Articles Posted in Emergency Medicine

With the pandemic  tearing through the United States and overwhelming U.S. health care system,  we pause from the grim news to tally  some of the nation’s blessings in this time.

We can be thankful for the courage, fortitude, dedication, and skill of an army of health workers of all kinds. They have put themselves and their loved ones at formidable risk and strain to treat patients under unprecedented duress. They have dealt with fear and uncertainty, giving little quarter, and approaching their own breaking points. Some health workers have themselves fallen ill, with some dying. Their sacrifices cannot be forgotten, and we need to give sustained and extra support to health workers as the pandemic enters its next perilous phase.

srabuse-150x150The coronavirus pandemic’s terrible toll on nursing homes and other long-term care facilities may be much worse than now estimated, as resident advocates, watchdog groups, and experts  tally “excess deaths” in the facilities — perhaps one additional casualty beyond any two formally attributed to Covid-19.

These fatalities are unacceptable, resulting from frantic and low-paid health workers’ inability to care for the aged, injured, and chronically ill infected with the coronavirus while also dealing with the needs of people so frail they require institutionalization. It’s tough reading, but here is what the Associated Press reported:

“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.

apnursinghomesurgechart-270x300Coronavirus cases are spiking among residents and staff at nursing homes and other long-term care facilities. They increased four-fold between May’s end and late October — even as deaths among the vulnerable also doubled, disturbing new data show.

Those are the findings of Rebecca Gorges and Tamara Konetzka, University of Chicago researchers who analyzed federal data at the request of the Associated Press. They focused on 20 states hard hit by the latest pandemic surge.

Konetzka said the data raise major questions about the Trump Administration’s efforts to safeguard the aged, ailing, and injured in institutional care by sheltering them from infections in their surround areas and increasing testing for residents and health workers. But Koentzka, an expert on long-term care, told the AP this about such a plan:

coronacasednov13cnbc-300x135Although company-reported data on the potency of a prospective coronavirus vaccine provided rare glimmers of hope, the rampaging coronavirus pandemic triggered clangorous coast-to-coast health alarms: Infections are skyrocketing. So, too, are hospitalizations. And, yes, deaths are spiking, as well. Records are falling each day.

Covid-19 is raging unchecked among the American people, with a season of travel and festivities with friends and families bearing down on the country.

Will travelers heading across the country or around the block to Thanksgiving feasts or December religious celebrations also ensure that public health forecasters’ glum models turn into lethal reality?  Will the 1,000 daily deaths occurring now double to 2,000 by mid-January and will the U.S. coronavirus death toll hit 440,000 by March?

elderaide-300x200Nursing homes put their residents at heightened health risks by scrimping on personnel costs and failing to deal with significant staffing shortfalls, especially as the coronavirus inflicted some of its highest death and infection tolls on the elderly, sick, and injured in long-term care, media investigations have found.

The profit-focus by health providers is not unique, and it has put huge burdens on poorly paid, lightly trained, and over worked home health aides. They have toiled to keep the vulnerable out of institutional care, even as the agencies that employ them give them little support.

Here is what the Wall Street Journal reported about long-term care facilities, based on its “analysis of payroll-based daily staffing data released … by the Medicare agency …  [for hundreds of] nursing homes that reported to the federal government virus-related deaths in the first half of 2020″:

covimask-300x159While Americans have been riveted for days about incremental shifts in election results, other confounding numbers raced ever higher and into worrisome places. Just consider these numbers: 128,000, 9.6 million plus, and 235,000 and more.

“Covid, covid, covid. By the way, on Nov. 4 you won’t hear about it anymore,” President Trump asserted during his closing re-election campaign rallies.

If only. The nation’s coronavirus pandemic is unchecked and showing signs of worsening, bigly, with records shattering on consecutive days for infections diagnosed: 100,000 on Nov. 4, 120,000 on Nov. 5, and 128,000 on Nov. 6.

chairinhomeDisturbing new data shows that a much-promoted plan by federal watchdogs to protect vulnerable residents of nursing homes and other long-term care facilities from Covid-19 resulted in dismal outcomes, with inspectors dispatched by the Centers for Medicare and Medicaid services largely dismissing infection-control concerns as the deadly pandemic raged.

“During the first six months of the crisis [inspectors] cleared nearly 8 in 10 nursing homes of any infection-control violations,” even as tens of thousands of facility residents were infected and died from the coronavirus, the Washington Post reported.

The newspaper’s investigation found this:

benfrankbuck-200x300The expected surge in coronavirus cases is slamming hospitals across the country, and they and the entire U.S. health care system will need major public support in difficult days ahead. Still, important markers also have gone down, so pillars of the medical establishment eventually may have to account for billions of taxpayer dollars they have been all but gifted already and why they charge sky-high prices for their medical services.

Noam Levey of the Los Angeles Times deserves credit for his reporting about the public largesse that already has benefited parties in the health care system. As he wrote:

“The Trump administration has pumped billions of dollars into the health care industry during the Covid-19 crisis, padding bottom lines at some of the country’s most profitable businesses even as millions of Americans have been left struggling with mounting medical bills. And although taxpayer money has poured into drug makers, hospital systems and medical distributors, administration officials have put few requirements on the businesses that took public assistance. Pharmaceutical companies could charge more for vaccines and treatments developed with public money. Medical distributors that received government assistance to air-lift supplies from China this spring were able to sell the material at undiscounted prices. And hospitals sustained with bailout money will be free to raise prices on patients for years to come.”

caddytweet-223x300As pandemic-curtailed traffic returns to greater normality, motorists, bikers, and pedestrians may need to pay increased attention to two novel means of transportation taking to the roads: monster-sized SUVs and zippy high-tech scooters.

Even as officials in the nation’s capital approved, as expected, new rules on e-scooters, Andrew Hawkins, a reviewer at the Verge news and information site, deserves credit for raising safety concerns about a rising slice of the U.S. auto market: the over-sized Sport Utility Vehicle.

In case you missed it, SUVs have become the nation’s vehicular obsession, particularly in the kid-filled suburbs, with experts estimating they made up a large part — 47.4% — of auto sales in 2019.

andbehome-300x191Audiences laugh when Sancho Panza, a sage but servile character in the musical “Man of La Mancha,” observes that “whether the pitcher hits the stone or the stone hits the pitcher, it’s bad for the pitcher.” A paraphrase of that aphorism — regarding community spread of the coronavirus and the elderly, particularly those in nursing homes — might be sadly apt these days.

From Norton, Kansas, to La Crosse, Wis., public health officials and owners and operators of long-term care facilities are watching with dread the predicted Covid-19 surge occurring in communities across the country and surrounding the aged, sick, and injured in institutions.

And while some extreme theorists — including in the White House — argue for a pandemic response that claims the vulnerable can be protected (say, in nursing homes) while the healthy should, doggone it, just get sick with the coronavirus and get it over with, common sense and evidence are laying waste to the risky “let’s let Covid-19 blaze so herd immunity takes effect” theory.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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