Chain Of Care

“A chain is only as strong as its weakest link.”

An immutable fact.

With this in mind, what is the medical “Chain of Care” needed to competently deliver curative care to patients testing positive to COVID-19?

 

To simplify our modeling without sacrificing the integrity of the chain, we can identify its links in four broad categories: People, Places, Products and Politics.

Yes.  Politics.

The Chain starts with an administrative backbone; the “backroom” of operating activities. Ad-Min tracks all phases of care from admission to discharge and everything in between: Logistics, documentation, procurement, maintenance, personnel, A/R, A/P, insurance, and so on.  Just because you can’t see them, do not diminish their role.  They are essential.

 

Now we move to the first “public” face of the chain, the COVID “testing” phase.

Following our “P’s”, this includes testers who are relatively low-tech healthcare specialists, testing kits and supplies, mobile and fixed-base testing sites plus medical labs for analysis.

Note: You will hear the term “N95” bandied about and it refers to both (1) face masks and (2) respirators.  N95 describes the efficiency of the device to filter 95% of all airborne particulate down to 0.3 microns in size. That’s very, very small; in fact, it’s 1/80,000th of an inch.  Bacteria ranges from 0.3 to 0.5 microns in size.

We need Personal Protection Equipment, which includes the N95 Face masks, throughout the entire chain of care.

If any of these are missing or compromised, the chain is broken.

Result: COVID spreads and people die.

 

Next we move to the COVID “mitigation” or treatment phase. This mandates medical specialists and sub-specialists from ER Docs (who are trained in triage), general surgeons, pulmonologists, respirologists, internists, respiratory therapists…i.e., virtually anyone with a medical degree who can roll up their scrubs and help (this is a medical emergency). Hospital rooms are requisite including ICU beds.

To separate positive COVID patients from non-COVID patients, we will see temporary hospital conversions in large building spaces, hotels and motels.  The military and National Guard will be activated including two Naval floating hospitals, Mercy and Comfort, as well as the construction of Mobile Army Surgical Hospitals (MASH).

Ventilators and N95 Respirators are essential including the full spectrum of PPE’s.

If we’re missing any of these critical “Chain” components, COVID spreads and people die.

 

Now we come to the uncommon denominator: Politics.  Arguably, the weakest link in the chain of care.

Politics is a new dynamic thanks to T Rump and his cadre of sycophantic prevaricators. Politics can strengthen or weaken each of these links by virtue of its timely and earnest response to the needs each of these evince.

Consider the facts:  T Rump has politicized the entire chain.  To him COVID is more of an economic and political event that a health crisis. At his political rallies, he has repeatedly undermined the urgency of the moment by dismissing the lethality of the COVID contagion calling it a “hoax”.  He follows this with an equally malevolent claim that its virulent spread is “under control,” and the number of its victims would soon be at “zero”.

Now that he acknowledges COVID is a bona fide pandemic, he bestows his favorable responses to governors desperate for federal emergency assistance who ”appreciate” him and engage in “Quid Pro Quo” in their “two-way street” dealings with him.

He’s not interested in representing all of America.

T Rump represents only himself.

A solitary, powerful force.

Ignorant. Narcissistic. Vengeful.

In the time of COVID, his un-evolved self is blind to the opportunity for wide ranging, non-partisan, compelling leadership and; instead, he continues to marginalize medical emergencies everywhere and their desperate mission to save lives.  His focus is on the economy, his re-election and debasing anyone who fails to praise him.

Result:  COVID spreads and spreads; tens of thousands die.

 

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