Articles Posted in Emergency Medicine

drugcrisisjulyodwoes-300x219With the novel coronavirus crushing the economy and helping to fuel joblessness, individuals’ isolation, and increasing hopelessness and despair among the already troubled, the opioid drug abuse and overdose crisis again is worsening — and fast.

As the Washington Post reported of what had been one of the nation’s leading public health nightmares before the Covid-19 pandemic:

“In Roanoke County, Va., police have responded to twice as many fatal overdoses in recent months as in all of last year. In Kentucky, which just celebrated its first decline in overdose deaths after five years of crisis, many towns are experiencing an abrupt reversal in the numbers. Nationwide, federal and local officials are reporting alarming spikes in drug overdoses — a hidden epidemic within the coronavirus pandemic.

covidpleasantview-home-300x111Owners and operators of nursing homes and other long-term care facilities have mounted a “nimfy” (Not My Fault) defense for the tens of thousands of deaths and infections of their residents during the Covid-19 pandemic. They claim they did the best they could under tough circumstances. And now they want not only special legal protections from those who suffered harms but also taxpayer bailouts.

But the industry’s disingenuous bleating has a big problem: It gets undercut by the second by infuriating actions — including by profit-mongering facilities “dumping” thousands of aged, sick, and injured residents on the streets or into flophouses, and by homes that still fail — despite warnings and penalties — to take basic steps to safeguard the vulnerable.

The New York Times — conducting the kind of sleuthing that real federal watchdogs could be taking on — reached out to “more than 80 state-funded nursing-home ombudsmen in 46 states” to detail “involuntary discharges.” As the newspaper explained of these inappropriate evictions by care giving centers, which may number more than 6,400 nationally:

fourth-225x300The United States heads into a long weekend celebrating 244 years of its independence in the deepening thrall of a microscopic killer. And political partisans, with their failure to deal with the Covid-19 pandemic, will push further still in the days ahead to divide what has been a remarkable, diverse union of states. Unlike virtually every other advanced country on earth, the pandemic in the United States has become politicized and partisan, to the detriment of our nation.

The novel coronavirus has infected more than 2.5 million in this country, killing at least 127,000 — more individuals than the U.S. casualties in World War I or the combined deaths the nation tallied in prolonged campaigns, combined, in Vietnam, Korea, and Iraq. The disease also may be far more widespread than believed — an even more worrisome possibility, health officials warn.

Despite the unfounded and magical assertions by President Trump, the summer has offered no letup to the predicted sickness and dying.

capnurse-300x169What’s in a name? The Covid-19 pandemic should force a major change in the big misnomer of long-term care institutions: Let’s stop labeling them with the term nursing — as if they provide significant medical services to the elderly, sick, and injured.

Instead, the coronavirus may lead the public to bust the myth put forward by owners and operators of nursing homes, skilled nursing facilities, assisted living centers, and other similar centers about how they treat some of the nation’s most vulnerable people, especially based on growing evidence amassing in news reports.

The care facilities knew they were not hospitals, with extensive equipment and highly trained doctors and nurses. The facilities found they often were sorely lacking gear — especially personal protective equipment. They too many times did not have the staff with the skills or training to treat already fragile residents infected with the novel coronavirus or recuperating from significant bouts with a debilitating illness. They did not have the Covid-19 tests they needed. They struggled to isolate the infected.

blmdckoshukunii-240x300Just as law enforcement authorities find themselves under fire for instances of racist, excessive uses of force, police agencies across the country seem hell-bent on giving critics more and more evidence for their argument that major policing reforms are needed.

The independent, nonpartisan Kaiser Health News Service and USA Today deserve credit for scrutinizing dozens of incidents involving officials’ actions nationwide against people protesting the Minneapolis police killing of George Floyd. As the news organizations reported (and in passages worth quoting at length):

“In a joint investigation into law enforcement actions at protests across the country after George Floyd’s death in police custody, KHN and USA TODAY found that some officers appear to have violated their department’s own rules when they fired ‘less lethal’ projectiles at protesters who were for the most part peacefully assembled. Critics have assailed those tactics as civil rights and First Amendment violations, and three federal judges have ordered temporary restrictions on their use.

dcfireems-300x145At least three recent deaths  in the DC area offer a grim reminder about the summer’s heat and the risks of drowning. With the Covid-19 pandemic changing the easy and relaxed availability of public and supervised pools and other cool water recreation spots, will this be a harbinger of needless tragedies?

Here’s hoping not.

But authorities have issued stern warnings already about swimming in the Potomac River, where they caution that the currents run stronger and the waters can be chillier than casual enthusiasts may expect. It is illegal to swim in the Anacostia and Potomac, primarily due to pollution concerns. As the DCist news site reported, though:

covidweight-300x200Health and nutrition experts may get a rare and unexpected chance in the Covid-19 pandemic time to see whether Americans have experienced even a minor reset in their maintaining a more healthful diet, increased exercise, and maybe even reduction in weight gain and its associated problems.

To be sure, these have been times of high stress, and much popular discussion has focused on people’s “Quarantine 15,” the excess pounds packed on in recent days due to worry, couch sitting, and the availability of food in the close confines of the homes to which so many of us have been confined.

And many restaurants, notably fast food vendors, offered high-fat, high-calorie takeaway for weeks now, even as they make plans to re-open.

covidcasespike23states-300x107The shambolic federal response to the Covid-19 pandemic has splintered the United States, with coronavirus infections rising in just under half the states (see NYT graphic, right) since Memorial Day and with too many Americans eager to whistle past the graveyard.

The nation leads the world in negative outcomes, with more than 2 million diagnosed infections and more than 100,000 deaths. As states and local governments relax public health measures to battle Covid-19, forecasters now estimate that 124,000 to 140,000 Americans will die of the disease by July 4.

Its trajectory looks grim in some of the biggest states, the New York Times reported:

coronaflawnursinghome-300x237Hundreds of thousands of institutionalized Americans have been infected with the novel coronavirus. Tens of thousands of them are dead. Yet a lethal bungling persists in the response to Covid-19’s savaging of residents of nursing homes and other long-term care facilities. Why?

Their owners and operators agree with medical scientists that significantly more testing is required, urgently, so the sick can be diagnosed, treated, and isolated.

But insurers and owners are bickering over who should pay for Covid-19 tests, notably for institutions’ staffers — many of whom are themselves getting sick and dying. As the New York Times reported:

asclepliusrodof-70x300As the Covid-19 pandemic has put huge stresses on medical systems around the globe, the strains have taken their toll:  The credibility and authority — of federal agencies like the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Centers for Medicare and Medicaid Services (CMS), and elite professional journals like the Lancet and the New England Journal of Medicine — have taken big hits in recent weeks.

In times of huge uncertainty and high anxiety, the public should be able to turn to these respected pillars of the health care establishment for steady, trustworthy, and independent information and execution of crucial policies that benefit the public.

The agencies are not just a pile of letters. Their work, based in rigorous medical science and the best available evidence, is supposed to reject damaging and dangerous rumor, hunch, myth, mis- and dis-information. They help to set standards for care, especially in crises, and they are charged with safeguarding us from disease, dangerous drugs and vaccines, and in protecting the old, sick, and injured in institutional care.

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