The Politicization of COVID

With the pandemic of COVID-19 we have seen things become politicized in a way and to a degree they never should.  It’s not the first time we have witnessed this.  Think back to the politization of vaccines we have witnessed by many.   Currently, COVID-19 potential treatments have been politized with hydroxychloroquine.  Some opinions are changing as more data and evidence is coming out.  This is leading to options based on science, experiments and real data, not hunches or politics.  But, desperate times cause for desperate measures.  And, at the beginning we were definitely in desperate times.

Now, Governors are giving “guidance” to Medical Examiners and physicians on filling out death certificates.  This is scary ground!  A medical examiner is a trained physician.  And, in many instances a pathologist with specialized training.  A close friend and colleague of mine recently received “guidance” from one state to list the primary cause of death on death certificates as “COVID-19” if confirmed that they had the disease by testing OR “probable COVID-19” if suspected to have the disease but not tested.  Yes, you read that right...suspected but not tested!

The cause of death section of a death certificate is designed to elicit an opinion.  In some instances this might vary among individual physicians because it is an opinion.  This is how a pathologist, especially a forensic pathologist, is trained and this is how the CDC explains a death certificate should be completed.    

Keep in mind there is also a section on the death certificate for underlying causes.  This is a section below the immediate cause of death for disease felt to initiate the final event.  Making COVID-19 the primary cause of death in anyone who dies and has tested positive is without a doubt inaccurate in some cases.  For instance, let’s say someone has a heart attack and dies.  The cause of death is a myocardial infarct.  However, if they had tested positive for COVID-19 upon admission, or before, physicians are being instructed that the cause of death should be COVID-19.  This can be inaccurate and flat out wrong as COVID-19 could potentially be listed as an underlying cause, not the immediate cause of death.

I understand this is being done to help collect data, but it will definitely cause an overestimation of deaths due to COVID-19.   In addition, it will cause some deaths to be contributed to COVID-19 that aren’t (remember the “guidance” of those suspected to have the disease but not tested).  

Even more worrisome is how some state governments are instructing trained physicians on how to fill out a death certificate.  The cause of death is an opinion that should be completed by an educated trained physician.   Not a politician by proxy.   This is now politicizing the pandemic even more and the data to help learn, study and make future decisions.  Manipulating data is bad science!  In fact, it’s not science!

I have no issue with politicizing healthcare policy.  Just make it a healthy debate.   But science, data, treatment and physicians trained judgment and autonomy should never politicized.  

ANOTHER COVID UPDATE

Well, its been about a week and half since my last post with the COVID numbers.  First, a shout out to my good friend Dr. Dave B for catching a mistake.  I inadvertently left a "zero" off of Iran's number of cases when I last posted.  The deaths and percentages were correct, just an oder of 10 wrong for the number of cases due to my sloppy proof reading.  Thanks to Dr. Dave for catching this so I could correct it!

There are currently over 2 million cases world wide and over 141,000 deaths.  This gives an overall  world wide death rate of greater than 6.5%.  The US continues to lead the world in number of cases and deaths by a long shot.  And, as you can see below, the percent of diagnosed cases that result in death continues to climb for all countries not named China.  Germany leads the way with the lowest death rate at 2.8%.  The US is at 5%.  Both have at least doubled since my last posting.  Let's hope we have seen the worst and are on the better side of the apex moving forward.

As is the same for everyone, COVID continues to wreak havoc on our world and our country.  A new norm will develop once all the dust settles.  If your'e like me you've often wondered or talked with friends and loved ones about what the new norm will look.  A few questions (and please feel free to comment)...How will this effect social gatherings such as sporting events?  What new businesses or services will be born out of this pandemic?  How will healthcare change from both a policy and a delivery perspective?  Just a few things I ponder often now.

One thing is certain, with great changes and challenges, new opportunities will always arise.  Despite all the loss and devastation, much good will come from this when the dust settles.  Stay safe everyone!

		Corona Cases as of 4/15/20
Country	Cases	Deaths	Change in	% Deaths
USA	648148	32588	2.5->	5
Spain	180659	18812	9.3->	10.4
Italy	165155	21645	12.1->	13.1
France	147863	17167	9.1->	11.6
Germany	134753	3804	1.3->	2.8
UK	98476	12868	8.7->	13.1
China	82295	3342	4.1->	4.1
Iran	76389	4777	6.1->	6.3
Turkey	69392	1518	2->	2.2

COVID-19 Update

It's been 8 days since I originally posted data on the effects COVID-19 is having on the world.  Obviously, those numbers are rapidly changing daily (unless you're China).  Needless to say, there should be an asterisk next to China as more and more reports seem to believe we aren't sure what numbers we can trust coming from that country.  After all, they do have a history of inaccurate and deceptive reporting in past epidemics.  So, take the numbers and death percentages of China with a grain of salt.

A few observations:  There are more than 1 million cases worldwide.  We have surpassed, by far, all other countries.   Spain and Italy are 2nd and 3rd in total cases diagnosed and we more than double them!

Our death rate has increased from 1.5% to 2.5%.  I think this isn't a surprise given the lag in deaths after diagnosis.  I'm hoping this percentage will not increase and may even decrease slightly as this spreads across the US more.  Spain, Italy, Germany, France, UK, Switzerland, Belgium and Netherlands have all increased as well.  And, with the exception of Germany, they have all experienced a much larger percent increase than us.  Germany has increased by 0.7% percent but this has more than doubled.  I expect Germany will increase more as this progresses.

It will be interesting to watch the data and statistics as this develops across the globe.  And, I still stand by my conclusion last week that despite what the politicians, "experts" or the WHO says, there is no other place in the world I'd rather have care, especially life saving care, than the United States of America.  Stay safe and well!

COVID-19 Cases as of 3/3/20 at 8am EST

Country	Cases	Deaths	% Deaths	WHO Ranking	Change
USA	245442	6098	2.5	37	1.5->2.5
Spain	117710	10935	9.3	7	7.3->9.3
Italy	115242	13915	12.1	2	10->12
Germany	85063	1111	1.3	25	0.6->1.3
China	81620	3322	4.1	144
France	59105	5387	9.1	1	5.3->9
Iran	53830	3294	6.1	93
UK	33718	2921	8.7	18	4.9->8.7
Switzerland	19303	573	3	20	1.4->3
Turkey	18135	356	2	70
Belgium	16770	1143	6.8	21	3.5->6.8
Netherlands	14697	1229	8.4	17	5.6->8.4
Austria	11301	168	1.5	9
Candada	11283	173	1.5	30
S Korea	10062	174	1.7	58

COVID-19 Update and Thoughts

As of 8am est today, March 26, these are the statistics of where the most effected countries stand.  I've listed them in order of the most number of cases (China).  I've also included the reported number of deaths for each country at this time, and what percent of total diagnosed cases resulted in death.

I thought it would be interesting to see how these percentages compare to the World Health Organization rankings of best overall health systems.  It would make sense (to me) that the higher ranked healthcare systems would fair better than the lower ranked systems in regards to percentage of deaths.  Right?  In the words of Lee Corso, "Not so fast my friend!"

Statistically, the numbers are skewed significantly as the top four countries are definitely on another level of diagnosed number of cases.  In my opinion its clear there are three different tiers in regards to number of cases.  Also, population demographics and other co-morbities need to be taken into account.  Nevertheless, viewing percent of cases resulting in deaths and the WHO rankings is an interesting finding.

Despite what the politicians, "experts" or the WHO says, there is no other place in the world I'd rather have care, especially life saving care, than the United States of America.  Stay safe and well!

Country Cases Deaths % Deaths WHO Ranking China 81285 3287 4 144 Italy 74383 7503 10.1 2 USA 68594 1036 1.5 37 Spain 56188 4089 7.3 7 Germany 39502 222 0.6 25 Iran 29406 2234 7.6 93 France 25233 1331 5.3 1 Switzerland 11435 165 1.4 20 UK 9529 465 4.9 18 S Korea 9241 131 1.4 58 Netherlands 6412 356 5.6 17 Belgium 6235 220 3.5 21

Are non-profit hospitals the biggest ripoff in America?

I came across an interesting read about the fleecing of our system and communities by non-profit hospitals..  My words in a nutshell...How the non-profit designation is sort of phony and allows benefits and advantages over those hospitals and healthcare systems that actually do pay taxes. I  believe it sheds much light on how many, if not all, of these "non-profits" operate.   Many in the community are not familiar with healthcare business and healthcare economics and should be aware.

Click the link below for the article.

https://www.medicaleconomics.com/med-ec-blog/how-nonprofit-hospitals-get-away-biggest-rip-america

Gratitude

With the sad breaking news of Kate Spade committing suicide it has me thinking about mental health and depression this morning. I’m currently on a family vacation with more “quiet time” than usual. It has been awhile since I have been able to unplug with my wife and kids. In fact, this has been our first true family vacation since getting married 2 1/2 years ago. We have taken numerous trips but usually for events or football games etc. Has it been a perfect start?  Honestly , no it hasn’t. But has it been worth it?  Absolutely!

What does all this have to do with depression?  Without a doubt neurotransmitters and neurobiology play an important role in depression. Substance abuse is another large player. I don’t want to talk about that though. Those issues without a doubt need medical and professional help. But there is something that not only assists with those conditions but can assist all of us in every day life. GRATITUDE.

First of all, nothing in life is or will ever be perfect. We will all have our ups and downs. Our mountains and valleys.  I’ve had my share of valleys. More than I care to count. But even in my not so perfect times I have had so much to be grateful for. Even in my lowest place there was much to be grateful for and that helped to persevere.

For me, gratitude is all about perspective. It’s a choice. For instance, I woke up this morning to look out at the pool and notice that my 12 year old left his slides down by the pool while swimming last night. I could choose to be angry that he left them or that I need to walk down there and get them before they “walk off” with someone. Or I can choose to be grateful that I get to wake up overlooking the Atlantic Ocean and sip on my coffee while I stroll to grab his slides and bring them back upstairs while they are still asleep.  After all, I could be getting ready to head into work instead. I can be grateful I have 2 pretty awesome boys....not perfect by any means but still pretty awesome.  I can be grateful I have a wonderful wife that has taken on the huge responsibility of not only dealing with me and my imperfections but has also chosen to be a step-mom to those 2 awesome boys who are still two teenagers and have many not so awesome moments.

Gratitude helps me to be less likely to take anything for granted. Gratitude helps me stay grounded. Gratitude helps me keep my priorities in check. Gratitude reminds me that life is pretty amazing. Now, I by no means do this perfectly but I do have so much to be grateful for. In fact we all do....no matter the current situation.

What are you grateful for today?

Back to Blogging

Blogging Again!!!!

I started this page well over five years ago.  The intent was to create a fun, informative avenue to attempt to begin blogging.  It lasted a short while.  However,  I never took it too seriously nor did I put in the time and/or effort to make it something of value.  Once again I have the urge!!!!

Without a doubt healthcare and medicine has changed drastically since my last post.  This trend will not stop.  Whether we are in a better place now can be debated on both sides.  However, the one thing I believe all will agree on is that changes have occurred and will continue to occur.

We shall see how long my attempt at blogging lasts this time.  I'm planning on posting regularly.  I'm also planning on the subject matter being extremely variable.  I intend to incorporate my personal life and experiences frequently, helping you to get to know me.  Often times expressing opinions where I'd love to hear feedback and your opinions (both in agreement and disagreement).  Hopefully, this will create an informative and entertaining dialogue for everyone involved.

Hope you will enjoy and engage!!