COVID19 - How it's affecting you

I can't watch Trump. Its too infuriating and not good for my mental health. It just keeps getting stranger, and now I am very concerned for all of my friends who work in the medical systems back home. Not the kind of news you want to see for your home town. https://www.washingtonpost.com/national/buffalo-conronavirus-cuomo-new-york/2020/03/31/58c8b8aa-7376-11ea-85cb-8670579b863d_story.html

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Speaking of being thrown under the bus....

[from CNN https://edition.cnn.com/2020/04/02/uk/uk-coronavirus-testing-criticism-intl-gbr/index.html ]

The BMA said its new guidance had been prepared for doctors who will need to make "grave decisions" about who should receive "scarce lifesaving resources" if the country's health system is overwhelmed by coronavirus cases. "As such, some of the most unwell patients may be denied access to treatment such as intensive care or artificial ventilation," the BMA's ethics guidance note states.

"This will inevitably be indirectly discriminatory against both the elderly and those with long-term health conditions, with the latter being denied access to life-saving treatment as a result of their pre-existing health problems." It says imposing an age cut-off would be illegal, but adds that older patients with pre-existing respiratory problems would have a "very high chance of dying despite intensive care," and are therefore lower priority for admission.

We're toast. 

Here are the guidelines in full
https://www.bma.org.uk/advice-and-support/covid-19/ethics/covid-19-ethical-issues

There will definitely be hard and horrible choices being made 

Speaking of being thrown under the bus....

[from CNN https://edition.cnn.com/2020/04/02/uk/uk-coronavirus-testing-criticism-intl-gbr/index.html ]

The BMA said its new guidance had been prepared for doctors who will need to make "grave decisions" about who should receive "scarce lifesaving resources" if the country's health system is overwhelmed by coronavirus cases. "As such, some of the most unwell patients may be denied access to treatment such as intensive care or artificial ventilation," the BMA's ethics guidance note states.

"This will inevitably be indirectly discriminatory against both the elderly and those with long-term health conditions, with the latter being denied access to life-saving treatment as a result of their pre-existing health problems." It says imposing an age cut-off would be illegal, but adds that older patients with pre-existing respiratory problems would have a "very high chance of dying despite intensive care," and are therefore lower priority for admission.

We're toast. 

Here are the guidelines in full
https://www.bma.org.uk/advice-and-support/covid-19/ethics/covid-19-ethical-issues

There will definitely be hard and horrible choices being made 

And this is exactly why it's so incredibly important that we protect our elderly and vulnerable right now. 

Speaking of being thrown under the bus....

[from CNN https://edition.cnn.com/2020/04/02/uk/uk-coronavirus-testing-criticism-intl-gbr/index.html ]

The BMA said its new guidance had been prepared for doctors who will need to make "grave decisions" about who should receive "scarce lifesaving resources" if the country's health system is overwhelmed by coronavirus cases. "As such, some of the most unwell patients may be denied access to treatment such as intensive care or artificial ventilation," the BMA's ethics guidance note states.

"This will inevitably be indirectly discriminatory against both the elderly and those with long-term health conditions, with the latter being denied access to life-saving treatment as a result of their pre-existing health problems." It says imposing an age cut-off would be illegal, but adds that older patients with pre-existing respiratory problems would have a "very high chance of dying despite intensive care," and are therefore lower priority for admission.

We're toast. 

https://www.bbc.co.uk/news/uk-wales-52117814

Here are the guidelines in full
https://www.bma.org.uk/advice-and-support/covid-19/ethics/covid-19-ethical-issues

There will definitely be hard and horrible choices being made 

That's what always happens with natiional health services and the staff will be used to making choices depending on their budget, equipment.

In additon to the above guidance on choices for the coronavirus, I assume it will also be - how many lives could that ventilator have saved if somebody is on it for longer.

That's what always happens with natiional health services and the staff will be used to making choices depending on their budget, equipment.

In additon to the above guidance on choices for the coronavirus, I assume it will also be - how many lives could that ventilator have saved if somebody is on it for longer.

Its happening in NYC as well. It has nothing to do with it being a national health service and everything to do with them feeling disabled lives matter less, even if the pre existing conditions don't impact ability to fight this illness. It's disgusting, but I also know the front line doctors are doing the absolute best they can in terrible circumstances without enough equipment.

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imposing an age cut-off would be illegal

I'm surprised that "legal" figures into this at all.  It can't be legal to discriminate against disabled people, especially when like Margo says their disability doesn't impact the outcome. 
I don't envy the doctors asked to make these decisions but I also thought that they make these kind of decisions all the time.  We've been prioritising organ transplants for a long time and I can only assume doctors make decisions about scarce organs that result in death frequently. 

They do make these decisions, e.g when to call time, etc.  Or when medicines are too costly or won't help.  I think though it's the scale of the decisions needed to be made all at once that will be hard.  And probably NHS trust dependant, of course. Post code lottery again.

Yeah, I kind of worry about "on the fly" decisions. Which I do understand may have to be made. They are doing the best they can. It's a horrible position to be put in.

However, 12 years ago I was told I had only a 3 out of 5 chance of making it five years and was advised to consider putting my affairs in order. Shortly thereafter I made a "miraculous" recovery and have been basically healthy, aside from a cold every year, since. So, I don't know if I had a truly miraculous recovery, I was initially mis-diagnosed, or a combination of both?   That was in a time when I had a say in my treatment, I made the decisions....  So having decisions about my life made by someone who doesn't know me, and doing them on the fly without being able to consult next-of-kin, is REALLY unsettling. I think I'm glad we both also have private insurance. However, given the scope of this, it may not matter. It would not be different in the USA. Unless I was wealthy. When it would.

I just am glad the NHS has almost none of the Daughter's or my medical histories on file. 

Still the best documentary I’ve ever watched was “NHS, £2 billion a week and counting”.  It was a Channel 4 series

I sit on several boards. THANK GOD none of them are making decisions on people’s lives. Hats off to the professionals who have to make those decisions. It was an eye opening and very humbling program. Well worth a watch.

It is worth mentioning resuscitation in a hospital setting only leads to about 17% of people actually leaving the hospital, most die either then or over the next few days. I don't know if they have figures for Covid-19 and if it's any better or worse. I've made clear to my husband that the only measures I would be OK with are intubation and an AED/medication to put my heart back into rhythm. I do not want CPR. I would not recover from CPR and the damage it would do to my spine. I think it's important for everyone to think through what they would want in a worst case scenario and to make that known, now and in the future. Its not an easy conversation to have but it matters!

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It is worth mentioning resuscitation in a hospital setting only leads to about 17% of people actually leaving the hospital, most die either then or over the next few days.

I read too that even if they survive, it is not good for older people to been on ventilators.

Sea change here.

For those of us with US Dept of Ed student loans, payments are suspended without penalty until 30 Sept 2020.

This is only for federal student loans that are owned by government agencies such as Direct Loans. However, this does not include private student loans or FFEL Loans.

Back  to CPR -

It can vary.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485389