Penny Wise and Pound Foolish: COVID PPE/Protection in Public Health Sector

[McCamy Taylor]

Right now the nation's big public health systems have a bit of a COVID problem. They would love to keep doctors/nurses/techs/patients safe. However, being part of the public health system, they are constantly being told "Save money!" "Keep costs down!" "Eliminate fraud and waste!" These messages are so ingrained within the system, that the system does not know how to respond to the new needs of COVID.

For instance, some health care providers think it would be a great idea to send moderate risk COVID patients home with a low cost pulse oximeter so that if oxygen saturation drops around day 8--like they do for those who go on to die--the patient knows to come back and maybe have a fighting chance. However the system that counts the money says "No way!" And then justifies its budget based decision by saying something like "If they read the oximeter wrong then they may come back to the ER unnecessarily and tie up services and put themselves at risk". (At risk of what, I have to ask? They already have COVID.)

Is not it better for someone to present to the ER with a false emergency rather than die at home for lack of info that would be readily available with an oxygen meter that the poor cannot afford but a health care system could buy in bulk and distribute? The answer, if you are a public health bean counter is a resounding "No."

Then there is personal protective gear, aka PPE. We have all seen the doctors and nurses in New York running around in a single (non N95 mask) with no other protective gear. And we have seen them die. Well, it is happening all across the country in public (i.e. "free" ) clinics. If you work at a for profit hospital and work around potential COVID patients, you will get this



If you work for public (non profit) health you will get this



And will be told "If they do not have symptoms then they can't have COVID and you are not at risk." Yeah. Right. Never mind that some people who have COVID have been proven to be contagious without symptoms. Never mind that simply speaking certain consonants can mobilize as many respiratory particles as a cough. Never mind that you can catch COVID through the eyes (or the openings on the side of that flimsy mask).

The safe way to get up close and personal with patients during a time when we are supposed to self isolate due to anyone could have COVID looks like this

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Or maybe this

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But these items are in short supply, FEMA keeps confiscating them and the Trump family keeps jacking up the price. Since the public health system cannot stop working, those who direct the public health system utter a string of lies about why such PPE is not needed in the public health sector (though apparently it is needed in the private health sector) and tell their front line health care providers "You are just being a bunch of whiny babies. You won't catch COVID. Get back to work."

How much time and money has gone into training the doctors, nurses, respiratory therapists who are going to get sick and die? How will we replace them? This is why I call these "cost saving measures" Penny wise and pound foolish. I guess the bean counters figure they will snatch up some low risk medical students to replace the 50 and 60 something nurses and doctors who are sacrificed on the altar of "fiscal accountability".

No one is listening to the providers. So, maybe we need to have the patients speak up. If you go to a public health clinic and see that the employees have a single flimsy paper mask even though they are getting exposed to sputum particles, maybe you should speak up. These health care providers have made a decision to take jobs that pay less and require more work. They are putting their lives on the line for you. Let them know you care.

[LiberalArkie]

1. At most of the hospitals and clinics now, the MD's and CNT and RN's are all contract workers.

In management mindset, easily replaced.