Ageism discrimination, Diabetes & COVID-19

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.

1 Like

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

1 Like

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…

2 Likes

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.

1 Like

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.

6 Likes

At 59, I don’t feel discriminated against, but I would be considered old by a 25-year old. Most young people her ein NYC seem aware of the risks to which they they expose others although they don’t wear masks, and older people seem to be a bit more careful, walking around in masks and keeping a large physical distance. If anything, it seems more like class divide, with service people - I live in a large doorman building with staff and many seniors have assistants - of any age being somewhat cavalier or seemingly unaware.

That said, there are supposedly recriminations in both directions, although I personally haven’t seen it…

1 Like

Singapore and South Korea responded much better , part of that is because they already had a problem with SARS before. Experience helped a lot in that.

But Korea has 51 million people and they have over 9300 cases. Maybe they will stay economically better off, but their culture would be much better at dealing and obeying directives to help.

Singapore has been much better, but in Singapore you get fined for leaving a toilet unflushed, 7 years in jail for theft and they still cane people as punishment. So they have a much stronger “hold” over their populace. That would not go over well here. When they say stay indoors, I think everyone mostly stays indoors in Singapore.

In the west they do not have the controls over a populace to obey requests to stay inside even. Take New York city especially as a huge example. People were still milling around places when they were told to stay indoors. And then you have subways packed with people because that is the only way New Yorkers are used to getting to the grocery, to even the essential jobs etc.

I don’t see any western country having enough control to do the same things. Nor would any of us want those restrictions as our normal way of life. Plus as I said before to stock up enough supplies for this and to constantly switch out those supplies would have been a huge cost that would have had to be budgeted for. And paid for by taxpayers.

What do you think your hospital costs would have been for every hospital to have 10 times, 20 times, 50 times 100 times of extra stock all the time. On something maybe if it was even going to happen. Your hospital bills would even be a lot more expensive than they already are.

1 Like

It is not a matter of absolutes, black and white, none versus everyone, but even within the European countries some governments were, or are, grossly incompetent. Boris Johnson is now infected, as is his health secretary.

It is not just a matter of control, but public health, messaging, and resources. Our own government is a case in point, denying it was a problem, incompetently creating their own test, not creating enough tests, not moving fast enough, not developing clear messaging, and not listening to the science.

5 Likes

@Marie20 - Not ignoring your comment about costs, but that kind of discussion can go down a rabbit hole, of the system we have now, the most expensive but middling competent medical care - this is not about individuals but systems - of largely privatized care that is run disproportionately for profit. There are many ways to have better health care for less per person, with everyone covered, than our current system.

5 Likes

I think messaging is incredibly important. This is where I feel our government has done an excellent job. The federal and provincial governments all seem to be closely communicating and are putting out very consistent messaging across the board and across all areas of government. Our prime minister went into self-isolation quite early on when his wife was diagnosed with COVID-19, which I think set a really good example. And, even though there are some people who will always choose to ignore new regulations (which has resulted in the need to resort to implementing fines), most people seems to be taking the situation very seriously. Today, our provincial government said that the data looks like we may be starting to flatten the (provincial) curve; transmission rates have been cut by 50% and our provincial healthcare system will be able to manage all the new cases if that trend continues or intensifies. But it’s still very tenuous and could get worse tomorrow. Extra resources were ordered weeks ago just in case. We’re being told these measures will be in place for the foreseeable future.

2 Likes

I agree with that statement but would we have been more prepared with a socialized care system. Socialized system only invite bureaucracies and it appears that bureaucracies are what has failed us now. Everyone was under the impression that these bureaucracies were going to take actions to save us all. It appears now that they are long on talk and short on actions.

This is a signature of our government, it doesn’t keep you healthy, it just makes rules that others must follow to keep you healthy. These bureaucracies have failed in their duties to make the necessary rules, in some cases even making rules that harm instead of helping.

As pointed out or health care system is mostly a for profit system, it was not profitable to have stockpiled onsite the necessary PPE to manage an infection such as Covid-19 at least enough to get through till the supply chain could be ramped up. The CDC, HHS and a host of other three and four letter agencies have been warning us of this possibility for years. You would think someone at one of these agencies would have thought it wise to mandate such stockpiles. The same can be said for ventilators.

Much has been said about how slow the US has been establishing testing, you can lay blame for this at the feet of bureaucracies. Before a national health emergency was declared any testing lab was allowed to develop and use a test, they just had to insure a certain degree of accuracy. After an emergency was declared there was an existing rule requiring that all testing must be first approved by the CDC. After this went into effect all testing labs decided to wait for the CDC to develop the approved test even though some were ahead of the CDC in development. To add insult to injury the CDC blew it with its first test, it was found to be inaccurate. We would not have the testing we have today if the prior approval rule were not finally lifted.

3 Likes

Here in Europe the level of preparedness does not seem to correlate with the type of health care system.

2 Likes

All administrations are not evil, nor are all bureaucracies, even if we use a dictionary definition:

a system of government in which most of the important decisions are made by state officials rather than by elected representatives.

Bureaucracies are in many ways more efficient than administration by elected officials. The Fed is a case in point. Much government work is done by career administrators, and provided their aim is civil service, not self-enrichment - I mean more than success in one’s career - government organizations are very effective unless they become captured, i.e., controlled by the same industries they regulate or subverted by political pressures.

As to the incompetence of our current government bureaus - you mentioned the CDC - that is a political issue, not inherently a problem of bureaucracies per se, and in fact, much of those types of problems can be explained by capture by corporations - the fox rules the henhouse - political hires with little expertise in their field nor expertise in government, and meddling by elected officials.

3 Likes

As a counter to the can’t trust the government meme, this article mentions the high level of trust in the government. Although perceived as ‘socialist’ they’re more capitalistic in many ways than other countries, including the US, with a high level of individualism, innovation, and wealth creation, but where Scandinavian cultures differs has more to do with them culturally choosing the quality of life and equality over success and work. Also, I can’t say this is a smart strategy, since only time will tell, but if successful, it might have less to do with government than with facets of Swedish culture.

In explaining Sweden’s current methods, experts point to other underlying factors: The country has high levels of trust, according to the historian Lars Tragardh, and a strict law in the Constitution prohibits the government from meddling in the affairs of the administrative authorities, such as the public health agency.

“Therefore, you don’t need to micromanage or control behavior at a detailed level through prohibitions or threat of sanctions or fines or imprisonment,” Mr. Tragardh said in a phone interview. “That is how Sweden stands apart, even from Denmark and Norway.”

Along the lines of discrimination going both ways, I was surprised by some comments from 20-somethings during a new hire orientation I was involved in at the end of 2018. For our 2-day introduction, we were divided in teams of 8, a mix of people, and we would listen to policy as well as engage in some team activities designed to educate us on corporate culture, like diversity and decision-making.

I was the oldest member at the table, a 58-year old software engineer. The other members ranged in age, but most were under 30, recent college graduates, medical school hopefuls, and early career medical professionals. As is common, I wound up leading most activities, either by contribution or by coordination.

At the end of the 2 days we were expected to say some nice things about each other, and I received compliments for my wisdom and leadership, which was very generous. As we were talking, I was surprised to hear how often these young people were criticized by older people or looked at with disdain. My comment, was that when I was their age, I never wanted to become one of ‘those people’ that disdained and criticized youth.

This is something that I am reminded of from time to time, that we often talk of ageism - and I see/hear it when I am in large groups of younger people - but bias exists in both directions, and I don’t mean to minimize the plight of older people, or the problem of ageism, since in this case it can be deadly…

2 Likes

Ageism Is Making the Pandemic Worse

3 Likes

The same article I though of sharing…

2 Likes

It’s just so unacceptable.

1 Like

Should age never under any circumstances be taken into account when a difficult health care decision has to be made?