I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: General Discussion => Topic started by: MooseMom on May 25, 2020, 08:16:29 AM

Title: "Protect the Vulnerable"
Post by: MooseMom on May 25, 2020, 08:16:29 AM
What does this phrase mean to you?

Everyone on this board is "vulnerable", whether you're on dialysis, have a transplant, or are a caregiver.  I keep hearing, "Protect the vulnerable, but let everyone else go back to work."  While I want to see everyone able to return to a "normal" life as safely as possible, I don't know what "protect the vulnerable" is code for.  How are "they" going to protect "us"?  "Vulnerable" people hold jobs, too, so are we doomed to economic hardship by not being able to go back to work?  If people are protesting against wearing masks or social distancing or whatever, how is that protecting the vulnerable?

Which activities are you comfortable in engaging in now that states are reopening?  Do you feel "protected" as you go out and about in the pandemic world?
Title: Re: "Protect the Vulnerable"
Post by: UkrainianTracksuit on May 26, 2020, 03:03:26 AM
So, I can only speak about public health messaging here and what comes out of leaders' mouths. And to be blunt, the elderly (even in our ads) are the ones acknowledged as "the vulnerable." And they should be, because they are. However, this creates a situation where in general the view is that the elderly are out of the workforce or living in nursing homes. And so, people are advised to go out of their way to "visit" their grandparents through windows (or at least not personally visit) or to ensure that nursing homes are protected. I remember well when the premier stated he would protect nursing homes by building a steel wall (figuratively) around them to protect the residents.

Long story short, this idea of "protecting the vulnerable" is nice and easy when we collectively have a view it is a certain demographic that we do not expect to interact with on a daily basis.

If these public health officials step back and take a real good look, there are a lot of more vulnerable people out there (I mean, how many people do you know with heart conditions, diabetes, on chemo, some sort of autoimmune disease) that still engage with the economy. And let's not forget how many seniors still work or need to to make ends meets? It would just seem like a much bigger problem to protect members of society that we can't really "picture" or lump together.

It is similar to other places, but our re-opening will occur in stages. The "high risk" (or I guess vulnerable) people are advised to wait until the last stage before they start to engage like the rest of the world.

Now to your question, no, I do not feel protected at all. My husband isn't too great with grocery shopping (even though he is provided with a list) so I do that myself. However, I go during the hour allocated for seniors and "those with disabilities." Well, that in itself is a problem. Every time I go, I get stopped. "This is a time for seniors." To which I say, "I have a compromised immune system." Is it technically a disability? Not visible, so that makes it even more of a "prepare to give an explanation." What I've started to do is carry around letters with me that came from the transplant hospital (meant for my employer) that blatantly states this person is high risk and should have appropriate accommodations.

I know masks are a questionable thing, but many people aren't wearing them. Obviously not my business and it is their right, but it just shows that others aren't really thinking about "the vulnerable", so why should I feel protected, you know? Just have to protect myself and the onus is on me.

Sorry for the rant. Haven't got through my first coffee yet and it's humid.
Title: Re: "Protect the Vulnerable"
Post by: enginist on May 26, 2020, 12:17:25 PM
It's a slogan.  The underlying message is that some of us are expendable.   But those are the odds of random mutation.  The Spanish Flu took the young and healthy, while this one is partial to the old and infirm. 
Title: Re: "Protect the Vulnerable"
Post by: PrimeTimer on May 26, 2020, 06:05:11 PM
I think more care needs to go into protecting those in nursing/physical rehab facilities. Perhaps staff and visitors need to wash up upon first entering such a facility. We've all heard horror stories about the abuse that goes on in some of these places so I would not be surprised if they are lax on hygiene and cleanliness. Perhaps nurses and doctors take things seriously but what about the nurses aides that they hire? How much are they trained or know about being careful with patients? How many busy nurses stop to take the time to wash or put on a mask or gloves (even with no Covid-19 going around)?

I don't think states need to be on lockdown but I do think masks should still be worn. At least where there are a lot of people congregating and of course, in tight quarters. I believe the masks are worn to protect others around you just as much as yourself. I think common sense needs to be deployed -and there lies the problem. At least from what I see. People are filthy. And they ALLOW their children to be filthy. I say "allow" because so often the parent actually sees the child being filthy but chooses to do nothing about it. Grosses me out but also really worries me that common sense is not being taught.  I see it every time I am out in public. I don't know about these days but as a child they taught handwashing in school during the early years. We had to wash our hands before lunch in-front of the teacher -every day. I suppose that is one reason why we had little sinks in our classrooms. And this was reinforced by our parents. We also weren't allowed to put our hands in our mouth or to touch everything as we went through a store. If we got messy (whether out in public or not) we had to go wash up. That led to being taught how to "not get messy". Is hygiene even being taught anymore? Has that continued or has it gone by the wayside?

Using common sense and being considerate (and aware) of those around you could go a long ways. Being careful to stay clean. Practicing hygiene is nothing new. Unfortunately, neither is selfishness and disgusting behavior.
Title: Re: "Protect the Vulnerable"
Post by: Simon Dog on May 26, 2020, 07:43:03 PM
The pretty much covers the mask thing.
Title: Re: "Protect the Vulnerable"
Post by: MooseMom on May 26, 2020, 08:15:09 PM
In an odd coincidence, I happened to read this essay about "targeted lockdowns" in the current edition of Time magazine.

https://time.com/5840194/targeted-lockdowns-coronavirus/

I was particularly struck by the idea of creating an "Elder Care Corp" and wondered how other high risk groups, like us, might be included in something like this.  If you're under 65 but are in a high risk group, is this something you'd be comfortable with in exchange for staying in lockdown?  I'd feel weird about it because I'm perfectly able to do my own stuff and don't feel like I need assistance a few hours a week.  It would feel like cheating to me.

Targeted lockdown sounds good in theory, but if we're having fights about the snowflakes who are wearing masks and the selfish b***ards who are not, I don't see how such a program could possibly work in a time when good governance and common sense are in such short supply.  I agree with enginist who notes that a lot of us have been labelled expendable.

SD, good chart re mask wearing!  LOL!

Anyway, I'd be interested in your thoughts.
Title: Re: "Protect the Vulnerable"
Post by: MooseMom on May 26, 2020, 08:23:54 PM
Also, this from the UK.  https://www.theguardian.com/society/2020/may/26/i-had-an-active-life-how-are-shielders-managing-lockdown-covid-19
Title: Re: "Protect the Vulnerable"
Post by: enginist on May 26, 2020, 08:45:44 PM
The lax oversight at nursing homes, UT, is due to campaign contributions from industry lobbyists.  Even Andrew Cuomo recently signed legislation that shields nursing home executives from virus-related lawsuits.

The coda tacked onto the end of the Guardian piece prompted me to make a small donation, MM.  I've always respected their journalism, and in this time of uncertainty I am trying to be more generous.
Title: Re: "Protect the Vulnerable"
Post by: UkrainianTracksuit on May 27, 2020, 04:37:20 AM
Enginist, sorry, you have me mixed up with PrimeTimer. as I didn't discuss that topic, nor am I in the US of A.

In Canada, we already have a national scandal over nursing homes though. The government called in the military to help in a handful of them and what the military saw compelled them to whistleblow and release a report. https://www.cbc.ca/news/canada/toronto/military-long-term-care-home-report-covid-ontario-1.5585844 (https://www.cbc.ca/news/canada/toronto/military-long-term-care-home-report-covid-ontario-1.5585844)

The only thing COVID has really done is shine a light on the fact these issues have been rampant for years. My husband and I looked after an older man (he was from our part of the world) so we saw the issues then (NOT to that extent) - and that was a time that didn't require "so much extra attention" due to PPE. So, I'm not surprised... but this is a different system. Yes, we have for-profit homes, but the Ministry of Long Term Care is mandated to conduct inspections. And those aren't often done as they should be. Our real issue comes with overworked PSW's and cuts to funding. Funny thing is that the premier now (who has handled the response well enough) now has to deal with a problem he exacerbated through funding cuts. At least here, they are talking about criminal prosecutions and lawsuits.

As for myself, besides feeling that protection is my own personal responsibility, I wouldn't feel comfortable with any mandated "protection." When an economy trumps public health in every sense, why should I expect any government to honestly care about my longevity? Haven't we learned from the inefficacy of such programs, unless carried out by non-profits who truly do care? (And they need funds now anyway!) My only issue is that compromised health is associated with age and have to explain myself if I do want to partake in allocated shopping hours. As my husband said, being from the Soviet Union, "We were born for this shit!" when it comes to lines, making due with some limited choices, and finding things to do that don't require a crowd. Speaking as someone with a relatively comfortable life, a personally mandated lockdown is not so bad. This isn't "The Gulag Archipelago", so I can basically learn to deal.

Unpopular opinion, I know.
Title: Re: "Protect the Vulnerable"
Post by: enginist on May 28, 2020, 03:42:42 AM
Yeah, sorry, UT.  I mixed you up with PT.  I knew you were a Canadian and thought you were from one of the Eastern Bloc countries.   You're very fluent in English, which you must have studied in high school and maybe even in grammar school, like they do in Germany.  I had two years of Russian in high school at the height of the Cold War, and I've always loved the Russian composers.  If Katrina were still here, she would also vouch for them.
Title: Re: "Protect the Vulnerable"
Post by: Simon Dog on May 28, 2020, 06:33:02 AM
Quote
When an economy trumps public health in every sense,
A problem is there is no honest discussion of the life vs. economy conflict and arriving at a balanced solution.

Some will say life trumps (no pun intended) all.  Fine.  If you believe that do you favor a strictly enforced national speed limit of 30mph to reduce traffic deaths?    If not, you are agreeing to the concept of trading risk to life for speed of ground transport.  If you agree that its OK to drive at 60mh, then how does that differ from operating at a point other than absolute minimum infections on the economy/life Covid tradeoff?
Title: Re: "Protect the Vulnerable"
Post by: MooseMom on May 28, 2020, 08:07:20 AM
I'd answer that, SD, first by saying there IS honest discussion of life/public health vs the economy, and that is why all states have reopened.  The problem comes with how "balanced solution" is defined.

I'd also say that without life, you have no economy.  Not only that, if you let a rampant virus get completely out of control, the economy will evaporate, anyway, as too many people will be too sick to either earn or spend.  Risk mitigation really protects life AND the economy.

The difficulty in crafting public health policy along with economic recovery policy is the fact that we just don't know yet what kind of risk mitigation is most effective while also being the least intrusive and burdensome.  We have not yet agreed, as a society, how this will work.  On the other hand, we HAVE agreed about the necessity of speed limits because we KNOW how speed affects accident/fatality rates, we KNOW that driving under the influence is deadly, and we KNOW that not even knowing how to drive puts others at risk, hence the requirement for having tests and drivers licenses.

Regarding covid, we still do not know why it is so lethal in some people while so many other people are asymptomatic.  We are not entirely certain from where the risk will come. 
Title: Re: "Protect the Vulnerable"
Post by: UkrainianTracksuit on May 28, 2020, 09:01:48 AM
Yeah, sorry, UT.  I mixed you up with PT.  I knew you were a Canadian and thought you were from one of the Eastern Bloc countries.   You're very fluent in English, which you must have studied in high school and maybe even in grammar school, like they do in Germany.  I had two years of Russian in high school at the height of the Cold War, and I've always loved the Russian composers.  If Katrina were still here, she would also vouch for them.
Yes, I learned in school, and my generation was exposed to a lot of English language media. You could learn to say fun things by hearing the English and watching the subtitles. Ha! Learning Russian during the Cold War means you have a whole different view of that period than me. And yep! We did produce some of the greatest composers. Borodin and Rimsky-Korsakov are personal faves. Then there's Shostakovich. Love Prokofiev too though some say his work is a little too much for them. You are most certainly correct in that Kristina would vouch for them as we had the odd conversation on the topic.  :)

One of the few decent things to happen due to quarantine is that some of the cultural institutions have put programming online. There, I mentioned the this current "time of troubles" to remain on topic. :P
Title: Re: "Protect the Vulnerable"
Post by: enginist on May 29, 2020, 04:18:21 AM
Здравствуйте, UT.  Доброе утро а также хорошего дня.
Title: Re: "Protect the Vulnerable"
Post by: UkrainianTracksuit on May 29, 2020, 05:52:48 AM
Спасибо, и тебе того же.  :thumbup;
Title: Re: "Protect the Vulnerable"
Post by: Simon Dog on May 29, 2020, 06:53:47 AM
I'd also say that without life, you have no economy.  Not only that, if you let a rampant virus get completely out of control, the economy will evaporate, anyway, as too many people will be too sick to either earn or spend.  Risk mitigation really protects life AND the economy.
Good point.  Cost/benefit analysis often misses second and third order effects.  For example, I've never seen a report on the financial cost of medical care for smoking related illness include a "credit" for amounts SS, Medicare and sometimes Medicaid save by the smoker having a shorter life span.