Excellent NPR story on one Midwestern COVID-10 riddled nursing home chain, including a close look at their financials. Yes, they under-staff to increase return on investment and, yes, they incorporate each facility separately to make sure there is little to fight over if a legal claim is brought over the fallout from the under-staffing and to make them attractive applicants for pandemic financial assistance from the government.
Louise Gluck’s Words Resonate
"…[T]he powerful are always lied to since the weak are always driven by panic."
Contact Tracing President Trump?
How many people were at that Bedminster, NJ fundraiser, attended by the President after he learned Hope Hicks had tested positive? Sure hope they got those liability waivers signed as a condition of admission.
HIPAA’s Privacy Rule: The Urban Legend — Kansas City Edition
Nursing Homes in the Wake of COVID-19
It could be that the failures of America's 15,505 nursing homes, with approximately 3 million residents, during the COVID-19 pandemic may be our teachable — our changeable– moment. Whoever said "never let a good crisis go to waste" may have been onto something.
The real question is how broad are the lessons we think we have learned. Is it primarily a matter of improving and perfecting staff, tracking and testing alone or have we learned bigger things, like the safety and quality of life advantages of smaller facilities?
A State of Denial
David Frum nails it in his recent Atlantic article when he notes: "the real policy of the United States is to claim the rewards of successful virus management—a return to schools and universities, reopened bars and restaurants, resumption of sports—without first doing the work of successfully managing the virus."
Co-Prescribing Naloxone
There is an excellent post over on The Incidental Economist outlining the rise in Naloxone co-prescribing under various state statutory regimes encouraging or even requiring it.
This answers some questions that have been on my mind since I opened a bag of post-surgical medications this summer to find, along with antibiotics and painkillers, some Naloxone. The discharge nurse breezed past it, not reviewing use or dosage as she had with all the other medications. I wondered if this was because she had encountered pushback from other patients such as "I don't need that."
The post, and my experience with the implementation of the California statute requiring such prescription to accompany one for certain high dose narcotic painkillers, made we wonder if just getting Naloxone in someone's hands is enough to really make a difference on overdose prevention. If you are barely aware you have the Naloxone prescription and are completely unaware how to use it, will you be likely to use it?
My Naloxone has been sitting on the corner of my desk for a few months– an attempt at a visual reminder to learn more about how to use it. It remains unused and unopened, just like the opioid painkillers that accompanied it. But have I learned more about how to use it, perhaps to help someone else with it? No, I have not.
Kayleigh McEnany: Talking About Pre-Existing Condition Exclusions at the RNC
I perked up when Kayleigh McEnany began to speak about her experience living with a positive BRACA2 gene diagnosis and her ultimate decision, in May of 2018, to have a prophylactic double mastectomy. "Wow, she's going to make the case that the ACA's ban on pre-existing condition exclusions may have saved her life", I thought. "Maybe she'll even give a shout out to the ACA provisions promoting such gene diagnosis and treatment."
Nah. She really wanted people to know Donald Trump called her after her surgery and that he cared. A little while later in her speech, she talked about the kind of world she wants for her baby daughter: one with strong values and compassion. But she never talked about whether her daughter, should she inherit the BRACA2 gene, would be able to get insurance coverage for her own testing and, if necessary in fear and sorrow, her own prophylactic surgery.
I want a better solution for BRACA2 gene positive women. But, at the very least, access to testing and affordable treatment options covered by insurance for all is what I want for you, Blake Avery Gilmartin, and for countless other American women as well. How will you obtain this if the ACA is repealed? Ask Mommy.
Just Where Did That Six Foot Rule Come From?
Where’s a Good Sanitarian When You Need One?
Some of the best writing in the world is found in the sports pages. I am reminded of this by a wonderfully headlined San Francisco Chronicle article by Ann Killion titled: Trying to Keep It Clean. Even better, the top quote from Stan Conte, former head trainer for both the Giants and the Dodgers sums it up so well: "The greatest epidemiologists in the world can't figure this out. Yet this is falling on an assistant trainer."
So, who's playing the role of sanitarian at your workplace/school? Are they qualified to do so? Are they as candid as Stan Conte?
Missouri State of Mind 