A Plan To Move Forward II

We thought our plan for moving forward was pretty clear and would be seen as workable. Apparently, we were wrong. We feel the wind generated by east-west and back head movements. The identification and protection of the most vulnerable are seen by some as impossible.
Others contend they’re already hunkered down. Neither of these things is presently valid. As we have pointed out, almost all of the at-risk group is known. The government and/ especially to the medical community know how to contact them. People with preexisting conditions are under medical care. We know this because a doctor has to prescribe their necessary medications. Doctors know how to reach people with diabetes, HIV, cancer, heart disease, and the many other conditions, COVID-19 puts them in grave danger. They can definitely contact their endangered patients. The government sends almost all the elderly social security checks, so they too can surely send them information.

Sheep are highly at risk of being attacked by hungry wolves. Shepherds of old didn’t just tell the sheep of the danger and advise them to lay low. Wolves can be seen as COVID-19 infected. The sheep are vulnerable. The shepherd’s job is to keep wolves and sheep apart. They could hunt the wolves down, but they don’t know where they are, so that takes a lot of work and time. On the other hand, the whereabouts of the sheep are well known so we can gather and protect them. In the best of worlds, we can do both, but which is more easily achieved?

We may think we’re protecting our susceptible, but the facts say otherwise. Over 76% of those needing extreme care are those with preexisting conditions. We can narrow it down even more. According to the Wall Street Journal, “Men are seen as three times more at risk of death in a hospital from COVID-19.” This experience is mirrored in other countries and our experience with other pandemics. We know who is in danger of overloading the system. It’s not healthy 12 yr school kids. Yet, we still have coronavirus outbreaks in nursing homes. Seniors stand in dangerous crowds during special grocery store hours only come up empty of necessities. According to today’s Wall Street Journal, the government is just now issuing guidelines for nursing homes. It just makes sense to build a dam upstream rather than be overwhelmed by the flood.

So how do we protect the truly at risk? As we mentioned in our last post, the government speedily needs to prepare a doctor’s letter and a survey to be sent by physicians to every one of their endangered patients. Each of the dangerous conditions has its doctors, and it’s their job to communicate with and help their patients. This letter must be a stern warning that they are in great danger of dying from coronavirus. The message would identify the recipient as at risk. It should contain a supporting barcode. This will allow them to get to the head of the line for needed services.

Accompanying the letter with a a link to an online short survey to identify the person’s circumstances and what they might need to be segregated. One would either land in one of three groups. Those needing only priority to get necessities, those requiring real help and those needing significant help or to be moved. This would also contain a release so the information could be shared. The letter and link to the survey online should be emailed ASAP. Backups should be mailed. Public service announcements should also be used to get the word out as soon and as wide as possible. We can expect robust compliance and cooperation. Imminent death tends to focus minds. A consortium of government agencies and Non-Government Organizations will review the surveys. The NGOs would seem the best bet for quick help. At least a dozen were listed in our local paper as ready and willing to aid the at risk. Government agencies could backstop the NGOs and concentrate on clusters of endangered. Nursing homes assisted living and retirement communities to leap to mind.

While some may only need aid in getting priority in getting delivery or safe pick-up of essentials, others will require more extensive help. A support plan put into effect. However, there will be circumstances where people will have to be physically moved. Multi-generational households where everyone can’t be quarantined in place will need to be separated. Either the at-risk person or the ones that must go out in the world will have to be placed elsewhere. Under epidemic circumstances, thist isn’t a problem. We have an almost endless number of empty hotels and motels across the nation. The owners would like nothing better than getting some revenue and work for some of their employees. Quality and location would be the standard for those who have to leave a multi-generational home to do essential work. For at-risk, the very best facilities should be used. After all, we’re talking someone’s loved one. Caregivers desiring to accompany the vulnerable should also be accommodated. Most hotels have kitchen facilities, but where needed, conveniently located restaurants can offer their services. This sounds expensive but will prove to be a great bargain compared to an endless lock-down.

This will require priority for specific resources. Test kits, face masks, and other safety apparel, along with the supporting workforce, will have to be diverted to achieve this great separation. This is where the primacy of the medical community may have to be curbed. They may resist giving up assets. Just giving up some face masks to the at-risk and those serving them may result in howls of danger to health workers. This would be terribly shortsighted. It would be akin to denying resources to build a dam upriver to use far more fighting a near-endless flood. A cost-benefit analysis must be made to allocate the assets. If people don’t end up in your ICU, you don’t need as many resources. Remember, every one put in the ICU represents a failure to protect. One in three COVID-19 patients put on a ventilator dies. The facts favor the dam.

Once the vulnerable are secured, we need to open the rest of the country. By that time or soon after, we hope we have the required tests to determine who recently became infected and who has had the disease and is now immune. The latter will help us not only the ill with lifesaving ant-bodies, but tell us who can safely work without protection for themselves and others. The at-risk can find someone certified and registered as immune to tend to their needs. A hairdresser or dentist and so many others they need will become available Even the quarantined endangered can begin to emerge.

Knowing who has achieved immunity will be a great gift.. It will help us determine when we have gained herd immunity. We know once the reasonably predominately younger and healthy go back to work, school, and normal life restored, the virus will rapidly spread. They may become sick, but few will die. At some point, we will achieve herd immunity, and the disease will die out. Then even the at-risk can resume their lives. The only problem may be getting Nana to leave the Four Seasons.

The immunity may or may not last. Based on our experience with similar diseases, at least a year would be a good bet. By then, we hope we’ll have a vaccine or at least an effective therapy. In the worst-case scenario, and the disease makes a reappearance, but we’ll have a plan in place that doesn’t crash the nation.

The thing to consider is even if we”re only able to cut ICU intermittences by 10%, it will go along way to diminish the possible overwhelming our medical facilities. At 20 % we probably would be out of the woods. At 30%, we know we would be. With an all-out effort to protect our endangered, we expect to do a lot better than that.

The major strength of this plan is it will give us a good idea when the lock-downs end. It’s probably is too optimistic securing those with underlying conditions in a month. Still, we will be able to track progress as each area reports compliance across the country. Everyone can start making plans to return to the field. The vast amount of people with a vested interest in a quicker return will get behind the effort. High profile people in sports and the arts can help speed up awareness and help. The prospective return of these segments will lift people’s spirits. Of course, the most significant lift in our souls will come seeing the light at the end of the tunnel. Instead of waiting endlessly in place waiting for a vaccine, the is a proactive way to get control of the epidemic. We determine when we get most people back to work and open the schools. Once people realize we’ve done everything in our power to protect those at risk, people can turn morally and ethically to saving the country from a terrifying depression. This is our plan, what’s yours?

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