Tuesday, June 09, 2020

Weaknesses revealed


Last week Erudite Partner picked up a friend from a hospital who had gone in with a complaint that had nothing to do with the virus. The next day, E.P. herself tripped and had to avail herself of the emergency room for diagnosis of torn muscles and tendons. (This too will pass.) Last night a friend who has been working partially out and about reported she'd decided she needed to be tested for the virus through her regular health care provider.

All these instances suggest that, in this city, the system has begun to overcome and normalize the disruption in healthcare caused by the pandemic. It's a darn good thing too.

Doctors Tomislav Mihaljevic and Gianrico Farrugia suggest that the more than 100,000 people we know have died from infection by the virus in the U.S. may be equaled by the number killed by the disruption of accustomed medical care. Other ailments that might have been treated have been deadly.

The toll from their deaths may be close to the toll from Covid-19. The trends are clear and concerning. Government orders to shelter in place and health care leaders’ decisions to defer nonessential care successfully prevented the spread of the virus. But these policies — complicated by the loss of employer-provided health insurance as people lost their jobs — have had the unintended effect of delaying care for some of our sickest patients. ...

Across the country, we have seen sizable decreases in new cancer diagnoses (45 percent) and reports of heart attacks (38 percent) and strokes (30 percent). Visits to hospital emergency departments are down by as much as 40 percent, but measures of how sick emergency department patients are have risen by 20 percent, according to a Mayo Clinic study, suggesting how harmful the delay can be. Meanwhile, non-Covid-19 out-of-hospital deaths have increased, while in-hospital mortality has declined.

It's not just gyms and movie theaters that we're afraid to venture out to -- it's also our doctors and medical centers.

The pandemic reveals the fragility of our civilization, less dramatically, but as surely, as Officer Derek Chauvin's crime captured on video.

Both were preventable disasters. "Preventable" seems to be my word for this season.

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