We now know COVID is fully airborne. We also know how to control airborne disease. So why are vulnerable people still dying of hospital-acquired COVID?
Doctors are just people who went to medical school, and often that was a long time ago. Like in all walks of life, some people are lifelong learners and others aren't. From personal experience, many doctors know less about the latest research on COVID effects and treatments than avid lay readers do. I was just told "don't bother with Paxlovid unless your symptoms are severe".
Hospitals are susceptible to lawsuits for hospital-acquired infections, but ONLY if it can be shown that they ignored protocols. That is the biggest driver behind several related realities:
* Reluctance of public health organizations to acknowledge airborne transmission and efficacy of masking
* Refusal of the CDC to create masking, air filtration, and isolation protocols that would open medical providers to liability if not followed
* Halting of COVID testing at hospital admission, where a negative test at admission would be damning evidence of HAI in court. Without it, plausible deniability.
"Halting of COVID testing at hospital admission, where a negative test at admission would be damning evidence of HAI in court. Without it, plausible deniability."
Never considered this. It might be the most painfully ironic Defensive Medicine™️ tactic I've ever heard of.
They also wanted to stop canceling elective surgeries because of the loss of income. Never mind the increase risk for all involved. Any bad outcomes wouldn’t be blamed on them.
This may also explain why WHO was weirdly slow to admit covid is airborne at the start, when the evidence seemed obvious - the US choir practice, the S Korean bus trip, the aircon duct infections, the absence of hand transmission.
And if other diseases are also airborne, it may explain why that was downplayed or disregarded.
While I didn't work in health care, I was a teacher (mostly) from 1991 until 2019. Everything you say about hospitals applies equally or more so to schools. God only knows what struggling schools did with their air-quality mitigation money from the federal government. They probably bought cleaning supplies and paid teachers a smidgen more. None that I know of actually addressed HVAC problems.
COVID19 was the nail in the coffin of my career, not because I'm immunocompromised, because I have congenital hypertension and am not willing to jeopardize the uncommonly physically active life I enjoy in the out of doors when I'm not in classrooms. Selfish? You bet.
Thank you for saying so much so well. I'm only sorry that my early retirement budget for subscriptions is spent and it does not allow me to support your work directly right now.
Just read this piece [+ your comment] & wish I could cheer for everything written , but living an isolated life due to my severe chronic illness making me too "high risk," I don't go to places where one can *CHEER* with everyone else anymore. Much worse is having a developmentally delayed (can't wear masks) AND high risk 5 y/o son who is supposed to be in Kindergarten atm, but we're too scared of uncontrolled Covid to send him to school now.
I have no clue what to do when someone has a disabled child with risks not only for themselves, but a parent back home as well, who's even more high risk for Covid due to severe chronic illnesses making it that they just can't get infected... especially repeated infections, since each time would be dodging an ever more powerful bullet.
How do we navigate the steaming pile of shוt left for my family? I'm already risking my health by delaying care I need all the time, and we couldn't send him safely to special ed preschool because Covid arriving just weeks before he turned 2, BUT it's about to get a million times worse as soon as my maskless disabled child tries to FINALLY get an education!
And no one has any answers beyond "hope" it doesn't infect my child by "doing the best" ~we~ can do. Well their best isn't going to be good enough to be ensured we're ALL there at his graduation!
I think people also forget the devastating impact on healthcare infrastructure caused by this new form of COVID denialism. It's incredibly taxing to constantly lose what few healthcare workers we still have (we began the pandemic with a critical shortage, which has only worsened). Not just the doctors and nurses, but ALL the staff that make it possible--the desk workers, the sanitation staff, etc. The clinic near where I live stapped masking for staff and patients as soon as it was legal to do so. The resulting fallout was devastating; there's been such a dramatic loss of staff that the clinic's cut available hours by almost *half.* We're losing providers and staff not just from quitting (either relocating to different clinics or leaving practice entirely), but from sickness and disability. Trying to get healthcare in my area as a disabled adult feels like a SAW trap, where I have to try and navigate a collapsing system to get the care I need to *survive*, while also fighting for myself against my own providers. Even if I make it out uninfected, the moral injury of fighting the very people who are supposed to care about you... takes its toll. I just wish people would care about us. Disability comes for everyone as we age (especially if you're repeatedly infecting yourself 1-3x a year with COVID), please don't wait until these issues start impacting you personally to speak up and help demand better.
We're among the vulnerable, and don't feel at all safe (because we aren't!) going to outpatient medical facilities.
Because society has failed to protect public health, we can't be physically present to participate in anything, but at least that's our choice. MEDICAL FACILITIES ARE ESSENTIAL TO HEALTH AND LIFE, and THEY ARE CHOOSING TO SICKEN AND KILL THEIR PATIENTS.
Every day, every minute, HCWs are violating the Hippocratic Oath.
Hello, Julia. First blog from you since February. What have you been up to? Your stuff is pretty good but I there are very few blogs I actually pay money for. Mine is free free.
A lot of the problem with covid is "don't wanna" attitudes. But the fact is that if people were ordered to do it, and the antivax types dealt with the way they should be, most people would comply.
it is not just don't wanna, and dont wanna spend the money. It is a eugenic mentality. They want to reduce the population generally and especially to wipe out the useless eaters. It is quite deliberate.
"Also implicit is the abandonment of collective care and public health, since the “back to normal” crowd places the burden of COVID precaution on disabled, immunocompromised and vulnerable people alone."
Recently, the NY Times had a story about how, actually, immunocompromised people aren't even at higher risk. False, of course. But that's how this is being justified today to the NY Times crowd, only a year after trying to shame everyone into getting COVID shots to protect those very same immunocompromised.
Honestly, I'm having trouble keeping the official narrative straight anymore. We've always been at war with Eurasia.
There’s a weird narrative that defies logic that people really want to believe. I have Common Variable Immunodeficiency and my own immunologist tried to tell me (w/ very low IGG, IGM, IGA), that COVID wasn’t a big deal for patients like me. Meanwhile, a common cold can give me pneumonia. My other doctor absolutely has the correct approach and I see him exclusively via telemedicine. It’s easy to look at this on face value of simple stupidity or ignorance, but it’s more sinister wrapped up in something more like pseudo science. They’ve been brainwashed in a way that makes it all seem “right”.
thank you for yet another terrific piece. one thing I've noticed recently is that many gyms, schools, and some healthcare facilities seemed to have spent too much money in 2020 and 2021 on "AirPHX," a company selling oxidizing air filtration. It seems to me that the research just isn't there on these systems, and that people would be better off with HEPAs and masking (of course), but I'm wondering if anyone has written about that or done a deep dive? It feels like a disservice that so many people may have a false sense of security because of this.
Nurses should run the country. I wish the very best of their cadre would run for elected office. They might consider starting a third party. A nurse should definitely run for President.
Thank you for the excellent reporting. I pray never to need medical care. That is an absurd, useless and horrific proposition.
I feel for anyone with LC or working under these conditions who knows better.
All of you are ignoring the elephant in the room: the rise of private equity owned hospitals. If they get more money for not getting certain types of infections, they stop testing for those infections. Period. Get private equity out of medicine and stop blaming the front line grunts.
"surgicals are far better than nothing; they are simply not the proper type of mask to best prevent infection with a fully airborne disease. For that, you need a mask that forms a seal around your nose and mouth."
The latter also doesn't prevent an infection. It only reduces the probability of an infection relative to the surgical mask.
Governments and organisations have no choice but to "move on" from responding to covid in ways that require the public to change or restrict behavior.
It happened even here in sensible NZ with a very popular govt, laudable restraint by the opposition party, great respect for our free public health system. Covid denialism eventually blew up and threatened to destablise the country. It became a powerful recruiting tool for libertarians, fascists and even outright Nazis. A permanent whackosphere has been consolidated out of every group or sector of society which sees itself as downtrodden.
A conspiracy theory that aligns with a person's financial interests & political ideology is easy to accept and difficult to dislodge. But if it is incorporated into personal identity, it is permanently incurable in most cases. That is what happened, and it spread fast.
There is no such thing as mass deprogramming, and if there were it would be unethical. All that could be done was to stop the flood of new recruits by dropping mandatory requirements.
Hospitals taking voluntary action eg to improve ventilation and sterilise any recirculated air, need to be careful not to create liability by effectively admitting there is a problem.
So patient advocacy groups wanting a safer hospital visit may need to play along, considering legally safe ways that hospitals can improve physical safety. Perhaps it could be framed as an anxiety issue to protect the hospitals.
Consider trans rights activists. If they had kept quiet about trans issues and instead discreetly helped push for schools & businesses to have more wheelchair-accessible toilets, the "bathroom bills" culture war might never have broken out and turned trans kids into weapons.
Juia, are you a healthcare worker? How many 12hr shifts for days, months and years did you work in n95 mask? Did you read OSHA guidance on N95 masks? Or healthcare workers and their physical health doesn't matter at all? You want to stick nasal swab in their noses every day for years consistently only because they work in the hospital? How many would choose healthcare profession knowing they will be masked and swabed daily? How many will quit whatever was left out of our healthcare? I know you won't stop, till last healthcare worker exhausted, but then it will be too late.
I worn an N95 continuously at work since 2020. It’s difficult but post covid cardiovascular issues would be worse. Covid is a vascular disease that destroys organ systems!
I don't understand this -- you don't realize that, with repeat infections, we aren't going to have any health care workers at all, rending your objections kind of moot. Those that don't get long-COVID, are nonetheless at risk for cardiovascular and neurological complications; The science on this is quite settled at this point. Look at the latest study released on the VA population just recently. Infection = bad. Repeat infections = worse.
Doctors are just people who went to medical school, and often that was a long time ago. Like in all walks of life, some people are lifelong learners and others aren't. From personal experience, many doctors know less about the latest research on COVID effects and treatments than avid lay readers do. I was just told "don't bother with Paxlovid unless your symptoms are severe".
Hospitals are susceptible to lawsuits for hospital-acquired infections, but ONLY if it can be shown that they ignored protocols. That is the biggest driver behind several related realities:
* Reluctance of public health organizations to acknowledge airborne transmission and efficacy of masking
* Refusal of the CDC to create masking, air filtration, and isolation protocols that would open medical providers to liability if not followed
* Halting of COVID testing at hospital admission, where a negative test at admission would be damning evidence of HAI in court. Without it, plausible deniability.
*
"Halting of COVID testing at hospital admission, where a negative test at admission would be damning evidence of HAI in court. Without it, plausible deniability."
Never considered this. It might be the most painfully ironic Defensive Medicine™️ tactic I've ever heard of.
They also wanted to stop canceling elective surgeries because of the loss of income. Never mind the increase risk for all involved. Any bad outcomes wouldn’t be blamed on them.
This may also explain why WHO was weirdly slow to admit covid is airborne at the start, when the evidence seemed obvious - the US choir practice, the S Korean bus trip, the aircon duct infections, the absence of hand transmission.
And if other diseases are also airborne, it may explain why that was downplayed or disregarded.
While I didn't work in health care, I was a teacher (mostly) from 1991 until 2019. Everything you say about hospitals applies equally or more so to schools. God only knows what struggling schools did with their air-quality mitigation money from the federal government. They probably bought cleaning supplies and paid teachers a smidgen more. None that I know of actually addressed HVAC problems.
COVID19 was the nail in the coffin of my career, not because I'm immunocompromised, because I have congenital hypertension and am not willing to jeopardize the uncommonly physically active life I enjoy in the out of doors when I'm not in classrooms. Selfish? You bet.
Thank you for saying so much so well. I'm only sorry that my early retirement budget for subscriptions is spent and it does not allow me to support your work directly right now.
Just read this piece [+ your comment] & wish I could cheer for everything written , but living an isolated life due to my severe chronic illness making me too "high risk," I don't go to places where one can *CHEER* with everyone else anymore. Much worse is having a developmentally delayed (can't wear masks) AND high risk 5 y/o son who is supposed to be in Kindergarten atm, but we're too scared of uncontrolled Covid to send him to school now.
I have no clue what to do when someone has a disabled child with risks not only for themselves, but a parent back home as well, who's even more high risk for Covid due to severe chronic illnesses making it that they just can't get infected... especially repeated infections, since each time would be dodging an ever more powerful bullet.
How do we navigate the steaming pile of shוt left for my family? I'm already risking my health by delaying care I need all the time, and we couldn't send him safely to special ed preschool because Covid arriving just weeks before he turned 2, BUT it's about to get a million times worse as soon as my maskless disabled child tries to FINALLY get an education!
And no one has any answers beyond "hope" it doesn't infect my child by "doing the best" ~we~ can do. Well their best isn't going to be good enough to be ensured we're ALL there at his graduation!
So sorry for the /rant in the replies!
Not only is this not selfish it makes complete sense
I think people also forget the devastating impact on healthcare infrastructure caused by this new form of COVID denialism. It's incredibly taxing to constantly lose what few healthcare workers we still have (we began the pandemic with a critical shortage, which has only worsened). Not just the doctors and nurses, but ALL the staff that make it possible--the desk workers, the sanitation staff, etc. The clinic near where I live stapped masking for staff and patients as soon as it was legal to do so. The resulting fallout was devastating; there's been such a dramatic loss of staff that the clinic's cut available hours by almost *half.* We're losing providers and staff not just from quitting (either relocating to different clinics or leaving practice entirely), but from sickness and disability. Trying to get healthcare in my area as a disabled adult feels like a SAW trap, where I have to try and navigate a collapsing system to get the care I need to *survive*, while also fighting for myself against my own providers. Even if I make it out uninfected, the moral injury of fighting the very people who are supposed to care about you... takes its toll. I just wish people would care about us. Disability comes for everyone as we age (especially if you're repeatedly infecting yourself 1-3x a year with COVID), please don't wait until these issues start impacting you personally to speak up and help demand better.
This is a *wonderful* post.
We're among the vulnerable, and don't feel at all safe (because we aren't!) going to outpatient medical facilities.
Because society has failed to protect public health, we can't be physically present to participate in anything, but at least that's our choice. MEDICAL FACILITIES ARE ESSENTIAL TO HEALTH AND LIFE, and THEY ARE CHOOSING TO SICKEN AND KILL THEIR PATIENTS.
Every day, every minute, HCWs are violating the Hippocratic Oath.
Hello, Julia. First blog from you since February. What have you been up to? Your stuff is pretty good but I there are very few blogs I actually pay money for. Mine is free free.
A lot of the problem with covid is "don't wanna" attitudes. But the fact is that if people were ordered to do it, and the antivax types dealt with the way they should be, most people would comply.
It is as I make out in my own piece here, https://timrourke.substack.com/p/a-bad-time-to-be-old
it is not just don't wanna, and dont wanna spend the money. It is a eugenic mentality. They want to reduce the population generally and especially to wipe out the useless eaters. It is quite deliberate.
"Also implicit is the abandonment of collective care and public health, since the “back to normal” crowd places the burden of COVID precaution on disabled, immunocompromised and vulnerable people alone."
Recently, the NY Times had a story about how, actually, immunocompromised people aren't even at higher risk. False, of course. But that's how this is being justified today to the NY Times crowd, only a year after trying to shame everyone into getting COVID shots to protect those very same immunocompromised.
Honestly, I'm having trouble keeping the official narrative straight anymore. We've always been at war with Eurasia.
There’s a weird narrative that defies logic that people really want to believe. I have Common Variable Immunodeficiency and my own immunologist tried to tell me (w/ very low IGG, IGM, IGA), that COVID wasn’t a big deal for patients like me. Meanwhile, a common cold can give me pneumonia. My other doctor absolutely has the correct approach and I see him exclusively via telemedicine. It’s easy to look at this on face value of simple stupidity or ignorance, but it’s more sinister wrapped up in something more like pseudo science. They’ve been brainwashed in a way that makes it all seem “right”.
So so so grateful for this piece--sending to everyone I know. Thank you 💓
thank you for yet another terrific piece. one thing I've noticed recently is that many gyms, schools, and some healthcare facilities seemed to have spent too much money in 2020 and 2021 on "AirPHX," a company selling oxidizing air filtration. It seems to me that the research just isn't there on these systems, and that people would be better off with HEPAs and masking (of course), but I'm wondering if anyone has written about that or done a deep dive? It feels like a disservice that so many people may have a false sense of security because of this.
Nurses should run the country. I wish the very best of their cadre would run for elected office. They might consider starting a third party. A nurse should definitely run for President.
Thank you for the excellent reporting. I pray never to need medical care. That is an absurd, useless and horrific proposition.
I feel for anyone with LC or working under these conditions who knows better.
All of you are ignoring the elephant in the room: the rise of private equity owned hospitals. If they get more money for not getting certain types of infections, they stop testing for those infections. Period. Get private equity out of medicine and stop blaming the front line grunts.
"surgicals are far better than nothing; they are simply not the proper type of mask to best prevent infection with a fully airborne disease. For that, you need a mask that forms a seal around your nose and mouth."
The latter also doesn't prevent an infection. It only reduces the probability of an infection relative to the surgical mask.
Governments and organisations have no choice but to "move on" from responding to covid in ways that require the public to change or restrict behavior.
It happened even here in sensible NZ with a very popular govt, laudable restraint by the opposition party, great respect for our free public health system. Covid denialism eventually blew up and threatened to destablise the country. It became a powerful recruiting tool for libertarians, fascists and even outright Nazis. A permanent whackosphere has been consolidated out of every group or sector of society which sees itself as downtrodden.
A conspiracy theory that aligns with a person's financial interests & political ideology is easy to accept and difficult to dislodge. But if it is incorporated into personal identity, it is permanently incurable in most cases. That is what happened, and it spread fast.
There is no such thing as mass deprogramming, and if there were it would be unethical. All that could be done was to stop the flood of new recruits by dropping mandatory requirements.
Hospitals taking voluntary action eg to improve ventilation and sterilise any recirculated air, need to be careful not to create liability by effectively admitting there is a problem.
So patient advocacy groups wanting a safer hospital visit may need to play along, considering legally safe ways that hospitals can improve physical safety. Perhaps it could be framed as an anxiety issue to protect the hospitals.
Consider trans rights activists. If they had kept quiet about trans issues and instead discreetly helped push for schools & businesses to have more wheelchair-accessible toilets, the "bathroom bills" culture war might never have broken out and turned trans kids into weapons.
Juia, are you a healthcare worker? How many 12hr shifts for days, months and years did you work in n95 mask? Did you read OSHA guidance on N95 masks? Or healthcare workers and their physical health doesn't matter at all? You want to stick nasal swab in their noses every day for years consistently only because they work in the hospital? How many would choose healthcare profession knowing they will be masked and swabed daily? How many will quit whatever was left out of our healthcare? I know you won't stop, till last healthcare worker exhausted, but then it will be too late.
I worn an N95 continuously at work since 2020. It’s difficult but post covid cardiovascular issues would be worse. Covid is a vascular disease that destroys organ systems!
I don't understand this -- you don't realize that, with repeat infections, we aren't going to have any health care workers at all, rending your objections kind of moot. Those that don't get long-COVID, are nonetheless at risk for cardiovascular and neurological complications; The science on this is quite settled at this point. Look at the latest study released on the VA population just recently. Infection = bad. Repeat infections = worse.