
US Betrays Healthcare Workers in Coronavirus Disaster - Reedx
https://www.medscape.com/viewarticle/927811
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swampthing
Not only are doctors and nurses getting muzzled and fired for commenting on
inadequate supplies, but many hospitals and clinics are refusing to allow
their doctors and nurses to bring their own masks. Doctors and nurses are
fighting hospital administration on this.

I understand why you wouldn’t want that happening in normal times, but to hold
firm on that policy now seems like utter madness.

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ur-whale
> I understand why you wouldn’t want that happening in normal times

Why?

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swampthing
You can imagine a doctor or nurse bringing in sub-standard equipment that then
causes an issue for a patient.

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xbmcuser
Yes but they are not being provided with adequate equipment the choices for
doctors and nurses is quit treating patients or take a chance get infected and
die or bring their own equipment to protect themselves.

~~~
swampthing
Which is why I said “normal times”.

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threatofrain
> Dr. Kooi Seng Chng: 8 months ago, the US was rated the most ready to face an
> pandemic. China was rated 51. Look at what has happened over the past 3
> months. US has become the new epicentre for covid19. How did that happen. It
> has all to do with mindset. Shockingly Americans don't believe in wearing
> masks..."

~~~
harry8
To be fair to the us, the who is telling them not to wear masks. They should
knowno better, sure. It's not like they slavishly follow the who.

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notauser
The U.S. did not use COVID-19 diagnostic tests produced by the WHO in favor of
producing its own.

So it could have deviated on mask guidance, too.

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harry8
yeah "It's not like they slavishly follow the who" is what I said too.
Probably should not have deviated there too, should have done it for masks. 0
for 2. How many lives will that cost?

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caconym_
My wife is a nurse in a hospital in one of the COVID epicenters, though she
does not work with patients that have _tested positive,_ and she is not
getting adequate protection. The PPE policies she's subject to have already
resulted in some of her colleagues being infected, but nothing has changed.
She is not _allowed_ to wear a mask for most of her patient interactions.

I don't know what to do.

~~~
tomp
What’s the worst that can happen? She gets fired? Doesn’t the hospital need
her more than she needs the hospital right now?

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harry8
Will his hospital get the equipment as it becomes available, one day, or is
this criticism going to obstruct that?

What is the crime being committed? If none, what should it be according to new
law given the body count that's really only just started.

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Melting_Harps
Sidenote: The opening paragraph is why, especially having done my undergrad
with mainly Pre-Med students, I will never understand why most would willingly
go into Medicine. It has to be a calling given all the misery and sorrow
you're exposed to on a daily basis; because in my experience most Physicians
are often very reluctant to encourage their children to go into that field.

I'm just thankful they exist at this point, given how this has all unfolded.

~~~
threatofrain
It's one of the best class mobility pathways.

~~~
Melting_Harps
> It's one of the best class mobility pathways.

Is it in the US? Spending 10+ years in school, all while drowning in 200k+
debt before you enter your practice is hardly what I'd call assured upward
mobility. And then you still have to work those crazy 60+ hour weeks in the
hopes that after your debt is paid off you can start to live as an established
MD well into your middle age.

Honestly, with all of that in mind being a dentist makes sense, being a
physician does not. But then neither is being a founder at a startup, and
we're all drawn to that for various reasons, too.

~~~
ComputerGuru
Doctors don’t have a hard time paying off those loans. It’s the liberal arts
students (for one) with loans ten times smaller but incomes a hundred times
less that can’t.

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salawat
I actually have a proposal to help with the issue of doctors getting taken out
of action by infection.

We need to train corpsman. Now. Specifically in the essential skills is to
handle the average duties involved with COVID-19 hospitalization and care.
Make sure they have enough skill to generally handle things, and if possible,
prefer training/drafting in those who have already developed immunity.

I understand it isn't a trivial feat by a long shot; but right now medical
expertise is to specialized in the sense that "general care" is beyond the
reach of even a modestly trained individual; making the loss of one fully
trained and licensed medical practitioner being lost devastating.

I'd propose the following:

A) Expedited training programs for conducting hospital intake, data entry,
basic vitals taking, basic equipment checking/operations, and familiarity with
COVID specific complications, and an escalation process.

B) Medical apprenticeship programs minus the 8 years of pre-schooling. We can
get back to that once things have settled down enough. Hours spent count
toward eventual medical training/licensure...somehow...

C) Same apprenticeship system should exist for ventilator operators

D) Expedited training in I industrial manufacturing aimed toward a medical
device manufacturing specialization.

E) Insurance companies get to pound sand. Someone has to pay for it all sadly,
if we're staying true to form; not necessarily saying we should.

F) Doctors/nurses/LPN's get assigned a squad of these gophers to manage
patients, only popping in to handle abnormalities/specific complications.

G) Practicing doctor's are highly encouraged to train and guide anyone willing
to at least provide some help.

Short of something like that, and I think we may start to see a pinch where as
things peak, medical professionals start dropping like flies or burning
through donated antibody laden serum transplants to cope with the absurd viral
loads they're being forced to endure by necessity.

If we can figure out a way to dilute that by spreading out repeated exposure
between different people (again, preferably those who have recovered), I think
the system will stand a much better chance of coping. Furthermore, it
decentralizes the very basics of medical care, builds/reinforces community
bonds, gives everyone a potential way to help out once they've recovered, and
will likely increase the quality of medical care for everyone by decreasing
the severity of overwork our artificially constrained supply of fully trained
medical personnel causes.

Short of doing something like that, I don't see any way to avoid losing a hell
of a lot of skilled, hard-working, and invaluable people during this time of
crisis. Hell, if I knew I'd already had the stuff and developed immunity, I'd
volunteer. Throw in some modest compensation, and I bet you'd get even more.
Or better yet, enstate a program of cost of care deferral by putting in hours
after recovery. It's not the most easy thing to get off the ground, but it's
better than nothing.

~~~
rubatuga
I'm currently going through medical school right now, and I don't particularly
see anything too radical with your proposal. It's true that in this situation
where we need more healthcare professionals, the prerequisite training is
extremely unrealistic and creates a huge bottleneck in terms of meeting
demand.

What is required is a new class of regulation to surround those (temporary?)
healthcare workers, providing licensure during public health emergencies. The
difficult situation is that this means a lowering of the standard of care
given, which I believe many doctors may not support, although desperate
patients most certainly will. Due to the protective nature of the multiple
boards/colleges of physicians, it may be better to create an independent
organization for certification. However, would we be willing to subsequently
dismantle these organizations?

~~~
salawat
>The difficult situation is that this means a lowering of the standard of care
given, which I believe many doctors may not support, although desperate
patients most certainly will.

Aren't we really already lowering the standard of care given in the case of
being overly reliant on chronically overwhelmed physicians?

And I don't think there would actually be any appreciable drop in standards of
care, as the entire process would revolve around basically focusing the
lightly trained on a hyper-specific subset of statistically relevant medical
issues with the assumption of "escalate if something we didn't train you on
happens."

You're still getting care from fully licensed professionals. Eventually. They
just have more hands to be where they can't.

>Due to the protective nature of the multiple boards/colleges of physicians,
it may be better to create an independent organization for certification.
However, would we be willing to subsequently dismantle these organizations?

Good question. I'd air on the side of not dismantling the program if for no
other reason than it seems to me we're already having trouble getting medical
practitioners out of schools and into the field doing good with our current
system. (Limited rotation slots for entrants per year, the securitization of
the debts of hopefuls being made worse by getting unlucky with being delayed
multiple-cycles from entry into the industry). The primary concern I have is
that I think that the college/board systems may be too fragile to the point
they represent more of an economic gatekeeper (by artificially constraining
supply) rather than a balloon holding up the standard of care. Then again, I
have no numbers whatsoever with regards to how many "bad practitioners" are
weeded out of the system by virtue of licensing authorities with which to back
that up; merely a vague personal hunch probably fuelled by a dislike for
needlessly rigorous licensure systems. Plus I have no idea the social/career
advancement issues such an organization would create. Would long enough
service in this context translate to full licensure after a time? How long
should that take? Does it make sense to maybe integrate the two disparate
systems as one at some point and maybe formulate a way where highly
restrictive entry-level licensure has a proof of experience based and
continuing education process by which further advancement toward unsupervised,
independent practice is slowly developed toward? What would that look like? Is
it feasible? Is it worse than we have now?

I don't know. I do know that in our current predicament though, we may be
literally killing off our societal immune system through overwork; and the
only way to overcome that, is through more hands.

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titzer
Regardless of your political stripes, this is a failure of preparedness and
leadership at so many levels. America deserves better. But deserve has got
nothing to do with it. We have to work towards being better at this. No amount
of throwing money or thoughts and prayers will fix it. Voting, maybe. But
holding leadership to account is part of the function of democracy.

The failures here are disgraceful.

When the dust settles, let's please remove the leaders who suck at this.

~~~
93po
Americans are getting what they voted for. Politicians that run on identity
politics and obscure meaningful issues with whatever popular social issue
people stick to as single issue voters. American voting patterns are not going
to change until the current younger generation becomes the majority.

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watertom
Why should healthcare workers be treated differently than any other
employee/cog?

The GOP want to run everything as a business, this went down exactly like a
business does things. Public safety is not the problem of The healthcare
industry.

