21. If we take steps to make it harder for youth to access these products, we can potentially prevent a whole new generation from starting this habit and becoming addicted to nicotine and tobacco in the first place. This is what Maine, Virginia, California, Oregon, Illinois, Massachusetts, New Jersey, Hawaii, Arkansas, Washington, Utah, and 450 cities and counties have done: they raised the tobacco sale age from 18 to 21. And while this is a new approach that’s just beginning to take hold, we’re already seeing promising results. In 2005, Needham, Massachusetts became the very first town to raise the tobacco sale age to 21. Within the first five years, high school smoking dropped 48%. The city of Chicago found a 36% decrease in smoking in 18-20 year olds just one year after implementation. By all accounts, this type of behavior change is a major public health achievement.

Read more at Forbes:
https://www.forbes.com/sites/billfrist/2019/04/15/how-changing-tobacco-laws-can-save-thousands-of-lives-billions-of-tax-dollars/#7e09706431d5

Most support tobacco policy changes that will save lives and tax dollars (The Tennessean)

THE TENNESSEAN | By Bill Frist, MD and Matthew Myers

As the leading cause of preventable death in Tennessee, tobacco use is shortening the lives of millions of people, affecting the health of children and adding $2.6 billion in health care costs to the state annually.  

Nearly one in four Tennesseans smoke. Centers for Disease Control and Prevention surveys show that 20.3 percent of Tennessee high school students reported using cigarettes, cigars, smokeless tobacco or electronic cigarettes at least once during the last 30 days. Based on current smoking rates, there are 125,000 kids in Tennessee today who will ultimately die from smoking, and smoking still kills more people each year than alcohol, AIDS, car crashes, illegal drugs, murders and suicides combined.

In addition, we are also facing a new epidemic of youth e-cigarette use. Nationally, use of e-cigarettes by high school students rose 78 percent in 2018, and more than 3.6 million middle and high school students used e-cigarettes.  

The good news, however, is that there are proven solutions. Over the last 20 years, states across the country have dramatically reduced tobacco use among youth by raising tobacco taxes, funding prevention programs and passing strong smoke-free laws. In the last few years, states have started raising the sales age for tobacco from 18 to 21. Research has shown that nearly 95 percent of adults who smoke started smoking before the age of 21. Raising the sale age would mean fewer teens would have access to tobacco products (including e-cigarettes) when their brains are still developing and more prone to addiction. Experts estimate that raising the tobacco sale age to 21 will, over time, reduce the smoking rate nationally by about 12 percent and smoking-related deaths by 10 percent, which translates into 223,000 fewer premature deaths, 50,000 fewer deaths from lung cancer and 4.2 million fewer years of life lost.  

Read more at The Tennessean: https://www.tennessean.com/story/opinion/2019/04/05/most-support-tobacco-policy-changes-save-lives-tax-dollars/3377168002/

Understanding The Burning Platform Of Health Care Spending Growth (Health Affairs)

HEALTH AFFAIRS | By Bill Frist, MD and Margaret Hamburg, MD

In January, we were honored to co-chair the inaugural meeting of the Health Affairs Council on Health Care Spending and Value. This diverse group of 22 health care leaders has come together to stimulate a national discussion about whether we should—and how we could—constrain what feels like runaway health care spending.

An explicit conversation about this issue has long been taboo in US health policy and politics, but with health care now consuming 17.9 percent of our gross domestic product (GDP)—up from 5 percent in 1960—that time is over. It is time for us to speak boldly and thoughtfully about the wisdom, sustainability, and return on investment of these levels of funding and examine the consequences of continuing health care cost growth along the lines of what we have seen in the past few decades.

The council’s formal charge, which will shape a three-year work plan and recommendations, is “to provide a focal point for evidence-based discussion, analysis, and action regarding what we get for our health care spending in the US, whether it is worth it, and how we might collectively take a more deliberate approach toward maximizing our investment in health care.” We want to ask tough questions, checking our allegiances and party affiliations at the door, and together, find evidence-based answers that are desperately needed to move this dialog forward. 

Read more at the Health Affairs blog:
https://www.healthaffairs.org/do/10.1377/hblog20190320.106452/full/

Tennessee’s education progress has slipped. Specific steps can turn it around (The Tennessean)

THE TENNESSEAN | By Bill Frist, MD and David Mansouri

A decade ago, the nonprofit State Collaborative for Reforming Education, or SCORE, began collaborating with Tennessee’s leaders, educators, and community and education advocates to make Tennessee one of the fastest-improving states in the nation.

Children in Tennessee today have better opportunities for success in college and career than any Tennesseans in history, and we are proud of the state’s unprecedented progress in student achievement. But as SCORE enters its second decade of service and releases our newest State of Education in Tennessee report, we want to see our students climb higher and faster.

From 2011 to 2017, Tennessee students made historic gains in national math and reading achievement, reaching as high as 34th or 35th in the nation. A few years earlier, we had been as low as 46th. Students in urban, suburban and rural areas all saw improvements. …

Read more at The Tennessean: https://www.tennessean.com/story/opinion/2019/03/11/how-to-reverse-tennessee-education-progress-declines/2919556002/

Tennessee Is Home To One Of The Deadliest National Parks In The Nation: Here’s How We Change That (Forbes)

FORBES | In Middle Tennessee, we are known for excellence in health care services, music, and economic growth. However, one distinction we would like to relinquish is being home to the national park with the highest number of suicides in the United States.

According to an analysis by Outdoor Magazine, the Natchez Trace Parkway is one of the nation’s deadliest parks with 25 suicide deaths from the Natchez Trace Parkway Bridge between January 2006 and September 2016. In recent years, the suicide rate has climbed, with five deaths in 2017 and three this past year. Suicide has become a public health crisis in my home of Williamson County, Tennessee, one that was brought to my attention by my wife Tracy through her work on the board of Centerstone. More tragedies are preventable if we act swiftly and intentionally.

Why is the Natchez Trace Parkway Bridge so deadly? The 1,572-foot-long concrete bridge only has a short, 32-inch railing barring a 155-foot drop. And since the first recorded death at the bridge in 2000, it has gained a reputation for being the “suicide” bridge. Famed country music singer-songwriter Naomi Judd, who struggled with depression, wrote in her autobiography that she contemplated ending her life by jumping from this very spot: “I knew exactly how I was going to carry out my suicide. … I would drive my car to the very center, and in one swift motion open the car door and climb over the railing. … After the 155-foot drop to State Route 96 below, it would all be over, now and forever.”

While Ms. Judd ultimately did not attempt suicide and was able to seek and receive help, 32 others have made the devastating decision to end their lives at the Natchez Trace. Now, friends and family members of these individuals are uniting as the Natchez Trace Bridge Barrier Coalition and partnering with the nationally recognized behavioral health leader Centerstone and the Tennessee Suicide Prevention Network with a singular focus: to raise the bridge railing or install a barrier to prevent future deaths. This is a cause I whole-heartedly support. And so does the science.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2019/03/07/tennessee-is-home-to-one-of-the-deadliest-national-parks-in-the-nation-heres-how-we-change-that/#58afbc387d5e

Trump’s call to end HIV is a worthy mission both at home and abroad (CNN)

CNN | In his State of the Union address, President Donald Trump brought attention to a disease that has almost disappeared from the headlines: HIV/AIDS.

He pledged to end the epidemic in the United States by 2030, setting commendable, ambitious goals for domestic prevention and treatment efforts.

I support President Trump’s pledged investment in domestic public health but believe we must also continue to build on our nation’s 15 years of global leadership in combating HIV/AIDS. Around the world, there are still nearly 37 million people living with HIV, more than 900,000 AIDS-related deaths a year and nearly 1,000 adolescent girls and young women infected with HIV every day. We can and must lead the global fight to end this pandemic.

Read more at CNN: https://www.cnn.com/2019/02/15/opinions/trumps-call-to-end-hiv-is-a-worthy-mission-frist/index.html

The Tax Credit that is History in the Re-Making (Forbes)

FORBES | At a time when our nation feels like it may be torn apart with increasing partisanship and clash of cultures, there is something all Americans share in common. We all take pride in our communities, our hometowns, the places where we were born and the places where we’ve put down roots. Part of that pride comes from a shared history, one that is preserved and told through our historic buildings, landmarks, and physical structures that are often the soul and essence of our towns and cities.

How can we best preserve and celebrate our past, while also meeting our communities’ needs for economic investment and job creation? One proven way lies with a little-known tax incentive that has been established at the federal level, and now is increasingly making a difference as states incorporate it into their tax codes. 

Read more at Forbes: https://www.forbes.com/sites/billfrist/2019/02/04/the-tax-credit-that-is-history-in-the-re-making/#18dc94911246

Why Tennessee should join 35 other states in adopting a historic tax credit (Tennessean)

THE TENNESSEAN | Earlier this week, Gov. Bill Lee made the commendable decision to direct all state agencies to find ways to improve how they serve rural Tennessee regions.

“My administration will place a high emphasis on the development and success of our rural areas,” Governor Lee said in announcing his first executive order. 

I strongly support our Governor’s committed focus, and have given thought to opportunities to move our rural towns, main streets, and downtowns forward.

What are some of the ways we can stimulate wage growth for some of our most vulnerable, improve the well-being of all our citizens, and pass along a better Tennessee to future generations?  One proven way lies with harnessing our heritage.

Incentives for historic preservation not only protect culturally significant buildings for the next generation, but also stimulate economic growth in our communities.

Read more in the Tennessean: https://www.tennessean.com/story/opinion/2019/01/25/tennessee-should-join-35-other-states-and-adopt-historic-tax-credit/2667076002/

What Andy Samberg And Sandra Oh Got Right At The Golden Globes: Vaccines Are Worth Celebrating! (Forbes)

FORBES | Last week at the Golden Globes, hosts Andy Samberg and Sandra Oh made headlines as they tried to give out free flu shots to celebrities in the audience. This surprise stunt showed famous stars looking shocked and nervous as needle-wielding nurses descended from the stage to offer vaccinations. Samberg joked, “If you are an anti-vaxxer, just put a napkin on—perhaps over—your head and we will skip you.”

This segment certainly got laughs, but perhaps more importantly it got the flu vaccine—and vaccinations in general—back into public discourse. Yes, it might be January but it’s not too late to get your flu shot. While flu season tends to peak between December and February, it can run as late as May.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2019/01/16/what-andy-samberg-and-sandra-oh-got-right-at-the-golden-globes-vaccines-are-worth-celebrating/#1d01d71ce78c

Has Childhood Obesity Become A National Security Threat? (Forbes)

FORBES | As a physician and lawmaker, I have long argued that federal global health aid improves America’s standing in the world and makes us safer by steadying unstable nations. Countries with healthy workforces have improved economic outputs, stronger family units, and are less likely to become havens for terrorists.  But what many may not realize is that the health of our population here at home also impacts our national security.  

Earlier this fall, Mission: Readiness, a group of 750 retired generals and admirals, published a new report, titled Unhealthy and Unprepared, showing that obesity is now a leading reason why 71% of young Americans are ineligible to serve in the military. This alarming trend, coupled with a decreasing number of young people interested in military service, means that our military soon may be unable to find enough recruits to protect American interests at home and abroad. And it’s already having an impact, with obesity rates cited as a major reason why the Army was not on track to meet its annual recruitment goals as of September 2018.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2018/12/19/has-childhood-obesity-become-a-national-security-threat/