Health Policy

July 1, 2020: Who Lives, Who Dies, Who Decides, Who Pays, Part I

Posted on July 01, 2020 at 12:00 AM

“The people in power right now are too comfortable with other people’s deaths.”
– Rev William Barber, Poor People’s March

2020 has brought planet Earth another world plague, a coronavirus that causes the disease COVID-19. The precise date of its appearance in unclear. Some suggest its emergence was in China in December 2019. Some infectious disease experts tried to warn our government in early January 2020. But mainstream media in the United States did not begin serious coverage until late February 2020. Tragically, this current American president refused to listen to the CDC (Centers of Disease Control and Prevention) message about the massive and dreadful suffering and death this virus would cause in its attack on human beings. He did, however, recognize that an epidemic might interfere with the numerous rallies he has planned for his reelection attempt.

Preliminary information suggested that deaths would occur mainly in our elderly and in people with chronic health problems such as heart disease, diabetes, or emphysema. Such people are labeled “of low personal value” in medical ethics terminology. But, as dozens of people of all ages filled hospitals in New York City, the speed of contagion and the nature of the deaths moved Governor Andrew Cuomo to “lock down” New York City on March 20, 2020. The rationale of lock down is that in light of the severe shortages of COVID-19 tests, everyone must be presumed to be infectious, so all people must take isolation precautions.

The insufficient number of reliable tests prevents our country from identifying asymptomatic people who are unknowingly contagious and prevents us from hospitalizing patients in an earlier life-saving manner when mild symptoms might be overlooked. Lack of testing also prevents contact tracing, which locates pockets of infection. For Trump, lack of testing also minimizes the numbers of those Americans infected with coronavirus, so as not to distract from Trump’s reelection efforts —“No testing, no problem.”

On March 30, Mayor Bowser and the DC Council locked down our nation’s capital city. What does lock down actually involve? Here is where the racism, sexism, and elitism become evident. A new definition of “haves” vs “have nots” has emerged.

  1. Shelter in place at home, maintain social distancing of 6 feet when outside the home, and wear simple face masks. Very difficult for anyone living in a small, crowded space.
  2. Stay at home except for urgent trips to medical offices or drug stores. Order-in food and cleaning supplies. But, citizens designated “necessary” MUST go out to work: mail carriers, people employed in the warehouses that fill the boxes that are delivered, grocery clerks, etc. They should be protected with face masks, gloves, and aprons. Many “necessary” workers must also use public transportation, which adds another layer of possible contagion. These are lower-wage workers, many of color and more of them female.
  3. Telecommute instead of going into the office. But of course, ALL health care workers (physicians, nurses, respiratory therapists, hospital cleaning crew, EMTs) cannot work from home while caring for patients with COVID-19. They must all have adequate supplies of state-of-the-art PPE (personal protective equipment). We have totally inadequate supplies of masks, gloves, face shields, and hair coverings. In fact, most health care workers must reuse, reuse, and reuse. And there are not enough ventilators. VENTILATORS!

Shortages of all equipment are procurement and supply-chain problems totally laid at the feet of an uninterested and unqualified president and his totally incompetent profiteering surrogate Jared Kushner. States were forced to bid competitively for all PPE and ventilators, which the federal government should have funded outright.

The current rough totals of COVID-19 are 3.3 million worldwide including 235,000 deaths. The United States reports 1.2 million who test positive for coronavirus with over 100,000 deaths. This year alone more Americans have died from COVID-19 than we lost during our 10 years of the Vietnam War. Most experts perceive our death toll to exceed 100,000 because many of the dead have gone untested, especially those in nursing homes.

Another new cauldron of disease and death has emerged, though testing is incomplete, in meat-processing plants in the Midwest. Many of the workers are undocumented and all are low wage. They have been told they must report for work, even if they feel ill, or they will be fired. Most live outside the environs of the respective cities. We will be following COVID-19 illness and death in all their ramifications, including who are infected, and who are affected, as well as advances in treatments. Stay tuned.

— Karen Pataky, Director for Public Policy and Chair, Health Policy Task Force 

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