COVID Shortage: You May Not Qualify for Treatment

COVID Shortage: You May Not Qualify for Treatment

( – As of April 3, 2020, the number of Americans infected with COVID-19 has pushed past 250,000 and accounts for nearly one-quarter of those confirmed worldwide. This number is growing by the minute, and it’s forcing governments on every level to make decisions no one wants to make. These decisions may soon include who will receive life-saving medical care and who won’t.

Supplies, Space, and Personnel

Medical equipment is the most urgent need. Healthcare workers need personal protective gear like masks, gloves, and face shields while assessing potential COVID-19 patients and treating the sick. Hospitals only have so much room for beds, though the Army Corps of Engineers is working frantically to build temporary treatment facilities across the country. And of course, those valuable, educated frontline workers are far more susceptible to the virus than the general population, which is a double blow to the battle. Every time one of them falls ill, the system loses a warrior and gains a patient.

However, ventilators, the machines that help a person breathe when their bodies fail them, are going to be the critical problem. The Society of Critical Care Medicine (SCCM) issued a report that there are approximately 62,000 modern units available. They further estimate that there may come a time when almost 1,000,000 people may need to be hospitalized with as many as 50% of those needing the machines. Those are very dark numbers.

Gut-Wrenching Decisions

Most of those who go into the various medical professions do so because they want to help people. But based on the SCCM estimates, the demand for ventilators will soon outpace the supply (a gross understatement). Bluntly put, doctors, with the help of government and medical associations, will need to decide who gets a chance at life and who will probably die.

This issue has already impacted European hospitals and doctors. In Italy, for example, a policy was quietly put in place that stated ventilators would not be provided to patients 80-years of age or older.

Dr. Douglas B. White, MD wrote an article in the peer-reviewed Journal of the American Medical Association (JAMA) to outline what criteria should be considered based on his decade-long research into pandemic issues. Dr. White also provided a follow-up interview.

The Commonwealth of Pennsylvania has adopted those criteria as its official rules across the state.

In the article, Dr. White immediately discards the idea of preemptive mass exclusions based on factors like age and underlying medical conditions, saying they are unethical and would violate the Americans with Disabilities Act (ADA). Instead, the model uses a system to score each patient, combining multiple components used in other areas such as organ donation. These include:

  1. The likelihood a patient will survive to discharge
  2. Long-term survival chances due to current health issues
  3. Age — who has yet to experience the range of life experience

The truth is, we aren’t the ones who get to make those decisions but make no mistake, someone will be making them. Unfortunately, that’s probably going to happen sooner rather than later and we have no way of knowing whether the medical community will use Dr. White’s guidelines, a set age limit or specific diagnoses that qualifies or disqualifies someone. That’s why right now, the best thing we can do, as citizens, is to stay at home and reduce the spread of this thing. We might even take some of the pressure off healthcare workers by using our skills to make the supplies that we can.

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