Are U.S. hospitals boosting Covid numbers? It is possible

Like many people I've heard stories that U.S. hospitals get extra funding for treating Covid-19 patients, but I didn't know whether or not that was true.  According to a report done by CBS news, it is.  

As per  a CBS San Diego affiliate, hospitals treating patients for Covid-19 receive substantially more money than treatments for non Covid patients.  The article cites a Minnesota State senator putting the amount at $13,000 for someone admitted with Covid and $39,000 if they're put on a ventilator.  However a Medicare spokesperson says that the amount varies hospital to hospital based on variations in local costs.

Here's the link:  

https://www.cbs8.com/article/news/verify/do-hospitals-get-paid-more-for-covid-19-cases/509-977c448f-d9a6-42f8-a443-968e9b610cac?fbclid=IwAR1_dVOmsoaX1HCwPxgwsRPm7VTeSwsQb0Lk1TQoupBSO70ZT0zvNhb5zL4

For those who aren't aware, hospitals in the United States are for the most part profit driven.  That doesn't mean that the entire American medical system is removed from government funding.  U.S. citizens aged 65 and up qualify for government provided health insurance via Medicare, so long as they've been residents for 5 or more years.  

Given that the novel and mostly benign coronavirus overwhelmingly targets the elderly and health compromised, that's a lot of money for a country with a reported 1.1 million active cases.  And that  number is sure to keep climbing higher and higher, substantially higher if fears about the relaxation of lockdown measures prove true.  

Does this financial incentive mean hospitals are falsifying discharge papers and death certificantes?  Of course it doesn't, but it is possible.  According to the report such actions would result in the payments being recouped as well as possible legal action.  

Given my opinion of human nature, especially when money is involved, I don't have any difficulty in picturing hospital adminstrators pressuring doctors to list Covid-19 as a cause of death when someone dies of cancer or heart failure or any number of conditions.  How would you be able to prove the deceased didn't have Covid?  Would they dig up a body and conduct a coronavirus test post mortem?

And given the financial strain hospitals are under, well....necessity isn't just the mother of invention, necessity is also the mother of lies and deceit.  U.S. hospitals are hurting financially right now, so much so that they're furloughing Doctors, Nurses and other staff.  Reports say 1.4 million health care workers were laid off in April alone.  No wonder so many American health care professionals are starting to speak out against lockdown measures.  

On the flip side I also think its possible that some jurisdictions are underreporting.  With the lack of availability of testing kits I have read news reports that some countries are not counting deaths as  due to Covid unless there's a positive test to back it up.  

And that makes this whole situation even more complicated.  How can you manage a situation without reasonably accurate measurements.  Financial incentives could be goosing the number of deaths in the United States, but it could also be lowering the numbers in countries like Japan where testing is a fraction of what's taking place in countries like the United States and Canada.  Both Canada and the U.S. are testing over 35,000 people per one million of populaiton while in Japan its only a little over 2,000 per one million of population.

Thanks for reading, I'll have more to say later.    

The Politics of a Pandemic - Everyone is doing the right things.....

Canadians, no matter where they live, can be assured of one thing in our fight against the novel coronavirus.  Whatever goverment is in place they are following the best advice of medical professionals and are being guided by the science, protecting the health and safety of citizens.   

That's true federally where the Liberals are in power, in British Columbia where the NDP rules,  also in Ontario where Doug Ford's Prorgessive Conservatives hold a majority, as well in Quebec where its François Legault and the Coalition Avenir de Québec calling the shots.  Every level of government across Canada is making all the right decisions. 

It was true when the nation's top medical officer did not require people coming back from hotspots like Wuhan China and Italy to quarantine themselves, and that masks weren't required.  And its true now that everyone is under a form of quasi quarantine and should wear a mask when indoors and unable to maintain physical distance....unless they have asthma or a lung condition which makes breathing through a mask difficult, then maybe not...

Is it any wonder Canadians, like a lot of people around the world, are confused.

Sweden is a favourite example for both those who think we've gone too far, as well as for those who think we either got it right or need to do even more.  As most readers will be aware, Sweden opted not to bring in strong lockdown measures.  

They didn't do nothing, but when compared to a country like Canada it was close to nothing.  So many of the closures deemed essential here, like shuttering elementary schools, bars and restaraunts were left open in Sweden.  They did ban public gatherings of more than 50 people, required all bar and restaraunt patrons to be seated, and urged people to work from home when possible and for the elderly and health compromised to isolate.

How they fared when compared to other jurisdictions is up for debate.  Their reported death toll is significantly higher than in Canada or in neighbouring Norway and Denmark, but far less when compared with other European countries that opted for strong lockdown measures like Belgium and Spain.  

With such wildly varying results I consider it at least reasonable to question whether or not strong lockdown measures are the deciding factor in how a country fares in its fight against the novel and mostly benign coronavirus.  Factors like vitamin D deficiency, the obesity rate of a population, population densities and likely many other variables could play a significant role in determining why some countries are experiencing higher rates of death than others.

Just looking at obesity, the United States reportedly has roughly one third of its citizens with Body Mass Indexes (BMI) above 30 which is the clinical threshold for declaring someone obese.  Of course in our politically correct times the Coronavirus might be dragged in front of a human rights tribunal for fat shaming if its true that Covid-19 is more deadly for the overweight as some studies are now indicating.

I have not been shy about expressing my opinion that I think Sweden chose the best path, not perfect but better than the route we chose.  Its a horrible situation, because no matter what road is taken the result is the same....death.  Tossing millions of Canadians out of work and onto government assistance (if they qualify and not everyone does) will have negative reprecussions, progressives have long known that poverty kills.  

And while it may sound crass, implementing measures that have tanked the global economy to levels not seen since the Great Depression, (and very likely worse) so that the sick and elderly can have a few more months of diaper changes was the wrong way to go in my opinion.  

Those who are worried that we're moving too soon and too fast in opening things back up though, of one thing you can be absolutely certain.  Our elected officials are acting on the best advice of medical professionals, they're being guided by the science and making the best possible decisions to protect the health and safety of everyone.  

Are we ready to be locked down for another 12+ months?

There's a lot of fear and anxiety out there as provinces begin to lift the isolation measures put in place to slow the spread of the novel and mostly benign coronavirus.  That's understandable, with so many comparisons to the lethal and devastating Spanish Flu still floating around its only natural for some to be worred.  And in our polarized world of right and wrong, black and white, good versus evil, lots of people are seeing this as an either or question.

Intelligent people though know that life is seldom that simple, especially in areas of government mandated public policy.

First of all it has to be realized that the isolation measures put in place, (such as they are and were) were never meant to stamp out this virus.  The purpose was to slow the spread, to flatten the proverbial curve so that our health care system would not be overloaded.  I think its more than reasonable to say that this goal has been accomplished.  

Obviously there was still viral spread happening even with isolation measures, but that was unavoidable given the essential nature of the supply chain.  I don't even like imagining the chaos that would have ensued if grocery store shelves were empty for weeks at a time with people forced to stay inside their homes.  Those eagerly awaiting the Zombie Appocolypse would have gotten their wish.

Flattening the curve doesn't stop viral spread, it simply delays it.  And unless we're all willing to hunker in our bunkers for another year or more (perhaps indefinitely) while we wait for a vaccine, then at some point the clamps have to be loosened.  And as restrictions are eased we're going to be seeing more infections, its inevitable and we should expect it.  

Beyond just flattening the curve and delaying infections, isolation measures have bought us time so that now we know so much more about this novel Coronavirus and the resulting Covid-19 illness.  

We know that overwhemlingly most negative outcomes happen in the elderly and health compromised.  Dr. Tam herself acknowledged this with the news that 81% of Canada's deaths are occuring in Long Term Care type facilities, where residents are both old and sick already.  Even in the small number of  younger people getting sick and dying of Covid there's emerging research suggesting a link between Vitamin D deficiency and serious illness.  

We've learned a lot thanks to social distancing, and we can use this knowledge to make informed decisions going forward.  Not everyone will listen, that's to be expected, we've had decades of research and science telling Canadians to stop smoking, and yet millions still do, I'm one of them.  

In short the number of cases isn't the number to watch in my opinion, its the number of hospitalizations and the degree to which our health care system is under strain.  And we should also remember that our hosptials were often over capacity even before this pandemic.  The term "hallway medicine" didn't result from Covid, it was already a normal state of affairs.

Lockdown measures are not a cure all, and in of themselves come with all manner of negative health issues and death.  As we slowly open back up we just need to be smart and protect the people the science says are most vulernable.  

Thanks for reading, I'll have more to say later.

Are we ready to move past panic mode now?

Liberal progressive consumers of news have long known that it pays to be skeptial of over the top reporting.  Whether it was the Gulf of Tonkin incident in Viet Nam or the more recent wars in the Persian Gulf, with Iraq presented as a major threat to world peace and security, the media loves to play on fear.  

A lot of Canadians are scared right now, and that is understandable given the fashion in which most media outlets have been reporting on the novel coronavirus.  I've seen frequent reference to:  "The deadly coronavirus".  And over the top messaging talking about the: "Tsunami of death".  

This is beyond irresponsible, its not reporting but hyperbole on steroids.  If media outlets treated all topics this way we'd have been reading about 'Killer Peanuts' for years now.  US comedian and political commentator Bill Mahar has used the term "Panic Porn" and its very fitting.  

Let's take a calm and rationale look at some simple and easily verifiable facts instead.  

Canada is reported to have 5,842 deaths attributed to Covid-19.  Over 80% of those deaths are occuring in Long Term Care type facilities, a Washington Post article from May 18th 2020 puts it at 81% as per Canada's Chief Public Health Officer.   At 80% that would put LTC deaths at 4,673 with the remaining deaths at 1,169....and of course those numbers are going to keep climbing.  

Death is tragic at any age, but to give the reporting some perspective consider the health of people in LTC type facilities.  Here are some statistics from 2019 from the Ontario Long Term Care Association:  

• 90% have some form of cognitive impairment
• 86% of residents need extensive help with daily activities such as getting out of bed, eating, or toileting
• 80% have neurological diseases
• 76% have heart/circulation diseases
• 64% have a diagnosis of dementia
• 62% have musculoskeletal diseases such as arthritis and osteoporosis
• 61% take 10 or more prescription medications
• 40% need monitoring for an acute medical condition
• 21% have experienced a stroke

Those wishing to verify this information, please do.  Here's the link:

https://www.oltca.com/oltca/OLTCA/Public/LongTermCare/FactsFigures.aspx?fbclid=IwAR2E0XAv-UotB3nzf9gFxtWd-d2omN5QwIhg1MZUOq7sH10n6uj6AsRFYCY

Death is never anything but tragic, of that there is little argument.  But I think most would agree that the death of a young child to something like a drunk driving accident is exponentially more tragic than the death of someone over 80 years of age who suffers from alzheimers and cardivocascular diesease.  Speaking as someone who has lost both his parents as well as both the grandparents I knew about growing up, sometimes death is viewed as a relief.  Sad and depressing, but a relief all the same, both for the person suffering as well as their family. 

One of the small blessings we can be thankful for with this pandemic is that Covid-19 has not taken the lives of any Canadian children.  Hopefully that will remain true, unlike seasonal flu which can be lethal to young children.   

Death is a depressing topic....for anyone.  Canada was likely going to have somewhere around 280,000 deaths this year before this novel virus reared its ugly head, now I expect that number will be higher.  The fact is every single Canadian (as well as everyone on the planet) suffers from a terminal illness called living, and the mortality rate is 100%.  As my late beloved father told me many times:  "Nobody gets out of here alive".  

But to get back to the topic at hand, about whether we're ready to move past panic mode now.  The first question one might reasonably ask is this:  Did we panic?  

For me the answer is unquestionably yes.  How else would you describe sacrificing people in need of cardiac surgery and cancer screening?  Or how about tossing millions of Canadians out of work and into the poverty that comes from living off government assistance.  And to add insult to injury the messaging is that these people are not essential.  

I'm sorry, but this really gets under my skin....this categorization of a human being's worth based on the job they preform.  Progressive types have campaigned about this for decades, advocating for the marginalized whether they be miners, factory workers, the unemployed, underemployed or any other group that has its humanity dimished, its disgusting.  

Does any one know a single mother who supports herself and her kids by waiting on tables in a restaraunt?  I know two, serving tables is a job that often falls on women, especially those not fortunate enough to have a post secondary education.  Now, on top of being out of work and forced onto government welfare, now they're being told they're not essential.  I don't like to use profanity, but sometimes its called for.  And this is BULL SHIT!!!

Everyone is essential.  

Yes, the novel coronavirus can be deadly, but not for 99% of the population.  Canada has reported 78,702 confirmed cases as I type this, with 33,002 being current.  Every health expert and medical professional is telling us that this is just the tip of the proverbial iceberg.  The reason this is just a small fraction of the real total case number is that most people have only very minor symptoms or none at all, and they don't get tested. 

While Canada has not yet conducted any large scale radomized testing to get a better handle on what the actual case count is, other jurisdictions have.  Places like California, NYC and Great Britain have conducted radmoized sampling by respected academic institutions like Stanford, USC and Oxford.  Their findings suggest the real case numbers are at least 20x larger, and perhaps as much as 55x larger than what is being reported.

If Canada's true case number is 20x higher than what has been confirmed, then the real case number is around 1.5 million.  And that would mean our mortality rate is less than half of one single percent.  Its worse than seasonal flu, but not the 'at least 10x more deadly' messaging used at the start.

And for this we've thrown 3 million working Canadians under the bus, subjected many to the stress of economic uncertainty....stress that can lead to depression, alcohol and substance abuse, spousal and child abuse, suicide.  These are issues that progressives used to care about, but now some are so afraid of the mostly benign coronavirus that they've forgotten to advocate for Canada's marginalized citizens. 

And sadly it gets worse, the economic fallout of lockdown measures has the UN warning about a pending global famine that will see over 100 million more people worldwide pushed to starvation, that we'll be seeing reports of 300,000 people dying each and every day for about three months, many of them children.   

I'll have more to say later, thank you for reading.