Exactly two years ago (April 2, 2020), I asked If we could build renal dialysis capacity, why not COVID-19 treatment centers?
On the one hand, the U.S. health care system is kind of lame. It consumes a ton of money. New York State spends $88 billion per year on its Department of Health, $4,400/year for every resident, mostly just for people on welfare in New York; Mexico spends about $1,100/year across all citizens, including those with jobs. The U.S. health care system delivers feeble results. Life expectancy in Mexico is 77 versus 78 in the U.S. Despite this prodigious spending, New York has completely failed to protect its residents from something that isn’t truly new.
On the other hand, the U.S. managed to build enough renal dialysis capacity to keep 468,000 Americans with failed kidneys alive. This is a complex procedure that requires expensive machines, and one that did not exist on a commercial basis until the 1960s.
Should this success story give us some hope that the U.S. will, in fact, be able to deal with the surge of demand for ventilation and life support created by the evil non-Chinese coronavirus?
Of course, one issue is that we had decades to build up all of this renal dialysis capability while we have only about one more month to build COVID-19 treatment capacity. But once we have built it, can we sail through the inevitable next wave or two of COVID-19?
The idea turned out to have some medical merit. “COVID Patients Fared Better at Dedicated Hospitals for It” (MedPage Today, 3/3/2022):
At the two M Health Fairview hospitals converted to treat COVID-19 starting in March and November 2020, overall mortality with COVID-19 was higher than in the health system’s other nine Minnesota hospitals (11.6% vs 8.0%, P<0.001).
But after accounting for the generally sicker patients treated at the dedicated hospitals, in-hospital mortality was a relative 22% to 25% less likely, which was significant in both unmatched and propensity-matched comparisons.
Complications were a relative 19% less likely than at mixed-use hospitals, Elizabeth Lusczek, PhD, of the University of Minnesota in Minneapolis, and colleagues reported in JAMA Network Open.
M Health Fairview converted two of its hospitals with building modifications to enhance remote telemetry, create negative airflow rooms with HEPA filters, and update interventional radiology and procedural suites and ensure that the healthcare workers there would have easy access to personal protective equipment (PPE) even in times of general shortage.
We’ve spent $10 trillion over two years in our fight against SARS-CoV-2? How many dedicated COVID-19 treatment centers did we get for this money? I’m thinking that the answer is close to zero, given that every time there is a bump in “cases”, we see media stories about non-specialized hospitals being overwhelmed.
Related:
- Florida implements my renal dialysis-inspired COVID care idea (sort of) (only for antibody therapy that quickly became worthless due to evolution)
I can only surmise that doing anything that sounded or resembled any of the deep heresy promoted in the Great Barrington Declaration (i.e., protect the truly vulnerable in ways like this) was judged to be the Dangerous Advice of Idiotic Nincompoops whose answer is to “Let Them Die” — which is basically what Dr. Alan Chartock, CEO of WAMC Radio, NPR dismissed the promulgators of GBD as. I’m sorry, I’m not quoting him directly – it’s paraphrasing, but I do remember one exact word he repeated: “FURIOUS.” In fact he drew it out long and juicy, like: “FUUUURRRRRRIOUS.” I also heard him summarize their work as: “Let Them Die.”
But he’s a Doctor!
https://gbdeclaration.org/
“Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19. By way of example, nursing homes should use staff with acquired immunity and perform frequent testing of other staff and all visitors. Staff rotation should be minimized. Retired people living at home should have groceries and other essentials delivered to their home. When possible, they should meet family members outside rather than inside. A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals.”
If you take that idea and extend its basic ideas into hospital settings, you arrive logically at solutions like the one you highlight from MedPage Today – 3/3/2022. Wow! Did that take a long time!
It’s really kinda criminal, IMHO. Heads should roll.
What’s even more astounding, Philip, is that you published *your* post in April and the Great Barrington Declaration didn’t happen until October of 2020 (about one month before the election which – had it gone the wrong way – would have visited upon us the most unimaginable catastrophe in all of human history.) You were four months ahead of it. How many preventable deaths occurred during those four months?
Sorry, not four months – SIX months. You were April, GBD was October. Let me state for the record – and speaking strictly for myself as a person from a “high risk/vulnerable” category who also bought and wore N95s, was vaccinated as early as possible with Pfizer and then boosted with Moderna – that I always thought your basic ideas regarding ventilation, separation and GBD’s ideas about “protecting the vulnerable” have been at least as important to my consistent string of negative PCR tests (a total of 7) as anything else – and maybe moreso. I learned to change my routines to stay as far away from other people who might be asymptomatic as I possibly could. That involved some alterations in my day-to-day activities, but it wasn’t too difficult. Except for my emergency room visit in December. I sat for about 3.5 hours in a crowded emergency room with people coughing and breathing into soggy bandannas along with other types of facial decoration, with no attempt made on the hospital’s part to separate the truly sick from the merely superficially injured (e.g., people who had a sprain and went to the ER.) Instead I sat directly underneath a ventilation duct that was blowing air out, in an N95+medical mask, and crossed my fingers.
God help me from visiting another American ER waiting room in my life time. That is really hell on earth. 4 hours passed by and not a single doctor saw my wife. This was at the same Medical school I studied at.
My experience in a Vienna ER was better and far better than the US one. Austria’s healthcare system is A++. And the doctor’s make less money.
German: Of course Austria is better! 5 docs per 1,000 people compared to 2.6 per 1,000 in the U.S. (https://www.indexmundi.com/facts/indicators/SH.MED.PHYS.ZS/rankings )
And of course they have to make less money because otherwise non-doc Austrians would be impoverished by paying all of those extra docs!