Health care and the Pandemic covid-19

It is so hard to be in the sidelines, now.  Watching what is happening, since the administration refuses to take the scientists seriously, and has gutted both the NIH and the CDC of the people who would normally be best at responding to the new virus which is both very infectious, and due to cause a lot of deaths from pneumonia, is painful.

We don’t have the testing capability, as there are not enough testing tools set up, and the factory which makes the test has to be ramped up to produce millions of kits for the test.

Doctors are worried, because if sick people come to the office, which is not set up for quarantine and for helping protect others from exposure, the staff and other patients may be exposed.  It seems that South Korea did the right thing by setting up 73 independent testing sites, with full protective gear, and allowing people to get tested without putting others at risk.

The self-quarantine or “distancing” being recommended is the only tool we have to blunt the disease onslaught, which has an exponential growth curve.  In one town there were 3 cases 1 week, 300 the next, and a thousand the following week.  This will rapidly overcome our hospitals’ ability to respond and take care of patients.   The need for oxygen will be easier to meet than the need for a respirator.  These machines are big and expensive and most hospitals don’t have many just sitting around not being used already.  The hospitals are mostly working at full capacity or above 95%, which means there are no extra beds or extra respirators, or the staff to take care of the patients.  In Wuhan, they built 2 hospitals in 2 weeks, but they did not have staff sufficient to man the hospitals.  In Washington state, the head of Public Health asked for 230,000 respirators.  Apparently finally yesterday they got about half of them.  I am amazed they got them!  We heard from doctors in Italy that they are trying to apply the ethic of “prioritization” which is to try to give the best treatment to the ones who are most likely to make it, which means they are not treating anyone over 60 or with an underlying condition with full resources.  They are on the edge of collapse of their medical system, and a beloved family doctor in Lombardy already died of the disease, as he came out of retirement to help with the disaster.

Many friends in many places say that the big stores are out of toilet paper, and zinc lozenges, alcohol and hand sanitizers.  Most of my friends over 60 are prudently canceling all the events they were intending to do for the next 2 months.  I feel sorry for all the loss to the air travel industry, the restaurants, and local small businesses,  who depend on people shopping.  I looked up the travel insurance, and they don’t accept a pandemic or epidemic as a reason for cancelling a trip and getting a refund.

I am also upset when doctors much more brilliant than I, who are on the front lines, say that they cannot get the tests they need.  The best thing that happened as the data began accruing this week, is that Katie Porter, a great Congresswoman, was able to question and make the head of the CDC agree to allow the testing for free.  Since the testing usually involves testing for influenza A and B, as well as a complete blood count (CBC) and metabolic panel (to be sure liver and kidneys are ok, and that the blood sugar and electrolytes are ok) adds up to over $1000 dollars.  Most people can not afford that test.  And we need people to be able to access the testing.  Most labs are apparently still ramping up the access to large numbers of tests coming in.

If someone is over 70, their risk is 8%, and if over 80 the risk is 16-20%.  If they are hospitalized, the risk is 20-30%.    We all need to stay home.  We all need to hunker down, but also talk to each other, trying to speak on the phone to elderly people who are feeling lonely and isolated.  IF you have teens who are healthy, ask them to offer to babysit for doctors or nurses with small children, who need to be at the hospital.  This is a hard time for the whole world.  All humans are at risk.

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