Nel's New Day

April 5, 2020

Solutions for the Current Health Crisis

Filed under: Health Care — trp2011 @ 10:48 PM
Tags: , , ,

During the past few weeks, the number of confirmed COVID-19 cases and deaths in the United States has become the highest in the world. On the federal task force, the finest minds that Dictator Donald Trump (DDT) could find have worked incessantly to come up with these solutions and spent hours each day at press briefings announcing them: washing hands, keeping away from people except in churches and other gatherings, and putting scarves across our faces. DDT’s son-in-law, Jared Kushner, is changing the website guidelines for federal stockpiles of vital medical supplies and equipment to ensure that they won’t be sent to states and will instead be sent to other countries, presumably for high prices.

Meanwhile Republicans have ideas to solve the crisis:

  • Arizona’s governor declared golf courses “essential.”
  • Delaware is starting trout fishing early to cut down on crowds.
  • Florida and Georgia governors are reopening beaches.
  • Idaho is pushing through a long-delayed livestock grazing allotment, perhaps to encourage social distancing among cattle.
  • Kansas is closing a women’s clinic to keep from sickening residents and staff at an unrelated nursing home. Iowa and Texas also want to block abortions to stop COVID-19.
  • Mississippi declared businesses such as department stores, real estate offices, and gun shops “essential” and allows gatherings of over ten people at offices and airports.
  • Missouri’s governor relaxed regulations for purchasing guns.
  • Tennessee governor closed down only one county because viruses probably won’t move to other ones.

Individual states cut back on confirmed cases and deaths by mandating shelter-in-place policies, for example in huge California areas on March 16. Ten days after California Bay Area health officer Sara Cody convinced seven northern coastal counties in the state to order people to stay in their homes, the fewer deaths in California than New York showed her wisdom and intelligence. On April 2, the Bay Area had 68 deaths with 215 across the state; New York had 2,375. New York has almost ten times the number of confirmed COVID-19 cases as California, a state with almost five times the population as New York. [visual san Francisco]

When Germany heard about the respiratory disease in China, the country immediately developed a test by mid-January that was later adopted by the World Health Organization (WHO). The test was in common use weeks later when DDT claimed that the number of cases in the U.S. would go to zero in a few days. Mass testing in Germany meant empty ICUs: neighboring France has over five times the mortality rate of Germany. With far fewer tests, Spain and Italy suffer more intense outbreaks because they miss mild and asymptomatic cases. Preparation in Germany also helps; the country has four times the number of ICU beds as Italy.

The United States has completed fewer than two million tests in a country of 330 million because the federal government hasn’t been able to make tests and the task force daily tells people not to get tested even if they are sick. The difference between the two countries is one test per 82 people in Germany and one person per 165 people in the United States. The CDC has reports from only 660,000 people at this time.

Bill Gates, smart enough to become richest man in the world, has ideas to catch up with the health crisis:

A consistent nationwide approach to shutting down instead of just voluntary response. DDT’s one expert, Dr. Anthony Fauci, has advocated this policy for weeks because he knows that viruses cross state lines without permission.

Federal stepping up on testing and establishment of priorities. All healthcare workers and first responders should have the test, followed by seriously symptomatic people.

Provision of masks and ventilators without states having to pay exorbitant prices.

A data-based approach to developing treatments and a vaccine. DDT could stop pushing rumors, panic buying, and non-proven cures. His push to take hydroxychloroquine with no evidence might mean he invested in the product.

A safe and effective vaccine. During President Obama’s first term, a vaccine for swine flu was developed within six months and 100 million doses distributed in eight months. COVID-19 will require billions of doses because diseases don’t respect country borders. Facilities for vaccine equipment needs to be built now, and private companies can’t take the risk that some of it won’t be used.

How to get more personal protective equipment, PPE, to the states from the federal government (Rep. Elissa Slotkin, D-MI):

Name one federal emergency medical supply czar with the authority to coordinate a plan of action.

Centralize FEMA procurement of medical supplies to eliminate bidding among states for supplies.

Consistently use the Defense Production Act to organize retooling manufacturers. A coordinator could tell them requirements for specific types of quantities of supplies, place bulk orders in advance with guarantees, and stop attacks on companies that are retooling.

Establish a coordinated approach to transportation and logistics to carry out a strategic plan for supplies. Idle commercial aircraft and, if necessary, the military fleet could expedite deliveries when they are needed.

Complete a comprehensive review of all Food and Drug Administration restrictions on what gear health-care professionals can use and, whenever safely possible, try to ease them. For example, gloves, masks and other protective gear used in other industries and in other nations could help keep our health-care providers safe, but some equipment doesn’t meet existing federal restrictions.

More ideas:

Borrow from the New Deal: Create a Covid-19 Recovery Corps (Steven Joffe, pediatric oncologist/ Ezekiel J. Emanuel, professor): Use COVID-19 survivors for tasks that non-immune people cannot perform such as non-medical activities in medical facilities and nursing homes and teaching.

End voter registration (Ellen Kurz, iVote): Because the virus has stopped people from registering voters, make sure that every eligible citizen can get a ballot and cast is safely. The government has records, such as Social Security numbers, that can serve as voter rolls.

Lift restrictions on blood donations from gay men (Kevin Ballen, sociology student at Harvard/Reese Caldwell, molecular and cellular biology student at Harvard): Gay men were barred from donating blood during the AIDS epidemic in the 1980s. They still cannot donate blood if they have had any sexual contact within the past three months even if they test negative for HIV, practice safe sex, and are in a monogamous relationship. The FDA relaxed the previous one-year limit.) Heterosexual people, even those engaging in risky sexual activity, have no restrictions on blood donations but comprise one-third of the people with HIV.

Let foreign-trained physicians join the fight (Leslie Omoruyi, foreign-trained physician): An estimated 65,000 physicians in the U.S., many with extensive training and experience, cannot be licensed to practice because they haven’t done their residency. The system could figure out how to best use these doctors.

Lift tariffs on Chinese medical equipment (Susan Shirk/Yanzhong Huang): These medical products subject to DDT’s import tariffs include face masks, gloves, protective goggles. and thermometers,

House mild cases in hotels (Jeremy Samuel Faust, emergency physician/Cass Sunstein, Harvard professor): This is the answer for mild cases that need to be isolated.

Suggestions for the next COVID-19 rescue bill:

Extended unemployment benefits. The most recent law gives additional unemployment benefts for four months, but this time limit doesn’t cover real-world conditions. A new act could tie benefits to a specific unemployment rate.

Support for hospitals and “frontline” workers. Funding in the last act for hospitals and health clinics won’t be enough. And people working under the danger of contracting COVID-19 from healthcare works to grocery store checkers deserve “hazard pay.”

More help for small businesses. Assistance for small businesses in the last act is inadequate, especially when much of may go to big companies. The truly small businesses need help not only to keep people on payrolls but also to pay rent and utilities so that they don’t fold.

Tighter requirements for big businesses. The lack of requirements for big businesses to help workers could be fixed in the next act.

Health coverage. People who lose their jobs must pay for the full cost of health insurance, often prohibitive. The government needs to subsidize coverage for these unemployed people and/or expand Medicaid to cover more people quickly.

Further rounds of direct payments. The one-time payments of $1,200 for adults and $500 for children in the CARES Act won’t even cover a month for many people, and the restrictions on the last law keeps many people from receiving the money.  

Aid to states. Most states must annually balance their budgets, perhaps impossible with the crushing debt from the virus fallout.

Infrastructure. A large bill to boost our sorely deficient transportation, water and sewer, broadband, and other systems would not only create jobs but also give long-term benefits.

Election administration. Republicans shaved off most of the vital funding for this year’s elections.

Meanwhile, the federal is ordering supplies for states—100,000 body bags and 85 refrigerated trucks for the civilian dead. Prisoners hired to dig mass graves are given PPE, unlike many healthcare workers. 

Today is Palm Sunday. I say to all those who went to church today: stay away from me.

On April 5, the U.S. has 336,830 confirmed cases and 9,618 deaths—an increase of over 1,000 today. The world has 1,274,265 confirmed cases and 69,471 deaths.

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