NOTE:
I am about to pitch some absolutely terrible ideas. But my hope here is that the medical community can take the basic ideas available and evolve them into something worthwhile. In ordinary times, I would have let the experts sort it out, but desperate times call for desperate measures. Now given what these ideas are I ask the medical community’s indulgence while examining the ideas put forth below.
With that said, here are the core ideas:
- Remote Hospital Treatment
Since many hospitals are at or exceeding capacity, the first idea would be to have hospitals allocate staff who do nothing but video conferencing for mild to moderate cases of covid for their full shift. Sort of like telephone operators from the 1950s. They field incoming calls, connect patients to resources and if covid cases are severe, patch a call to EMS and dispatch an ambulance for hospital intake (if possible). All phone / video conferencing is recorded (the latter on both audio AND visual) - Operation Resource Allocation
Now these remote staff could either be per hospital, or the various hospitals could pool resources and personnel so as to share the cost & resource burden of having dedicated staff and limited resources. An additional benefit to pooling resources between the hospitals is also to quickly and efficiently determine WHICH hospitals have capacity to intake another patient(s). - Remote Medical Kit
The hospital remote operators could provide self-help medical kits for mild to moderate cases upon request by the patient. That includes X number of disposable face masks, a reusable machine-washable one, a topical cream to repulse nail-biting face grooming (https://twitter.com/WSJ/status/1346350734393171969), long swabs for a nose covid check, medications made to specification, such as remdesivir, regeneron (if available), blood thinners, etc. Basically a medical plan specific to the needs of the patient.
The authorization would pass through a single doctor who manages the prescription requests for the operators.
All of this, plus a panic button that patches through to emergency services if there is an adverse or unexpected reaction.The patient (if they have full guardianship) can designate someone to administer the medication(s) for them. The patient self-treats and self-administers for covid. That means setting up IVs, taking pills, etc. A patient can conference to the hospital any particulars, such as living will, etc. - Medication Availability
If the medication is not available on site (either the dedicated hospital / pooled hospital pharmacies), the calls can be faxed to the patient’s pharmacy (if they have one). - Housecall Liabilities
Limited hospital liability for housecall treatment (such as adverse reactions — anaphylactic shock, non-sterile environment, etc), as a condition to treatment via video conference. Including certain HIPAA exceptions. Privacy can’t be reasonably guaranteed in a person’s house, especially in a teleconference. Petition congress for good faith self-treatment exceptions for CoronaVirus. Lawsuit liability wavers, good samaritan, etc. - Delivery drivers (company vehicle to prevent viral transfer?).
Presumably for incapacitated patients. Must wear PPE at all times. The driver uses an electronic system to confirm delivery, or pings hospital personnel directly. Medications would require signature confirmation by the patient. - Followup & Palliative Care
A doctor or nurse uses video conferencing to check in on the patient, or on technical specifics like how to administer dosage. Instructing on how to wrap a bandage, etc.
HOSPITAL LAND MANAGEMENT — MAKESHIFT HOSPITALS
Given that hospitals are at or exceeding capacity, it’s becoming increasingly necessary to start looking at federal land being repurposed for emergency tent and temporary hospitals.
These could be done at the state and local levels, instead of full reliance on federal resources. People need to start thinking about thinking of a hospital without walls. I only recommend this usage while the corona crisis emergency is active. Operations wind down when the federal disaster is over.
Collaborate with US Dept of Interior and CDC (or non-US equivalents in other countries) to clear public land for emergency use and set up makeshift hospitals.
3D-PRINT VENTILATORS
I am aware there are patents and special plastics in use for human consumption for medical equipment. But this is a disaster we’re talking about here, where people are dying left and right. When we are talking about a dire situation, do we worry about plastics in the blood stream but the patient is alive, or a dead patient that conformed to regulations?
I think at this point we need to start thinking about cheap mass produceable ventillator systems that can keep people alive. And then worry about the repercussions of that later. Federal and state disaster legal liability protection would be needed obviously.
We would also need to look into relaxing patent rules for ventillators / medical supplies while the federal emergency declaration is active.
MILITARY HOSPITALS
We should also think about petitioning Congress & Mr. Biden about opening up military hospitals for civilian treatment to handle the overflow.
INTERNATIONAL HOSPITALS
When Joe Biden assumes office, we should probably look into lifting helicopters into Mexico or Canada, if the respective heads of state are amenable to the idea. This way we can treat the patients in border states if many of the hospitals there are at or exceeding capacity.
CONCLUSION
I just want to reiterate that I am aware that the set of ideas I’ve pitched might be bad or wanting in many areas. But I am pitching these in the hopes that the medical community can expand and improve upon them so that resources are freed and more people get treated for this awful virus. Even if people must resort to more independent care for this to happen.
Thank you for your time. *
