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.

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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.

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.

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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.

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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.

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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.

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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%.

LEARN MORE FROM THE CDC

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.

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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.

As health care professionals, AAHPO leadership is focused on the health care needs created by this humanitarian crisis. Since 2011, AAHPO has had a special relationship with physicians from Artsakh, who have been trained within the AAHPO, Dr. Raffy Hovanessian Medical Education Program. As these same physicians have been forcibly displaced themselves, AAHPO pledges its support to these physicians. Below, we are sharing an update on AAHPO Team efforts to assist physicians in Artsakh and Artsakh refugees:

• AAHPO’s platform facilitated the identification of supplies needed by the burn center in Armenia, as well as their purchase, delivery, and fundraising for approximately $10,000 worth of supplies. Special thanks to Raffi Barsoumian, MD, who did this almost single-handedly. This is an amazing effort to which we are indebted.
• AAHPO Board Member Kim Hekimian, PhD, is organizing a triage effort to assist Artsakh refugee women who are pregnant. Dr. Hekimian estimates that we will need to raise approximately $10,000 for this project.
• We have initiated the process for AAHPO to become a tax-exempt vendor for the medical supply company, McKesson. This effort should enable AAHPO to facilitate the purchase of point of care Hemoglobin measures and possibly other urgently needed supplies as the Armenia situation unfolds.
• AAHPO’s letter of solidarity with the Artsakh health care provider refugees has been sent to them in both Armenian and English. A survey of their needs is to go out shortly. Special thanks to Dr. Hambardzum Simonyan, Program Director in Armenia, for his assistance in this effort.
• The AAHPO, Dr. Raffy Hovanessian Medical Education Program fundraising event is scheduled for November 4 (see article, below). Special thanks to our Co-chairs for contributing to this event. They include but are not limited to: Seta Nalbandian, Shoghag Hovanessian, Dr. Aram & Rima Cazazian, Dr. John & Dr. Sophie Bilezikian, Dr. Joyce Kurdian, and Dr. Lawrence V. and Magda Najarian.

At the November 4 Fundraiser for the AAHPO, Dr. Raffy Hovanessian Medical Education Program, Pulitzer Prize Winner Peter Balakian will be talking about the book he translated, Bloody News from My Friend, by Siamanto, which depicts the atrocities committed by the Ottoman Turkish government against its Armenian population. The book is based on letters written by Mr. Balakian’s grandfather.

At the Fundraiser, 3 of Mr. Balakian’s books will be offered for sale, and Mr. Balakian will be available to sign them: Bloody News from My Friend, Ozone Journal, Black Dog of Fate.

Please note that admission will be free for all students (with current student ID). Please invite any students that you know.

Peter Balakian
Peter Balakian (born June 13, 1951) is an Armenian-American poet, prose writer, and scholar. He is the author of many books including the 2016 Pulitzer prize winning book of poems Ozone Journal. The son of orthopedic surgeon Gerard Balakian, MD and Arax Aroosian. Peter Balakian was born in Teaneck New Jersey and grew up there and in Tenafly, New Jersey. He attended Tenafly public schools, and graduated from Englewood School For Boys (now Dwight Englewood School).

Peter Balakian also is author of other award-winning books, including the memoir Black Dog of Fate, winner of the PEN/Albrand award in 1998 and The Burning Tigris: The Armenian Genocide and America’s Response, winner of the 2005 Raphael Lemkin Prize and a New York Times best seller (October 2003). Both prose books were New York Times Notable Books. Since 1980 he has taught at Colgate University where he is the Donald M and Constance H Rebar Professor of the Humanities in the department of English and Director of Creative Writing.

Learn more: https://en.wikipedia.org/wiki/Peter_Balakian