Ageism discrimination, Diabetes & COVID-19

Has anyone with diabetes and Covid-19 experienced Ageism discrimination during your treatment?

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What do you mean?

Do you mean like in Italy where they are putting priority on getting “younger” people because they don’t have the resources to treat them all?

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Rudy, we are unlikely to see heavy duty ‘triage’ start for another week or two. Triage occurs in every emergency room, every day. It is a process of sorting patients according to the priority they need to provide/recieve treatment.

Triage is also used during mass casualty situations. Mass casualty situations are defined as any time medical responders don’t have enough resources to treat patients. Mass casualty incidents might be defined, for example, if you have a rural car accident with 4 patients and only 2 medics. That is a situation where you might have too many people seriously injured and not enough medics to respond appropriately.

You might imagine what is happening now as a really slowly evolving, global mass casualty situation. If you have any basic questions about how this works, feel free to ask.

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Ageism Definition: Unfair treatment of people who are becoming old or who are old:

Kind-a like the nazi did in WWII?

Kind-a like the nazi did in WWII?

Well, it was definitely developed to deal with war time casualties.
In general, it is meant to preserve the largest number of human lives, but there are a lot of different perspectives on how it might be implemented during this time. It is likley to vary between different locations.

People who appear at the hospital first, are most likely to get the most access to care. As things move along, that access will be less and less. Serious cases are likely to die. Children will likely get priority because, in general, healthcare workers get super traumatized by the death of children. It might be reasonable to expect all ventilators go to children and teenagers. Anybody older than that may not get those resources.

Think of it like a sinking ship. There are long established societal conventions that prioritize women and children. Those conventions go way back to maritime law and wartime practices. Although, women aren’t in that priority category anymore. Its gonna be kids.

I can tell you, from experience, though, that healthcare workers will prioritize their own. They recognize that 1 healthcare provider can save multiple lives. So, they use those types of calculations. Also, Its harder to watch someone you know and work with die. Instinct and empathy will exercise their influence. Its only natural.

I’m sure you all are sick of this song, but since I mentioned a shipwreck, I gotta do it.

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A very good response.

From the articles I read, Italy has already been having to make choices. Bottom line, there are just not enough supplies to go around (there) so physicians are having to choose. It may get to that point here, particularly in high impact areas like New York.

I agree with mohe0001, the people that appear at the hospital first are most likely going to get the most access to care. But, as more and more people come in, and supplies aren’t available, the providers will have to go into a triage mode and they are going to treat the person most likely to survive.

My heart breaks for these doctors. The emotional toll treating this virus, particularly in the high impact areas, is going to be extreme.

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Good article about age related decision making for US hospitals. Says among other things that WA plans to use age as a factor, NY does not. Also says that age discrimination is clearly illegal per federal law. Unfortunately I think Italy has cleared the way for age to be a major factor in triage decisions.

Wow…they were pretty blunt.

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The death case in Italy is growing day by day, know it has reached 7503 death. They are discriminating the patients which not good but they are trying to save the people who can really survive & fight from virus.

Very blunt article. And also very sad. But I understand that if they have 10 ventilators and 20 people that need them and 10 of those people are under 20 that they will get them first. But it obviously doesn’t make me happy as I’m 63.

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This is so incredibly troubling for me that I thought long and hard about how to mitigate against it happening. On a related note, I surely strongly and passionately hope that if in the future they’re gonna trot out these mortality comparisons between young and old, that when they’re calculating the old deaths they include whether or not they were denied respirators in favor of a younger person. In other words, do NOT dare to compare treated young Covid pts with untreated old Covid patients. Please.

My solution to help mitigate against this. Get all Covid pts out of the hospitals now and into already set up separate facilities. Not a separate floor or suite. A different building with dedicated equipment and staff. A Covid Corp. Expecting ER docs and nurses to go from MIs to hemorrhage to organ failure to Covid is just unrealistic on an ongoing basis. As is rationing care away from older people.

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@The_Senator_From_Glu You’re right about that. In Italy they are supposedly refusing to aid or even accept people for care over a certain age in certain areas that are vastly overwhelmed. So that means more older people will die. That then adds to the “fact” that more older people die, skewing it even more that if you are old you are more likely to die.

They are splitting the ventilators in NY. Its good thinking. 1 vent = 2 people. It will buy them time. Nobody wants to triage. Nobody likes it. It is very, very hard on moral.

They also have a lack of blood, so don’t get into a motorcycle accident right now. If you can, donate to Red Cross. Everybody shoudl try not to get hurt. I had to think about that before climbing up a tree to fix something yesterday.

There are things we have control over and things that we dont. Blood is something we DO control.

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That’s a very tricky procedure, because you can only do this if you have two patients with very similar requirements.

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In longer articles on the ventilator sharing, they do mention that the requirement sneed to be very similar. That said, the FDA just approved a system for sharing a ventilator among 4 people:

It’s disheartening that the US health care system is so unprepared, and that the government is so incompetent, but I admire the ingenuity and commitment I see from the medical world, as well as its related scientists and administrators…

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I’ve been saying this for weeks. Separate facilities would also cut down somewhat on their isolation issues too. They could also than further separate by severity. Having the more inexperienced doctors working with the less severe cases and the more experienced doctors working with the more severe cases. NYU is offering early graduation for the doctors that are supposed to graduate in a month. What they need to do is do that with all the 4th year med students and team them up with retired physicians. The retired physicians are most likely very vulnerable. You could have the young people be the hands, eyes, etc and the connect them with video chat (or something like that) so the retired physicians could be the experience.

Separate facilities could also cut down on the need to “isolate” one patient from another. I don’t see where you would have to isolate one Covid pt from another. You could put more people to a room. The “less” serious cases you could set up like a field hospital, saving hospital beds for older or more ill patients.

Where I live the “adult” hospitals that had pediatric services have shut those down and transferred all pediatric to the pediatric hospitals to open up areas for Covid. (I think we have 3 pediatric hospitals in the state). The peds hospitals have said the will take anyone 21 and younger (Covid and non-Covid) to help take the pressure off of the other hospitals.

@JamesIgoe I don’t believe there is anyway a government or health care system could have been prepared to handle this, not one country was, not one health system is.

But for the massive need to happen so suddenly, how could you even prepare? Have massive amount of money in hospital wings that sit empty? Government and health systems that buy protective equipment that just sits for years and then has to be replaced because of new advances that work better or the old ones started to deteriorate?

Sure we want it handled as best as possible, but for 20, 40 years plus people have been saying this could happen but no one actually expected it. If we really did we all would have had a ventilator at home for use when, not if, it was going to be needed.

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I would avoid absolutes, as there were countries that were prepared for just this issue since they had experienced SARS and/or responded rapidly and smartly.

The relevant quote from a prior post, linked below that:

Even before the virus began spreading in Singapore, the prime minister, Lee Hsien Loong reminded the public about the 2003 SARS outbreak and said he planned to overreact to the coronavirus. “We have built up our institutions, our plans, our facilities, our stockpiles, our people, our training,” he said on Jan. 31. “Because we knew that one day something like that would happen again.”

My post, referencing that quote and mentioning some other notable predictions:

Even then, some countries were not only prepared, but they also responded very well, in particular, South Korea, without draconian measures:

The idea that it couldn’t have been avoided is just plainly false. I see it as primarily a failure of government and our policies regarding health care.

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