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Vitamin D & Covid-19

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Thursday, May 7, 2020

MUSC World-Class Vitamin D Research Team to Study Connection to COVID-19 Prevention and Treatment

Medical University of South Carolina (MUSC) College of Medicine scientists and clinicians, led by world-renowned vitamin D research experts Bruce Hollis, Ph.D., professor emeritus in the Department of Pediatrics, and Carol Wagner, M.D., a professor in the Department of Pediatrics and neonatologist, are planning a focused research effort to determine if individuals with sufficient baseline levels of vitamin D have more protection against severe COVID-19 infection.

Recent reports in the medical literature point toward a potential link between vitamin D deficiency and the pathogenesis of COVID-19 in certain patients. This information aligns with what Hollis, Wagner and other national experts have established in their own vitamin D research in at-risk populations – unrelated to COVID-19 – that vitamin D deficiency is more prevalent among African Americans and individuals with more melanin in their skin as well as in some elderly nursing home residents who have very low exposure to sunlight. In addition, effective vitamin D repletion can be accomplished safely and with minimal expense.

“Our team has the ability to determine vitamin D levels for COVID-19-positive patients and track that information to begin this work. This area of study is worthy of their expertise and efforts,” said David J. Cole, M.D., FACS, MUSC president. “This is a great opportunity to raise awareness that this due diligence is needed so we can potentially help particularly vulnerable populations in our community.”

To be clear, neither these studies nor MUSC are suggesting that vitamin D cures or prevents COVID-19 infection. However, the body of prior and emerging scientific evidence would suggest that individuals with low vitamin D levels who contract COVID-19, including African Americans and elderly nursing home residents, might experience worse clinical outcomes than other groups with normal vitamin D levels.

“It is important to study this topic to determine if recommending vitamin D supplementation for vulnerable populations can make a difference in COVID-19 outcomes. If valid,” Cole explained, “we would have an inexpensive, readily available strategy not only to help these groups of individuals but also the general population of South Carolina and beyond.”

MUSC scientists point out that recent COVID-19 and vitamin D studies suggest that at-risk individuals with historically low levels of vitamin D also had increased severity of COVID-19 infection and worse clinical outcomes, especially if the viral infection reached the lower respiratory tract. Certain cells located there are known primary targets of the virus, and if affected, it becomes harder for the lungs to initiate tissue repair and rebound from an infection, thus causing acute respiratory distress and the hospitalization of patients nationwide.

Hollis, Wagner and their team are rapidly pursuing clinical studies to validate or refute the clinical assumption that when patients have sufficient vitamin D levels, their immune responses to the virus’ primary targets are enabled, stronger and more capable of fighting off the most acute form of COVID-19.

“If we know that certain groups of the population are already at high risk for deficiency, and recent, valid studies suggest that increasing vitamin D levels might help prevent or lessen the severity of the disease, it would seem irresponsible to us as health care providers and scientists not to pursue this for our statewide and national community,” Wagner said. “We know vitamin D has a critical role in many functions of our overall health, so we have a responsibility to our families, neighbors, coworkers, friends and community to help answer this question.”

Essentially, the team seeks to replicate recent findings related to COVID-19 and vitamin D deficiency and explore the idea that patients might need to reach sufficient vitamin D levels through the appropriate clinical standard dosing of IV or oral supplements or, in some cases, simply get more exposure to sunlight. As the research effort matures, Hollis and Wagner plan to offer guidance on whether supplementation in certain individuals improves their clinical outcomes following a positive COVID-19 test. In addition, they hope to offer insight into whether vitamin D supplementation for all South Carolinians could improve their vitamin D statuses and mitigate the severity of COVID19 should they become infected.

“Our previous work has demonstrated that African Americans and other vulnerable populations can achieve vitamin D sufficiency through clinically validated supplements, which is a relatively inexpensive therapy that has a large safety profile when given in doses between 4,000 to 6,000 international units a day to adults,” Hollis said. “Some individuals with low levels of melanin in their skin can achieve better vitamin D sufficiency just by standing or sitting for 15 to 20 minutes in the direct sunlight each day that its possible, which is another easy way to address low vitamin D levels.”

Scientists know that vitamin D is present in very few foods, and typically at lower levels than what is needed for sufficiency, but it can be produced by the body when human skin is exposed to ultraviolet rays from sunlight, which triggers vitamin D synthesis. It promotes calcium absorption by the gut and helps strengthen bones. Additionally, vitamin D has been shown to play an important role in a number of other bodily processes like modulation of cell growth and differentiation and enabling proper innate and adaptive immune functions to fight off pathogens. It’s also thought to protect against some chronic conditions, including cardiovascular disease, diabetes and some cancers.

Hollis and Wagner have more than 60 years of combined vitamin D research experience, with a collective body of work referenced and replicated across the spectrum by institutions such as Harvard University and the National Institutes of Health. They have accrued thousands of citations and have been published in numerous peer-reviewed journals on various subtopics around vitamin D deficiency and sufficiency.

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Another Blow Dealt: Charges Not Directly Linked To Victim Breonna Taylor

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Residents of Louisville, Kentucky along with spectators across the world have waited for more than six months with anticipation for the verdict in the Breonna Taylor case. Anticipation has been boiling so much so that city and state officials began preparing days ago for uncertainty in the event that protests and riots could potentially break out once the verdict was read. The Kentucky National Guard and state police were called in and a 72-hour countywide curfew has been enacted. Once again there is further division, unrest, and lack of trust in another American city as clashes have already began to erupt in the streets of Louisville.

The verdict is in and the long-awaited grand jury charges are as follows. Only one former police officer, Brett Hankinson, was indicted on three felony counts of first-degree wanton endangerment. In a nutshell, the other two officers will face no charges and the charges Hankinson faces are not directly related to the wrongful death of Breonna Taylor, but rather his reckless action of “wantonly shooting a gun” into an apartment (not Breonna’s). First-degree wanton endangerment is a Class D felony, the lowest of four classes of felonies, the maximum sentence is five years; the minimum is one year.

Last week an announcement was made by the city of Louisville that a $12 million settlement had been reached with the family of Breonna Taylor. Continued prayers for the family of Breonna Taylor and the city of Louisville.

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2021 Budget Adopted

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City of San Antonio’s Fiscal Year 2021 Budget Makes Investments in Public Health, Housing and Workforce Development

SAN ANTONIO (September 17, 2020) – Today, the City Council unanimously adopted the $2.9 billion Fiscal Year 2021 Budget, which is $4.4 million lower than last year’s budget, stays well below the statutory cap on property taxes and continues to invest resources in the four pillars of the Recovery & Resilience Plan, which includes keeping people in their homes, training people to secure jobs that are available today, supporting small businesses and improving digital connectivity for residents.

“The goal of the fiscal year 2021 budget is to maintain the city services that our residents expect, while also helping them recover from the devastating economic and health impacts of the COVID-19 pandemic,” said City Manager Erik Walsh. “We’ve been able to make meaningful investments in the services our community asked for, including public health, housing and human services, such as resources for mental health and support for those experiencing homelessness.”

The FY 2021 Adopted Budget invests $346 million in the community to vital services including health, housing, education and human services; this is in addition to the $291 million from federal grants targeted to assist the City with the response and recovery from the COVID-19 pandemic. Additionally, as part of the continued response to COVID-19, many departments, such as Metro Health, Fire, Neighborhood & Housing Services, Economic Development and Human Services, have changed their focus to address the challenges brought by the COVID-19 pandemic and help San Antonio recover from its effects.

Public Health

$45.8 million is allocated to Metro Health, including $20.3 million in the General Fund, which is a 29.6 percent increase compared to the FY 2020 Adopted Budget, the largest proportional increase of any department. The Adopted Budget creates a new Violence Prevention Division in Metro Health with a total investment of $8.9 million, including $1.3 million in new funds, and the transfer of 20 Crisis Response Team employees from the San Antonio Police Department to Metro Health. 

The adopted budget also includes $1 million to expand the Healthy Neighborhood Program and to create a new Community Health Connector Partnership and augment other public health programs. The adopted budget also adds $120,000 to add 12 healthy corner stores in Districts 1, 2, 4 and 7, while maintaining support for the eight stores in District 3. This program provides healthy food options to areas that lack access to grocery stores. 

Housing

The FY 2021 Adopted Budget allocates $27.5 million for affordable housing initiatives. This allocation also includes $300,000 for new legal kiosks at key city locations to assist at-risk populations. 

Policing

The adopted budget includes $486.5 million for the San Antonio Police Department, an increase of 1.7%. Nearly all of the increase is contractually-obligated (by the collective bargaining agreement with the police union) or state law-required. The proposed budget reallocates $1.6 million from the police budget to accept a federal COPS grant to hire 25 new officers focused on preventing domestic violence and reduces overtime for police officers by $3.4 million.

The FY 2021 Adopted Budget also introduces a deliberate process to address foundational issues within the police department, review police services and engage the entire community on expectations. The San Antonio Police Department responds to more than 2.1 million calls for service per year, some of which may be more appropriately handled by other departments and service providers. The process will review foundational issues, such as accountability and discipline of officers, determine the community’s expectations of the police department, incorporate community input and identify funding and alternative response mechanisms. A draft plan will be presented to the City Council by April 2021. Negotiations for a new Collective Bargaining Agreement with the San Antonio Police Officers Association will begin in the spring of 2021.

Support for Residents Experiencing Food Insecurity

The budget also invests $1 million in the San Antonio Food Bank’s Culinary Center. The project will provide more prepared meals for families experiencing food insecurity. The center will also increase Culinary Training program class size, provide space for on-site nutrition education classes and allow the San Antonio Food Bank to be more prepared in the event of a natural disaster or future pandemic. 

General Fund 

The General Fund, the largest operating fund in the proposed budget, is $1.28 billion, which is a 0.7 percent increase over FY 2020. The increase is primarily due to compensation increases from the collective bargaining agreements with the police and fire unions. The Adopted Budget includes new and existing investments in community service priorities. These investments include:

  • Small business support: additional $500,000 that partially reinstates a City fee waiver program and an establishes a new entrepreneurship program
  • Violence Prevention: a new division in Metro Health with a total investment of $8.9 million, including $1.3 million in new funds and the transfer of 20 Crisis Response Team workers from SAPD to Metro Health
  • Affordable Housing: $27.5 million to assist residents at risk of displacement and facilitate the development of affordable housing
  • Homelessness and Mental Health: $36 million investment, representing a $1 million more than FY 2021. $560,000 will allow the City to expand the Homeless Outreach Team created through the recovery and resiliency plan resulting in 11 district outreach Teams (one per district and downtown). $500,000 is added for an alternative mental health response option
  • Healthy Food Access: $120,000 to add 12 healthy corner stores in Districts 1, 2, 4 and 7, while maintaining support for the 8 stores in District 3
  • Education: $1.1 million to AlamoPROMISE to provide college scholarships to Alamo Colleges students
  • Human Services and Workforce Development: $24.3 million for delegate agencies providing critical services to San Antonio residents

The General Fund also adapts to a new fiscal reality and the impacts of COVID-19 by including $87 million in budget cuts over two years ($38 million in FY 2021 and $49 million in FY 2022) due to revenue reductions caused by the COVID-19 pandemic. Some the of the reductions include: 

  • Reduction of $14 million through City hiring freeze for most vacant positions, no pay increases for City employees, and other compensation adjustments
  • Suspension of economic development incentives saving $5.5 million
  • $3.4 million in reductions to the Police Department overtime budget and suspension of Police Cadet Hiring Bonus program ($739,500) 
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New SAPD Protocols

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San Antonio Police Chief William McManus announces new mental health crisis call protocol and permanent end of the use of “no knock” warrants.

SAN ANTONIO (September 11, 2020) — Today, San Antonio Police Chief William McManus issued new orders updating San Antonio Police Department (SAPD) policies relating to how SAPD responds to mental health calls and prohibiting the use of “no knock” warrants.

“The decision to revise these policies was made to better protect our officers and the public,” said Police Chief William McManus. “The newly established Escalated Mental Health Crisis Protocol’s objective provides officers with a way to help an individual who is need of mental health assistance. This new protocol aims to deescalate situations and equip officers with the tools needed in the field to protect lives.”

“I’m completely supportive of Chief McManus’s policy revisions. These encounters can unnecessarily put officers and the public in harm’s way,” said City Manager Erik Walsh. “Over the course of the next few months, we’ll continue to work with the community and evaluate SAPD’s programs, policies and call response to align with best practices.”

This June Chief McManus suspended the use of “no knock” warrants for both search and arrest warrants. In June, District 2 Councilwoman Jada Andrews Sullivan issued a Council Consideration Request (CCR) seeking to discontinue the use of “no knock” warrants.

“I’d like to thank Chief McManus, City staff and my council colleagues for working to keep our community safer. Thank you to the community for making their voices known and truly asking us to review policies in full detail,” said District 2 Councilwoman Jada Andrews Sullivan. “By discontinuing “no knock” warrants we are saving lives of both the public and our officers.”   

Updates to the policies were shared with today’s meeting of the City Council Public Safety Committee Meeting, which is chaired by District 6 Councilwoman Melissa Cabello Havrda. Councilmembers Jada Andrews Sullivan, Ana Sandoval, Clayton Perry and Rebecca Viagran also sit on the committee. 

“Today we made tangible steps towards making our city a safer place for the public, police officers, and our community as a whole. I have spent hours listening to and reading public comments and meeting with community groups. Thanks to Councilwoman Jada Andrews-Sullivan, Chief William McManus, Deputy City Manager Maria Villagomez, the Baptist Ministers Union, the San Antonio Police Officer’s Association, individual police officers, COPS Metro, Community Churches for Social Action, organizers Pharaoh Clark and Josie Garcia, and countless others for their dedication to making substantive changes to city policy. I remain committed to fostering meaningful dialogue, thoughtful questioning and a genuine desire to foster progress rather than division. Today is a win for our city,” said District 6 Councilwoman Melissa Cabello Havrda. 

The updated procedures are detailed below.

Procedures 503, entitled Obtaining and Executing Arrest Warrants and Procedures 504, entitled Execution of Search Warrants have been revised as follows:

  • Prohibits officers from applying for or participating in the service of “no knock” search warrant entries
  • Prohibits officers from applying for or participating in the service of “no knock” arrest warrants.
  • Prohibits entry into premises when serving high-risk warrants and requires the use of alternative strategies to include setting up a perimeter and encouraging the individual being sought to surrender.

The Escalated Mental Health Crisis Call Protocol will be used for mental health crisis calls involving violent acts or the presence of weapons. The protocol includes the following provisions:

  • The Communications Unit will try to determine if a service call is a mental health crisis involving weapons or violence. If an Escalated Mental Health Crisis Call exists, the dispatcher will dispatch a supervisor to the scene.
  • The responding officer will coordinate with the assigned supervisor and will try to contact the complainant to gather as much information as possible prior to the supervisor’s arrival. If an Escalated Mental Health Crisis Call exists, then the SAPD Mental Health Unit Supervisor will dispatch the SAPD Mental Health team to respond to the location.
  • Responding officers will not approach the person in crisis, unless the person initiates contact or there is a life-threatening situation. Officers are instructed to evaluate the situation and to be prepared to take appropriate measures to protect themselves and others. Officers are also instructed to conduct interviews of relatives, friends, neighbors or others that can provide useful information.

For more information about the San Antonio Police Department’s policies and procedures visit SanAntonio.gov/SAPD

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