Different Takes: If Care Has To Be Rationed During Coronavirus, Doctors Will Face Agonizing Decisions; Supply Chain For Medical Devices Will Suffer

The New York Times: How The Coronavirus May Force Doctors To Decide Who Can Live And Who Dies
The coronavirus pandemic could soon force American physicians to face a tragic challenge — rationing medical care as the number of ill patients overwhelms the supplies, space and staff available in hospitals. Today, the United States has fewer than 800,000 hospital beds, about 68,000 adult intensive care unit beds of any kind, and, even with the strategic reserve, fewer than 100,000 ventilators. As disease spreads this will not be enough. (Ezekiel J. Emanuel, James Phillips and Govind Persad, 3/12)

The Wall Street Journal: It May Not Be The Virus That Kills Me 
With each passing day, the coronavirus pandemic reveals that many of our lives hang by a thin fiber-optic thread that can snap at any time. As more people are quarantined and businesses grind to a halt, supply chains will break down. While this will have negative economic consequences for all, for many of us it will be a matter of life and death. My life depends on an artificial pancreas I wear on my belt. Without the insulin it delivers 24/7, I would die within a few days. I’m not sure where the insulin and components for my pump and the related sensors, transmitter and continuous glucose monitor are produced. The supply chain of the world’s largest insulin producer, Novo Nordisk, runs through the U.S., Brazil, Denmark, France, China, Russia, Algeria and Japan. (Mark C. Taylor, 3/12)

The New York Times: Coronavirus And The Isolation Paradox
In December, a woman in Tulsa, Okla. used a Craigslist post to plea for holiday companionship. “Anybody need a grandma for Christmas?” she wrote. “I’ll even bring food and gifts for the kids! I have nobody and it really hurts.” More than three in five working Americans report feeling lonely. Now that the country is facing a disease outbreak that demands measures like “social distancing,” working from home and quarantines, that epidemic of loneliness could get even worse. (Abdullah Shihipar, 3/13)

CNN: Doctor: How To Reduce Your Vulnerability To Coronavirus — When Sleeping
What you may not know about coronavirus — the disease that has reached pandemic proportions — is that one of the times you are most vulnerable to contracting it is while you’re sleeping. Here is how this can happen, and what you can do about it. (Bruce L. Davidson, 3/13)

CNN: The Right Role Model For The Coronavirus Crisis Is Tom Hanks, Not Donald Trump
The coronavirus pandemic will challenge our country in ways we haven’t seen in our lifetimes. And we are culturally unprepared. It’s not that America hasn’t faced public health crises before. A century ago, America confronted the far more deadly Spanish influenza epidemic, which killed an estimated 50 million people around the world, including members of my family. We confronted the polio epidemic, which crippled hundreds of thousands of people, including, many believe, an American president. And when a cure for polio was found, Dr. Jonas Salk gave away the patent for free to help as many people as fast as possible. (John Avalon, 3/12)

The New York Times: Pandemics Kill Compassion, Too
Some disasters, like hurricanes and earthquakes, can bring people together, but if history is any judge, pandemics generally drive them apart. These are crises in which social distancing is a virtue. Dread overwhelms the normal bonds of human affection. In “The Decameron,” Giovanni Boccaccio writes about what happened during the plague that hit Florence in 1348: “Tedious were it to recount how citizen avoided citizen, how among neighbors was scarce found any that shewed fellow-feeling for another, how kinfolk held aloof, and never met … nay, what is more, and scarcely to be believed, fathers and mothers were found to abandon their own children, untended, unvisited, to their fate.” (David Brooks, 3/12)

New England Journal of Medicine: Virtually Perfect? Telemedicine For Covid-19
Recognizing that patients prioritize convenient and inexpensive care, Duffy and Lee recently asked whether in-person visits should become the second, third, or even last option for meeting patient needs. Previous work has specifically described the potential for using telemedicine in disasters and public health emergencies. No telemedicine program can be created overnight, but U.S. health systems that have already implemented telemedical innovations can leverage them for the response to Covid-19. A central strategy for health care surge control is “forward triage” — the sorting of patients before they arrive in the emergency department (ED). Direct-to-consumer (or on-demand) telemedicine, a 21st-century approach to forward triage that allows patients to be efficiently screened, is both patient-centered and conducive to self-quarantine, and it protects patients, clinicians, and the community from exposure. It can allow physicians and patients to communicate 24/7, using smartphones or webcam-enabled computers. (Judd E. Hollander and Brendan G. Carr, 3/11)

Boston Globe: Puerto Rico Must Act Now To Stop The Coronavirus 
The US commonwealth of Puerto Rico will face a major crisis if it cannot contain a Covid-19 outbreak when it arrives. And it will arrive soon, if it hasn’t already. A cruise ship passenger diagnosed with pneumonia was admitted to a San Juan hospital and isolated while waiting the results of a coronavirus test. (Caroine Buckee, 3/13)