How to Protect Yourself from a Wrong Way Driver

Lawrence V. Najarian, MDNote from AAHPO President Lawrence V. Najarian, MD: Recently, while driving at night on a highway, my family was almost killed by a wrong way driver. The only thing that saved my family was a reflexive understanding of the situation that I developed after reading about a fatal, wrong way driver accident that happened in our area two years ago. That understanding was critical to my reaction in the few seconds I had to grasp and respond to this situation. I would like to share information about wrong way drivers to help others who may find themselves in this dangerous situation that I thought would never happen to me.

Photo courtesy NTSB

Wrong-way driving, where a driver operates a vehicle the wrong way on a road or highway against the intended flow of traffic, can result in some of the most severe types of crashes according to the National Transportation Safety Board.

The AAA Foundation for Traffic Safety reports that despite accounting for only 3.7% of all fatal crashes on divided highways between 2010 and 2018, a high percentage of these incidents are fatal as they typically result in head-on collisions.

A study of wrong-way driving from the Iowa State University Institute for Transportation notes that wrong-way driving can occur on a variety of roadways including divided highways, freeways or arterial roads. These events are often associated with driver confusion resulting from roadways that are challenging to navigate.

Recent data from the AAA Foundation for Traffic Safety also shows a concerning rise in fatalities related to wrong-way crashes. An average of 500 deaths occurred annually from wrong-way driving crashes on divided highways between 2015 and 2018, a 34% increase from 375 deaths annually from 2010 to 2014. Wrong-way drivers made up 52.8% of fatalities from wrong-way driving crashes followed by their passengers (5.7%) and occupants of other vehicles (41.1%) between 2010 and 2018. These numbers remained elevated as roughly 500 people died in wrong-way crashes annually in 2019 and 2020, according to the Federal Highway Administration (FHWA).


What to Do if You Encounter a Wrong Way Driver

It’s essential to take immediate and decisive actions to protect yourself and others from a wrong way driver. Here are some steps to follow if you encounter a wrong-way driver:

  1. Stay calm and focus on your own driving.
  2. Quickly assess the situation to determine the best course of action.
  3. Safely and promptly move to the right lane or shoulder, and create as much distance as possible from the wrong-way driver.
  4. Do not swerve into oncoming traffic or abruptly change lanes, as this can increase the risk of a collision with other vehicles.
  5. Obey traffic signals and signs while trying to distance yourself from the wrong-way driver.
  6. Signal and Honk:
    – Turn on your headlights and hazard lights to make yourself more visible.
    – Honk your horn to alert the wrong-way driver and other nearby motorists.
  7. Dial 911 to report the situation, and provide information about your location, the direction of travel of the wrong-way driver, and any other relevant details.
  8. Avoid confronting the wrong-way driver or attempting to block their path. Let law enforcement handle the situation.

Remember that your safety and the safety of others are the top priorities. Always use your best judgment and follow the guidance of emergency services when encountering a wrong-way driver.

Study: Hip Fracture Burden to Nearly Double Worldwide by 2050

John Bilezikian, MDNote from AAHPO Board Member John Bilezikian, MD, a renowned metabolic bone disease expert, regarding the article which appears below these remarks:

Osteoporosis, a disorder of weakened bones associated with increased risk of fracture, is a major international health problem. A recent update of the scope of this problem was recently published by Douglas Kiel, Professor at Harvard and a leader in studies related to the global epidemiology of osteoporosis. In the report recently published in the Journal of Bone and Mineral Research, the flagship journal of the American Society of Bone and Mineral Research, Dr. Kiel reports that the expected incidence of hip fracture, the most serious complication of osteoporosis, is likely to increase over the next 30 years, despite a downturn in hip fractures in many countries. The study accessed data from 19 different countries and included over 4 million hip fractures. The reason for the expected doubling in the number of hip fractures, worldwide, relates to the aging population. With aging comes increased risk of osteoporosis and fractures. Another important finding of the study confirms the point that many individuals who sustain an osteoporotic hip fracture do not received therapy to prevent another one. The risk of another fracture in someone who has sustained a hip fracture is markedly higher if treatment is not instituted. This study describes differences among countries but underscores, overall, the need for greater awareness of this disease and for implementation of measures to prevent and treat it.

Image by kjpargeter on Freepik

An international study that included researchers from Harvard Medical School indicates that while age- and sex-standardized hip fracture incidence rates have decreased in most regions around the globe, the number of hip fractures worldwide is projected to nearly double by 2050, compared to 2018.

A significant treatment gap in patients sustaining a hip fracture and not receiving therapy to prevent future fractures was also observed in all countries and regions, particularly in men.

The study, recently published in the Journal of Bone and Mineral Research, reviewed more than 4 million cases and highlights an urgent need for better strategies in hip fracture prevention and care.

Hip fracture remains a global public health concern contributing to increased dependency, morbidity, and mortality and placing a burden on patients, their families, and health care systems.


Can Armenia’s refugee crisis catalyse health-system reform?

Editor’s note: This article is co-authored by AAHPO Board Member Kim Hekimian, PhD and AAHPO Member and MD/PhD student Christopher Marskosian, as well as Shant Shekherdimian, MD, Kent Garber, MD, MPH, and Ara Darzi, KBE, MD. The article was recently published in The Lancet, a prestigious British medical journal.

The immediate health needs of the refugees are immense. Before the exodus, people of Nagorno-Karabakh had been living under a punitive 9-month blockade, resulting in malnutrition and worsening health conditions due to scarcity of food, medicine, and vaccines. During their exile, a fuel depot explosion led to hundreds of casualties among refugees. Other factors contributing to medical needs include the suddenness of displacement, forfeiture of medical records, and loss of established longitudinal health-care providers.

But as headlines fade and humanitarian priorities shift elsewhere, Nagorno-Karabakh refugees will continue to face challenges in accessing high-quality health care. The Armenian Government intends to integrate displaced people into the health-care system, providing them with the same care as their host communities. However, Armenia has a health-care infrastructure with scarce resources and of inadequate quality. Given this reality, it would be wise for the global health response—typically focused on the acute needs of the refugees, and sometimes guilty of setting up health programming in parallel to government efforts—to simultaneously strengthen local health services towards universal health coverage, improved primary care, and optimized outcomes.


Congratulations to AAHPO Service Award Winners: Dr. Kayayan and Dr. Barsoumanian

On Sunday, January 21, AAHPO recognized Ara Kayayan, MD and Raffi Barsoumanian, MD for their exemplary medical service to Armenians (see photos below). This was the highlight of the Winter Brunch, which was well-attended and enjoyed by AAHPO members, families and guests. CLICK HERE and scroll to the bottom of the page to see more event photos of our Winter Brunch event.

Ara Kayayan, MD, center, accepts the AAHPO Service Award from AAHPO President Lawrence V. Najarian, MD, left, and AAHPO Vice President Garbis Baydar, MD, right. Dr. Kayayan is an internist in Albany, NY who was “AAHPO’s eyes and ears” during the treatment and recovery of Bishop Mesrop, who was severely injured in 2022. Dr. Kayayan is a highly respected physician in the Albany area, and an active member of the Armenian community there.

Raffi Barsoumanian, MD, left, accepts the AAHPO Service Award from AAHPO Vice President Garbis Baydar, MD, center, and AAHPO President Lawrence V. Najarian, MD. Dr. Barsoumanian, a surgeon, was recognized for traveling to Armenia to treat soldiers who suffered severe burns in the 2020 war and required skin grafts. Dr. Barsoumanian returned to Armenia a second time to bring essential medical supplies for the treatment of soldiers.

What You Need to Know About the Latest COVID Variant

Editor’s Note: Pediatric Infectious Disease Specialist and AAHPO Board Member Tsoline Kojaoghlanian, MD reviewed the article below and approved sharing it with AAHPO newsletter readers.

In early November 2023, the latest COVID variant, called JN.1, caused less than 5% of COVID-19 cases in the U.S. Now it is estimated to cause more than 60% of them. Virologists including Andy Pekosz, a professor in the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health, are paying attention.

Here, Pekosz explains what virologists are seeing, what this new variant means for case rates and treatments, and why it’s so important for more people to get the updated COVID-19 vaccine rolled out this fall.

What’s most important to understand about this variant?
This latest variant should be a reminder that we have tools to fight off COVID infection and minimize severe disease: Tests detect JN.1, the new vaccines protect against severe disease, and antivirals are still capable of treating infection from JN.1. We just have to use these tools more effectively than we have over the last six months.

So far, only 8% of children and 19% of adults have received the latest vaccine, so a lot of people are missing out on protection from this virus.


Paxlovid™ is a Potential Lifesaver. So Why Aren’t More People Taking It?

Editor’s Note: Pediatric Infectious Disease Specialist and AAHPO Board Member Tsoline Kojaoghlanian, MD agrees with the article below, which asserts that Paxlovid is helpful and should be more widely prescribed and taken.

With COVID-19 cases again on the upswing, the antiviral Paxlovid has been slow to gain traction among patients and doctors even though the medication reduces hospitalizations and deaths.

A recent National Institutes of Health study of about 1 million people found that only 15% at risk for severe disease took a five-day course of the prescription medicine. Of the patients who took Paxlovid, the medication reduced the risk of death by 73% and hospitalizations dropped 26%, showing the medicine is highly effective for people at risk of severe complications.

COVID-19 deaths, hospitalizations and visits to the emergency room increased at double-digit rates in the last week of December, the Centers for Disease Control and Prevention reported. But deaths and hospital stays remain far below earlier peaks.


Should You Take Aspirin for Heart Health?

Aspirin has long been considered a lifesaving option to lower the risk of heart attack or stroke. In fact, aspirin has been used for centuries for medical purposes, beginning more than 2,500 years ago when Egyptian physicians used willow bark as a pain reliever. Aspirin is also one of the most studied therapies in cardiovascular disease over the last half century.

However, taking a daily aspirin isn’t an option for everyone. Is it right for you? It depends on a variety of factors including age, general health, history of heart health, and more. which you should discuss with your health care provider.

Fortunately, we have AAHPO members and cardiologists Shant Manoushagian, MD and George Petrossian, MD to help us sort it out.

“Generally speaking, the widespread use of aspirin for primary prevention of cardiovascular disease has fallen out of favor due to bleeding risk, especially in those over age 60,” noted Dr. Manoushagian. “Guidelines now call for individualized, shared decision-making between health care provider and patient after weighing risk/benefit and cardiovascular (CV) risk vs. bleeding risk.”

“If able to be tolerated, aspirin should be used in patients who have had a prior heart attack, stroke, have documented CV disease, a prior stent of a heart artery or peripheral vascular disease,” said Dr. Petrossian. “In these patients, aspirin reduces the risk of heart attack and stroke.”

Both of these specialists emphasized that the decision to use aspirin should be made in discussion with your health care provider.


Some Reasons to Get Off the Fence about COVID Booster

Editor’s Note: AAHPO Board Member Tsoline Kojaoghlanian, MD, a pediatric infectious disease specialist, agrees with the article below, and also recommends the flu vaccine for those age 6 months and older, and recommends the RSV vaccine for the elderly (scroll down to see additional article).

Though many people remain on the fence about getting the latest COVID vaccine booster, new research suggests a strong argument for getting the shot this winter: It sharply reduces the risk for COVID.

Researchers found that getting vaccinated led to a 69% reduction in long-COVID risk among adults who received three vaccines before being infected. The risk reduction was 37% for those who received two doses. Experts say the research provides a strong argument for getting the vaccine, noting that about 10% of people infected with COVID go on to have long COVID, which can be debilitating for one quarter of those with long-lasting symptoms.

The data come from a systematic literature review and meta-analysis published in October in Antimicrobial Stewardship & Epidemiology. Researchers examined 32 studies published between December 2019 and June 2023, involving 775,931 adults. Twenty-four studies, encompassing 620,221 individuals, were included in the meta-analysis.


Why You Need a Flu Shot and Who Should Receive an RSV Vaccine

There are many reasons to get an influenza (flu) vaccine each year.

Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits.

Flu vaccination can keep you from getting sick with flu.

  • Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020, the last flu season prior to the COVID-19 pandemic, flu vaccination prevented an estimated 36 million influenza illnesses, 16 million influenza-associated medical visits, 390,000 influenza-associated hospitalizations, and 25,000 influenza-associated deaths.
  • During seasons when flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40% to 60%.


Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms. However, it can be dangerous for older adults.

RSV vaccines help protect adults 60 years and older from severe RSV illness. Older adults are at greater risk than young adults for serious complications from RSV because immune systems weaken with age. In addition, certain underlying medical conditions may increase the risk of getting very sick from RSV. Older adults with these conditions may especially benefit from getting RSV vaccine. If you are 60 years and older, talk to your healthcare provider to see if RSV vaccination is right for you.


From Artsakh to Armenia: A Professional Journey Enhanced by Continuous Learning

Dr. Gayane Tevosyan, 47, started her career more than two decades ago as an ENT specialist at Stepanakert Republican Medical Center. Back then, she served around 90 patients per day, covering night shifts in Stepanakert and nearby areas.

“I often worked at night as we had a huge gap in ENT specialists. However, I liked it and would do it repeatedly if needed,” said Gayane, who has resettled in Yerevan since the September 19 attack by the Azeris.

While her professional journey began in Artsakh, Gayane’s desire to enhance her skills led her to embrace continuous learning. In 2016, she participated in the AAHPO, Dr. Raffy Hovanessian Medical Education Program (above, Gayane is holding her graduation certificate from the program), an initiative to provide healthcare professionals with opportunities to expand their knowledge and expertise. Gayane’s first experience with the program, hosted at Erebuni Medical Center, was a revelation, introducing her to new insights, particularly in ear-related procedures.

Encouraged by the enriching experience and to distract herself from psychological traumas, Gayane has recently been enrolled in the ENT training program at the Astghik Medical Center in Yerevan. The program exposed her to cutting-edge techniques, including endoscopy and various methodologies not previously practiced in Artsakh.

Gayane emphasizes the importance of ongoing education for doctors, citing the information acquired during retraining sessions that significantly contribute to patient care: “Being retrained is crucial for every doctor,” Gayane affirmed, “It equips us with the latest knowledge on treating patients, explaining medical complexities to them and developing effective therapeutic tactics. I am eager to apply for the program again.”

The AAHPO, Dr. Raffy Hovanessian Medical Education Program was initially introduced in 2011 within Artsakh. The program has now been extended to include healthcare providers who were displaced from Artsakh to Armenia. Currently, AAHPO is assisting the physicians with finding employment and resettling in Armenia. AAHPO is trying to prevent a “brain drain” of talented Armenian physicians.

“We want these physicians to continue to practice and contribute to the health of Armenians in Armenia and not leave Armenia during this most turbulent time,” noted AAHPO President Lawrence V. Najarian, MD.