POINT OF VIEW

Coronavirus: Life, death, dollars

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Google searches reveal our deepest fears: Stock markets crashing. Coronavirus cases skyrocketing. A virus threatens our wealth and health. And we search for answers that give us no good direction.

Ignoring facts makes things worse. President Trump promised that anyone who wants a COVID-19 test can get one. Then U.S. Health & Human Services secretary Alex Azar cautioned about rationing tests to “only those who have a doctor’s prescription” because “that is our medical system in the United States.”

We remember “it’s the economy, stupid!” But when health and wealth comingle …

 

It’s our health care system, stupid!

Here in the Bronx — New York City’s epicenter of COVID-19 — our most vulnerable neighbors cannot get tested. Why? Because the 22 percent of our neighbors without insurance and 50 percent on Medicaid don’t have primary care physicians. According to Azar, no PCP, no Rx, no test.

“Those people” are likely not on his radar. But “those” people are our neighbors and work in our homes, care for our children, and nurse our elderly parents. They stock the groceries we buy, cook and clean in restaurants we frequent, and ride beside us on public transport.

Some are legal immigrants, avoiding the test because of the “public charge” rule. They drive taxis and Ubers, used by the rich-seeking “safety” from public transport.

“You cannot buy your way out of this epidemic,” regardless of your wealth, maintains Dr. Stephanie Woolhandler, distinguished professor of public health and health policy at CUNY, Albert Einstein, and Harvard Medical School. “We’re going to have to conquer coronavirus together.”

 

Band-Aids, however welcome, are not enough

Acting without federal guidance, Gov. Cuomo has declared a state of emergency, banned all gatherings of 500 people or more, ordered prisons to produce 100,000 bottles of hand sanitizer per week, compelled quarantines for those infected, and urged voluntary quarantine for everyone else.

That’s a start. But our city health system already appears overwhelmed. Nurses surveyed say that hospitals are “wildly unprepared.” Patients who had reasons to be tested and doctor’s prescriptions report that at a major New York City hospital, they couldn’t get the test.

 

Testing, however welcome, is also not enough

We can only slow this pandemic if we and all our neighbors have the tools to do so. Yes, we need to get tested. The safety of all of us requires those who need treatment to get it. And those who have the virus need to be quarantined. And those who have been exposed should quarantine themselves.

Meanwhile, all of us need our government to use its emergency powers to guarantee testing, paid sick leave, and health care.

We think of ourselves as living in a “developed nation” — so how about “drive-thru testing” as in Korea and Germany, customized for our densely populated borough? How about specially equipped buses (with trained and protected staff) stopping in every neighborhood so people with symptoms can get tested without flooding emergency rooms?

In Korea, they are testing 10,000 people a day. The United States has tested 10,000 people since January.

Ten million lives may depend on “flattening the curve” of this pandemic, slowing transmission. As Dr. Aaron Carrol explains, “a crucial thing to understand about the coronavirus threat … is the difference between the total number of people who might get sick, and the number who might get sick at the same time. Our country has only 2.8 hospital beds per 1,000 people. That’s fewer than in Italy” where triage means many elderly get no treatment at all.

More important, there are only so many intensive care beds and ventilators.

If transmission in the Bronx isn’t slowed, and if even only 10 percent of those of us infected in the Bronx need hospitalization, the Bronx will need four times as many hospital beds as are in all of New York City. What if, as COVID-19 spreads, you have a fall? Need surgery? Suffer a heart attack? Will you find a bed in any New York City hospital?

 

First aid welcome, but our body politic needs urgent care

We are in a health crisis. What each of us does next can save lives, or doom them. Our state legislators are sending out newsletters with updates for how to deal with the virus. But no wall protects against microbes.

Our elected officials in the state senate and Assembly need to address how all of us are in this together.

We need government leadership, widespread (free) testing, job protection for those without sick leave, accurate information, and — most important — health care that’s not rationed by wealth.

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