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The cacophony of the COVID-19 crisis

Ton La, Jr., MD, JD
Conditions
March 26, 2020
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ICE is requesting bids for 45,000 N95 masks

Why is ICE soliciting for masks when our frontline health care workers need them? There is no social distancing during detention and deportation, and what ICE is doing puts the public at risk. We should immediately suspend detention and deportation for the time being!

Health care workers forcing to take PTO to self-quarantine

When PPE (personal protective equipment, e.g., face masks and gowns) are in low stock in the face of overwhelming demand, certain medical staff (e.g., psychiatrists) are not allowed to use PPE or to take any other reasonable measures to reduce exposure. In turn, if health care workers exceed their vacation, PTO, and sick leave time due to self-quarantine, they are unpaid. Where is the fairness in that? The more workers that get sick, the higher the patient load on those who are left. Hospitals are becoming warzones, and we are failing our brave men and women who are fighting a known threat while we stay at home and pray.

The unproven hydroxychloroquine/azithromycin treatment

Ever since a French study put forth that this combination of drugs could potentially aid COVID-19 patients, providers across the country started to hoard and stockpile hydroxychloroquine and overprescribing to loved ones and friends, where some are using it for prophylaxis! It is not surprising at all why President Trump has encouraged the nation to get prescriptions of the drug and to try it out, what’s there to lose? Taking it is potentially fatal, as was shown by an elderly couple ingesting chloroquine to prevent coronavirus, with the husband now dead and the wife in critical condition.

The demand for hydroxychloroquine has caused back orders at pharmacies, and who is affected the most? Patients with lupus, rheumatoid arthritis, and other autoimmune diseases who are prescribed hydroxychloroquine to keep at bay flare-ups. Is this just? Absolutely not! This is a vulnerable population, and for physicians to give out prescriptions like candy is irresponsible. Aren’t physicians not supposed to do no harm? I am shocked that there are doctors out there who are succumbing to the demand for hydroxychloroquine for profit because they know that this anti-malarial drug can be dangerous and is not FDA-approved for COVID-19. This is akin to giving in to a patient demanding antibiotics when they have a viral infection.

An absurd CDC recommendation

It is satirical for the CDC to publish on their website (and to keep it there) that “In settings where facemasks are not available, HCP [health care providers] might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort.” They even go on to say that, “However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option.” So, why would the CDC even recommend this to health care providers? It is utterly disrespectful to every health care professional, and the CDC should have said instead that they are actively working on the PPE shortage instead of offering a purely inferior means of protection that health care workers are actually using now. My only reasoning is that having this verbiage is some sort of hospital liability protection if workers resort to homemade masks (which is already happening).

Where’s Waldo?

Where is the Joint Commission in all of this? Cleaning masks to reuse them multiple times, seeing suspected and positive COVID-19 patients without wearing masks when there are none left, and donning one isolation gown for an entire shift are all clear violations; yet, no one has heard from them. What about running codes without wearing PPE, or even sending COVID-19 positive patients back home?

Like the CDC, the Joint Commission is complicit when they do not publicly speak against the reuse of facial masks. Don’t they understand that health care workers throughout the country are resorting to these desperate measures because we are simply unprepared? I even heard of people wanting to 3D print masks, and health care workers pleading to anyone and everyone, from construction workers to your next-door neighbors, to donate their N95 masks to hospitals in need. The sheer lack of foresight and accountability is deplorable! Especially since we faced Ebola a few years ago and seemed to have learned nothing from that time period in regards to investing in epidemic/pandemic prevention.

Utterly poor leadership

Most of those with overarching decision-making capacity at hospitals are MBAs and non-health care people. Why are nurses and doctors being penalized for wearing surgical masks around the clock to protect themselves against a virus that has no vaccine, while during flu season, they are forced to wear masks if they themselves cannot take the flu vaccine? Why are these administrators, most who have no clinical knowledge, making decisions for that impact health care providers who are ruling patients out for COVID-19 and treating those who have the virus? How much abuse are health care providers going to take before they call it quits?

This is the opportunity for all health care workers to call out hospital administration officials who are forcing them to see patients when they cannot protect themselves, and to take back the positions that they hold. Does it make sense for a firefighter to run into a burning house without the proper equipment? No, so why is it okay then for nurses and doctors to immediately see acutely ill patients who potentially have COVID-19 without the proper gear? Hospitals also need to be held accountable for forcing nurses to wear one mask each for their entire 12-hour shifts when visiting multiple patient rooms. As it doesn’t make sense for a soldier to be given one bullet to fight off an enemy, it is absolute insanity to expect a nurse or physician to where one mask to see multiple potential COVID-19 patients.

The biggest and ugliest problem

The COVID-19 crisis has finally shown all of America its darkest secret: the federal government reacts to problems instead of trying to address the root causes to prevent disasters. Because the U.S. simply reacted to the virus coming to our shores, all hospital systems are egregiously unprepared, as shown by the nationwide PPE shortage, the delays in testing, and the lack of leadership to protect our frontline health care workers. We should not be having governors competing with one another for PPE. We need this administration to step up and declare a national shutdown and to finally invoke the Defense Production Act. If we are truly the greatest country in the world, let’s make that point right now and make the right decisions for the entire population.

How can you help? GetUsPPE.org is a leading national, grassroots effort to equip front line health care workers with the protective equipment they need to keep us – and themselves- safe. Share #GetUsPPE, and visit GetUsPPE.org today to request for and donate PPE.

Ton La, Jr. is a medical student, can be reached on LinkedIn, and is affiliated with GetUsPPE.org.

Image credit: Shutterstock.com

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