Friday, February 28, 2020

Coronavirus Tests For All?

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I woke up this morning and immediately asked a couple of the best members of Congress to draft a bill that would give every American resident a free voucher for a conornavirus test. This morning, as the markets tumbled another thousand points in early trading, Reuters reported that "Investment-advisors are increasingly worried that U.S. authorities are not doing enough to prevent a widespread outbreak of coronavirus in the country, potentially adding further downside to already-battered markets. Their criticisms include the number of people so far tested by the U.S. Centers for Disease Control and Prevention (CDC), which some say is too small, the possible difficulties of imposing lockdowns on U.S. cities and concerns that the White House could bungle containment efforts." I had just read this column published by the American Conservative from Louisiana Bernie-hater Rod Dreher, which begins with a letter from a doctor updating Dreher on the coronavirus.
My wife and I were watching her Mandarin TV station news this AM. This was the feed from Beijing-- their vision of the Today Show. The leading story was a five-minute discussion of the fact that the world is now looking at the USA and its response to the virus-- and it is clearly being bungled. After weeks of snickering at China, he world is now having a belly laugh at the way the USA is handling the situation. The Chinese people have sacrificed greatly for the whole world to have a month or two to prepare-- and this is the way the USA has decided to use their time-- and by the way, they have not even tested 500 people. It is very clear to us that they are lying about their numbers.

You will have to forgive me-- they are meaning this to be propaganda-- but I cannot find a lot that is untrue in these statements.

The concern, worry, and anxiety being expressed by my patients is becoming stronger by the day. Unsolicited, the patients are starting off every visit with “What do you think?” or “What should I do?”

The feast of consequences we have created with our profoundly dysfunctional health care system is about to be served.

First off, this could not have happened at a worse time of the year for most patients with our now ubiquitous high deductible plans. Until the first $10,000 are met, everything is done out of pocket. So instead of going to the ER and the URGENT CARE centers across America where they will likely have to pay at least $1000 for a visit, patients with very concerning symptoms are going to either stay at home and continue to work, or flood their primary care doctor’s office because it is much less expensive. The ER and URGENT CARE are much more likely to be equipped to handle this situation, with negative pressure rooms and appropriate gear. Local doctors’ offices are not and never will be able to handle this kind of load with this kind of danger. Not a thing is being done about this at any level in our “preparations.”

I am in a primary care office. And this has already begun. We are already in the middle of a very nasty flu year. My office is full of people coughing and hacking. There were three patients of particular concern already this week; two have been shown to have the flu; the other one is very very concerning-- and demonstrates the complete and total failure of our public health systems to be prepared.

It is a young twentysomething business professional. They have spent the past three weeks in one of the places outside of China that has been in the news lately. In fact-- the very city. Their job requires multiple meetings, and people people people all day. The trip home went through two international airport hubs, and then two of our major hub airports.

About half way through the trip, the patient became febrile, and began having a cough. All during the way there were close quarters with other passengers in the plane and in the concourse, and multiple kiosk experiences getting boarding passes and luggage claim. A trip through security being forced to remove sweaty socks, coughing and hacking the whole time.

The flu test was negative. I then contacted our local public health office, and was told that I needed to contact the CDC. The first person on the phone had trouble spelling the state in which I was located, and could not get the information correctly in the computer. After several minutes of this, I was finally connected to a “specialist”. I was asked if the patient had been to Wuhan or if they had been in contact with anyone from Wuhan. I then told her the story, and my concern about this person being in the city that had been in the news the past week.

“Well, sir, they do not meet the criteria for testing, so we will not be able to do it.” I got a bit hostile. “Wuhan is last month’s news! This is a real problem-- I have this young person’s life in my hands! You have got to be kidding me...”

“Sir, I will not be talked to like that. I will now end this call.” Click.

Our public health system-- once the envy of the world-- reduced to a customer service transaction. The consequences will soon be enormous.

The patient is about the same-- still having fevers. I do not know what they have. But I told them it was their civic duty to go home and remain home. Self-imposed quarantine-- and they are doing it. We have community help to make sure they are being looked after.

If you think it is just me, I would urge you to read the story coming out about our first patient with no known exposure risk. It is just stunning-- from the UC Davis medical school.

They basically had the same response from the CDC.

And please note also: this [California] patient does not have a head cold or a little flu-- this patient is on a ventilator and fighting for their life. I wonder how many ventilators are in the city of Sacramento, and what will happen if more and more and more people start coming in this ill?

And I am hearing a lot about vaccines. Vaccines are not going to save us. They are years down the road-- and any confidence I had in our HHS Secretary Mr. Azar (experience for the job: he’s a former big pharma lobbyist) is now completely gone-- Please look at this tweet:




“We would want to ensure that we work to make it affordable, but we can’t control that price, because we need the private sector to invest.. Price controls won’t get us there.”

So, the message is the vaccine will be priced at whatever they want, if only the 10% or up can afford it, too bad. We are not about public health-- it is all profits, profits and more profits.

I would remind everyone that in a previous pandemic-- that of polio-- Jonas Salk developed the first vaccine. He could have been wealthy beyond the dreams of Mammon. But what did he do? He donated the vaccine to the world.

What is wrong with us? What has happened to this Republic?




Again: the feast of consequences is on the way.

I am certain the fire that is about to rain down will take us all by surprise.

We did once have leaders who stood in the breach with the people in some of the darkest days of this Republic. “We have nothing to fear but fear itself” and in the absolute darkest days of WWII-- “Everything we have and everything we are is at stake-- everything we have and everything we are shall be given.”

What do we have now? Stock market tips, and oh this is just a flu, it will blow over.

I pray to God every day for this country. May he have mercy upon us.
Dreher followed that letter up: "It is hard to imagine a better issue for a democratic socialist running for president than a Big Pharma executive Trump put in charge of the health ministry saying that he won’t guarantee that a vaccine for the pandemic about to hit America will be affordable to people, because the Free Market."

Goal ThermometerMilwaukie Mayor Mark Gamba, the Medicare-for-All congressional candidate in Oregon's 5th district told us that "It's clear that the federal government is going to fail utterly when the Coronavirus hits America. I think it's critical that local governments have their act together. Rich, I'm wondering if you could pull together a meeting with 3 of the big hospitals in the area to talk about their capabilities and how fast they could ramp up? Do we have some place else in the county we could create an isolation unit? What are their abilities to test for the virus, etc. Once we get them lined up. I think it would be good to get as many of the mayors as possible along with the chair in a room with them so that we be can begin to formulate a plan and solutions. Why is a small town mayor having to do this?  Because our Federal Government is already utterly failing.  Every clinic and certainly every hospital should be able to run tests in-house.  Without that, when the virus hits, we will have an unimaginable situation where every medical facility in the country will be jammed with everyone with any sign of the disease whatsoever, and they will need to be quarantined until tests are run... by who?  The CDC? Run by the trump administration? I strongly recommend that states, counties and cities get on this immediately. Do not expect the clown car that currently passes for a federal government to do a damn thing until it is far too late. Sound familiar? It's why I'm running for congress. Leadership in DC is clearly in short supply."

Mike Siegel, a strong Medicare-for-All advocate-- and on the verge of an historic win in Texas on Tuesday-- connected the dots between pandemics and the need for Medicare-for-All. Mike told us this morning that "Now more than ever, we need universal health care and universal paid sick leave, not to mention a government that believes in science and a strong public school system to build community literacy. Our current Administration is a threat to humanity and must be replaced."




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5 Comments:

At 9:39 AM, Anonymous Anonymous said...

I am finding I have difficulty caring about whether a greedy and ignorant species survives. It certainly appears that few members of this species really care about anything of value to them, for they allow exploiters and abusers to thrive while they themselves wither.

 
At 4:13 PM, Anonymous Anonymous said...

Dreher was making solid points until: "I pray to God every day for this country. May he have mercy upon us."

Someone with his powers of reason and logic who prays? Perhaps this, more than anything else, is what condemns humankind to the same fate as dinosaurs... or, more aptly, the Moa (extinct because mankind killed it).

If the world looked with admiration or envy at America for anything AFTER JFK was assassinated, it's on the world. We haven't earned any such thing for almost 60 years. Certainly, we should have inspired nothing but disgust and guffaws since 1980.

 
At 6:33 PM, Anonymous Anonymous said...

I cannot even imagine the perpetual priapism that health insurance and phrma are enjoying over this shit plowing through the American "pigeon" demographic.

I bet each boardroom has someone assigned to do the calculations for how many copays, deductibles and other OOPs they will be able to post at the end of FY2020... and the resulting stock price bacchanal.

They only need to finesse the governments' pretense of a response such that the idiot "pigeons" don't realize that MFA is the only answer and therefore start voting for Bernie. If they can sit on this until after the convention, they'll be golden.

they know this.

 
At 10:28 PM, Anonymous Anonymous said...

They remain deluded, 6:33. I have had to cut back on my meds already, and I can no longer afford to see a doctor since my medical coverage got cut off yesterday. Yes, I've applied for Medicare, but I'm told that it won't start for three months or so.

I'm hardly the only one this is happening to. Having no money means those greedy bastards can get none from me. Fuck them and the high horses they stole to ride in upon.

 
At 7:41 AM, Anonymous Anonymous said...

10:28, you are among millions.

yet the only choices for each election are those who will refuse to change anything... and everyone who votes shall vote for one of them.

the answer is clear. has been for decades.

but elections continue to thwart the only clear answer.

that's America. where voters know what they need but never, ever vote for it.

 

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