We all now have the benefit of two years, but looking back, if you were President for that entire time, what would you have done (the same or differently) with the goal of fewer hospitalizations, fatalities while limiting the disruption of the economy.
COVID-What would you have done?
- Thread starter HALL85
- Start date
No shutdowns, no panic. Encourage those at risk to protect themselves, but otherwise live normally.
i would have shut down for the 2 weeks. i would have overstated the severity of covid so people take it seriously, but wouldnt shut down or have any restrictions there after. maybe some restrictions for the remaining month. i would encourage masks and leave it to private businesses to decide. i would educate and push for smart behaviors including social distancing and avoiding large crowds etc.
i dont think we totally blew it initially. i think we blew it once this is year 2 and there are still lingering restrictions.
i would also do massive education of TREATMENTS.
i dont think we totally blew it initially. i think we blew it once this is year 2 and there are still lingering restrictions.
i would also do massive education of TREATMENTS.
Thanks for indulging me with answers to the question.
The first thing we should have done was to immediately lock down our borders. The virus would have still hit the shores, but we lost valuable time to understand what we were dealing with. Another 60-90 days would have helped in deploying strategies to protect the elderly; understand and avoid some treatments were detrimental (i.e. ventilators). Additional time to develop treatments that were ultimately approved (remdesivir, convalescent plasma, etc.)
Our ability to triage cases could have significantly reduced fatalities and the stress on our healthcare system (and workers). And we had the technology to do so from the start. Begin with telemedicine platforms that had already been deployed and were slow to adopt (meaning they had capacity) prior to the pandemic.
If you were symptomatic, get routed through a doctor via telemedicine:
* Immediate triaging by a trained physician to run through a list of questions and make the decision on directing the patient (i.e. go to emergency room, a clinic dedicated to receiving less critical patients, stay home and monitor daily - since their would be an event where the physician or nurse could monitor the patient). People were getting care too late; getting sent to the wrong place, etc.
* Telemedicine could also have been deployed for people that didn't have symptoms to get assessed by a trained physician on their risk factors and then have a plan of care to address comorbidities that could be followed up on and biometrics captured along the way. This could all have been done from home and more efficiently leveraging our existing physician network. During the pandemic, physician offices were closed in many cases and docs were left idle where they could have been advising people what to do to given them the best chance of survival.
* In addition, once the link with physician and patient has been established for risk factors, the doc can also start asking questions related to mental health and depression to uncover problems before it's too late. Experts agree we are going to have a huge hangover of suicides, mental health episodes, depression, etc. as a result of the pandemic. Telemedicine counselling could have been expanded a lot faster. Once again, these places were all shut down during the height of the pandemic.
One last thing on telemedicine....people that had chronic diseases were not being monitored with the same frequency (cancer patients). Logic will tell you that a number of people will have had their life shortened because of the lack of having a physician interface and management of the disease for many months.
Two years post first case and we have an unhealthier population with no plan on how best to avoid hospitalization and/or death. That's shameful.
On the economy front, we should have let each state determine the best path for managing it's economy. Policy was uneven on the state level, but putting that in the hands of the Federal Government would have been a disaster, unless there was a respected team of medical professionals and business people that could have put forth some overarching guidelines. I use the example of a mom & pop store having to close while Home Depot and Walmart could remain open. A golf course only allowing one twosome per 18...WTF?
We have killed some family businesses and created all sorts of mental health issues as a result of it for no good reason other than politics. I think this is where Sweden did a good job. Most of their fatalities were in nursing home management; not as a result of keeping the economy open.
This is not a Trump/Biden gets blame or credit.
The first thing we should have done was to immediately lock down our borders. The virus would have still hit the shores, but we lost valuable time to understand what we were dealing with. Another 60-90 days would have helped in deploying strategies to protect the elderly; understand and avoid some treatments were detrimental (i.e. ventilators). Additional time to develop treatments that were ultimately approved (remdesivir, convalescent plasma, etc.)
Our ability to triage cases could have significantly reduced fatalities and the stress on our healthcare system (and workers). And we had the technology to do so from the start. Begin with telemedicine platforms that had already been deployed and were slow to adopt (meaning they had capacity) prior to the pandemic.
If you were symptomatic, get routed through a doctor via telemedicine:
* Immediate triaging by a trained physician to run through a list of questions and make the decision on directing the patient (i.e. go to emergency room, a clinic dedicated to receiving less critical patients, stay home and monitor daily - since their would be an event where the physician or nurse could monitor the patient). People were getting care too late; getting sent to the wrong place, etc.
* Telemedicine could also have been deployed for people that didn't have symptoms to get assessed by a trained physician on their risk factors and then have a plan of care to address comorbidities that could be followed up on and biometrics captured along the way. This could all have been done from home and more efficiently leveraging our existing physician network. During the pandemic, physician offices were closed in many cases and docs were left idle where they could have been advising people what to do to given them the best chance of survival.
* In addition, once the link with physician and patient has been established for risk factors, the doc can also start asking questions related to mental health and depression to uncover problems before it's too late. Experts agree we are going to have a huge hangover of suicides, mental health episodes, depression, etc. as a result of the pandemic. Telemedicine counselling could have been expanded a lot faster. Once again, these places were all shut down during the height of the pandemic.
One last thing on telemedicine....people that had chronic diseases were not being monitored with the same frequency (cancer patients). Logic will tell you that a number of people will have had their life shortened because of the lack of having a physician interface and management of the disease for many months.
Two years post first case and we have an unhealthier population with no plan on how best to avoid hospitalization and/or death. That's shameful.
On the economy front, we should have let each state determine the best path for managing it's economy. Policy was uneven on the state level, but putting that in the hands of the Federal Government would have been a disaster, unless there was a respected team of medical professionals and business people that could have put forth some overarching guidelines. I use the example of a mom & pop store having to close while Home Depot and Walmart could remain open. A golf course only allowing one twosome per 18...WTF?
We have killed some family businesses and created all sorts of mental health issues as a result of it for no good reason other than politics. I think this is where Sweden did a good job. Most of their fatalities were in nursing home management; not as a result of keeping the economy open.
This is not a Trump/Biden gets blame or credit.
could our physicians really take on the influx of covid AND continue with the daily treatment which you suggest? seems contradictory. telemedicine is good, but its not opening up the doctors schedule, probably the opposite. and one of the issues is that people werent being proactive with their health. youre suggesting to increase the volume of telemedicine visits tenfold. and how do hou get biometrics across telemed? you just said pulse ox is the big factor for timely triage yet you cant do that over the computer unless everyone has the device.
Not all physicians were treating people in the hospital. Most primary care physicians were sitting at home doing very little.
almost impossible to get a new (and good) primary care doctor in the last year +
would think that more physicians would be available for new patients if it was how you said it was
Not really…it was hard enough for hospitals to navigate the traffic during the peak. Just because you’re a doctor nurse doesn’t mean you’re trained in that kind of emergency medicine. Most would have just gotten in the way. COVID exposed a lot of strengths and weaknesses in our ability to respond to a pandemic. I wouldn’t point my finger a physicians and caregivers as something that was wrong.
WHO now advises against convalescent plasma treatment.
www.cnbc.com
WHO strongly advises against convalescent plasma for treating Covid patients
The WHO issued a strong recommendation against administering convalescent plasma to treat Covid patients, citing research that shows no improvement in patients.
no this isnt contact, this is accepting new patients. no matter in person or telemed. there is still a lack of drs accepting new patients.
Yes that is true. We’ve had a general physician shortage for some time. Good physicians can be selective.
so i think i would count this as reason #1 no? you seemed to miss it. how can people set up telemed apt with drs who dont exist or dont want to accept patients?
so we have drs who are sitting at home doing nothing during the pandemic and others that dont accept new patients?
they still have to meet with patients. maybe there are some operational efficiencies but its not cutting down on things it does for the patients like travel
I would have done with the Governor of Florida did with schools. Starting with the 2020 academic year, kids are back in school, normal schedule, no masks. Teachers don't want to show up, unions want to play games, too bad and see your a** out. Instead of f***ing with our kids like they have done in New Jersey for closing on 2 years now. Years from now when we look back on this, the aspect that will resonate the most if how we screwed with our kids, especially the young ones who need to be in school socializing and interacting with their peers more than anything else.
I wouldn't have also "settled" or "allowed" what most schools did at the younger levels from March 2020 - June 2020, which is basically say they "weren't prepared" to deal with a "remote" situation. BS. Every other job had to figure things out in short order to survive. My company had to change on a dime, and we did, because we would have been hurt and lost money (or jobs) if we didn't. Of course the teachers union makes public schools virtually bullet proof, so we had physical education teachers in my town (and others I know about) basically pre-recording instruction videos to be played on "zoom", while they were out golfing by noon each day on the tax payers dime.
I wouldn't have also "settled" or "allowed" what most schools did at the younger levels from March 2020 - June 2020, which is basically say they "weren't prepared" to deal with a "remote" situation. BS. Every other job had to figure things out in short order to survive. My company had to change on a dime, and we did, because we would have been hurt and lost money (or jobs) if we didn't. Of course the teachers union makes public schools virtually bullet proof, so we had physical education teachers in my town (and others I know about) basically pre-recording instruction videos to be played on "zoom", while they were out golfing by noon each day on the tax payers dime.
You are conflating two issues so sorry if I confused you.
For the past two decades we have been experiencing a shortage in primary care practitioners. More prevalent in rural areas or cities that just aren’t attractive. Most physicians will have a target number of how many patients they will except into their practice. Payer mix enters into that as well.
During the early months of Covid, many primary care offices shut down completely. Any patient interaction had to be initiated by the patient and they were either diagnosed over the phone or told to go to an urgent care center or emergency room that was open. They had a lot of downtime as a result of that. They were also not accepting new patients because most of their staffs were furloughed I couldn’t process new patients, nor did they want to add any new patients not knowing when their offices might reopen.
So yes, there was excess capacity during the height of the pandemic while we could’ve used them to triage and proactively guide patients whether they had Covid or not.
There is a difference of opinion between WHO and FDA (end of article). In order to speed the plasma to market, a randomized trial was never completed. In addition, antibody titer wasn’t being differentiated at the start so if two COVID survivors donated plasma, and one had twice the antibodies as the other it was treated the same. What researchers found (and later implemented) was a high/low titer differentiation. Low titer while being stored, is no longer being used to transfuse. IMO, better and more effective therapies available now, although plasma has no long term side effects.WHO now advises against convalescent plasma treatment.
WHO strongly advises against convalescent plasma for treating Covid patients
The WHO issued a strong recommendation against administering convalescent plasma to treat Covid patients, citing research that shows no improvement in patients.
