Showing posts with label COVID. Show all posts
Showing posts with label COVID. Show all posts

Tuesday, May 2, 2023

Nope, My Life Ain't EZ

And now I have COVID. Diagnosed early Sunday morning at an ER. I'm feeling much better now, just 2 1/2 days later, but this infection has further delayed my first infusion to treat the melanoma until May 15th. This 14-day delay is due to the hospital's established medical protocol. 

Medical protocols are complicated things with lives of their own. They are established by committee with recommendations from the medics often conflicting with recommendations from the administrators, the accountants, the lawyers, and their insurance companies. Once in place, it's really difficult for an 'employee' medic (even more so for a contracted medic) to deviate from said protocols except in case of imminent loss of life or property. Our entire care for profit system has become a gigantic machine, accelerated by need and new discoveries and throttled by accountants, insurance companies, and lawyers. Once you are entered into the system for any particular need, you become an item on a conveyor belt. The system serves the 'typical' patient quite well, while serving the lawyers, administrators, and insurance companies even better. Less so for caring medics and those that don't quite fit into the mold. 

I've also applied to the Mayo Clinic Hospital in Phoenix to see if they want to take me on as a patient. Maybe I'll hear from Mayo next week. Same system, different machine.

And to make things more interesting, Glenda, my 73yo nearly blind and memory deficient wife, has a fever and fatigue tonight, so I'll probably have more to deal with to care for her tomorrow.

Wednesday, July 28, 2021

An EZ Invitation

This is an invitation to all my rugged individualist friends: Hey, good buddy, let’s go hunting out in the wild. Bring the camp gear. Bring the guns. Let’s get some game for the freezer and maybe a trophy for the wall. Let’s have a great, old-fashioned good time!

But we want to be safe and practice the things we’ve learned about being rugged individuals, including weapon safety, proper hydration, careful orienteering, and dressing for the weather. There are other things to consider. As we go into the untamed wildlife habitat to stealthily stalk creatures, keep this in mind: Lyme disease is everywhere in the wild where we would be hunting. It can make you really sick, with skin and nerve problems, or even a fatal heart ailment! You get it from a tick bite, and those little bastards, the size of a poppy seed with a painless bite, are opportunists. But don’t get worked up about it, it’s pretty easy to protect ourselves from Lyme disease.

To be safe, just make sure to slather on a good DEET-based insect repellent while we are on our trip. You can also get hunting gear and clothing that is impregnated with DEET to give a little extra protection.

Yes, using an insect repellent is a pain, and, yes, there are some reported side effects (even a couple of deaths!) from using insect repellents. Some people have medical conditions and can’t use them at all! But if you don’t have those issues, what the heck. In the vast majority of reported cases of adverse reactions, the discomfort or illnesses are mild. Nearly 90% of reported adverse reactions to DEET don’t even require hospitalization. In any case, such negative effects are nearly always much less severe than Lyme disease.

Even with DEET and proper coverage with special cloth, there is still a chance you may get a tick bite resulting in Lyme disease. Sorry. Nothing’s perfect. There is no 100% sure way to prevent the spread of the illness. Careful use of insect repellent won’t guarantee you won’t get sick, but it does greatly reduce your risk and nearly everyone who can safely use DEET agrees the risk-benefit calculation favors careful use of the repellent. Using the repellent and distancing yourself from the brush where you may be exposed to ticks followed by a careful inspection of your skin, when applied together, greatly reduce any risk. After all, we are here for hunting and fun, right? Don’t want a preventable illness to spoil that!

Wait. What’s that you say? You won’t use the repellent? You feel like you are being manipulated by my warning? My warning is some evil political ploy to ‘control’ you and your behavior?

Well, you certainly have your rights. If you don’t want to use insect repellent no one is going to force you to do that. After all, it is your body and your decision to make, and we can all respect that. If you get sick, you will be the one suffering and incurring huge medical bills. And you won’t likely be spreading Lyme disease to your friends, family, and strangers you meet. No. It’s not as if it were a respiratory virus or something where there would be a personal responsibility to protect others from your infection. Nope. Not like that at all.

 

For more information, see:

 

Lyme Disease Treatment Guidelines. Lyme Disease Association. https://lymediseaseassociation.org/about-lyme/medical/treatment-guidelines/?gclid=CjwKCAjwgISIBhBfEiwALE19SYtP3TDQwgRa5jbpbnChAJIpgGjreBhFm0B0Pxq81ZuOVMUp7UfFAhoCn8YQAvD_BwE. (2017, February 3).

 

Schwartz AM, Hinckley AF, Mead PS, Hook SA, Kugeler KJ. Surveillance for Lyme Disease — United States, 2008–2015. MMWR Surveill Summ 2017;66(No. SS-22):1–12. DOI: http://dx.doi.org/10.15585/mmwr.ss6622a1

 

Can One Die of Lyme Disease? New Health Advisor. https://www.newhealthadvisor.org/Can-You-Die-from-Lyme-Disease.html. (2019, September 1). 

Thursday, April 16, 2020

The Modern Ethical Dilemma of COVID-19


As anyone who has ever spent more than five minutes considering it knows, economics is an extremely complicated matter. It's been called the dismal science. Maybe the most simple rule of the economy is that any transaction that leaves both participants happy is a positive thing and enriches the overall economy.

Some hold out that we should now open the economy fully to stanch the financial bleeding. Yes, they say, some will die, but mostly the old and ill anyway.

The loss to society of illness and premature death has been studied and written about in great detail. I'll give you just a couple of links, later, so you can ponder this question.

But, first -- even if all the deaths were those receiving social security -- do you think those recipients stuff the money in their sofa cushions? No. As a retiree, I can tell you that the money gets spent on housing, utilities, food, clothing, transportation, medical care, and recreation (to include gifts for children and grandchildren). Every dollar they spend is good for the economy. All the vacation travel canceled due to COVID-19? Much of it by seniors. Ask any airline executive what that's worth to the economy.

But the elderly and sick won't be all of those taken. When a person in mid-life (20 to 45) is taken, there are somewhere between 1/2 and 2 million dollars of value lost, forever, to the economy. They won't fill a job. They won't raise a family. They won't spend their earnings. They won't pay taxes. They won't invent the next big thing. Imagine if the cancer that took Steve Jobs life had done that when he was in his 20s, or if Alexander Fleming had died young.

But, wait, there's more! Even if this illness killed nobody, even if the illness didn't close a single business, there is a horrendous cost from the illness. I've read that COVID-19 runs 8 to 16 days from onset to death or recovery. What does that illness cost? My most recent 3-day hospital stay for surgery cost nearly $150,000.00; so $50K a day. Maybe that's high. Maybe the average is more like $20K a day--and that does not include the loss to the economy from that person being off the job. Every dollar spent on health care that could be prevented is a dollar that isn't spent in restaurants, stores, bars, and entertainment venues.

In the 1918 flu epidemic, 20% of Americans were stricken. Let's be conservative and work with only 1/4th of that as possibly needing hospital care -- if only 5% of our populace of 300,000,000 is stricken by COVID-19, that's fifteen million people. If their average hospital stay is half the sixteen days, 8 days at $20K a day, that's 2.4x10^12 dollars--$2.4 TRILLION. Pure, direct cost to the economy, not including the loss of their productivity. The total, true cost is much higher and beyond the scope of this discussion to calculate. If 2% of the fifteen million ill will die, that's 300,000 deaths -- news flash, we are already over 100,000 world-wide -- how long till just the U.S. reaches that.

So if by closing and quarantining we can reduce the illness by only half, that's a savings of at least $1.2 Trillion just from the avoidance of the illness.

It has been said that those who will not learn from history are doomed to repeat it. OK, look at history: Again, in 1918, the jurisdictions that quarantined early, stayed long, and enforced it suffered MUCH, MUCH less than the jurisdictions that did a poor job of quarantining. They had lower mortality, lower morbidity, less overall impact to their economies and recovered MUCH, MUCH faster and fully. Minneapolis tightened early and long: 388 deaths per 100,000 people. Pittsburgh didn't: 1,244 deaths per 100,000 people. And the financial recovery was strikingly different. Minneapolis tightened early and long: Growth in employment in 1919 over double the rate Pittsburgh saw in 1919.

Pittsburgh: 1,244 dead per 100,000. That same rate would mean 3,732,000 deaths in the U.S.; nearly 25,000 deaths in just the San Antonio, TX area. 25,000 fewer to work, spend and live in one city. About half of COVID-19 deaths have been people younger than 65. What would the loss of 12,500 full-time employed do, long-term, to the economy of San Antonio? And the human cost – are we ready to allow this kind of carnage without doing all within our power to fight it? I believe we have a moral imperative to do all we can to prevent illness and death. This is our real-life ethical dilemma of the trolley problem (see: https://en.wikipedia.org/wiki/Trolley_problem)

The illness, the cost of care, the deaths, the lost productivity has the potential to impact the economy in a much more negative fashion than the quarantine. And for much longer -- literally, forever.

There is something called the parable of the broken window, introduced by Bastiat in 1850, that considers the impact of negative events on the economy. A broken window in a storefront, good or bad? Good for the glazier, bad for the storekeeper. No, in the long run, it is bad for everyone because it causes resources to be expended just to maintain the status quo -- there is no advancement when the window is repaired -- things are simply returned to their earlier status.

For further reading: