Dated March 30, 2020
Dear Colleagues and Friends:
Three days ago I had no Covid-19 patients in the hospital. Two days ago there were two in critical care. One of the two, a patient for more than 20 years, died Sunday (March 29) at 3pm. Her daughter cried to me “She didn’t deserve to die this way, all alone.” She’s right. My first, not my last, patient to die of Covid-19. When the daughter gave me details of who else was exposed to her mother, those that need for testing, I said ashamedly that I have no access to testing or tracking of exposed individuals. Another patient of mine is intubated. I am hoping he will survive.
Before Trump’s inauguration, there was a warning from the Obama administration: ‘The worst influenza pandemic since 1918’ would be coming and Obama officials briefed the incoming administration on this exact scenario.
What’s Trump’s planning approach: “Trump ties coronavirus decisions to personal grievances”. Trump took to Twitter Sunday afternoon to tout the ratings of his news conferences, claiming without evidence that mainstream media are going “CRAZY” because of his popularity on television”.
In the absence of both medical equipment and testing in the world’s richest country, many are debating how to allocate scarce medical resources. Patient-level decisions are being made with this perspective.
Others are thinking about estimating the cost of this pandemic. Academics are calculating how we can decrease social distancing after implementing contact tracing and adequate testing
Still, others are trying to put pen to paper imagining a better health system that includes planning for the next pandemic. Meanwhile, Scott Gottlieb and Mark McClellan (excellent Repub policymakers) have detailed options for the current pandemic.
To put any long term health reform ideas into place, we need members of Congress and an executive branch interested in long term health reform not just tearing down health systems.
Via Ask Nurses and Doctors, I am in the process of organizing round tables for incumbent members of Congress and encouraging people to write letters to the editor such as these. The picture in the excellent LTE by Barbara Floyd is worth a thousand words. Happy to help anyone who is interested in putting “pen to paper”.
In the meantime, my physician colleague has been extubated and continues to improve but is still in the hospital.
Norbert Goldfield MD