At Least We Saved the Nursing Home Patients, Right?
I just want to point out how this pandemic is NEW for every doctor alive. There are no living experts. And we got a lot of things wrong. Anybody who says THIS IS THE WAY we should have done it is an idiot. Even with hindsight, there is still disagreement. That is because politics and ego got in the way of logical thought.
In NY, they sent COVID patients back to nursing homes and this wiped out many of the elderly in there. I will get back to this in a bit. While doing this they shut the state down and put it in an economic tailspin. But they solved CV19, right? Nope. It is coming right back. I would expect more Draconian laws there to protect the governor who needs to keep his book sales up. You know, the one where he gloats over how he got it right and how smart he is.
So, here we are near Thanksgiving and new state laws are being put into place. Viruses respect curfews and state line boundaries so these restrictions are the obvious answers. My sarcasm aside, I hope we can get to a place where we can actually listen to all scientific views. I still think being careful is important. I still think that masks have a place. But CV19 is not going to stop from these maneuvers.
What has been the cost of lockdowns, school closings, and severe restrictions? It’s been tremendous. Somehow, many of the preaching FB doctors forget how this has destroyed small businesses and therefore the families behind them. They also neglect the skyrocketing amount of depression, anxiety, suicide, substance abuse, and domestic abuse that is occurring. We are social animals and this is taking its toll. You can’t be the brave doctor screaming from social media rafters to STAY ISOLATED while ignoring the effects of doing so.
And about those nursing homes. This is from an AP article:
When COVID-19 tore through Donald Wallace’s nursing home, he was one of the lucky few to avoid infection.
He died a horrible death anyway.
Hale and happy before the pandemic, the 75-year-old retired Alabama truck driver became so malnourished and dehydrated that he dropped to 98 pounds and looked to his son like he’d been in a concentration camp. Septic shock suggested an untreated urinary infection, E. coli in his body from his own feces hinted at poor hygiene, and aspiration pneumonia indicated Wallace, who needed help with meals, had likely choked on his food.
“He couldn’t even hold his head up straight because he had gotten so weak,” said his son, Kevin Amerson. “They stopped taking care of him. They abandoned him.
And this:
As more than 90,000 of the nation’s long-term care residents have died in a pandemic that has pushed staffs to the limit, advocates for the elderly say a tandem wave of death separate from the virus has quietly claimed tens of thousands more, often because overburdened workers haven’t been able to give them the care they need.
Nursing home watchdogs are being flooded with reports of residents kept in soiled diapers so long their skin peeled off, left with bedsores that cut to the bone, and allowed to wither away in starvation or thirst.
So, what was worse: Dying from CV19 or dying from isolation and neglect? I don’t know the answer but can we have a discussion without hating each other? Personally, if I end up in a nursing home then let me risk getting CV19 rather than be isolated and unable to tell dirty jokes. Pneumonia used to be called the “old man’s friend”. I’ll take that risk.
So, what is why answer to all this? Well, you may hate me but I refer you to what I said in MARCH of this year.
I have some thoughts on how to get through this pandemic. We are in a strange place right now. I have heard a million theories on how to solve this crisis so if this idea sounds similar to anyone else’s it is because it probably is.
– 1. Stop testing for CV19. It costs too much, takes too long, and are highly inaccurate. Oh, and there really is no proven treatment.
– 2. Let’s get it over with. Let’s let the younger generation prove their worth and do what they are good at doing. I would have anyone under 50 get out and get infected. Instead of flattening the curve we spike it higher and faster so that it is gone just as fast. We will deal with the sick young ones only if they are REALLY sick. They are not social distancing anyway. And there is NO way they will stay locked for much longer. Let them build up antibodies and become the herd immunity to buffer us older folk.
– 3. Anyone over 50 has to be quarantined 100% for a month to let the above happen.
– 4. Let’s get a vaccine going to give to the older group.
Why am I saying this? During the 1918 pandemic, there really was little economic impact. Amazing, right? This pandemic is KILLING the economy. People need to work. Let the people under 50 go back to work NOW. If they feel sick let them stay at work until they can’t do it. Why? They need to infect others. They need to make money.
Will some young ones get very sick? Yes.
Will this be easy to handle emotionally? No,
The bigger picture is just that. We do need to look at the whole world. If we can TRULY quarantine those who actually will listen (older folk) and are most at risk (older folk) then let’s use herd immunity to its fullest.
Now, I am open to critical thought on this, not just criticism. And, honestly, I am not even sold on my own theory, which I admit I stole from others. I don’t know if I can handle seeing a young person perish with CV19.
Fire away.
I said this EIGHT months ago. I stand by it. I am open to criticism without hate. Let’er rip.
Bingo. Infections gonna’ infect. Everybody needs to get real.
Whatever happened to good old “evidence based medicine” that was all the rage?
Putting Swanz-Ganz catheters in everybody seemed like a good idea at the time too.
First, do no harm.
OK….I mostly agree with you. I think the testing is ridiculous. I never know whether the test is accurate or not and then get inundated with questions about it. I don’t agree with your age cut off. I think 50 is too low to hit the panic button. I should be greatly concerned but I am not. I am 57, diabetic, smoke and am on Otezla and Humira. I cannot isolate and disappear. People need me and I am not independently wealthy. I will not be taking a vaccine. I cannot in good conscience recommend something that has been blasted out the door with no long term testing. If this was Ebola, maybe. Not for a disease that most (99%) recover from with no help. The politics have gotten in the way of common sense.
“I just want to point out how this pandemic is NEW for every doctor alive. There are no living experts.”
Doug, were you around in 1968? Maybe I misunderstand what you’re saying, but if you’re saying that the last pandemic was 1918-1919, that’s not true. 1968 comes to mind.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31201-0/fulltext
One million to as many as four million deaths worldwide. Half of the French workforce was out sick. The Germans stacked bodies in the Berlin subway tunnels and drafted garbagemen to dig graves, they couldn’t bury them fast enough. The Brits converted warehouses into wards.
About a hundred thousand deaths in the USA, which would be comparable to today’s pandemic, given significantly smaller population then. Surely COVID wil outstrip the 1968 pandemic when all is said and done.
Somehow we managed to run in-person political conventions, and the Chicago riots for that matter, not to mention Woodstock in 1969. They didn’t shut down the country.
I agree with your thoughts especially the one that criticize what has been done to date. It is NEW for everyone. Seriously, the depression and social isolation is so harmful and what we have been doing is clearly not working. Yes, wear masks, that is reasonable– but shutting down for week after week? The politicians get to have big birthday parties and protesters get to protest, the malls are open, but churches are closed? Is this really helping? I think it is time for something different– ? home testing kits maybe. 2 weeks to slow the spread helped a bit, but now its time to adjust and pivot.
And I said in March, “Yes, the elderly are at greater risk and should exercise more caution (or have it exercised by their family). But closing schools indefinitely, ending major sporting events, and hoarding toilet paper are the sort of seemingly temporary reaction that can cause long-term harm…The deaths so far and those that are coming are each and every one sad and matter, but that does not justify the mass, reflexive panic we are seeing. I think physicians should everywhere be advising everyone to calm down and live their lives, and I think we are failing badly in that respect.”
We still don’t know how many MILLIONS were likely infected prior to March, yet on the basis of bad numbers, health care was used successfully to give cover to authoritarian rule in a number of states. Damn our profession for not speaking out en masse against curfews and closures ostensibly to “save lives.” Our refusal to open up EVERYTHING in the hot months is the reason for these spikes now. We have made this virus more deadly, more costly than it otherwise would have been.
I am curious who will be lining up for these new vaccines. I personally do not want to be the first one on the block. I suspect all nursing homes and ALF’s will require mandatory vaccination. So they will be the guinea pigs. Remember only about 50% of the population agrees to take the flu shot. There is no indication how long immunity lasts. I am 66 years old. I remember thalidomide and Guillian-Barre and vaginal clear cell carcinoma. Some side effects take years (or generations) to become evident. These vaccines were obviously rushed.