Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Plugging the Diversity Leak and Strengthening the Legal Profession: Examining the Importance of Targeting Underrepresented Minorities on the Educational Pipeline to Law

At first glance, the legal profession appears to be thriving with diversity. Three women, including one Hispanic woman, and one African American man currently serve on the United States Supreme Court. The country’s first African American president recently left office, taking with him the country’s first African American woman to hold the office of attorney general. This appearance of diversity is not particularly new — Presidents Barack Obama, Bill Clinton, and George W. Bush all had progressively more racially, and ethnically diverse cabinet picks compared to their predecessors. The illusion of diversity persists even outside of politics and government, in the entertainment world, going back over 30 years with the likes of attorney Claire Huxtable in The Cosby Show and later Judge Phillip Banks, more commonly known as Uncle Phil on The Fresh Prince of Bel Air. Today, Emmy, Tony, and Oscar winner Viola Davis personifies a highly revered attorney and academic on How to Get Away with Murder and millions tune in weekly to watch attorney Olivia Pope balance a successful law firm and political career in Scandal. LGBT individuals, gay men in particular, also see greater representation as attorneys on television. Yet law is one of the least diverse professions in the United States. The vast majority of attorneys — 88% to be exact — are white and white males hold a majority of all high-ranking, prestigious positions. This persistent lack of diversity among legal professionals and individuals in leadership positions is more accurately portrayed by the optics of our current presidential administration. In its stark contrast to predecessors past, the administration of President Donald J. Trump exemplifies the state of diversity in the legal profession. Once all of President Trump’s cabinet picks are confirmed, women and non-whites will hold only six positions. There will be only three visible minorities in the cabinet — an African American, Asian American, and Hispanic American — and all three possess the highest level of academic achievement among cabinet members yet hold some of the lowest ranking cabinet or cabinet level positions. This Article does not attempt to blame the decrease in diversity on President Trump, or any other administration or official. Rather, the aim of this Article is to identify the importance of education in its role as the integral equalizer in achieving success in high-level leadership positions. In doing so, it becomes evident that diversifying the legal profession greatly depends on pipeline programs that target racial and ethnic minorities, or other narrowly focused minorities, and cultivate academic achievement. In an effort to quantify the value and potential reach of diversity pipeline programs, Part II of this Article begins by delineating and quantifying diversity in the United States population, in American law schools, and the legal profession. Part III discusses various goals of diversity and identifies the aim adopted by this Article and a majority of pipeline initiatives. Then, Part IV defines the education pipeline to the legal profession before describing the potential of pipeline programs, as exemplified by those already operating. In Part V, this Article takes the position that pipeline programs are essential to the future of the legal profession — not only for the programs’ ability to diversify the legal workforce, but for the potential such initiatives carry in ensuring public confidence in, and accessibility to, the legal and judicial system. Lastly, this Article concludes by reminding the reader that society looks to the legal profession to draw its leaders but the profession cannot be expected to fill this need with attorneys of color that do not exist. The legal profession, as action-oriented problem solvers, must place itself at the forefront of ensuring membership is as inclusive as the communities we seek to serve