Health Care Employees and Personal Choice

There is a pretty awful and in my opinion crazy debate going on in my area of Upstate NY relative to a requirement for all healthcare workers to be vaccinated by the end of September. Gov. Kathy Hochul has put the requirement in place as part of her new administration. There are some medical exemptions but no religious exemption. 

Almost as quickly as the Governor put the requirement in place we began hearing from Hospital CEO's raising concerns about the vacancies this requirement would cause in their facilities. Of course it must be said that these facilities have traditionally had a high vacancy rate due to specific shortages, wage issues and other management decisions made by these CEO's. These folks also know how to muster political support for their issues so no surprise that other parties began to be heard from as well.

Employees themselves began to complain about the requirement and began throwing around the personal choice argument while holding demonstrations at their facilities. Of course burn out, vacancies and threats of quitting were all part of their approach too. Next we heard from 10 or so county leaders, administrators and surprisingly public health officials. These folks weren't so much against vaccinations or vaccines, they just thought the timing was poor and it would, yes, you guessed it, lead to more vacancies. The alternative being pushed was to offer employees weekly or more frequent testing. Personal choice was again the undertone of all of the discussions.

Now I understand that there are probably other things going on here. It's no surprise that most of this political support is coming from the Governor's opposition party. That's the party that says we don't have a legitimate President, that communists, socialists and nazis are lurking around every vineyard and dairy barn.  I'm also sure there are many reasons for the reality of impending resignations and increased vacancies in the health care field and they don't all have to do with anti vaccination feelings by these employees. 

We all need to recognize that these folks have been through hell. They have been short staffed, working overtime and watching people die and others not receiving appropriate care. Their wages have never been great. All of this takes a toll and none of us can really judge people needing to make a decision to leave those conditions. All of that though is very different than an anti vaccine position by an educated and trained health care or public health professional arguing for personal choice. People have gone to school, been educated and trained in issues like disease prevention, infection control and how diseases spread.

The Governor is saying she won't back down and I hope she doesn't. As a person with a serious, life threatening disease and disability, I don't want to receive health care in or from a facility where health care professionals aren't or won't follow the science or the things they were taught to receive their degrees and certifications. I don't want to be provided care by a facility who's top administrators can't figure out what's wrong with their own management. 

It's most disappointing that public health officials and departments have been dragged into this by their county administrators and convinced that a concern about vacancies outweighs their responsibilities for good public health practices. Public health is not local, its not about economic development and job protection.

Of course all health care workers should be vaccinated in a pandemic. Give me a break. The personal choice is still there. Find another job.

Socialism or Capitalism? Neither One Seems To Work In A Pandemic!

We all know the debate. It was started most recently by the former President and his followers in the fascist wing of the GOP.  Socialism is terrible, the road to communism and State control. Capitalism is wonderful. It encourages competition, individual success and a market driven economy. Or from progressives, Capitalism leaves out those on the bottom and just leads to a smaller and smaller group of people who are in power. Socialism will solve all of our problems, everyone will be treated equally.

Well it turns out that all we need is a pandemic and a mass vaccination program to prove that neither of these systems seem to work. That's right, the Covid vaccine implementation response in the US is pretty clear proof that no one has very many answers to protecting citizens in the US and that should scare the hell out of everyone.

Operation Warp Speed may have been fast in the development of vaccines, partly by eliminating regulatory hoops for FDA approval, but that's about it. Getting shots into arms has been a disaster. Public Health has failed, federal, state and local governments have failed and so has the private sector through a network of pharmacies. In all of these cases, the incompetence relative to information technology is absolutely stunning. People all over our country are chasing their tails, jumping lines, finding out who they know, trying to help parents or grandparents and driving themselves crazy from early morning to late at night, attempting to get that elusive vaccine appointment.

It's a shambles, from approving more eligible categories than the supply can accommodate, to sending mixed messages about where appointments can be made. Yes, it is and it will get better but it never should have happened this way. People should never have been put through the maze and stress that we've seen up until now. Information technology exists that would have allowed people to fill out a form once, become pre-registered and placed on a wait list tone contacted when their turn came. There are systems we use everyday that would allow the kind of straight forward management necessary. Did anyone ever think of the fact that information on people over 65 is already captured through Medicare? That's just one example. Did anyone realize that the pharmacies being contracted with would all set up their own separate registration processes leaving people to navigate three or four different systems?

Let it sink in. These are the people who are responsible for other agencies that supposedly build fail safe systems for nuclear war or who are able to land a vehicle on Mars. Organized government can accomplish great things but it can certainly also be responsible for great failures and irresponsible behavior. There are over 500,000 souls and 500,000 families that can attest to that. There's no excuse for the failures we've seen and yes, we should expect more.

Covid-19, Pulmonary Fibrosis And Fear

I've been very lucky in my life of 76 years. I've survived a lot. Twenty-six years ago, the upper lobe of my right lung was removed along with a malignant tumor. It placed stress on some physical activities then and required a time of healing. In 2014 I had another run-in with cancer, this time in my colon. Again, surgery, healing and lifestyle changes. 

That was then, this is now. A little over a year ago, I was diagnosed with Pulmonary Fibrosis, a terminal illness complicated by Emphysema. I've probably had it for a longer period of time but now it's very evident. I use supplemental oxygen 24/7 and struggle with pretty basic activities. I'm staring my mortality in the face during the Covid-19 pandemic.

As it turns out, doctors are finding that individuals struck by the Covid-19 virus, in some cases, experience lung damage very similar to fibrosis, scarring of the lung tissue that impacts the everyday functions of the lungs. Pulmonary Fibrosis is a progressive disease where tissue in the lungs becomes hardened like glass and less and less functional. There are medicines that try to slow it down or stop the progression but they seem to work in some cases and not others. They are also extremely expensive and come with various unpleasant side effects. I've been taking one of these for close to a year. 

Pulmonary Fibrosis is also considered a rare disease. Research resources have been fairly limited and most treatments are experimental. Due to Covid-19 and the reported similar pulmonary impact on the folks who have become known as "long haulers", some of this is changing. Doctors and researchers are looking at Pulmonary Fibrosis and treatments as more people are impacted long term by Covid-19. Perhaps something new will come from the additional research.

In the meantime, people like myself with Pulmonary Fibrosis or IPF as it's known, are extremely vulnerable to respiratory failure as a result of contracting Covid-19. The fear of exposure and the self-imposed physical isolation is pretty extreme. There is very little outside activity that is safe. Some is necessary, like blood tests due to the potency of the medication prescribed. Most Doctor visits are via computer with a few exceptions. I am pretty much tethered by 50' of oxygen tubing which allows for a simple walking exercise program through my house. 

I have the best caregiver and aide, my spouse, Jeannette. She spends time in isolation with me, getting out for longer walks as well as outside yard and garden work in better weather. She finds curbside shopping alternatives in our rural community. She keeps me positive and we help each other laugh. We organize, we plan. We enjoy nature from windows and decks. I try to stay relevant by reading and writing but my energy level sometimes keeps me stuck in the same place, both physically and mentally.

With all of this going on, it's important to understand that there's always someone having a more difficult time than you or me. There are people who's health situation is worse than mine. But there are others too. Young people struggling to pay their rent or their mortgage. Homeless people trying to make it while living on the street. Families without food trying to figure out where meals will come from and how children will be fed. People working at or dying in hospitals. Families are losing loved ones at an astronomical rate, sometimes without the chance to say goodbye. These are difficult times to say the least. Many of us are living in fear, perhaps for different reasons but the fear is very real. 

Watching our government fail us is hard. It's debilitating. Watching fellow citizens casually blow off Covid-19 and refuse to follow basic health and safety precautions is stunning. People like me who are seriously compromised by health conditions need the help of people who care enough to take precautions for themselves and others. We also need help from federal and state government. Responding to a pandemic isn't a State's Rights issue. It's very clear that states don't have the resources to vaccinate everyone. They don't have the resources to do that and do contact tracing. I for one would much rather see our military assisting states and citizens instead of waging or responding to battles. We know that the military is capable of building hospitals and/or mobile vaccination sites. That's what we all need right now - people caring about each other and not worrying about whose job it is. Wear those masks and wash your hands. Help out where you can.

Return to Schools Decision Is Heartbreaking

Watching and listening to all of the discussions taking place about children returning to school in the middle of a health pandemic is truly heartbreaking. Parents, kids, teachers, administrators and communities are all struggling with the decisions they have to make. Sadly there is no national leadership or direction to this critically important issue other than Donald Trump saying "schools have to open". Of course everyone is in agreement on schools needing to reopen but the critical issues are when and how to do it safely for all of us. I really fear that we are heading for chaos and danger for everyone if things continue to go as they seem to be going right now - every district trying to plan on their own, with little assistance from the state and federal governments.

There really doesn't seem to be recognition that without the correct planning and protocols in place, community spread will be the result of these reopenings. Why is it that we all seem to be in the mindset that school has to take place from September through June. It's a nonsensical, made up calendar that can and should be changed based on the threats that school districts and children face. People have talked about lengthened or shortened academic years forever. Lots of things should be possible relative to annual calendars but there is nothing that says schools have to open in September. 

The worst thing is that everything we are all facing was predictable - the confusion, the anger, the threat itself, the economics, the spread. Yes, everything we're facing was predictable over the past 3 or 4 months. All of that time could have been spent on a national response or it could have been spent on a true shutdown to get the Covid 19 virus under control. But instead, we've argued among ourselves about mask wearing, parties, bars reopening, if children are immune, etc., etc. Yes, we've wasted time, critical time and now a false calendar deadline puts pressure on all of us. 

The answer still exists - take the necessary time to get this virus under control as other countries have done. Yes, it's going to take us longer now but that's because we didn't do it right the first time. We all just have to bite the bullet and realize that a national shutdown based on positivity data is a necessary response at this point and that will take national leadership. If the President won't do this on his own, then elected officials in a nonpartisan way along with public health officials throughout the country have to stand up to him and make it happen.

Look no further than your children and grandchildren to see that it has to be done. Yes it's heartbreaking. Every decision being made or worse, not made, is heartbreaking. But all of us could certainly stand down for two or three weeks, stay home and wear masks.

Urge to Re-open vs Safety

Here in my little corner of Upstate New York, people are certainly trying to figure out how to go back to some kind of normal in their lives. As I've mentioned before, I am a highly compromised and vulnerable person at 76 years of age and diagnosed with Pulmonary Fibrosis and Emphysema. I've been self isolated from the beginning of this Covid-19 crisis except for two instances of going out to get necessary blood tests.

Yesterday I ventured out for the first time for a car ride with my wife and was really surprised to see all of the activity around town and at Mennonite greenhouses that dot the area. People are clearly feeling antsy and are trying to move Spring along just a little faster and my sense is that most are trying to do it safely. We didn't stop anywhere on this ride but just wanted to get out and take in some sites around the area.

Governor Cuomo has indicated that our regional area of the Finger Lakes is able to reopen cautiously as of May 15. People seem to be moving forward even faster than that. It seems that once you release the brake or as he says open the valve, all hell is ready to break loose and honestly it will be very hard to close things down again unless the consequences are truly dire. So it seems that concentrating on safety is the best all of us can do and yes, that safety includes factoring in the people who are out there not following safety procedures.

Of course all of this would be easier if the Center for Disease Control would issue clear guidance on best practices for various types of businesses and entities. Everyone would be served by this - businesses, government, educational and health facilities, churches and the public at large. That really shouldn't be too much to ask of the federal government or of our state or counties.

In the absence of CDC guidelines on re-opening, it seems to me, that most of the precautions we all need to take are common sense:

• We should continue to wash our hands and use hand sanitizer often and between stops at stores or other places we visit.
• We should really measure some of our stops based on density - you know, how many people are at a particular location.
• We should understand that part of the density issue an be measured by noise factors. If there's loud shouting, cheering, people talking over one another, we're probably in too dense an area. 
• We should continue the social distancing guidelines and wear masks or face covers.
• We should listen to public health officials. They know the issues and follow science and data. Basically, we can trust them to have our best interest at heart.

That's it. We are in this together and we have to depend on each other. I'm not interested in admonishing or giving the non believers a hard time. I just want to see us get through this. So as you go about your business, be safe and stay safe and treat each other with respect.