Coronavirus Diary (24): Peace Trains

A lot of the news about India’s handling of the COVID-19 pandemic has been demoralizing, and justifiably so, but I haven’t seen much coverage in the American press of one of India’s more ingenious success stories. Apparently, the Indian government has decided to re-purpose railway cars as medical facilities. This particular idea seems to be the successor to an earlier one, described in a recent paper in the Bulletin of the World Health Organization. Continue reading

Coronavirus Diary (23): “A Disdain for Science”

A plea from my sister-in-law, Jessica Franklin, MD, of Valley Hospital in Ridgewood, New Jersey. She posted this on Facebook, and was reluctant to have it posted publicly, describing it as more a “frustrated, heart-broken rant than a reasoned opinion.” But there’s been no paucity of reasoned opinions at this point. Every other commenter on her Facebook post has a story to tell about someone’s backsliding or refusing to comply with social distancing, the ban on gatherings, etc. If we’re going to break our health care workers and our health care facilities in this excruciating way, we should have the courage to watch it happen in real time.  Continue reading

COVID-19 Narrative (2): Chris Matthew Sciabarra

This is the second in my series of COVID-19 Narratives, by my dear friend Chris Sciabarra, sheltering in place in Brooklyn, New York. Though the series is primarily about what I called the “supply side” of the health care equation during this crisis, I wanted to run some posts that described the “demand side” as well, that is, what it’s like to be a patient during the pandemic. Particularly valuable about Chris’s post is how it illustrates the implications of the COVID-19 pandemic for people with serious medical conditions whose previously scheduled medical procedures have now been deemed “elective.” “Elective” in this context doesn’t mean “optional.” It means downgraded to second or third priority out of sheer, dire necessity: hospital beds, equipment, and personnel have to be left vacant or unused to absorb the overwhelming crush of COVID-19 patients we expect to see. And even at the center of the pandemic, we haven’t yet reached the peak of that crush. Continue reading

Coronavirus Diary (19): This Isn’t John Galt Speaking

The existence of inanimate matter is unconditional, the existence of life is not: it depends on a specific course of action. Matter is indestructible, it changes its forms, but it cannot cease to exist. It is only a living organism that faces a constant alternative: the issue of life or death. Life is a process of self-sustaining and self-generated action. If an organism fails in that action, it dies…

–Ayn Rand, “The Objectivist Ethics”

Imagine a version of Atlas Shrugged in which the Taggart Tunnel disaster involves a causal process driven primarily by Mother Nature, and what goes off the rails is not a train but a health care system. Now imagine that the hero of the piece is not a shadowy figure like John Galt but the functional (not moral) equivalent of Dr. Robert Stadler. Now imagine that a retreat to Galt’s Gulch is a physical impossibility. If, for some readers, this requires a re-conceptualization of how the world works, maybe a lot of other things do, too. Continue reading

Coronavirus Diary (18): N95 Masks and Ultraviolet Lamps

I confess to complete ignorance as to the science on this, so I’m just throwing the suggestion out there care of my Facebook friend Richard Saint Cyr, MD, who’s done some of the relevant leg work.

Wouldn’t it be amazing if you could reuse your N95 masks dozens of times, knowing it’s completely sterilized from COVID-19 and all other germs? What if first line responders could come home and sterilize all their gear overnight? Doesn’t that sound like a fantastic way to help this critical shortage of PPE? Of course! Get the Gates Foundation on this! Call Elon Musk! Oh, wait… it already exists… it’s called ultraviolet light! More commonly called UV-C sterilization or Ultraviolet germicidal irradiation (UVGI, ultraviolet light in the C-band at 254 nanometers destroys DNA and RNA just enough to stop reproduction of all germs. It’s been around for over 140 years, it’s used in many industries, and hospitals across the world already use UV-C to sterilize their rooms of all germs. It can be cheap, easy to do, and quick. It’s already approved by the FDA for medical use! So… why is no one shouting from the rooftops about this? 

I don’t know, but I’m always up for shouting. Read the rest here. Continue reading

Coronavirus Diary (17): Geriatric Oncology during COVID-19

Here’s a press release from an old friend that I’ve mentioned here a couple of times before, William Dale MD, the Arthur M. Coppola Family Chair in Supportive Care Medicine at the City of Hope in Duarte, California. William specializes in geriatric oncology, the treatment of cancer in older patients, which for obvious reasons presents severe challenges during an event like the COVID-19 pandemic. His pushback against the repulsive ageism that has recently come to the surface of our discourse is an enormous relief to read. Continue reading