Читать книгу The Next Pandemic - Betsy McCaughey - Страница 4

AMERICA IS SUFFERING through two public health crises, one caused by a viral pandemic from halfway around the globe, and the other we’ve brutally slammed on ourselves.

“Suffering” understates each of these crises. Coronavirus is a vicious disease. Most of us have never before witnessed scenes like the corpses piled up behind hospitals in New York City, the epicenter of the pandemic. The virus’s victims, mostly elderly, drown when their lungs fill up with fluid. They die alone, because even their families are barred from visiting their bedside. Their bodies are deposited in bags and forklifted into refrigerator trucks.

Each death is a tragedy, and tens of thousands have already died that way, with more to come.

But the second public health crisis – the shutdown – is almost certain to kill even more Americans. And their deaths will be gruesome, too. Deaths of despair. Leaving behind families who are emotionally broken and destitute.

The shutdown is almost certain to kill even more Americans than Coronavirus. And they will be gruesome deaths, too. Deaths of despair.

Tens of millions of workers have been laid off because of the government-imposed shutdown. Before the virus hit, America’s unemployment rate was 3.5 percent, the lowest in fifty years. Now Goldman Sachs predicts unemployment will be at 15 percent by midyear. A St. Louis Federal Reserve economist grimly predicts 32 percent unemployment – which is worse than during the Great Depression.

No model or guesswork is required to foresee the deadly impact. Job losses cause extreme suffering. Every 1 percent hike in the unemployment rate will likely produce a 3.3 percent increase in drug overdose deaths and a 0.99 percent increase in suicides, according to data provided by the National Bureau of Economic Research and the medical journal Lancet. These are facts based on past experience, not models. If unemployment hits 32 percent, some 77,000 Americans are likely to die from suicide and drug overdoses as a result of layoffs.

Then add the predictable deaths from alcohol abuse caused by unemployment. Ioana Popovici of Nova Southeastern University and Michael French of the University of Miami found a “significant association between job loss … and binge drinking … and alcohol abuse.”

The impact of layoffs goes beyond suicide, drug overdosing, and drinking. Overall, the death rate for an unemployed person is 63 percent higher than for someone with a job, according to findings in Social Science & Medicine.

Not to mention the tragedies of people who spent decades building a small business, only to see it destroyed in weeks because of the shutdown.

Shutdown-related deaths are likely to far outnumber deaths due to coronavirus.

This comparison is not meant to understate the horror of the coronavirus for those who get it and their families. Or to second-guess public officials, who have acted with the best of intentions.

But America should never have to endure another shutdown. The shutdown wasn’t caused by the virus. It was a frantic response to America’s unpreparedness. The nation’s Strategic National Stockpile of medical equipment was nearly empty. Our medical supply chain put us at the mercy of China for masks, antibiotics, and medical supplies. Hospitals were unprepared to stop the spread of infectious diseases. Nursing homes with minimal infection control were destined to become death pits once the virus hit.

The shutdown was originally justified as a way to “flatten the curve,” allowing time to expand our health care capacity, so that lives would not be needlessly lost in an overwhelmed, undersupplied system.

The time was well used. Through herculean efforts by governors, the White House, the Federal Emergency Management Agency (FEMA), the US Army Corps of Engineers, the Defense Department, and private-sector companies all across the United States, hospitals in hot zones like New York City got the ventilators they needed and field hospitals took in the patient overflow.

But that begs the question, why was America so unprepared?

Washington politicians can hardly wait to appoint a commission, launch hearings – preferably televised, of course – and piously demand answers to that question. House Intelligence Chairman Adam Schiff and senators Dianne Feinstein and Kamala Harris already have introduced a bill to set up the investigation, claiming the “federal government was unprepared.”

They’d like to pin the blame on Donald Trump, but these politicians need to look in the mirror. Nearly every single year for the last two decades, commissions and committees have warned Congress that the medical stockpile was inadequate, our dependence on China was fraught with danger, and our health departments were unready for a pandemic. The Congressional Research Service, the US Government Accountability Office, the Congressional Budget Office, and many others sounded the alarm again and again.

Their findings were ignored, their reports gathered dust, and the very members of Congress who are so outraged now did nothing.

Meanwhile, regardless of who was president, whether a Democrat or a Republican, career federal health bureaucrats ignored America’s unpreparedness, while pouring resources into their favorite global projects. They committed billions to fighting Ebola, building health labs and medical training systems on other continents, and conducting disease-fighting programs in forty-nine countries.

In 2015, the Obama administration even sent $3.7 million of taxpayer money to fund the Wuhan Virology Institute.

While globalism prevailed, preparedness at home faltered.

So here’s the message to Washington, DC: No more commissions and televised hearings are needed. It’s time to act. This Broadside is a road map for how to battle the next pandemic without a shutdown. It’s based on real-time facts on the ground, as the battle against the virus continues.

Many of the steps toward national preparedness listed here are already being taken. The rest are within reach, thanks to the burst of scientific innovation the crisis has inspired.

Stock the US Strategic Stockpile to the brim.

Build a “made-in-America” supply chain for medical supplies.

Level with the public about precautions such as masks.

Improve hospital infection control.

Don’t allow nursing homes to become death pits.

Get regulators out of the way, so patients have access to treatments.

Use technology to make workplaces safe from viruses and bacteria.

America ignored the warnings from SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), the avian flu, and the swine flu. But for the next pandemic, we can be prepared.

STOCK THE STOCKPILES, RETIRE THE RATIONERS

During the pandemic, working-age people have been worried about missing paychecks, caring for kids home from school, paying for groceries, and cancelling plans. But people in their fifties, sixties, and older have had bigger worries. Many have been lying awake wondering if this is how they’re going to die.

At its most severe, coronavirus attacks the lungs, making it impossible to breathe without a ventilator. Landing in the hospital on a ventilator is bad. But worse is being told you can’t have one.

When it looked like hospitals in New York were going to run short, Governor Andrew Cuomo complained, “You can’t find available ventilators no matter how much you’re willing to pay right now because there is literally a global run on ventilators.”

It’s a little late. Several years ago, after learning that the state’s stockpile of medical equipment had 16,000 fewer ventilators than the 18,000 that people living in New York would need in a severe pandemic, Cuomo and state health leaders came to a fork in the road. They could have chosen to buy more ventilators to back up the supplies hospitals maintain. Instead, Cuomo’s health commissioner, Howard Zucker, assembled a task force for rationing the ventilators they already had.

Regardless of whether we had a Democrat or a Republican president, career federal health bureaucrats ignored America’s unpreparedness.

In 2015, that task force came up with rules that would be imposed when ventilators ran short. Patients assigned a red code would have highest access, and other patients would be assigned a green, yellow, or blue (the worst) code depending on the decision of a “triage officer.” In truth, a death officer. Let’s not sugarcoat it. The decision isn’t up to your own doctor.

In 2015, Cuomo could have purchased the additional 16,000 ventilators needed for ^$36,000 apiece, or a total of ^$576 million. That’s a lot of money, but in hindsight, spending one-half of 1 percent of the budget to prepare for a pandemic would have been the right thing to do.

To be fair, many state governments made the same mistake, and stockpiled few or no ventilators. And yes, they also wrote ghoulish plans for who would get one, either then or when the pandemic arrived.

The federal Strategic National Stockpile was also undersupplied with ventilators to meet the coronavirus emergency.

Then the pandemic arrived. Noted rationer Dr. Ezekiel Emanuel, once an advisor to President Obama, cowrote an article in the New England Journal of Medicine putting forward his concept of fairness.

New York City’s deputy commissioner for disease control, Demetre Daskalakis, said he anticipated “some very serious difficult decisions.”

Arthur Caplan, a bioethicist at NYU Langone Medical Center, said there is no single “right” answer about who gets a ventilator. With all due respect, there is a right answer: Everyone who needs one.

In Wuhan, China, doctors recently faced the grim arithmetic of 1,000 patients needing ventilators and only 600 ventilators being available. Italy is rationing ventilators, too.

But in the United States of America, rationing ventilators should be unnecessary. State and local hospitals knew of the shortage, had the money, and should have bought the lifesaving equipment, instead of making a plan on who would live and die.

Lesson to the bioethicists in universities across this country who like to write rationing rules: Americans don’t want their government holding back on the things they need to stay alive.

That’s a lesson everyone – except the bioethicists – agreed on when the pandemic arrived. Even Cuomo said he found it abhorrent to deny any single person a ventilator.

Fortunately, the Trump administration did something about it, swinging into action to marshal the private sector to ramp up ventilator production. “There’s been no American that has needed a ventilator that has not received one,” announced Adam Boehler, CEO of the US International Development Finance Corporation, in mid-April.

In the year prior to the pandemic, according to administration figures, the United States produced 30,000 ventilators. In 2020, it’s going to produce 200,000.