Doctors Feeling Outrage

David Posnett — Sat, 21 Mar 2020 01:05:38 +0000

Coronavirus tragedy: Chinese doctor who postponed wedding to treat patients dies of infection. Feb 21,2020.

From Norbert Goldfield (Ask Nurses and Doctors LLC, AND)

Three updates from AND

From Andrew Goldstein. If you read anything today – read this.

I’m watching my hospital, my city, and my world be hit by surges of people sick with COVID19. I know people who have lost loved ones already, and I know health workers who are sick.

But this is actually the tense silence before the storm. The real tidal wave is yet to come and it is still somewhat preventable, if only we intensify our public health approach immediately and ensure it is equitable and humane. With that in mind, my colleague Akash Goel MD and I wrote this plea in The Hill today:

A plea from NYC physicians: Our window of opportunity is closing to avoid Italy’s fate

We know there are challenges and concerns about such measures but I think we can solve them. I hope you will share this message. We must follow the lead of countries that have taken these massively life-saving steps earlier, or we’ll likely join the ones that regretted not doing so.

Spread the word NOW.

2. It was a matter of time. One of my colleagues, is a retired non practicing physician on life support with Covid-19. One friend has been hospitalized. Despite this challenge, the administrator of our practice emotionally said to me yesterday how each and every physician has volunteered to do more. 200 health professionals in the Baystate system that I am part of are under quarantine. Conditions for which I would ordinarily see the patient – were all managed by phone yesterday.

3. For those interested in more details on our emerging understanding of covid 19 and its antecedents pls sign up for regular updates and the latest research from NIH. https://www.nih.gov/health-information/coronavirus

4. We need to keep in mind who is responsible for the Covid-19 debacle in this country; who is responsible for cutting back just passed legislation on paid leave (any number of the medical assistants I work with are at home with their kids instead of at work); who is blithely stating falsehoods time and time again; who could have taken action but didn’t – it is the executive branch (with help from the U.S. Senate). See these links:

https://www.nytimes.com/2020/03/15/opinion/trump-coronavirus.html?searchResultPosition=8

https://www.nytimes.com/2020/03/20/us/coronavirus-poverty-school-lunch.html/

https://www.politico.com/news/2020/03/19/trump-slash-red-tape-to-find-coronavirus-drugs/

https://www.nytimes.com/2020/03/20/us/politics/trump-coronavirus-supplies.html?action=click&module=Spotlight&pgtype=Homepage;

Please act on your outrage via letters to the editor; op-eds; uploads on you-tube videos or any other form of communication We are happy to help review any communication you choose to write. Norbert Goldfield MD and David Posnett MD

The Terminology of Keeping Distance

David Posnett — Fri, 20 Mar 2020 03:46:50 +0000

The concepts of social distancing, quarantine and isolation are being interpreted in a variety of ways, not always correctly. Here’s a guide to help you make the right decisions. It comes mostly from a NYT article on ‘social distancing’ by Tara Parker-Pope from March 19th, 2020.

The terminology comes from the public health field but most of us struggle to comprehend the exact meaning and what should be applied in our own situation.

Social Distancing

“Social Distancing: This Is Not a Snow Day.” To slow the coronavirus, wrote Dr. Asaf Bitton, we must act quickly and start “making daily choices to stay away from each other as much as possible.”

Social distancing is ultimately about creating physical distance between people who don’t live together. It means closing schools and workplaces, canceling concerts and Broadway shows. For individuals, it means keeping six feet of distance between you and others and avoiding physical contact.

It means no dinner parties, no playdates, no birthday parties even with a few friends.

Who should do this? Everyone.

Shelter in Place

This means stay home. Don’t leave the house unless you absolutely have to. Don’t socialize with people outside your family. Don’t go to a friend’s house for dinner or invite a trusted friend over.

You are allowed to go outside for essentials (groceries or prescriptions) but you should limit those trips to no more than once a week if possible. People with essential jobs — public safety, medical, sanitation or grocery worker — can still go to work. And you can visit someone if you are their caregiver.

You can walk the dog or exercise outside as long as you keep a six-foot distance from others.

Continue reading the main story

Who should do this? Everyone who lives in an area with a mandatory shelter-in-place order (Northern California and possibly, soon, New York City). But many infectious disease experts say that everyone else should voluntarily shelter in place.

Self-Monitoring

Checking your temperature, and watching for signs of coronavirus infection (fever, shortness of breath and coughing, flu-like symptoms.) A person who is self-monitoring should already be staying home and limiting interactions with others.

Who should do this?those with possible exposure to the virus but had only distant contact with the infected person.

Self-Quarantine

This term is used to separate and restrict the movement of someone who is well but who recently had close contact with a person who later was diagnosed with the virus. A person in self-quarantine should follow all the rules of sheltering in place, except they should avoid going to stores or interacting with the public even on a limited basis for a 14-day period. (A friend should bring you groceries.)

A person in self-quarantine should sleep in a separate space from other family members.

Who should do this? Persons without symptoms, but with a contact history (with someone who later became ill.)

Self-Isolation

Isolation is used to separate a person who has a diagnosed case or someone who has distinct symptoms including a cough, fever and shortness of breath, but hasn’t yet been tested or received test results. A person in isolation should be confined to a separate room with no or minimal contact with the rest of the household (including pets) and use a separate bathroom if possible. Most of the time, a sick person will feel a bit miserable, but he or she can pick up food trays left at the door. Sanitize a shared bathroom after using it.

Who should do this? Anyone with a confirmed case of Covid-19, a person waiting for test results or a person with obvious symptoms who is still waiting to be tested. Everyone else in the household should self-quarantine.

Official or Mandatory Quarantine

A government-imposed lockdown on a community, as has happened in Italy, in which movements are severely restricted. People can still go out for essentials and to get fresh air, but they can do so only under strictly controlled conditions or on a specific schedule imposed by public safety officials.

Who should do this? Everyone who lives in an area under quarantine. “We haven’t seen this in the U.S.,” according to Dr. Bitton, but certainly in Wuhan, Hubei, Italy, and other countries.

isolation – R&R – Reachout and Rebuild