Category Archives: Healthcare

Pandemic Update – 5 July 2020

As I watch the statistics–new COVID-19 cases and new COVID-19 deaths–there are other observations that present themselves. One is that every weekend the numbers fall in comparison to the weekdays. I attribute this to delays in reporting. Weekend staffing in hospitals and government agencies tend to be lower than during the week, so the cases and deaths get added after the weekend. Numbers tend to run higher early in the week, which I believe is to catch up for the weekend.

Although new cases are increasing in many areas, deaths continue to decline. Among those with the most new cases, Florida started to climb about 24 June, Arizona’s cases began increasing 16 June, with a similar trend in South Carolina. North Carolina, on the other hand, has been on a steady rise since March.

I thought there might be an increase after the Black Lives Matter demonstrations, and I used Minnesota, Washington state, and the District of Columbia as likely examples. I saw no dramatic increases. These demonstrations began 25 May, so we’ve been through two incubation cycles. On television, it appeared that many demonstrators maintained wore masks.

I have no idea where things are headed and I make no sweeping claims based on the statistics I’ve been tracking. However, I believe that facts are important and they are the first step toward solving any problem, including the pandemic.

 

Pandemic

As you may recall, I rely on data* for decision making whenever possible. For some decisions, there are little or no data, but for many others there are an abundance of data. For example, the COVID-19 pandemic provides significant data.

I don’t have the fancy models that the experts use, but once upon a time I seem to recall taking some statistics classes in college and other courses that included statistics. I’ve been tracking the number of new cases of COVIDS-19 and deaths from the disease using Worldometers. Under the principle of KISS–keep it simple, stupid–I use only a linear progression and a 5-day moving average.

Deaths, thank God, continue to decline. Apparently, the medical professionals have figured out how to reduce, if not eliminate, its harshest outcome.

New cases, on the other hand, not only continue to climb, but have recently accelerated. I don’t have sufficient data to guesstimate the reasons; I have my opinions, but there are too many opinion driven events already.

Here are my results:

* Data is plural for datum, although is is often used both as singular or plural.

I Told You So!

Back in my healthcare days, there was a general practice physician who delivered babies, which back then was still quite common. This was long before ultrasound could provide an image of sufficient clarity to determine sex, so the reveal didn’t occur until the baby was born.

Naturally, soon-to-be parents back then were as interested in knowing as much about their child as parents are today. This physician’s solution was to tell the mother during a routine prenatal visit that her baby was a boy. At the same time, he’d write in her chart “girl.”

After the birth, if it was a boy, he’d say, “I told you so.” If it was a girl, he’d show her the entry in the chart.

[If I had a clever segue, it would go here.]

I have been trying to avoid most of the alleged news–and that refers to every single outlet, from ABC to Zee in India because my blood pressure is high enough already, thank you. The news reports are:

  • The COVID-19 pandemic will be around for years if not centuries.
  • We’ll have a vaccination in a few months and COVID-19 will be obliterated.
  • Mail-in ballots suffer from voter fraud.
  • Some states have been using mail-in ballots with no problems; the President and his Press Secretary vote by mail and have done so for years..
  • The economy is great–look at the stock market.
  • The economy is terrible–look at unemployment.

Like that old doctor, I think the only thing to believe is the news media is positioning itself to be able to say, “I told you so.”

Life and Death

According to https://www.worldometers.info/coronavirus/country/us/, we’ve now experienced over 100,000 deaths. Our leaders response? They are too busy arguing among themselves, apparently for the sake of arguing.

It’s like someone in a swimming pool is drowning. The lifeguards do not act as they argue whether it is better to use the pool hook, a flotation device, or to jump in and help them.

They can’t agree, so the unfortunate individual drowns. The lifeguards then explain that whichever measure they would have chosen doesn’t matter, because the swimmer died anyway.

It Will Never Be a Movie

If the Coronavirus COVID-19 were a movie treatment, it probably never would get made. Look at the plot elements:

  1. A deadly disease begins in a faraway city known for both selling live exotic animals for food and for having a secret government lab.
  2. The disease is viral. Viruses, unlike bacteria, do not respond to antibiotics. Since a virus is not actually alive, it cannot be killed, only neutralized.
  3. The disease preferentially attacks the poor, minorities, the aged, females, and people with pre-existing medical problems.
  4. Some who are infected by the disease show no symptoms, but are carriers of the disease and can transmit it to others.
  5. Some of those infected exhibit flu-like symptoms, are misdiagnosed. The defining symptom, death, follows soon thereafter.
  6. Some adult patients show no obvious symptoms, except upon examination, it is discovered that their oxygen levels are dangerously low, which can lead to death.
  7. Children, at first were believed to be asymptomatic, later many develop a whole host of symptoms that are completely different from those experienced by adults.
  8. Politicians, faith healers, scammers, etc. seize the opportunity to amass wealth and/or power.
  9. Much of the protective equipment, drugs, and medical supplies needed to handle the disease are produced in the country from which the disease originated. Many US companies had moved manufacturing offshore to save money; there is insufficient manufacturing capacity in the US.
  10. Scientific experts advice is ignored while the Internet and other sources promote a variety of alleged cures, treatments, and religious talismans–none of which seem successful.
  11. There is insufficient capacity to test all suspected cases, so the number of people affected are likely under reported. Some cases are only diagnosed after death, when an autopsy is performed.
  12. State and local governments discourage people from engaging in activities that spread the disease, encourage the use of masks to protect others, and maintaining a six foot buffer between people.
  13. With workers unable to do their jobs, the economy suffers. People are laid off or lose their jobs.
  14. The number of confirmed cases in the US approaches 1.5 million confirmed cases, with nearly 90,000 deaths. These numbers only include patients who were tested or otherwise diagnosed.
  15. Some claim the disease is caused by a new cellular telephone system; others call it a hoax; still others see it as a conspiracy to restrict constitutional rights.
  16. Armed dissidents, encouraged by a variety of sources, protest the social distancing, stay-at-home orders at the state capitals, clustering in large groups, usually without masks.
  17. In the meantime, the country from which the disease arose and several of its allies launch cyberattacks on the US to steal medical secrets relating to healing or preventing the disease–and anything else they come across, once they get inside a computer.
  18. As US cases seem to slow their rate of growth, state and local governments relax social separation. People immediately return to pre-pandemic behaviors and the dissidents declare victory.

The screenplay ends here. The audience is left in limbo, unsure whether the disease is indeed winding down, or preparing for a second wave. Unsure as to the future of the economy.

As I said at the beginning, no studio would ever consider wasting time on a script for this scenario.

COVID-19 Fuss

I don’t know what all the fuss is about. Maybe I just look at things differently.

After years of working, spending five days each week lusting for weekends when I could be home.

I like being home.

Then there’s the mask thing. I’m not particularly grotesque, but, in my opinion, I look better with any type of mask than I do without. Bruce Wayne felt the same way.

So, what’s the fuss? Tell me what’s a happening.

It’s Not About You

https://upload.wikimedia.org/wikipedia/commons/7/77/Sneeze.JPG

“The right to swing my fist ends where the other man’s nose begins.”
                                                                                  – Oliver Wendell Holmes

Wearing a mask in public is not to protect the mask wearer from germs. It’s to keep germs from being transmitted to others. COVID-19 is a respiratory disease and is contracted by inhaling the virus.

A sneeze is a veritable biological weapon. Whatever is in your mouth and nasal system is sprayed as an aerosol, covering an area well beyond the social distance of six feet. In fact, it appears to be well over 20 feet. The droplets can remain suspended in the air for several minutes When they settle, pathogens are deposited on surfaces with a virus that can last up to several days.

National Geographic has an interesting article.

Some decry that their rights are being violated by pandemic restrictions, such as face masks.

Using Supreme Court Justice Holmes logic, your right to go without a mask also ends where my nose begins.

 

 

COVID-19 Special Circumstances

Some of the rules for avoiding COVID-19 have the usual confusing special circumstances that need clarifying:

Is it okay to touch your face when you’re in the shower?

Speaking of showers, do you need to wash your hands before taking a shower, after taking a shower, or both?

Do couples who live together and sleep in the same bed need to stand six-feet apart in public to avoid being criticized?

If your family has more than 10 members living in the same house, do number 11 and above have to leave and find somewhere else to live?

Sorry, I may be getting silly after self-isolating, but so far I’m still healthy!

Hleath Caer

I spent many years in healthcare, as a technologist, as a manager, and even worked for a major medical equipment company, managing the techs who would demonstrate and teach radiologic technologists how to use the latest, greatest equipment.

I’m glad those days are over–especially my time in management. It was awful enough when hospitals established their own collection agencies–complete with a stable of lawyers, of course. Now, as clinicians try to help patients in the midst of the COVID-19 pandemic, hospital administrations do not help. Instead, they throw up roadblocks.

In some hospitals, health care workers have been forbidden from wearing masks as protection in the hallways.

In at least one hospital, personal protective gear was at a premium, so nurses put up a GoFundMe site and purchased masks, surgical shoe coverings, etc. Rather than appreciating the lengths that the nurses would go to help their patients, one nurse was suspended for distributing the unauthorized products.

We could blame it on the stable of lawyers, but they don’t actually decide. They advise, lean heavily against the possibility of a mega-million dollar hospital experiencing a couple thousand dollar judgement. They do add to administrators’ hesitance about making decisions.

As a former Fellow of the American College of Healthcare Executives with all kinds of letters after my name, here’s my suggestion.

  • If it helps the patients, do it. Combat doctors and medics save many lives doing what needs to be done, not what the book says.
  • If you are not actively involved in patient care, your job is to grease the skids for those who are.
  • If you, or the person most important to you–parent, spouse, child–were the patient, would you want care delayed or withheld because of such stupid reasons?

Oh, and maybe have the administrators, lawyers, etc. assist by having actual contact with patients. They may not be qualified to provide patient care, but they can transport patients, clean and stock rooms, etc. Every other healthcare worker has and probably is doing such tasks today. If administrator and their staff feel it is beneath them, then they are in the wrong business.

C’mon people.

 

 

Random Thoughts

There’s no specific theme or topic–just goofy stuff that has gone through my head as I self-isolate.

1. There’s no understanding the lengths people will go through to take advantage of others. A museum near Amsterdam closed because of the COVID-19 emergency. Someone–or several someones–broke in and stole a Vincent van Gogh painting, The Parsonage Garden at Neunen.  As near as I can tell, except for artwork that the Nazis looted, there are less than a dozen masterpieces that have been stolen and not recovered.

Imagine if the thieves had put their time and talent to work doing something worthwhile. Then again, maybe they think that they look good in fluorescent orange jumpsuits.

2. The hospital ships USNS Comfort and USNS Mercy supporting New York and Los Angeles are amazing. They started out as commercial supertankers, and if memory serves correctly, were cut in half to make them longer. USNS indicates that the ship is owned by the US Navy, but is not a commissioned vessel. The crew is a combination of military and civilian mariners under the direction of the Military Sealift Command.

The 1000 bed medical facility is under the command of a captain from the Navy Medical Corps or Navy Nurse Corps. Each has a complement of diagnostic and treatment facilities including radiology, CT Scan, 12 operating rooms, and a burn care unit.

Years ago, I had the opportunity to visit the USNS Mercy and she’s an awesome ship. Both have helicopter landing pas for patients being medevaced. The trauma receiving area–similar to an emergency room–has its deck painted red, an old tradition so blood isn’t as obvious. After all, these were built to support combat casualties.

 

Rules of Acquisition

The Ferengi appeared as aliens in several Star Trek iterations. They were the ultimate business people who frequently quoted from their 286 rules of acquisition. I’ve heard they were originally planned as the villains for Star Trek: The Next Generation, but came across as more silly than intimidating.

In my favorite interaction, one Frengi asks, “What if this becomes a war?” The other replies, “Rule 34.”

The first responds “Ahhh, war is good for business. But, but, what if it doesn’t lead to war?” The response is “Rule 35.”

“Ahhh, peace is good for business.”

Today there are real Ferengi; not as exotic looking, but every bit as greedy:

  • People pretending to be employees with the Centers for Disease Control and Prevention are knocking on doors, wearing white lab coats, telling residents that they’re testing for COVID-19. Then they rob them.
  • A former White House advisor asked if people staying home to avoid the virus is worth the economic consequences.
  • Senators dumped stocks after being briefed on the coronavirus, but before that information was released to the general population.
  • All kinds of scammers are selling phony medications or religious talismans.

Oh, wait. Rule 14.  “Anything stolen is pure profit.”

Premeditated Twinkie Offenses

I have no inherent dislike or paranoia about guns. I served in a war zone and carried a weapon. I like to go to a range and plunk at targets.

However, there are those today who are purchasing guns to protect their “stuff” in the event of shortages. It’s disturbing to think that anyone would kill another person over a loaf of bread, a side of beef, or a twinkie.* Talk about premeditated murder.

Somewhere around 250-280 AD, there was a pandemic–probably smallpox. The Roman death rate was around 30 percent, but in areas with a Christian presence it dropped to 10 percent. Why? The Romans deserted their sick friends and relatives to avoid catching the disease. Christians, even knowing that they might catch the disease, cared for one another.

 

* These are probably the same people who physically fought their way through the crowd to grab 18 cases of toilet paper.

Sorry, I Don’t Believe in Reality

Well, actually I do, but there are apparently many others who do not. The coronavirus COVID 19 is the current pressing example. People are dying–why wouldn’t you believe in it?

Easy.

If someone has a radio talk show or a podcast that makes money for them, there’s more money in denying reality than accepting it.

KACHING!

As a human being, I am embarrassed. It may not be as profitable, but it is more human to help one another instead of leeching off others’ misfortune.

Medical Mayhem

One of the problems with medical issues is that scientists’ and physicians’ assessments must constantly be revised. As additional facts are uncovered, logical conclusions are changed. That is difficult for some people to accept.

For example, 1.2 + 1.2 when rounded is two. However, if additional research adds a mere .1 to the equation, the answer would be rounded up to three. This is how science works.

This is how reality works. This is how life works.

The view of the effects of coronavirus is changing as more data are available.  This is good. This is how the intellectual process works. This is a time for thought, not emotion.

Viruses are unaffected by opinions, polls, or politics. So too are suffering and death. It is by keeping an open mind, examining the facts, re-examining the facts, and focusing on facts that we can progress.

Bring on the NANOBOTS!

See the source image

I love nanobots.

Nanobots are microscopic robots that can do anything from curing disease to treating injuries or providing energy to weapons. There’s just one minor problem with nanobots . . . .

They don’t exist in the real world.

But they are a staple in science fiction. Have an insurmountable problem? Write how nanaobots resolved it—it’s the best Deus ex machina* tool ever. For example:

Powerful, evil dudes attack good people, who are powerless to resist.
Nanobots are released that change the mental and emotional state of the bad guys. Soon, everybody sings Kumbaya.

However, there may be technology on the horizon that provides the benefits of nanobots using existing materials. The first, albeit tiny, steps are being taken in utilizing a virus to edit genes in a patient by using the CRISPR technique. It’s not as sexy as the nanobots in a John Scalzi novel, but this is real world technology, which is rarely sexy.

Will it work, or like so many other ideas, fail to execute as imagined.

Stay tuned!

 

 

* Deus ex machina (/ˌdeɪəs ɛks ˈmækɪnə, – ˈmɑːk-/ DAY-əs ex-MA(H)K-in-ə,[1] Latin[ˈdɛ.ʊs ɛks ˈmaːkʰɪnaː]; plural: dei ex machina; English ‘god from the machine’) is a plot device whereby a seemingly unsolvable problem in a story is suddenly and abruptly resolved by an unexpected and unlikely occurrence.[2][3] Its function can be to resolve an otherwise irresolvable plot situation, to surprise the audience, to bring the tale to a happy ending, or act as a comedic device.

Corona Virus Side Effects

There is a lot of angst regarding the corona virus (COVID-19). Oddly, most news coverage focuses on its impact on the stock market.

The news media, critically important for a democratic society, focuses on stories that sell newspapers, encourage internet clicks, or result in more pharmaceutical advertising during the evening news.

However, it’s best to put things in perspective.

According to the Center for Disease Control and Prevention (CDC) there are now 459 COVID-19 [link] cases in the United States. There was a death  today, which although is regrettable, makes a total of one.

On the other hand, influenza (the flu) has sickened at least 19 million across the U.S. and led to 10,000 deaths and 180,000 hospitalizations. This does not seem as significant because we encounter influenza every year. The Spanish flu in 1918 killed between 50 and 100 million people around the world.

The disease that infects millions and kills thousands is no big deal because we see it every year. A new disease, because it is novel, scares us to (near) death.

I’m not minimizing the potential of the virus. However, COVID-19 has been sensationalized, so the threat and probability of encountering it are more prominent in our mind, regardless of likelihood. Each of is, at least at this point, far more likely to be seriously affected by or to die from influenza, yet we focus on COVID-19.

I wish each of you good health–and a speedy recovery for your equity holdings.

 

Win a House!

St. Jude’s Research Hospital for Children has a very clever method for raising money. Why? Because they do not charge patients for services.

Danny Thomas, the 1950’s television star, was born Amos Jacobs back in Toledo, Ohio (my hometown). He prayed that God would point him to the career God intended. He promised to build a hospital if God answered. God answered. The hospital is St. Jude’s.

Please note that Danny Thomas did not ask for success, only to be pointed in the right direction.

St. Jude’s prime fundraiser, at least around here, is to raffle off a house at $100 per ticket. Apparently, the house is constructed with each trade or contractor contributing their time, effort, and materials. The winner  gets a house and the money goes to the hospital to help the kids.

However, as nice as the house is, St. Jude could possibly double their money if they wanted to. The current house being built here has four bedrooms and three bathrooms–perfect for a young family. However, for this year we did not buy a ticket because we’re trying to downsize.

As we many,, many, many Baby Boomers age, maybe a second house raffle for a single floor ranch would be attractive. I know I’d buy a ticket (or two or three).

Oh, and build it somewhere without covenants, conditions, and restrictions. I don’t want Gladys Kravits isn’t a neighbor. (If you don’t get the reference, you wouldn’t be interested in a single floor ranch.)

Clear Title

Sometimes, in our effort to remain relevant, we change simple, explanatory terms to ones that are less so. For example, when people reach middle age and there are hormonal changes, we now call it menopause. First, it’s not a pause; when we pause, we usually start up again. Second, a lot more happens to the female body than the lack of menstruation.

In my parents’ day, they referred to it as “change of life,” which in my opinion is a much better description. Everything seems to change–muscle mass, skin tone, libido, moisture in the mucosa, hair color, energy level, hot flashes, etc., etc., etc.

Menopause sounds more clinical even though the name refers to only one symptom. In reality, pretty much everything is different.

Men may not have the same physiological catalyst or the hot flashes, but life changes for them as well–muscle mass, skin tone, libido, energy level, etc.

I think the old title worked better.

Hide and Seek

Courtesy, the Punchbowl.net

Like most others, as I get older, I regularly suffer from CRS*. I’m not yet to the point where I can hide my own Easter Eggs, but I do find that I’ll walk into a room and wonder, “Why did I come here?”

I’ve decided that instead of complaining, I’ll make a game of it. For example, when I open the refrigerator door with the intent of getting a particular item, often I forget. I scan the shelves, hoping to remind myself what it was that I wanted.

It’s kind of like playing the childhood game of “I Spy,” only I get to play both the person who is looking for the item and the one who selected it.

It’s actually not that much fun, but sometimes ya gotta do what ya gotta do.

 

*Can’t Remember Shit Stuff”

Musical Redux

It was totally predictable–marketing people freely disclosed their intentions decades ago. Nevertheless, it’s discouraging. It hearkens too much to Love, Actually when the word Christmas is squeezed into the classic rock song “Love Is All Around Me.”

What? You ask.

The use of rock and roll songs from baby boomers’ younger days to sell all manner of pharmaceuticals, now that we’re older. Songs by Blondie, The Doors, Steppenwolf, and the Who augment the television advertisements that bombard us.

Hey, didn’t the Who sing “I hope I die before I get old”?