“One thing that happened is that after the 2009 H1N1 pandemic there were a lot of masks distributed to states and localities and they simply weren’t replenished. Then there was a plan to purchase thousands more ventilators. A contract was signed with a small medical equipment company in Southern California. That company was then bought by a different medical equipment company, and in the end the contract wasn’t fulfilled. The new ventilators never came in.
So there are these matters of prioritization and inattention that can affect whether in fact we have the supplies that have been recommended in the stockpile.”
“There’s a key period that a lot of people are now focusing on, which is late January to mid-February. This is a point at which we were already aware of what had happened in China, and the World Health Organization had declared Covid-19 a “global health emergency of international concern.”
That was really the time to consider whether we had the supplies we needed of these essential items and to figure out whether the stockpile needed to be replenished rapidly and do whatever it took to make sufficient supplies available — whether that meant purchasing supplies from other sources or even using the DPA to force manufacturers to shift to production of ventilators, for example.
So even if it had not been replenished prior to this administration, there was a chance to do a better job at the outset.”
“We were just about to leave for the two-hour drive to the hospital when the nurse called back. She said Duke University Hospital was now requiring the results of virus testing prior to admitting anyone for surgery. They didn’t have a test to give me; just a policy that required me to get one. I contacted my physician in Winston-Salem, but he said the hospital there was only testing patients who had been admitted with serious virus symptoms. Almost as quickly as it had been scheduled, the surgery was canceled.
I don’t know how long it will be before there are enough tests available that someone like me can get one. But unlike other people who might just be curious about whether they are infected or not, I have a clock ticking in my body. While I wait for the test, this cancer could metastasize. By the time they can perform the surgery, it might be a moot point.”
“Right now, the biggest worry is whether the medical system has enough ventilators and protective equipment to treat patients with Covid-19, the disease caused by the novel coronavirus.
But another troubling shortage is on the horizon: doctors, nurses, and other health care personnel.
As patient demand continues to ramp up nationwide and more health care workers are unable to show up for work, either because they contract the virus or because they have to self-quarantine, doctor shortages are a real possibility”
“One solution is to make it easier to bring in doctors and nurses from abroad.”
“even before the current crisis, the immigration system made it difficult for foreign doctors and nurses to work in the US and go where they’re needed. Doctors may face long wait times for green cards, restrictions on where they can settle geographically, and limitations on where they can practice while they’re waiting for a green card. Nurses, meanwhile, also face long waits for green cards and can’t come to the US under temporary skilled worker visas.
The implications of a shortage would be devastating, both to overworked personnel and to the patients for whom receiving medical attention could be a life-or-death matter. But it’s a problem that more immigration could easily fix”
“Not only does the current system make it exceedingly difficult for doctors to stay in the US long-term, but it also severely restricts where in the US they can go.”
“Certified N95 respirators are special. Unlike a conventional surgical mask, N95 masks are built so that 95 percent of very small airborne particles can’t get through. These masks also need to be approved by the CDC’s National Institute for Occupational Safety and Health and, depending on the type, the Food and Drug Administration. In order to fulfill those requirements, N95 masks must be constructed so that they seal tightly around one’s mouth and nose, unlike surgical or cloth masks which are loose-fitting.
The United States is now confronted with a shortage of N95 masks for a number of reasons. The masks themselves are difficult to make, in part because they require specialized equipment to meet stringent regulatory standards. Many of the companies that can make the masks are also in China. That supply chain wasn’t prepared for a pandemic, especially one that originated in the same country where many of these masks are produced. And as the novel coronavirus spread throughout China, the country’s government bought its domestically produced masks, ensuring they weren’t exported. That’s made the gap between supply and demand in the US much larger.
In the absence of a pandemic, the US has typically not produced enough of these N95 masks to meet the needs of its own workers. Prestige Ameritech and 3M are the two primary companies that do end-to-end production of medical-grade N95 masks in the US, and both are both ramping up production. Another American company, Honeywell, recently started producing N95 masks at its Rhode Island and Phoenix facilities. Still, these three companies won’t solve our mask shortage.”
“”In the United States, fewer births and more deaths reduced population growth to a 100-year low,” reports a new study by demographers at the University of New Hampshire (UNH). They add that “in nearly 46 percent of counties, more people died than were born last year.”
As I reported last year, the U.S. total fertility rate fell in 2018 to 1.73 births per woman, the lowest rate ever recorded. In general, the U.S. total fertility rate was been below replacement fertility—the level at which a given generation can exactly replace itself, usually defined as 2.1 births per woman—since 1971.”
“Interestingly, the low—that is to say, negative—population growth in 1919 was largely the result of the decimation caused by the Spanish flu pandemic. Between July 1918 and July 1919, U.S. population actually dropped by 60,000 people.”