Literatus: Rationing with a heart

RATIONING medical goods and healthcare workforce is not supposed to be unexpected in this war against Covid-19.

Even the United States—with its churning industry capable of supplying the world—is also rationing. Veterans in public health are expected to anticipate that. Only the gullible believe that either our borders are impenetrable or our health care system has the capability or the resources to deal with Covid-19 like scientifically advanced nations.

It is also gullibility to believe that healthcare services must stop because no physical protective equipment (PPE) is available. It is not saying that healthcare providers must not use PPEs. It is saying that large hospitals have the financial resources to produce their own PPEs even without government assistance. They have the technical access to design and money to finance their production locally to shore up depleting supplies. It is unthinkable for provincial duopolies in healthcare to complain about not having the PPEs or respirators because they have the means to acquire more.

The hospitals that need external support are smaller community hospitals, public ones included, with budgets already depleted. However, even these hospitals receive payments for their services and supplies so that there is always money around.

Desperation moves people to innovation. The masks being used around our communities are no longer made in some distant factories. They are made in homes by entrepreneurial individuals or simply those who care enough to help others when no supplies can be bought in drugstores.

Everyone is rationing. Communities under enhanced community quarantine have their resources stretched to the limit as work ceased its engine, at least for some. If ventilators must be rationed, physicians Robert Truog, Christine Mitchell and George Daley suggested in the March 23 issue of The New England Journal of Medicine that patients and families be engaged in inevitable “do-not-intubate” orders for high-risk patient groups (elderly). Families should be clearly informed about this decision.

This courtesy can be easily forgotten as healthcare providers scramble for rationing supplies. A phone call will do. The number should be in the patient’s record. Please remember that these families may no longer see their loved ones again. No saying goodbye. Not even a funeral to arrange.

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