Medicine and Politics - Is it a good mix?

Before we begin. THINK about what makes sense to you as you read along.

INTRODUCTION:

What makes sense to you? I know when smoke is being blown up my rear, and people are stirring the shit pot.

I was planning to write about this topic, but received a request from a reader to talk about the politics of Covid-19. Being in medicine for over 30 years, I've learned a thing or two, and seen enough to last many lifetimes. Why am I writing this?

There are times that political bashings is not required.

Especially in a medical crisis.

What upsets me is everyone is watching the news and glued to their TV's and internet daily, learning about new developments. I am sick and tired of seeing our leaders, FEMA, and others, battered to death about foolish issues. The first thing you learn in any crisis is to fix the problem. Once that's done, you debrief and see where things went wrong and fix them for the future. Every critical thinking situation works that way. WHY? BECAUSE IT WORKS.

Let me give you one example, and there are many more, but this one stands out. I get it. A jouralist needs to dig, get the story, dig up the facts as well as the dirt. It's news. However, when does it become anti-productive and place doubt and fear in the mnds of the public during a medical crisis such as this? I watched an interview with Peter Gaynor, from FEMA the other day. He is responsible for the allocations of supplies. Who interviewed ihim is irrelevant.

Many of you may have seen it. The journalist conducting the interview kept insisting on getting an answer to why the federal stockpiles have not been totally depleted to meet the demand. The question was repeatedly answered, the same way each time. Mr. Gayor kept stating, "I have to think about today, tomorrow, and the next weeks." He further noted that more supplies were being sent to the highest affective areas first. This was not stated once, it was stated multiple times as the question kept being repeated to the point of badgering, at least in my opinion. Also, the interviewer wanted dates, amounts, etc. I'm sure that little earpiece to receive messages from the producer was going crazy. The impression I got was that the interviewer kept asking these questions to make it appear he was lying. That's just my opinion of course. YEsterday, the President gave his update. He spent roughly ten minutes quotes date, amount, and types of supplies sent to affect areas. A total waste of ten minutes when we need to know more pertinent information. The dates, amounts, and type of supplies means nothing. Supplies were sent.

HERE IS THE COMMON SENSE PART. Who in their right mind would ever totally deplete all our supplies? Some number of supplies need to be held back should something acute happened elsewhere. Do we just send the whole inventory to one place and screw the rest of the country? Or, do we allocate, meaning, send more to where they are needed, and less to areas less affected, and keep a reserve should an acute outbreak happen somewhere else. Everyone believes just because production is ramped up, orders are placed, the product immediately happens, and by the gift of magic dust, it appears where it is needed.

First, the supplies it need to be manufactured, inspected, packed, shipped, and be delivered to where they are needed. That does NOT happen overnight. It takes days. People are working around the clock seven days a week to meet the demand. For God's sake, stop badgering them. Every interview I watch, someone states, "It's happening." Well, it is, but it's not going to happen overnight. With regards to stockpiles. HERE ARE SOME FACTS.

MEDICAL SUPPLY COMES WITH AN EXPIRATION DATE. These dates are determined by when the materials might degrade to the point where they are no longer effective as designed. To stock billions for years without being used is useless. I worked as a paramedic in a high volume innercity. We had a call volume that exceeded over 90,000 calls each year. That was for one out of five regions in the state that I worked in. You could NEVER have the amount of personnel on duty 24/7 to cover every POTENTIAL disaster that could occur. There is an old saying that goes like this. "We can staff for call history we have with an added percentage for increased volume. We cannot staff for calls we do not know will occur."

This is why EVERY first responder system works under a mutual aid plan. If a disaster, someitmes refferred to as an MIC, (mass casulaty inncident), occurs, the sytem has the ability to pool resources. They can use the entire states resources, and even federal resoures if needed. Just as we are doing now. However, at times, even that may not be enough. This is our present situation. Look at is this way. Sometimes a firefighter will start another fire to stop the spread of one already burning. That's called a controlled burn. Isn;t that what the CDC is doing now? Stay home, social distancing, clsoing non-essentail business. "A CONTROLLED BURN TO STOP THE SPREAD."

Another thing I heard reprted was, a form of a new virus was predicted last year and ignored. Why weren't we ready? No country has the resources to be prepared for every prediction. I can predict the same. Anyone who knows anything about science and medicine will tell you viruses mutate. It is possible to have a pandemic becuase of a new strain of virus any year. History has shown us this. If you believe our healthcare costs are high now, imagine in a perfect world if we had a hospital bed and available staff for every person on the earth, at any given time? Now factor in supplies, and your cost rising expodentially.

COMMON SENSE:

In medicine we plan for disasters. We train for them, we stock supplies, within reasonable parameters, for what we may need, without having to throw so much away due to expirations dates because they are never used. In the private sector, they can rotate stock, when you are stock piling reseves, you would have to rotate them as well into the private sector in order to not throw them out when they expire. That alone would cost millions to manage. As a medic I would check the expiration dates of the medications I carried at the start of every shift. Some medications we use on a regular basis, others, not so much. On the fire department would would send back boxes of expired meds that were not used. However, we needed to stock them just in case. Some of that is the cost of doing business. The trick is to draw a comfortable line as to how much to stock. It's not a perfect system, and every system has room for improvement. When an event occurs, we learn, and improve on the system.

Everyone asks why aren't vaccines or meds developed yet to combat this virus? Does it make sense to blindly administer medications without knowing the effect they might have? Some testing MUST be done or we run the risk of killing people that might not have died. Like it or not, you cannot blindly move forward.

UNDERSTANDING:

Before we can understand a reaction, we must understand the cause. As it pertains to Covid-19, the world is still trying to understand the cause, origin, and learning more about the virus and how it will affect us each day. NO ONE IS A MASTER OF THIS DISEASE. We cannot predict when a virus will occur, yet alone mutate. However, history has shown us that viruses will. No one can develop a vaccine for a virus that they do not know is going to exist, or what future strains will develop. That is one of the problems with the flu shot. Once a new strain comes out each year, the new vaccine is for the previous year. Therefore, the flu shot will help, but may not be totally effective against the new strain. Makes sense, right?

That is NOT an anti-productive process. It's a realistic process. Should someone get the flu after receiving the shot, the hopes are it will be a milder case. Of course, the science goes much deeper, but for the purpose of this post, I do not need to make a medical researcher out of you. The important thing is that we understand the process, the public, and how they will react to a given situation. Keep this in mind. A human reaction is directly proportional to how things are presented to them. Meaning, presnt panic, and you will get panic. Present calm, and youi will get calm. It's not what we say, it's how we say it that causes the problem. HOW WE PRESENT IT.