Coronavirus

The Focus on COVID-19 Is Hurting Other Patients: Dr. Jeffrey A. Singer

A surgeon and policy analyst tallies up the steep costs of delaying and denying elective surgery and other care during the coronavirus pandemic.

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Over the past few months, virtually all medical care in the country has been focused almost exclusively on treating the novel coronavirus. Fearing a surge of cases, authorities told patients to stay away from hospitals and doctor's offices unless they thought they had COVID-19 and many states banned non-emergency surgeries and diagnostic care.

The good news is that many places never experienced overload. The bad news is that many hospitals and medical systems are actually laying off doctors and nurses due to overall flagging demand.

Physician Jeffrey A. Singer tells Nick Gillespie that the understandable focus on coronavirus is hurting patients whose care for heart disease, cancer, and other ailments has been delayed or foregone. A surgeon and senior fellow at the Cato Institute, where he writes frequently on health care and drug policy issues, Singer also talks about how many medical regulations that have been temporarily suspended should never be reinstated and the ways in which telemedicine will likely flourish in the post-pandemic era.

In a wide-ranging conversation, Singer also notes that there has been a subtle but unmistakable change in the focus of public health since shelter-in-place orders were put in place. At first, he says, the idea was "flattening the curve," or slowing the rate of infection so medical providers were not overwhelmed by the number of cases. Now, he says, the discussion is about making sure no one gets infected, an unrealistic goal for a viral infection in the absence of a vaccine.

Audio production by Ian Keyser.

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  1. We are so fucked. First, the narrative was “14 Days to Flatten the Curve.” Then it was “30” to prevent deaths. Now it’s “We must prepare for the second wave.” Half the country supports staying at home indefinitely. Protesters are cast as nutjobs. Governors talk of such B.S. as implementing anti-riot acts to close roads into and out of cities. News this morning was all about implementing a national income and rent and mortgage forgiveness. We should be marching in the streets in outrage and yet we cower in our homes like the good little Munchausen victims that we are. Read up on pandemic of 1968, which was even more virulent. The difference in psychology then versus now is stunning.

    1. Worst part is that it is a very small segment of the population arguing that no government has the powers they are currently implementing. Asking is one thing, threatening jail time for no face coverings and shit? Yeah. That’s why gun sales are up.

      1. Maybe in the blue states not here.

        1. I live in the us area of az… the mayor hasnt shown her face in the last month. But the ue states are largely cowering. Although it looks like southern California may have an awakening.

          1. Blue area of az*

            1. Current covid hospitalizations in AZ: Roughly 800.

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    2. I’ve noticed this too, and while it’s easy to blame the same culture that creates snowflakes freaking out over hurtful pronouns and socialists priming the public pump to expect government almighty to fix all problems with more free money, that only pushes the blame one step away. What has made the public so susceptible to all these hurtful pronouns and expectations of free money?

      I think it comes down to inevitable government expansion. Bureaucracies natural evolution is to expand, because as soon as the workload of a bureaucracy (say, payroll or HR) gets into too much overtime, they hrie a new full time employee and suddenly everyone’s workload drops below full time by a little, so everyone, especially including supervisors, makes up busy work. Then as baseline workload continues its inexorable increase, the busy work ought to be cut back, but has become part of the normal workload by then. Thus perpetual expansion.

      Markets keep this in check because these inefficiencies get weeded out by loss of business and eventual buyouts or bankruptcy. Governments are a monopoly and only go bankrupt through revolution.

      What I think is truly at fault is this inexorable government expansion. It has led to a population which finds it easier to sic government on competitors than improve your own position; it is literally better to mind other people’s business than your own. I believe most people, the vast majority, would be happier minding their own business, but government gets in the way not just through benign neglect, but actively. You don’t have a license to sell raw food, only cooked food? You have to ask competitors for permission to enter a market? You have to have a full year of full time schooling to braid hair?

      At some point, people just give up. Either go with the flow and resent those who persevere or work around the obstacle, or shift to the shadow economy and ignore government until you go to prison.

      That is the core problem, I believe. Kids grow up with that in mind, and most are incredibly resentful of those who still have enough gumption to work around government obstacles.

      (When I say most people would rather mind their own business, I do not mean stop gossiping and shunning reprobates or freaks. I do mean siccing the government on others. When you had to jump through permitting hoops to add a fence or deck or swimming pool, and your neighbor skips all that malarkey, it’s really hard to blame yourself for not having been brave or clever enough to do the same, and much easier to complain, especially if the neighbor brags and makes fun of you for having been such a lap dog.)

      1. Agreed. I would in fact argue that it’s not the millennial “snowflakes”
        who are driving acceptance of this garbage, but the over-40-year-olds—many of whom should know better—who are freaking out and accepting, even demanding, more bureaucratic control.

        1. Good point. The snowflakes are too young to know better. It’s the adults who should know better. Maybe the snowflakes are the Dorian Grays of the 40 years olds having their mid-life crisis.

          1. Karen. Her name is Karen. And if you are as far from others as the governor has told her is appropriate, or if you’re not wearing a mask like the good governor told her, she’s gonna ask to speak to the governor and make a huge stink.

      2. What I think is truly at fault is this inexorable government expansion. It has led to a population which finds it easier to sic government on competitors than improve your own position; it is literally better to mind other people’s business than your own.

        alephbet…I liked this observation. It made me think of Patrick Henry’s comment, “Guard with jealous attention the public liberty. Suspect everyone who approaches that jewel.”

        This pandemic has really made me think about that.

    3. No one has been cowering in my state for the past two weeks and we dropped all restrictions yesterday. The red states are open stop acting like NY is the whole country.

      1. Lucky you. But what I know of the states that are open, they are only open to 25 percent capacity, most require masks, few people comfortable with going out, and a lot of businesses choosing to remain closed until “authorities” deem it safe, regardless. Which of course is their right, but it’s a mindset that I’m talking about, and one that I think is overwhelming, from my experiences. And I don’t live in NYC. I live in a sparsely populated state with 3,000 cases and about 100 dead. Our governor is locking things up indefinitely and majority of people are fine with that.

        1. Not here. Everyone is out buying garden supplies. Less than half have masks. We don’t give a fuuuuuuck.

          1. Good to hear. But I think y’all are in the minority, unfortunately.

        2. Went out yesterday, I live in Northeast Montana, Tractor Supply’s parking lot was full. No one in the store had a mask on. Went to the Supermarket, parking lot was full and only saw one person wearing a mask. Now my cashier did wear gloves, which I noticed she had not changed, thought about saying something but figured anyone that stupid wouldn’t get it anyhow. So I’ll just wash my food off and cook it thoroughly and drive on. Our Governor only did a limited phase 1 open, but it looks like rural Montana said fuck that, open is open.

          1. Tractor Supply and grocery stores are all considered essential so they never closed to begin with. Can you go to the mall? Out to a bar? A restaurant? An art gallery or barber shop? Go buy a car or piece of furniture? Can you go back to work in an office? Your child go back to school or college?

            1. To be fair, at this point going back to school or college is pointless if you remember anything about what it was like when you were that age. This time of year is when you start salivating for the summer to start, and these kids have been out of the classroom for so long anyway that getting them to focus on any kind of classwork would be like herding cats.

              I’m REALLY interested to see what happens if Trump decides to keep the international travel ban in place through the rest of the year. Colleges these days get a ton of tuition and room/board revenue from international students, especially Chinese trust fund kids.

            2. Two weeks ago the parking lot was empty at Tractor Supply and the Supermarket parking lot had only a dozen cars in it. People up here are over it was my point. The Governor only authorized phase 1 but no one listened and don’t care anymore. Hell, his quarantine was cracking before he started phase 1 and I only think he backed off because he knew he couldn’t enforce it anymore.

            3. And my office reopened but we can still work from home if we want.

            4. Overall my point is that people are ignoring the Governor and carrying on with their lives.

      2. Here in Missouri, the libertarian leaning mayor of a small St. Louis suburb wanted to re-open May 4th (which is what the state re-opening is), as opposed to the County re-opening (which is indefinite).

        But the public and media uproar forced him to backtrack from this.

    4. Here is a link to the article.

      http://groups.google.com/d/msg/soc.culture.israel/CKqqrIQyDOw/TKL7TvpnBgAJ

      Philip Snashall, a now retired professor of medicine, wrote in the British
      Medical Journal that his two-year-old daughter contracted the first known
      case of the Hong Kong flu to hit Europe. “How things change,” he noted. “The
      stock market did not plummet, we were not besieged by the press, men in
      breathing apparatus did not invade my daughter’s play group.”

      The global response to COVID-19 couldn’t stand in starker contrast. Leaders
      have made the decision to do everything possible, including bringing entire
      economies to a crashing halt, to limit the loss of life. . . .
      Joel Hay, a professor of pharmaceutical economics and policy at the
      University of Southern California, told me that the role of science has also
      changed. Medical technology has vastly improved from a time when people
      still did computations on slide rules. But the data it produces has seduced
      some into thinking that we know more than we actually do and that we can
      produce useful models to predict the course of this novel coronavirus
      disease. “We’re being bombarded with data, but we often act like the guy who
      looks for his keys under the lamppost because the light is better there,” he
      told me. “We aren’t asking more fundamental questions, like ‘Does this $20
      trillion experiment in lockdowns actually work?’”

  2. Now, he says, the discussion is about making sure no one gets infected, an unrealistic goal for a viral infection in the absence of a vaccine.

    He just wants people to die.

    1. “Hello, exactly!!!” -Dirk Diggler

    2. Seriously, though! Initially this was supposed to be about not overwhelming hospitals. Well, other than the few “hot zones” (NYC, etc.) hospitals are UNDERwhelmed and more than ready for more Cov-19 patients.
      The truth is, even WITH a vaccine, nobody can be 100% “safe” from this virus. And the public seems to think that is the goal and what we have to achieve before “lifting restrictions”. Not true. That was NEVER the goal of “flattening the curve”.
      So. Hospitals and healthcare providers are ready. Many people are sick of house arrest and being forced to be unemployed. Let the “scared” folks continue to stay in. let individual businesses decide their “masks”, “number of customers allowed inside” and other policies, and let those of us willing to risk death take our chances.
      And don’t accuse me of wanting to kill “vulnerable” people. Those folks CAN choose to stay home indefinitely if they wish, and my infection status won’t affect them.

      1. Even if you think a bunch of people will get sick, there’s never going to be a better time for them to BE sick than when we’re ready for them. That’s now.

  3. Actually, the real mission and strategy has never changed. Since the beginning, most government leaders–and the media–have focused on feelings:
    1. Make the people feel that this is a Big Deal.
    2. Make the people feel that a given official or agency is doing (or not doing) something.
    3. Make the people feel that compliance with restrictions is essential.

    1. Good point.
      Also, make people *feel* together… behind our screens

    2. You do know there were 8 states that didn’t have lockdowns right?

      1. And surprisingly they faired better or the same as those that did lockdown. Gee it is almost like the lockdowns had no real impact other than destroying lives and livelihoods and liberty.

        1. Has anyone thought about throwing some tea in the Lincoln Memorial Reflecting Pool?

  4. We need to keep the lockdown going until the real enemy, capitalism, dies.

    How did I do, OBL?

    1. The middle of the country is open for business. It’s the commie coasts were the problem is.

      1. Unfortunately, we depend on the coastal states to ship out goods to market.

  5. yes this is in the blue stat not here. source browngh

  6. Nearly all of this is driven by government politicians who have jobs for life and will do anything to get reelected. Businesses who don’t want to be sued if one customer gets the flu. People, mostly left wingers, scared to death of their own shadows and willing to shame others into acting the same. The real cost is going to hurt though. The number of virus deaths is going to be minuscule compared to the economic and health damage done during this bullshit government tyranny.

  7. Very nice article, have a great knowledge

    1. I smell a spam link coming.

  8. What I don’t get is what exactly hospitals are doing to Covid 19 patients, if there is no treatment. Just watch them lie in their beds until they need a ventilator?

    1. A wide variety of things, depending on how sick they are. If they are fine, just observing them seeing that it doesnt progress. Then there is a spectrum of respiratory interventions (nebs, supplemental O2, non-invasive assistance) before the vent they can get if needed. All the stuff that falls into “supportive” care.

      Still trials of meds going on as well, we were on the plaquenil kick before it got the media clusterfuck treatment. We have some antivirals we are using as well.

  9. Even if you think a bunch of people will get sick, there’s never going to be a better time for them to BE sick than when we’re ready for them. That’s now. Know More best schools in greater noida west

  10. That is clearly the case in every country and needs to be dealt with with care. Similar stories have been published many times on GhanaPlus.com

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