“Shared expectations lead to predictability.”
366. More hospitals are no longer able to give the routine standards of care.
Q: Are hospitals in northern Idaho the only ones giving the “crisis standards of care?”
A: The “crisis standards of care” is when guidelines are drafted that staff will use to sort which of the patients who normally would be admitted will be either be required to wait in their cars (or in ambulances) in the parking lot until a bed becomes available, or turned away and sent home without treatment. Only comfort care (sedatives and painkillers) is usually prescribed. Last week’s column identified that the state of Idaho was moving to ban mandated mask-wearing and vaccinations for school students, teachers, and staff as well as health care workers. They now have the lowest vaccination rate of any state in America. (46% have received at least the first dose!) Last week on Thursday, the Deputy Director of the Idaho Department of Health and Welfare, Dave Jeppesen stated, “We don’t have enough resources to adequately treat the patients in our hospitals, whether you are there for Covid-19 or a heart attack or because of a car crash.” The entire state of Idaho has enacted crisis standards of care for all of its 18 acute care hospitals.
In Alaska, the Providence Alaska Medical Center in Anchorage announced It will begin providing crisis standards of care for its patients because they no longer have the resources to treat all patients who appear. This is especially significant because, for critical care, Providence Alaska Medical Center is the largest hospital in the state and is the primary referral center receiving critical care patients from all the other nine critical care hospitals in that state.
As of last week, there were eight other states that had only 10% or less of their state-wide ICU beds available and were preparing their critical standards of care, should they be required: Alabama, Georgia, Tennessee, Mississippi, Louisiana, Kentucky, Texas, and Arkansas.
This breakdown of our national healthcare system will have repercussions for many years to come as planning finds ways to prevent future similar situations.
367. The number of deaths caused by Covid-19 in the U.S. is exceptionally large.
Q: How many people have died in America because of this disease?
A: Since the beginning of the pandemic in the U.S., there have been nearly 680,000 people whose deaths were attributed to this disease. This means that one out of every 500 men, women, and children living in the country is no longer living! And unlike heart disease and cancer, the previous leading causes of death, Covid-19 has claimed a disproportionate number of young people.
368. Most Americans support vaccine and mask mandates.
Q: There are a lot of people angry about mandated vaccines and masks. Is this a problem?
A: News reports have increasingly shown instances where people are angrily demonstrating their lack of support for the mandated use of masks or for getting vaccinated. Last week, findings from a new poll from Monmouth University were released. Amid the increasing risk of becoming infected by the highly contagious Delta variant, the survey shows that a majority of Americans support the vaccine mandates announced by president Biden last week. Among other findings in this poll, Americans also support instituting state guidelines for mask-wearing, social distancing, and requiring proof of vaccination for certain activities such as boarding an airplane or reporting to a workplace. Interestingly, the majority support for these measures is found in both blue states and red states, although a significant number of people, most of whom are Republicans, remain opposed to getting vaccinated.
The poll finds that 66% of Americans support face masks being mandated for all school students, teachers, and staff (68% in blue states and 63% in red states). The difference between blue states and red states in each of the multiple questions asked did not differ by more than 5%. The vocal opposition to mandates is obviously not representative of the view of the general public.
369. Opposition to public health methods are becoming laced with anger.
Q: What are people thinking? Crowds are angrily opposing masks and vaccinations!
A: Throughout the country, reports are increasing of threatening behavior against officials who, following tradition and legal procedures are being challenged and ostracized. Politically, we hear of public officials being asked to “find” enough votes to declare an election was won by the actual loser. In public health, recent events have affected the ability to contain the pandemic – to reduce the chance that new mutations will emerge. Early on, Anthony Fauci, MD, who led the scientific effort to control COVID-19 received many threats against him and his family. This caused the federal government to provide him with around-the-clock security detail. In Florida, school superintendents who mandated face masks in their districts were punished for violating the ban on such mandates by the governor cutting funds equal to their salaries. Not all such threatening confrontations occur in red states or in the south. Several weeks ago, Governor Lamont spoke in Chester Connecticut about his plans for reopening schools in September. A vocal crowd shouted him down repeatedly over his plans for masking of staff and students and vaccines – causing the meeting to end early and the governor leaving amid curses and shouting. In NH, state representative William D. Marsh, a retired ophthalmologist, had opposed continuing legislation to ban vaccinations and mask requirements. As a result, he was threatened with removal from his leadership role on the public health committee. Last week, when it became apparent that the NH legislature was going to refuse to accept large federal funding to expand vaccinations in the state, he changed his party affiliation from Republican to Democrat.
These and other public health examples of threatening and angry demonstrations are part of a much broader undercurrent displaying an emerging trend in the country. In this week Monday’s Hartford Courant, front page, Clare Feldman said, “the level of vitriol and anger and frustration has risen over the last few years,” Clare is chair of the Board of Trustees of the Hartford Seminary, and was announcing a change in its name and logo to reflect their emphasis on peacebuilding, interreligious dialogue, and conflict resolution.
Anne Appelbaum has frequently written on the challenges to democracy in America. In an article in the recent Atlantic Magazine, Anne identifies we are behaving like the Puritans: “A growing illiberalism, fueled by social media, is trampling democratic discourse. The result is ruined lives and a chilling atmosphere in which mob justice has replaced due process and forgiveness is impossible.” This is an interesting perspective.
Anne Applebaum The New Puritans https://www.theatlantic.com/magazine/archive/2021/10/new-puritans-mob-justice-canceled/619818/
370. Anthony Fauci, MD, identifies the best way to protect unvaccinated children.
Q: How can I protect my 11-year-old sixth-grader who cannot yet be vaccinated?
A: Under intense criticism for the delay in approving vaccines for children under age 12 before school reopened, Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, concisely and accurately identified the best way to protect everyone from the highly infectious Covid-19 currently sweeping the country: “surround them to the extent possible with people who are vaccinated.” This includes in the school, all teachers, staff, and children over age 13, and at home, all siblings over age 12, parents, and others living in the same abode.
