As virus surges anew, Milan hospitals under pressure again

MILAN (AP) — Coronavirus infections are surging anew in the northern Italian region where the pandemic first took hold in Europe, putting pressure again on hospitals and health care workers.

At Milan’s San Paolo hospital, a ward dedicated to coronavirus patients and outfitted with breathing machines reopened this weekend, a sign that the city and the surrounding area is entering a new emergency phase of the pandemic.

For the medical personnel who fought the virus in Italy’s hardest-hit region of Lombardy in the spring, the long-predicted resurgence came too soon.


“On a psychological level, I have to say I still have not recovered,’’ said nurse Cristina Settembrese, referring to last March and April when Lombardy accounted for nearly half of the dead and one-third of the nation’s coronavirus cases.

“In the last five days, I am seeing many people who are hospitalized who need breathing support,” Settembrese said. “I am reliving the nightmare, with the difference that the virus is less lethal.”

Months after Italy eased one of the globe’s toughest lockdowns, the country is now recording well over 5,000 new infections a day — eerily close to the highs of the spring — as the weather cools and a remarkably relaxed summer of travel and socializing fades into memory. Lombardy is again leading the nation in case numbers, an echo of the trauma of March and April when ambulance sirens pierced the silence of stilled cities.

So far, Italy’s death toll remains significantly below the spring heights, hovering recently around 50 per day nationwide, a handful in Lombardy. That compares with over 900 dead nationwide one day in March.

In response to the new surge, Premier Giuseppe Conte’s government twice tightened nationwide restrictions inside a week. Starting Thursday, Italians cannot play casual pickup sports, bars and restaurants face a midnight curfew, and private celebrations in public venues are banned. Masks are mandatory outdoors as of last week.

But there is also growing concern among doctors that Italy squandered the gains it made during its 10-week lockdown and didn’t move quick enough to reimpose restrictions. Concerns persist that the rising stress on hospitals will force scheduled surgeries and screenings to be postponed — creating a parallel health emergency, as happened in the spring.

Italy is not the only European country seeing a resurgence — and, in fact, is faring better than its neighbors this time around. Italy’s cases per 100,000 residents have doubled in the last two weeks to nearly 87 — a rate well below countries like Belgium, the Netherlands, France, Spain and Britain that are seeing between around 300 to around 500 per 100,000. Those countries have also started to impose new restrictions.

This time, Milan is bearing the brunt. With Lombardy recording more than 1,000 cases a day, the regional capital and its surroundings account for as many as half of that total. Bergamo — which was hardest hit last time and has been seared into collective memory by images of army trucks transporting the dead to

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3 million tested for coronavirus in Chinese city

BEIJING — Authorities in the eastern Chinese port city of Qingdao say they have completed coronavirus tests on more than 3 million people following the country’s first reported local outbreak of the virus in nearly two months.

The city’s health department said Tuesday that no new positive cases had been found among the more than 1.1 million test results returned thus far. The city said it had a total of 12 cases, six with symptoms and six without, since the new outbreak was first spotted over the weekend at a hospital.

The National Health Commission, however, said Tuesday that at least six new cases of the virus were found in Qingdao in the past 24 hours.


The reason for the discrepancy was not immediately clear.

The National Health Commission numbers released Tuesday reported a total of 30 new virus cases in the previous 24 hours nationwide. It broke down those numbers into 13 cases in which people had symptoms and 17 cases in which they had no symptoms. The total number of locally transmitted cases, both with and without symptoms, was 11, while the rest were listed as imported.

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HERE’S WHAT YOU NEED TO KNOW ABOUT THE VIRUS OUTBREAK:

— Takeaways: Coronavirus at center of Supreme Cour t hearings

— Defiant Trump defends virus record in 1st post-COVID rally

— As pandemic presses on, waves of grief follow its path

— Black churches mobilizing voters despite virus challenges

— ‘So frustrating’: Doctors and nurses battle virus skeptics

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— Follow AP’s pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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HERE’S WHAT ELSE IS HAPPENING:

SEOUL, South Korea — South Korea has reported 102 new cases of the coronavirus, its first daily increase over 100 in six days. The steady rise is a cause of concern as officials have lowered social distancing restrictions this week after concluding that the viral spread was slowing after a spike in mid-August.

The figures released by the Korea Disease Control and Prevention Agency brought the national caseload to 24,805, including 434 deaths.

Fifty-eight of the new cases was reported from the densely populated Seoul metropolitan area, where transmissions have been linked to hospitals, sports facilities, a funeral home and an army unit.

Thirty-three of the new cases have been linked to international arrivals, including passengers from Russia, Nepal, Japan and the United States.

South Korea relaxed its social distancing guidelines beginning Monday, which allowed high-risk businesses like nightclubs and karaoke bars to reopen and for professional sports leagues to proceed with plans to bring back fans in the stands.

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AUSTIN, Texas — An ongoing wave of COVID-19 cases in the El Paso area prompted Gov. Greg Abbott to announce Monday that a surge team of medical professionals would be dispatched to the area.

The 75 doctors, nurses and respiratory therapists being dispatched will be accompanied by a supply of extra personal protective equipment to support efforts by El Paso hospitals to meet the surge of coronavirus infections. The team will be in addition to

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COVID Cases Climbing in 36 States | Health News

By Robin Foster and E.J. Mundell
HealthDay Reporters

(HealthDay)

WEDNESDAY, Oct. 14, 2020 (HealthDay News) — Coronavirus outbreaks in the Midwest and Western United States have driven the national case count to its highest level since August, fueling fears of what the coming winter will mean for the country.

COVID-19 cases are starting to climb in 36 states, including parts of the Northeast, which is starting to backslide after months of progress, The New York Times reported. More than 820 new deaths and more than 54,500 new cases were announced across the country on Tuesday, the newspaper said. Idaho and Wisconsin set single-day records for new cases.

About 50,000 new cases are being reported each day in the United States for the week ending Monday, the Times reported. That is still less than in late July, when the country was seeing more than 66,000 cases each day.

But the trajectory is worsening, and experts fear what could happen as cold weather drives people indoors, where the virus can spread more easily, the newspaper said. The latest spike in cases shows up just before the increased mingling of people that comes with Halloween, Thanksgiving and Christmas.

Sixteen states each added more new cases in the seven-day period ending Monday than they had in any other weeklong stretch of the pandemic. North Dakota and South Dakota are reporting more new cases per person than any state has previously, the Times reported.

“A lot of the places being hit are Midwest states that were spared in the beginning,” William Hanage, a Harvard University infectious diseases researcher, told the Washington Post. “That’s of particular concern because a lot of these smaller regions don’t have the ICU beds and capacity that the urban centers had.”

COVID-19 hospitalizations have already begun rising in almost a dozen states, including Ohio and Pennsylvania, raising the probability that increasing death counts will soon follow, the Post reported.

Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told CNN that he hopes the numbers “jolt the American public into a realization that we really can’t let this happen, because it’s on a trajectory of getting worse and worse.” He called the rising numbers “the worst possible thing that could happen as we get into the cooler months.”

It is unclear what is driving the climbing case count, but it could be the long-feared winter effect already taking place, or the reopening of businesses and schools, or just people letting down their guard on social distancing efforts, the Post reported.

Second COVID vaccine trial paused

A second coronavirus vaccine trial was paused this week after an unexplained illness surfaced in one of the trial’s volunteers.

Johnson & Johnson, which only began a phase 3 trial of its vaccine last month, did not offer any more details on the illness and did not say whether the sick participant had received the vaccine or a placebo. The trial pause was first reported by the health news website STAT

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Enclara Pharmacia Announces the Appointment of Mark Morse as CEO

Enclara Pharmacia, the market leader in comprehensive pharmacy management services to the hospice community, announced today the appointment of Mark Morse as Chief Executive Officer. He will assume day-to-day leadership of Enclara and work in partnership with its current leadership team to help reduce pharmacy costs for hospices, improve patient care, and support caregivers through digital innovation, medication access, clinical care and more.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20201014005070/en/

Mark Morse, Chief Executive Officer, Enclara Pharmacia (Photo: Business Wire)

Mark succeeds Andy Horowitz, Enclara founder and CEO, who made plans to move into a strategic advisor role as part of Humana’s acquisition of the pharmacy services provider in February. In the months since, Horowitz has provided direction and leadership throughout the integration process to help bring the two companies together and ensure a smooth transition. He will continue to act as a strategic advisor as part of the Humana-Enclara agreement, and remain involved in the long-term success of the company.

“A key part of our strategic plan, established when Humana agreed to acquire Enclara, was that I would transition into an advisory role when it made the most sense,” Horowitz said. “I believe we have reached a point where it is time for a new leader to execute on the roadmap we have established. I’m really proud of the entire Enclara team and the company we have built together, and I am confident in how Mark will lead Enclara into the future.”

Before joining Enclara, Morse most recently served as Humana’s vice president of Pharmacy Service Operations, overseeing a team of approximately 3,000 associates in 16 domestic and overseas locations. Under his leadership, Humana was named the best in Mail Order Pharmacy Customer Satisfaction in the J.D. Power U.S. 2020 Pharmacy Study, the third consecutive year Humana received this honor. Throughout his over 30-year career, Morse has also led the strategy and operations for many large-scale sales, systems and customer-focused initiatives.

“Andy and his team have built an amazing company, which serves a critical and noble need in the market and for the patients it serves,” Morse said. “I care deeply about advancing both Enclara’s growth and hospices’ capacity to provide quality end-of-life care. My goal is to leverage Humana’s scale and resources to help Enclara deliver timely and cost-effective pharmacy solutions while maintaining what makes Enclara uniquely Enclara.”

Morse’s previous roles at Humana include serving as practice leader for pharmacy benefit management sales, generating an additional $50M in annual revenue. He was also sales director for national and major accounts. Prior to joining Humana in 2001, Morse spent six years with United Healthcare, serving as the business owner for its consumer portal and operations director for health plan and systems migrations. Morse holds a Bachelor of Science in Management Systems from Rensselear Polytechnic Institute, America’s first technological research university.

About Enclara Pharmacia

Enclara Pharmacia is a national full-service PBM and mail order supplier of medications and clinical services developed specifically for the hospice and

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How to know if chest pains are serious

Chest pain can stem from many health issues. Some are quite serious, while others may be nothing to worry about.

Sometimes, chest pain indicates a blocked artery and a heart attack. This is an emergency situation, in which the heart is not receiving enough blood and oxygen to function correctly.

However, chest pain can also stem from a health issue affecting the lungs, stomach, or muscles, for example.

It is crucial to receive emergency care for chest pain, especially if it is sudden and severe and accompanied by shortness of breath, dizziness, or both.

Many heart conditions can cause chest pain, including:

Heart attack

A heart attack may be the best-known cause of chest pain, and the pain usually occurs in the center of the chest.

People experience this pain differently — some describe it as uncomfortable, sharp, sudden, and severe, while others report a squeezing sensation. In some people, the pain comes and goes.

It is worth noting that a heart attack does not always cause chest pain. A person may experience other symptoms, with or without chest pain, including:

  • cold sweats
  • lightheadedness
  • nausea
  • pain in other areas, such as the arms, back, jaw, or stomach
  • shortness of breath
  • dizziness
  • sweating

Also, males and females may experience heart attacks differently. Learn about the symptoms common in females here.

Anyone who believes that they may be having a heart attack should receive immediate medical attention.

Aortic dissection

This cause of chest pain is a life threatening condition in which a tear forms in the lining of the aorta, one of the body’s most important arteries.

If the tear is large enough or a doctor cannot treat it in time, it can cause fatal bleeding.

The symptoms are similar to those of a heart attack, and they may also include:

  • leg pain or paralysis
  • paralysis on one side of the body
  • difficulty speaking or seeing

Anyone who may be experiencing this should receive immediate medical care.

Pericarditis

Pericarditis occurs when the sac that surrounds the heart, called the pericardium, becomes inflamed.

This can cause chest pain, especially when a person takes a deep breath.

Aortic stenosis

The aortic valve allows oxygenated blood to flow out of the heart’s left ventricle and into the rest of the body.

Stenosis occurs when this valve becomes stiff, either from age or disease. When this happens, and the heart pumps out less blood, it can cause chest pain.

Hypertrophic cardiomyopathy

This condition causes the heart’s muscle to become overly thick, shrinking the heart’s chambers. As a result, the heart is able to hold less blood and cannot pump as effectively.

Hypertrophic cardiomyopathy can also prevent the heart from keeping a healthy electrical rhythm.

The lungs reside in the chest cavity, and the following health issues affecting the lungs can cause pain in the area:

COPD

Chronic obstructive pulmonary disease (COPD) is an umbrella term for emphysema and chronic bronchitis.

People with COPD often have pain in the upper middle chest, as well as lung inflammation,

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Infection Control Problems Persist in Nursing Homes During COVID


The new analysis draws on self-reported data from nursing homes collected by the federal government over four weeks from late August to late September. While some states fared much worse than others, all 50 states and the District of Columbia had one or more nursing homes that reported inadequate PPE supply, staff shortages, staff infections and resident cases. Forty-seven states reported at least one COVID-19 death among residents.

The analysis found that more than 28,000 residents tested positive for COVID-19 during the four-week reporting period, and more than 5,200 residents died, showing that the virus is still raging in nursing homes. More than 84,000 long-term care residents and staff have died since January, and more than 500,000 residents and staff have contracted the disease, according to the Kaiser Family Foundation’s tally, accounting for roughly 40 percent of the national death toll. Long-term care providers include assisted living, adult day care centers and more, while AARP’s new analysis features just nursing home data.

“This is a nationwide crisis, and no state is doing a good job,” says Bill Sweeney, AARP’s senior vice president of government affairs, adding that the results of AARP’s analysis are “profoundly disappointing.”

“While the pandemic has been unexpected to all of us, basic infection control should have been going on in nursing homes for a long time,” he says. “These are places where people are vulnerable to infection, whether it’s COVID or something else, so for these facilities to still not have basic PPE, even now, with a deadly virus in the air, is outrageous and unacceptable.”

Staff infections nearly match resident infections

For months, providing adequate PPE and developing plans to mitigate staffing shortages have been “core principles” set out by the Centers for Disease Control and Prevention (CDC), for COVID-19 infection control in nursing homes, which generally house older adults with underlying conditions who are at increased risk of infection and severe illness from the disease. PPE stops the transfer of infectious droplets through the air, while adequate staffing ratios mean better care and less person-to-person contact.

Yet in 18 states, more than 30 percent of all nursing homes reported PPE shortages, and in 26 states and the District of Columbia, more than 30 percent of nursing homes are experiencing staff shortages. N95 respirators were the most in-demand PPE item across the country, with 11 percent of all nursing homes reporting shortages. And nursing home aides (certified nursing assistants, nurse aides, medication aides and medication technicians) were the most in-demand staff, with 27 percent of all nursing homes reporting shortages.


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Anti-vaxxer theories about Fauci and me hurt public trust

Bill Gates worries about the implications of the baseless anti-vaxxer conspiracy theories targeting him and Dr. Anthony Fauci that have emerged during the coronavirus pandemic, telling CNBC they can erode confidence in public health strategies.

In an interview that aired Wednesday on “Squawk Box,” Gates said the false claims about him and Fauci, the nation’s top infectious disease expert, may have implications in getting the public to adopt measures such as vaccines and face coverings that can help slow transmission of the virus.

“The whole digital media space where people are dealing with the bad news, the pandemic, has spun up a lot of conspiracy theories,” the billionaire philanthropist and Microsoft co-founder said. “And the two people who are most targeted in those are Dr. Fauci and myself, in terms of, ‘Do we have some sort of maligned reason to think vaccines are important in general?'”

“That’s unfortunate, particularly if it undermines the mask wearing or if it undermines, as the vaccine gets approved, … [how] people not only protect themselves, but protect their loved ones, protect the community by participating in something that’s proven to be safe?” added Gates, whose charitable foundation has contributed millions of dollars to coronavirus vaccine and treatment research.

Gates’ interview ran one day after Facebook announced it was implementing a new global policy that bans any advertisements that seek to discourage people from receiving vaccinations. Previously, the social media giant’s policy restricted ads for vaccine hoaxes that had been singled out by health groups such as the Centers for Disease Control and Prevention.

Gates said he has not spoken to Fauci about the conspiracy theories because “neither he and I have know how to stop that.” But Gates said he and his staff at the Bill and Melinda Gates Foundation have regular conversations with the director of the National Institute of Allergy and Infectious Diseases about the development of therapies for Covid-19.

“[Fauci] and I talk about the antibody studies. The scientific team at the foundation gets on the phone with him on a regular basis because he’s seeing company innovations that we’re not, we’re seeing things that he’s not because we have a global view,” Gates said. “It’s a helpful collaboration, which we’ve always had.”

Gates also lamented the U.S. response to the coronavirus pandemic, particularly the lack of support lent to the scientific community. “Most governments take advantage of their scientists and listen to them. They don’t undermine them and attack them,” he told CNBC.

He wondered why some people in the U.S. are pushing back on masks so much. “We tell people to wear clothes. I don’t think of it as some ultra-important, freedom thing, that there’s another part of your body, at least for the duration of the pandemic, we’re asking you to cover up most of the time.”

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China carries out 4.2 million tests in Qingdao

BEIJING — China says it has carried out more than 4.2 million tests in the northern port city of Qingdao, with no new cases of coronavirus found among the almost 2 million sets of results received.

The city has reported a total of 12 cases, six with symptoms and six without, since the new outbreak was first spotted over the weekend at a hospital.

China on Wednesday reported 27 new cases of coronavirus, including 13 new cases of local transmission and 14 cases brought from outside the country. The local cases included seven that had been shifted to confirmed from asymptomatic. It wasn’t immediately clear whether any of those involved cases reported in Qingdao.

China has reported a total of 4,634 deaths among 85,611 confirmed cases of COVID-19.


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HERE’S WHAT YOU NEED TO KNOW ABOUT THE VIRUS OUTBREAK:

— WHO: Europe reported more than 700,000 coronavirus cases last week

— Dutch order bars, restaurants closed over coronavirus concerns

— India has 55,342 coronavirus cases, lowest single-day tally since mid-August

— Safety monitoring panel will try to determine what might have caused sickness in a second COVID-19 vaccine trial paused over unexplained illness

— New poll finds coronavirus pandemic has thrust many Americans into role of caring for an older or disabled loved one for first time.

— Cristiano Ronaldo latest high-profile soccer player infected with the coronavirus, Portuguese soccer federation says.

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— Follow AP’s pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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HERE’S WHAT ELSE IS HAPPENING:

BOISE, Idaho — Idaho health care experts say coronavirus is increasing as kids are returning to school — but most of the new infections aren’t happening in school buildings.

Instead, Dr. Joshua Kern with St. Luke’s hospitals in the Magic Valley says it’s likely because many people are treating the return to school like a return to normalcy and slacking off on good habits like social distancing, hand-washing and mask-wearing.

A tally from Johns Hopkins University shows Idaho currently ranks sixth in the country for new cases per capita, with a total of more than 48,660 confirmed cases of coronavirus statewide. So far more than 500 Idaho residents have died of COVID-19.

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DENVER — Colorado is experiencing another surge of coronavirus cases and hospitalizations, prompting Gov. Jared Polis to plead Tuesday with residents to wear masks, stay home as much as possible, and maintain social distancing practices.

As of Tuesday, Colorado’s three-day average positivity rate — the percentage of total tests coming in positive — was 5.4%, and the state recorded 1,000 new cases both on Saturday and on Monday, the highest daily numbers recorded during the pandemic, Polis said.

About 290 people were hospitalized for COVID-19 on Tuesday, the highest total since May 31, The Denver Post reported.

During a briefing on the pandemic, Polis didn’t suggest he was contemplating renewed mandatory restrictions on business or other activities to stem the surge. But he insisted: “If this continues, our hospital capacity will be in jeopardy.”

The World Health Organization recommends

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Healthineers launches rapid coronavirus antigen test, sees tight supply

By Ludwig Burger

FRANKFURT (Reuters) – Siemens Healthineers on Wednesday announced the launch of a rapid antigen test kit in Europe to detect coronavirus infections, but warned that the industry may struggle to meet a surge in demand.

The German group, whose rivals in diagnostics include Roche, Abbott and Becton Dickinson , said its test cassette did not require lab processing and would deliver results in 15 minutes, but that the required nasal swabs would have to be taken by healthcare professionals.

PCR (polymerase chain reaction) tests, which scan genetic code for the markers of a virus, are the gold standard for finding infections but are two to three times more expensive than antigen tests and require processing in a lab.

Antigen tests, which look for proteins found on the surface of the virus, cost about 4-5 euros ($5-$6) each, but miss a few percent of the infections that PCR tests would have caught.

Currently, slightly more than 1 million standard PCR tests are performed in Germany every week.

However, public health systems around the world are eager to provide quick diagnostic tools, and test more widely, to help locate hotspots of the pandemic.

Germany’s health ministry last week said it had secured 9 million antigen tests.

The regional state of Bavaria followed up this week with an order for 10 million antigen tests, saying it had options to purchase from Healthineers, Roche and Abbott. It did not give a timeframe for their use.

“The volumes that are being circulated globally are probably at the limits of what manufacturers can currently supply,” a Healthineers spokesman said.

“We are currently in talks with various governments over possible supply orders.”

The United States and Canada are also buying millions of tests, as is Italy, whose recent tender for 5 million tests attracted offers from 35 companies.

Healthineers is also planning to seek approval for a launch in the United States. ($1 = 0.8501 euros)

(Additional reporting by Caroline Copley; Editing by Riham Alkousaa and Editing by Kevin Liffey)

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Breast cancer survivor urges women to get regular screenings and mammograms, thanks local non-profit ‘The Rose’

The first time Ediana Quijada found a lump in her breast, she was laughed off and told “it was happening because of her period and nothing to worry about.”

It was far from nothing. After a six-year battle with metastatic breast cancer, the cheerful Houston native is happy to share her story with other young women, advising regular breast exams, early detection having made a key difference in many cases.

In the fall of 2012, 29-year-old Ediana was finishing her construction management internship at the University of Houston.

The internship did not offer health insurance but UH hosts free mammography screenings in October in honor of Breast Cancer Awareness month. However, when she told the nurses about her lump, they assured her, with a cursory glance, that she was too young to worry about cancer. She was sent away without a mammogram.

Reassured and a little abashed about being paranoid, she busied herself with assignments as the stresses of the semester took over. The second of four siblings (two sisters, one little brother), Ediana said she had no reason to suspect the worst because there was no history of cancer in her family.

But the lump wouldn’t stay quiet.


“I started feeling that the little lump was getting bigger and bigger,” Ediana said. “I could measure it; it was an inch now. Or is it in my head? Then I would calculate, my period must be coming, that’s why the lump’s getting big … and my breast is turning pink.”

A visit with her mother’s doctor in December confirmed the devastating news — a large mass in her breast. Could be a tumor. Clearly, the cancer had made good use of the two-month delay.

“I didn’t have insurance, so my mother took me to a walk-in clinic,” Eidana said. “The doctor said, ‘oh my God, why didn’t you come before?’”

A few hours and one $100-ultrasound later, she was advised to do a biopsy.

“The biopsy cost over $2,000, I thought ‘I can’t do that right now,’ and he (the doctor) referred me to The Rose,” Ediana said.

That first encounter with The Rose marked the beginning of Ediana’s long, painful but ultimately successful battle with breast cancer. A Houston-based nonprofit group, The Rose provides breast cancer screenings and treatment regardless of patients’ ability to pay. They began Ediana’s treatment by conducting another ultrasound, this one costing only $10.

A little monster inside your breast.

Ediana was paired with a patient navigator who helped her through the system and set up her appointments.

“It turns out I was Stage 3, Type C, which is borderline Stage 4,” said Ediana. “Very aggressive and very bad. They said, ‘it looks like you have a little monster inside’.”

Given the tumor’s massive size, treatment had to begin immediately. When three painful rounds of chemo (each lasting around eight months), one round of radiation and one surgery failed to eliminate the cancer, her doctors put Ediana on an–at the time–experimental drug called T-DM1.

“This

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