Outrageous, ridiculous, unjust, just plain stupid – KMZ Digest

‘Diversity’ Doesn’t Include Disabled Veterans Like Me

itsme — Wed, 09 Oct 2024 21:28:02 +0000

Image credit: Pexels

Matthew Winans

September 11, 2024

At college campuses nationwide, the newest students are starting class, but I’m not among them. Many medical schools rejected my application, and when I asked why, several told me that my service in our nation’s armed forces didn’t matter, and that I should have spent more time proving my commitment to “diversity” and “equity.”

I served in the United States Army from 2012 to 2017. During my service, I intended to apply to the F. Edward Hébert School of Medicine, the military’s medical school, but health-related issues and a service-related disability cut my career short. After being honorably discharged, I set my sights on attending a civilian medical school to become a pathologist.

I never assumed I would be a shoo-in, nor do I believe veterans like me have some “right” to acceptance. Still, I thought my chances were strong because of my degrees in different fields, years of work history as a medical technologist in numerous hospitals, and other experiences. Plus, I thought my veteran status could help, given medical schools’ universal preference for diversity. In the 2022-2023 school year, only 154 matriculants were military veterans out of 22,712 in total. If varied experiences and backgrounds are what medical schools want, I figured I had a lot to offer.

Turns out, the medical schools don’t agree.

Take my experience with the Morehouse School of Medicine, a historically black college in Atlanta. I’m white, but it has a good reputation and is the closest medical school to my home. After my application was rejected, I requested reapplicant counseling, which helps you learn how to improve your chances in subsequent applications. In May, an admissions counselor told me that my MCAT score wasn’t high enough, even though I scored in line with the average Morehouse matriculant. I couldn’t get an answer as to why that wasn’t good enough. The counselor did tell me that I made a mistake by not discussing “equity” in my essay. Apparently, as a white man, I needed to show a special dedication to serving non-white patients.

The counselor also told me that my military service didn’t qualify as volunteering, even though we have an all-volunteer military. An associate dean of admissions at Georgia’s Mercer University School of Medicine said the same thing, disrespectfully equating my military service to a cashier’s job. I found myself wondering: What kind of volunteering do medical schools want? I found the answer in my reapplicant counseling session for the University of Alabama’s Heersink School of Medicine.

Once again, the admissions counselor dismissed the idea that military service constitutes volunteering. Instead, she said, I needed to volunteer at a “free clinic in a barrio” or an “inner-city soup kitchen.” When I asked why those kinds of volunteering were better, the counselor told me I needed to prove my “cultural competence.” I can’t imagine a member of another race being told they have to demonstrate cultural competence. In addition, it’s insulting to assume that volunteering is the best way to gain such competence. I served alongside a highly diverse group of soldiers, learning valuable lessons about different races, religions, and traditions. I’m also married to a Kenyan woman, have three biracial kids, and have traveled to East Africa many times.

What makes volunteering in a barrio or the inner city somehow superior to my numerous personal experiences? The answer is the same reason the Morehouse counselor wanted me to mention “equity.” It proves your devotion to the diversity-industrial complex.

It’s possible I was beaten out by more qualified applicants at these and other schools. There’s always someone better than you in life. However, after what I encountered at many medical schools, I’m not confident that the quality of my application was the deciding factor. If I had overtly capitulated to the DEI worldview, I bet I’d be starting medical school this fall. (Ditto, if I was non-white.) The Supreme Court may have banned affirmative action, but the medical advocacy group Do No Harm has shown that medical schools are finding numerous ways to make admissions decisions based on race. Since medical schools are openly disrespectful to the sacrifices of disabled veterans like me, what makes anyone think they won’t continue to unfairly and illegally elevate race?

I plan to apply to more medical schools this year, but I’m not optimistic about my chances. My ability to use the education benefits I earned through service to my country is controlled by race-obsessed administrators. In today’s politicized world of “diversity” and “equity,” I fear there’s no room for a disabled white male who joined the Army to defend his country instead of padding his resume by going to the barrio or the inner city and then boasting about it.

This article was originally published by RealClearPolitics and made available via RealClearWire.

intellectualtakeout.org/2024/09/diversity-doesnt-include-disabled-veterans-like-meSeptember 11, 2024

AUTHOR

Matthew Winans

PROFILE

‘I’m So Burned Out’: Fighting to See a Specialist Amplified Pain for Riverside County Woman

itsme — Thu, 13 Jul 2023 20:57:18 +0000

Teresa Johnson believes she was mistakenly given iodine before a CT scan in September 2022, triggering a severe allergic reaction resulting in extreme, chronic pain and neuropathy. “I would never wish this on anybody,” she says.
^{_{(COLBY TARSITANO FOR KFF HEALTH NEWS)}}

By Molly Castle Work

OCTOBER 10, 2023

SAN JACINTO — Teresa Johnson can’t escape the pain. It’s as if she’s getting pierced by needles all over her body, all at once. At night, she sometimes jolts out of sleep thinking bedbugs are attacking her. But it’s just the unfailing pain — day in and day out.

Johnson, 58, said her ordeal started in September 2022, when she went for a CT scan of her abdomen after a bout of covid-19. Though Johnson warned the lab she was allergic to iodine, she believes the lab tech used it in an injection, triggering an allergic reaction. She spent the next three weeks in the hospital, feeling as if her body was on fire.

When she was discharged to her home at the base of the San Jacinto Mountains in Riverside County, Johnson said, her quality of life deteriorated and her frustration mounted as she waited for her Medi-Cal plan to get her assessed by a specialist. She could barely walk or stand, she could no longer cook for herself, and sometimes she couldn’t even lift her leg high enough to step into the tub.

“I would never wish this on anybody,” Johnson said while rocking back and forth on the couch to still the pain. “You don’t know if you should cry, or just say OK, I can make it through this. It messes with you mentally.”

Johnson said her primary care doctor told her he wasn’t sure what triggered the pain but suspects it was compounded by the lingering effects of covid. Johnson, who is diabetic, developed neuropathy, a type of nerve damage, possibly after the allergic reaction caused her blood sugar levels to skyrocket, her doctor told her.

He referred Johnson, who receives care through California’s Medicaid program for low-income people, to an endocrinologist in March. But Johnson said she was not offered timely appointments, and it took more than six months, four referrals, multiple complaints to her health plan, and a legal aid group’s help to finally snag a phone call with an endocrinologist in mid-September.

Access to specialists — from gastroenterologists to cardiologists — has been a long-standing challenge for many Medi-Cal patients, especially those in rural areas or regions facing staff shortages. The Inland Empire, where Johnson lives, has the second-lowest supply of specialists in the state, according to the California Health Care Foundation. (California Healthline is an editorially independent service of the California Health Care Foundation.)

The state Department of Managed Health Care, which regulates most Medi-Cal health plans, requires plans to get patients in to see specialists within 15 business days, unless a longer waiting time would not harm the patient’s health. But the timeline often looks very different in reality.

“It’s hard to get a specialist to contract for Medi-Cal patients. Period,” said Amanda Simmons, executive vice president of Integrated Health Partners of Southern California, a nonprofit organization that represents community health clinics. “Specialists don’t want to do it because reimbursement rates are so low.”

Johnson said she made her first call in March to the endocrinologist assigned by her Medi-Cal insurer, Inland Empire Health Plan, and that the office offered her an appointment several months out. Over the next four months, she received three more referrals, but she said she got a similar response each time she called. When Johnson objected to the lengthy wait times, requesting earlier appointments, she was told there was no availability and that her condition wasn’t urgent.

“They told me it wasn’t important,” Johnson said. “And I asked, ‘How would you know? You’ve never seen me.’”

Esther Iverson, director of provider communications for the plan, declined to speak about Johnson’s case but said the plan makes every effort to meet the 15-day requirement. It can be challenging to meet the standard, she said, due to a lack of available physicians — especially for certain specialties, such as endocrinology and pain management.

She pointed to the nationwide physician shortage, which is more pronounced in rural areas, including parts of San Bernardino and Riverside counties, where the plan operates. She also noted that many physicians decided to leave the field or retire early due to burnout from the covid pandemic.

“God blessed me with an amazing family. They love me so much and take such good care of me. Sometimes I feel like a burden to them,” says Teresa Johnson, with 22-year-old granddaughter Iasia Bailey, who helps care for her. (COLBY TARSITANO FOR KFF HEALTH NEWS)

At the same time, she said, the plan’s enrollment ballooned to 1.6 million as eligibility expanded in recent years. Statewide, more than 15 million Californians are enrolled in Medi-Cal.

“The highest priority for us is timely access to quality care,” Iverson said.

During her quest, Johnson enlisted the help of Inland Counties Legal Services, which provides free legal representation to low-income residents. They called the plan multiple times to request earlier appointments but got mired in bureaucratic delays and waiting periods.

In one instance in August, after the insurer told Johnson it couldn’t meet the 15-day time frame, her legal representative, Mariane Gantino, filed an appeal, arguing that Johnson’s request was urgent. The insurer’s medical director responded within a few hours denying the claim, saying the plan concluded that her case was not urgent and that a delay would not cause a serious threat to her health.

“I’m so burned out after dealing with this for so long,” Johnson said in mid-September. “Why do they have the 15-day law if there aren’t going to be any consequences?”

A few days later, Johnson finally received the call she had been waiting for: an offer of a phone appointment with an endocrinologist, on Sept. 18. During the appointment, the doctor adjusted her diabetes and other medications but didn’t directly address her pain, she said.

“I’m in the same position,” Johnson said. “I’m still in pain. What’s next?”

Over the years, Johnson has worked a variety of jobs — from driving eighteen-wheelers cross-country to weaving hair — but her most consistent work was as a caregiver, including to her six children, 21 grandchildren, and three great-grandkids, with another great-grandchild on the way. Now, because of her extreme pain, the roles have been reversed. A daughter and granddaughter who live with her have become her full-time caregivers.

“I can’t do nothing. I can’t take care of my grandkids like I used to,” said Johnson, who sleeps most of the day and wakes up only when her pain medication wears off. “I was planning to take care of the new baby that’s coming. I probably can’t even hold her now.”

This article is part of “Faces of Medi-Cal,” a California Healthline series exploring the impact of the state’s safety-net health program on enrollees.

The hidden extra costs of living with a disability

itsme — Mon, 12 Jun 2023 20:29:16 +0000

By Muriel Generated with AI

Disability is often incorrectly assumed to be rare. However, global estimates suggest than one in seven adults has some form of disability.

The term “disability” covers a number of functional limitations – physical, sensory, mental and intellectual. These can range from mild to severe and might affect someone at any time across the lifespan, from an infant born with an intellectual impairment to an older adult who becomes unable to walk or see.

What is perhaps less well-known is that studies consistently show that people with disabilities are disproportionately poor. They are more likely to become poor and, when poor, are more likely to stay that way, because of barriers to getting an education, finding decent work and participating in civic life. Taken together, these barriers significantly and adversely impact their standard of living.

Calculating the cost

However, a new body of research reveals another major barrier, previously missing from most studies: People living with disabilities also face extra costs of living. Our team’s recent review of the evidence suggests that living with a disability may cost an additional several thousand dollars per year, adding up over time to be a significant financial burden on households.

People with disabilities may have more
basic necessities than people without.
Antonio Diaz/Shutterstock.com

Governments draw poverty lines at a level of income that they believe is sufficient to meet a minimum standard of living. Someone at the poverty line presumably has just enough resources to house, clothe and feed themselves at an acceptable level, and participate in the basic activities of being a citizen. Increasingly, countries provide cash benefits or food transfers to people below this poverty line so they are able to reach this minimum standard for basic resources.

The problem is that people with disabilities have extra costs of living that people without disabilities do not have. They have higher medical expenses and may need personal assistance or assistive devices, such as wheelchairs or hearing aids. They may need to spend more on transportation or modified housing, or be restricted in what neighborhoods they can live in to be closer to work or accessible services.

When this is the case, then some people with disabilities might appear “on paper” to live above the poverty line. But in reality, they don’t have enough money to meet the minimum standard of living captured in that poverty line.

In our recent review of the literature, we found that people with disabilities in 10 countries face large extra costs of living. These costs can range widely, from an estimated US$1,170 to $6,952 per year. In a developing country such as Vietnam, for example, the estimate stands at $595 for additional health costs alone.

We used a method called the standard of living approach, which estimates extra costs based on the gap in assets owned by households with and without disabilities. Extra costs accounted for a large share of income, from a low of 12 percent in Vietnam to 40 percent for elderly households in Ireland.

Comparing the costs of disabilities across countries is challenging. Recent studies measure what is actually spent, not what needs to be spent. Estimated costs might be less in developing countries not because it is less expensive to accommodate the needs of people with disabilities in those countries, but because the goods and services needed are not available. If wheelchairs or hearing aids are nowhere to be found, then a person cannot spend money on them.

This could lead to the paradoxical finding that, as a country starts becoming more inclusive, the measured costs of living with a disability could increase. But hopefully, at the same time, the ability of people with disabilities to work and go to school will also increase.

Unanswered questions

A woman is escorted from protest opposing cuts to Medicaid in front of Senator Mitch McConnell’s office on Capitol Hill on June 22, 2017.
AP Photo/Jacquelyn Martin

There is much we still don’t know about what it costs to live with a disability. In our comprehensive review of the literature, we found only 20 studies that estimated increased costs of living with a disability. The vast majority were from developed countries.

We need better information on how these extra costs may vary by type of disability, and how they may be affected by efforts to remove barriers to participation. For example, how would building a fully accessible public transportation system impact the extra transportation costs that people with disabilities face?

Our work also suggests we may need different income tests for people with disabilities when it comes to social protection programs. For example, should the income limit for receiving cash transfers or subsidized housing be higher for families with disabilities because they face these extra costs? Some countries, such as Denmark and the United Kingdom, provide benefits to support families with disabilities who bear these costs.

Another important question is whether these benefits are adequate. Do they allow people with disability and their families to reach at least a minimum threshold for standard of living? To what extent does this improve their participation in society or the economy?

Supporting people with disabilities

To address these questions, we need to monitor these issues over time. For that, we need more and better data on disability in different countries linked to good data on income, assets and expenditures. We recommend adding well-formulated disability questions to the standard household surveys currently used by most countries to chart their citizen’s wellbeing. The best example of such questions was developed under the aegis of the U.N. Statistical Commission via the Washington Group on Disability Statistics.

It’s also important to undertake qualitative research. For instance, focus groups and in-depth interviews would help researchers better understand the needs of people with disabilities in their own terms.

Policymakers also need to make social programs sensitive to the issue of extra costs associated with disability – for instance, in income tests and benefit amounts or through social health insurance programs. Our review has led us to believe that even well intended anti-poverty efforts and social protection schemes that do not take into consideration the additional costs of living with a disability will leave millions of people who have disabilities, and their families, in poverty.

Authors

Sophie Mitra-Associate Professor of Economics, Fordham University

Daniel Mont-Principal Research Associate in Epidemiology and Public Health, UCL

Hoolda Kim-Graduate Student in Economics, Fordham University

Michael Palmer-Senior Lecturer in Economics, RMIT University Vietnam

Nora Groce-Chair of Disability and Inclusive Development, UCL

Covid stole my Dad’s final months

itsme — Mon, 31 Oct 2022 19:11:39 +0000

OPINION: Because of the pandemic, I couldn’t visit him in his nursing home, and because of his dementia he couldn’t understand why. Mismanagement of this crisis has failed the elderly and caused incalculable hurt.

By Alison McCook 11.09.2020

On September 16, my father died.

He lived the last six months of his life entirely cut off from his family and friends. That’s because he was one of the 1.3 million people living in nursing homes across the country.

He didn’t have Covid-19, but even though the disease didn’t take his life, it took his time. It took his last months away from him, during which he couldn’t enjoy the relationships he’d spent his life building. And research suggests this isolation might have hastened his decline.

So I’m sad, and angry. And I know I’m not alone. I am one of the many, many Americans trapped in a spiral of grief/rage over what our elderly loved ones have already lost because of the pandemic, and its ongoing mismanagement. After the United States finished last week charting its worst day yet for COVID cases, with no end in sight, some people are wondering when they’ll be able to reconnect with their parent, sister or spouse. For others, like me, that time never came.

My dad was 77, and had been living with dementia for years. He was a widower and I am an only child, so as his caregiver, I paid his bills, took him to more doctor’s appointments than I can count, and untangled any messes his mind made — I canceled credit cards, reinstated lapsed insurance policies, taped instructions to the remote control. And I answered his many, many questions. One in particular: “When are you coming to see me?” If I was already there, he would ask when I was coming back.

So I came, as often as I could. First to the old stone house he had shared with my mother, which started to crumble around him due to neglect, then to a continuing-care facility in Philadelphia, where he eventually moved to skilled nursing. Several times a week, I brought him a chocolate-frosted doughnut and Diet Coke, held his hand, and put on an old Western. Even when he could no longer talk, I knew the question. So every time I left, I promised him: I’ll be back soon, Dad.

On March 6, his facility called to say they had closed the doors to all visitors due to Covid-19. My stomach was in knots, but there was simply nothing I could do. I got updates, such as after he lost 10 pounds, then 20, then 30. The day they began allowing in-person visits — with residents and visitors on either side of the locked front door in the lobby — I signed up. But Dad didn’t like leaving his room, so he spent the entire visit screaming at everyone around him from his wheelchair, drowning out my muffled voice on the other side of the glass, begging him to understand that this was the best we could do. His nurse cried, watching us.

So I stuck with weekly video chats on tablets, as the time stretched to months. I never knew what he could see or hear, and he didn’t say much at all, but I chattered endlessly to fill the time, promising to once again bring him doughnuts and Diet Coke, and to hold his hand. A few months ago, I asked if he would like that. “Very,” he told me. It was one of the last words I heard him say.

On the night of September 15, his night nurse called to say he was actively dying. Suddenly, I could come right away. I used the employee entrance, wrapped myself in protective gear from head to toe — hair cover, face mask, face shield, gown and booties — and, finally, walked into his room.

Having wondered for so long what it would be like to see him again, it was not what I expected. Dad wasn’t himself anymore, and I wasn’t me. At least, I wasn’t me to him. I talked to him, stroked his arm, held up old pictures, but he didn’t show any signs that he knew who I was, or even that I was there. He just lay still, fighting to breathe, his eyes half-closed and glassy. I had finally come to see him, but it was too late.

After more than six months apart, we had 10 hours together.

I know I have a lot to be grateful for. I was with him when he died. I had time to remind him about the good life he had lived.

But still, I am angry.

“I believe there must be a way to safely reconnect separated families.”

I’m angry that our country is failing at testing. When I broke the news to my 6-year-old daughter that her beloved grandfather had died, I couldn’t even hug her — simply because I didn’t have his Covid test result until a day later, two days after he had been tested.

What angers me most, though, are the months my dad and I were separated from each other. This might even be what killed him: Analyses from the UK and US have found a spike in deaths from dementia compared with previous years, and 79 percent of surveyed care homes in the UK said the lack of social contact was hurting the health of patients with dementia. This is not a surprise: Research has linked loneliness with faster cognitive decline.

I believe there must be a way to safely reconnect separated families. After long-term care facilities in the Netherlands opened their doors in May, a July study reported that in-person visits were a “huge added value” over video calls or window visits. Many states have begun to allow in-person visiting indoors; in Pennsylvania, where I live, facilities are supposed to follow a series of protocols before they can begin thinking about lifting restrictions, and at the time of my dad’s death, his facility hadn’t experienced enough case-free days in a row to start reopening. I knew he was getting excellent care, but I used to fantasize about a separate floor or unit in the facility for patients whose families have accepted the risk of Covid-19, where visitors wear masks, and staff receives hazard pay.

Yes, it’s a complicated problem with no easy fix. But as a grieving daughter, I know we haven’t tried hard enough. We have known about Covid-19 for almost a year now, and the end isn’t near: My region has recently seen a surge in cases, and experts say we have a long period — months, at least — of restrictions ahead. But many elderly can’t wait that long. We owe it to them — people in nursing homes and those sitting at home, alone — to figure out how to reconnect them with their loved ones in a meaningful way.

A Teachers Union Shaped CDC School Guidance. Is That a Problem?

itsme — Thu, 11 Aug 2022 20:31:31 +0000

The influence of the union has prompted debate over its role in scientific decision making.

BY HANNAH THOMASY June 10, 2021

WHEN THE U.S. Centers for Disease Control and Prevention issued much-anticipated guidelines for school reopening in February, some critics argued that the nation’s premier health agency had set unreasonably strict standards for schools to follow.

But the two largest teachers unions, the American Federation of Teachers and the National Education Association, long hesitant about reopening schools amid the Covid-19 pandemic, rallied in support of the document. “For the first time since the start of this pandemic, we have a rigorous road map, based on science, that our members can use to fight for a safe reopening,” AFT president Randi Weingarten wrote in a statement released that day.

One detail not disclosed at the time: The AFT had a hand in crafting the guidelines. On May 1, The New York Post broke the news of emails between the union and the CDC, obtained by the conservative watchdog group Americans for Public Trust, showing that the CDC had consulted with the teachers union, and that two suggestions from the AFT had been incorporated, almost verbatim, into the final document.

Debates over school reopening have pitted the unions against some advocates and parents clamoring for reopening, and the revelation sparked accusations of undue political influence over CDC decision-making.

The mingling of politics and science has been a heated issue during a pandemic that has, so far, claimed the lives of around 600,000 Americans. On dozens of occasions, the Trump administration attempted to silence scientists and influence health policy, preventing an effective pandemic response, according to a report from the Brennan Center for Justice at New York University School of Law.

But the Biden administration assured Americans that it would be different, promising that policies would be based on evidence and that science would be separated from political influence. In early May, the administration announced a panel to investigate past political meddling in government science.

Now, some Republicans are claiming that the AFT emails show that even under the new administration, the CDC is subject to political influence. These emails, wrote Republican Representatives Cathy McMorris Rodgers, Morgan Griffith, and Brett Guthrie in a joint letter to CDC director Rochelle Walensky, “raise significant concerns about whether you, as the Director of the CDC, are putting politics over science and Biden-Harris campaign donors over children.”

The issue has sparked an inquiry into the CDC from Congressional Republicans. And it has raised pointed questions about political pressures at an agency that, since the beginning of the pandemic, has been subject to heightened national scrutiny.

But divisions remain over whether the union exercised undue influence — or if, as several policy experts told Undark, the CDC was simply doing the routine work of consulting stakeholders.

“What we saw last year were clear examples” of “politicians or people on the political level changing the interpretation of science,” said Richard Besser, who served as acting director of the CDC in 2009. “And that is very different than affected parties being able to provide input.”

WHEN THE CDC’S guidelines arrived in February, less than half of U.S. public school students were attending full-time in-person school. At the time, there was substantial disagreement about whether the benefits of in-person schooling outweighed the risks of reopening. Some parents and pediatricians argued that the evidence showed reopening could be done safely, and cited concerns about children’s development and mental health. Teachers unions argued that many schools did not have the resources to safely control transmission.

The CDC’s guidance was mixed. The agency recommended reopening schools. But it also set standards that placed more than 90 percent of counties in the “high community transmission category,” meaning that schools there would have to implement strict — some said prohibitively strict — measures if they wanted to hold in-person classes. For all schools, the CDC recommended maintaining a distance of 6 feet between students.

Some researchers thought the February guidelines were too strict, and that the available scientific evidence indicated that schools could be safely reopened with less prohibitive measures.

“The fact that they said that students needed to be 6 feet apart from each other — there was no evidence showing that that was necessary,” said Tracy Høeg, a physical medicine and rehabilitation physician at Northern California Orthopaedic Associates, and co-author of an often-referenced study of Covid-19 transmission in Wisconsin public schools. Six feet, she added, “was just not achievable for really any school district.”

Daniel Benjamin, a pediatric infectious disease expert at Duke University, also questioned the science behind the guidelines. “There’s a lot of stuff in that February guidance that’s entirely made up, and written as though it’s factual, when in fact it’s opinion, or is a hypothesis,” he said in a recent interview with Undark.

For example, Benjamin questioned the logic of recommending stricter measures or remote learning in areas with high community transmission rates. “If you mask, and community transmission rates are high or low, people do not give each other Covid at school,” he said. In a February interview with CNN, Walensky stated that unreliable masking “is among the reasons that we have transmission within schools when it happens.”

Benjamin’s own research on 11 North Carolina school districts found that transmission within schools was “extremely limited,” and that instances of Covid-19 in schools seemed to have little to do with rates of community transmission. (Those schools maintained 6 feet of distancing.)

“There’s a lot of stuff in that February guidance that’s entirely made up, and written as though it’s factual, when in fact it’s opinion, or is a hypothesis,” Benjamin said.

Not all epidemiologists agree, though, that the February guidelines departed from the science — or even that the science is especially clear. Sten Vermund, a pediatrician and infectious disease epidemiologist at Yale University, said the guidelines were reasonable, if a bit on the conservative side. “There you were, in the middle of respiratory virus season, with school outbreaks all over the country,” Vermund said. At that time, he added, it did not seem that “CDC felt comfortable radically altering guidelines.”

Justin Lessler, a professor of infectious disease epidemiology at Johns Hopkins University, said he thinks there is still uncertainty in the debate over school distancing guidelines and whether students should be 3 feet or 6 feet apart. “I do think it is an area where we are maybe not on the strongest evidentiary footing either way,” he said.

In a recent paper, Lessler and several colleagues found that the parents of children participating in in-person schooling had an increased risk of testing positive for Covid-19. For the CDC guidelines, Lessler said, it was “perfectly reasonable” to implement stricter measures in areas of high community spread. The evidence, he said, suggests schools “can play a role and help drive a wider community epidemic.”

THE THORNIER POINT, perhaps, is how those guidelines came about — and whether the AFT’s involvement crossed some line.

In the press release for the February guidelines, Walensky stated that, in addition to reviewing scientific evidence, “we have also engaged with many education and public health partners, to hear firsthand from parents and teachers directly about their experiences and concerns. These sessions were so informative, and direct changes to the guidance were made as a result of them.” The statement didn’t offer specifics.

In May, White House press secretary Jen Psaki told reporters that the CDC engaged with about 50 different organizations while drawing up the guidelines. CDC spokesperson Jasmine Reed sent Undark this list, which includes the Department of Education, as well as other education groups and public health organizations. (The AFT did not respond to requests for comment from Undark.)

The emails obtained by Americans for Public Trust reference meetings between individuals from the AFT, the CDC, and the White House Covid-19 response team shortly before the school reopening guidelines were released. In the emails, Kelly Trautner, the AFT’s senior director of health issues, thanked Walensky for her “continued openness to our suggestions and input.” The New York Post reported that two elements discussed in the emails were incorporated “nearly verbatim” into the guidelines: First, that guidelines might need to be updated in the case of high community transmission of variants; and, second, that remote work concessions be made for teachers with high-risk conditions.

The evidence, Lesser said, suggests schools “can play a role and help drive a wider community epidemic.”

Not everyone found those suggestions especially controversial. But the AFT gives millions of dollars to Democratic candidates each election cycle, and, for some researchers skeptical of the guidelines, the emails seemed to confirm that the process had been murky. “I think it would be important to know more details about that, like who did they consult, and what was the timing of it, and which group did they give more weight to, and preference to, in terms of rewriting it?” said Høeg.

Asked why he thought the CDC chose these more conservative guidelines, Benjamin, the Duke epidemiologist said, “The CDC tends to look at research, and they listen to stakeholders, and sometimes they listen to some stakeholders more closely than others.”

Some experts, including Lawrence Gostin, a professor of global health law at Georgetown University, say that all CDC guidance should be based solely on the science. “You do want to get feedback from stakeholders,” he said. “But you want the feedback to be based upon what are the relevant considerations for health and safety. Not pure political pressure.”

Others say that guidance like this, where the health and well-being of different groups may be at odds, is inherently political. “I think what made the school opening guidelines difficult was, it wasn’t just about science,” said Vladimir Kogan, a political scientist at Ohio State University. “Unfortunately, at the time until now, some of the science remains unsettled. It really got into the policy space of balancing competing demands and competing interests.”

After the CDC guidelines came out, Kogan co-authored an influential op-ed accusing the agency of failing “to follow the science” that suggested reopenings could be done safely.

In an interview with Undark, Kogan suggested that the teachers union involvement had some parallels to other cases in which special interest groups shaped government legislation. “I think the concern here is very similar to the concerns that people had during the Trump era, like coal interests writing environmental regulations, right?” Kogan said. “That it’s not obvious that the people involved have broader society’s interests at heart.

“I think that one thing that rubs people the wrong way is the extent of AFT involvement,” said Kogan. “I think, it’s one thing to consult with somebody. I think it’s another thing to copy and paste their preferred language.”

THOSE KINDS OF CLAIMS have been swiftly weaponized by Congressional Republicans and conservative groups. Walensky was questioned about the involvement of the teachers union in Congress on May 11. A week later, Americans for Public Trust, the group that acquired the emails via Freedom of Information Act requests, launched a $1 million advertising campaign criticizing Biden and the CDC for working with teachers unions. The campaign accuses policymakers of “sacrificing kids, keeping them out of school, to pay back liberal dark money groups.” Just a few days later, Republican senators wrote a letter to the leaders of the CDC and the Department of Health and Human Services asking for more details about the CDC’s communications with the AFT and other non-governmental organizations.

But, in interviews, several public policy experts and former CDC officials said that soliciting and incorporating feedback from various stakeholders was an essential part of making useful public health recommendations amid a crisis, and that AFT’s involvement seemed to fall within those boundaries.

“I would have been surprised, and frankly disappointed, if in drafting guidance that affects schools, CDC wasn’t engaging with teacher groups, parent groups, local public health,” said Besser, the former CDC acting director, who now runs the Robert Wood Johnson Foundation. “One of the challenges in emergency response when you’re dealing with an emerging infectious agent,” like the U.S. did with the 2009 H1N1 outbreak, “is that you’re always making guidance based on limited science,” he said.

“I think, it’s one thing to consult with somebody. I think it’s another thing to copy and paste their preferred language,” Kogan said.

Erin Sauber-Schatz, a CDC injury prevention specialist, said consulting with many different organizations is routine. In her work with the CDC’s transportation safety team, she said, she regularly consults both governmental and non-governmental groups. “We really try to pull in information from all different groups when we’re thinking about any public health problem,” she said, “because that allows us to provide the best answers and the best guidance regardless of the public health topic.”

Lloyd Kolbe, who ran the CDC’s Division of Adolescent and School Health from 1985 to 2003, described using a similar process when designing school-based education programs to prevent the spread of HIV. During that process, Kolbe said, they were advised by various groups, including a major teachers union.

Public health experts outside the CDC, including Georges Benjamin, director of the American Public Health Association, and David Michaels, an epidemiologist at the George Washington University School of Public Health, didn’t find the AFT emails surprising, either.

“I think agencies do have to rely on stakeholders to understand,” said Michaels, who is also the former assistant secretary of labor at the Occupational Safety and Health Administration. The CDC, he added, should judge those outside comments with a critical eye. But, he said, “that doesn’t mean that they should reject them.”

Hannah Thomasy is a freelance science writer splitting time between Toronto and Seattle. Her work has appeared in Hakai Magazine, OneZero, and NPR.

The Freeway Flag

itsme — Mon, 08 Aug 2022 19:40:52 +0000

I was driving home today and saw a faded American flag hanging on a freeway bridge near Rancho Cucamonga. I figured it was probably from one of the local Marines that was killed last year in Kabul during our shameful exit from Afghanistan.

So here’s my question:

Why hasn’t anyone who played a part in this foreign policy disaster been fired? None of the high ranking military officers, cabinet secretaries, and other experienced officials were really held accountable for this debacle.

Our military left billions of dollars in military equipment behind, abandoned a valuable airport, left Americans in Afghanistan, and the marines were killed on their watch.

Nothing.

I wonder how long the flag will hang above the freeway.

The Federal Government Gave Billions to America’s Schools for COVID-19 Relief. Where Did the Money Go?

kim zolotar — Fri, 22 Jul 2022 20:55:16 +0000

The Education Department’s limited tracking of $190 billion in pandemic support funds sent to schools has left officials in the dark about how effective the aid has been in helping students.

After the pandemic shut down schools across the country, the federal government provided about $190 billion in aid to help them reopen and respond to the effects of the pandemic. In the year and a half since millions of children were sent home, the Education Department has done only limited tracking of how the money has been spent. That has left officials in Washington largely in the dark about how effective the aid has been in helping students, especially those whose schools and communities were among the hardest hit by the pandemic.

“We’ve been in the pandemic now for nearly a year and a half,” said Anne Hyslop, the director of policy development at the education advocacy group Alliance for Excellent Education. “There is a responsibility to the public to make sure the funds are spent responsibly, but also make sure that the funding that is spent is accountable to supporting students and educators.”

Provisional annual reports submitted to the federal government by state education agencies underscored the dearth of clear, detailed data. Agencies classified how the funds were spent using six very broad categories, including technology and sanitization. According to a ProPublica analysis of more than 16,000 of the reports covering March 2020 to September 2020, just over half of the $3 billion in aid was categorized as “other,” providing no insight into how the funds were allocated.

In the absence of a centralized and detailed federal tracking system, the monitoring of relief funds flowing to the nation’s more than 13,000 school districts has largely been left to states. Some districts have been found to be spending their federal funds on projects seemingly at odds with the spirit of the aid program, such as track and field facilities and bleachers.

While such spending is not prohibited by the federal government, the stated goals of the relief program were to open schools safely to maximize in-person learning and, more broadly, to address the impact of the pandemic.

The Biden administration wants to collect more data. But its efforts have come more than a year after the previous administration began disbursing the relief funds, and some school districts have bristled at the belated push for more detailed data collection.

Hyslop said that while this may place an added burden on districts, the information is essential. “We need this data to make sure the needs are met, to make sure high-needs schools are not being shortchanged. … We have to make sure this is actually supporting students.”

The majority of the school aid was allocated from March 2020 to March 2021 and funneled through state education departments into K-12 school districts, which have until 2024 to budget the last of the funds.

Under the terms laid out by the federal government, states are responsible for developing tracking systems to ensure districts are spending the money on countering the effects of the pandemic.

The federal government has long given states considerable latitude in setting standards and curriculum. Christine Pitts, a fellow at the Center on Reinventing Public Education, said responsibility for tracking COVID-19 relief funds has similarly been delegated to the states, creating a patchwork of oversight practices. “There’s 50 states, and oftentimes in education that means there’s 50 different ways of doing the business,” said Pitts.

The federal government has started to request limited information from states on how districts have spent their funds. The department also requires spending plans from states, and those plans must be approved before the last round of funds is released.

These limited reporting requirements reflect the early, urgent days of the pandemic, when officials wanted to get money to school districts as quickly as possible.

In June 2020, as the first federal relief dollars were beginning to flow to districts, the office of inspector general of the Education Department warned in a report that the department must improve its oversight, monitoring and data collection to reduce potential fraud and waste. The OIG noted that after the 2007-2008 financial crisis, the Education Department was responsible for allocating $98 billion through the American Recovery and Reinvestment Act, which led to numerous investigations into abuse and waste.

When the OIG raised concerns last year to then-Deputy Education Secretary Mick Zais, Zais said the pandemic aid legislation itself had created “enormous pressure” to distribute funds quickly, according to an OIG report.

A spokesperson for the OIG, Catherine Grant, said that while distributing pandemic aid presented its own challenges, oversight and monitoring were “longstanding” issues for the department.

Luke Jackson, a spokesperson for the Education Department, said in an emailed statement that the department was working with states and districts to collect preliminary data to “to ensure federal funds are being spent to best serve the needs of students, educators, and school communities.”

The law places few restrictions on how districts can spend the federal aid, as long as the investments are loosely connected to the effects of the pandemic. This wide latitude has enabled districts to fund projects that some education experts have deemed questionable.

In Iowa, the Creston Community School District allocated about $231,000 of its pandemic relief funds to upgrade its outdoor stadium, including an expansion of its bleachers. According to district documents, the construction is intended to provide increased space for social distancing and to make the bleachers wheelchair accessible.

Creston’s superintendent, Deron Stender, did not respond to ProPublica’s requests for comment.

Last month in Pulaski County, Kentucky, the school board approved the reconstruction of its track and field facilities, allocating about $1 million in federal pandemic funding for the track replacement.

“We want to have facilities that are great for our students,” the district superintendent, Patrick Richardson, told a local paper after the project was approved. Richardson did not respond to ProPublica’s requests for comment.

“There is certainly a lot of flexibility on how the money can be used,” said Hyslop of the Alliance for Excellent Education, but said athletic investments are “not in the spirit of the law.”

The statement from Jackson, the Education Department spokesman, did not address a question from ProPublica about using relief funds for athletic projects.

In other cases, the spending priorities of school districts have drawn complaints from some parents. In Virginia, Fairfax County Public Schools spent more than $45 million of its early pandemic funding on ventilation systems and personal protective equipment. But some parents said that more federal aid should have been directed to services for students with special needs, who represent about 14.4% of the 178,000 students enrolled in the district.

Debra Tisler, a former special education teacher, said that her 15-year-old son, who has dyslexia, saw the 20 hours a month of specialized instruction that he received before the pandemic cut in half over the course of more than a year of virtual learning.

In January 2021, the federal education department opened up an investigation into Fairfax schools because of “disturbing reports involving the district’s provision of educational services to children with disabilities during the COVID-19 pandemic.” Asked on Tuesday about the status of the Fairfax investigation, the Education Department’s press office did not have that information readily available.

“They have the ability to do it and they are choosing not to. It’s heartbreaking,” said Tisler, who has had a contentious relationship with the district. In August, her son went back to school in person.

In the first two waves of pandemic aid from the county, state and federal governments, Fairfax schools received at least $157.5 million, of which it spent $9.6 million on direct services for students with disabilities to help them catch up, according to budget documents. Helen Lloyd, a spokesperson for Fairfax County Public Schools, said that much of the initial coronavirus relief funds paid for “systemwide technology, school safety mitigation measures and equipment and PPE costs.” She said it is not possible to calculate the proportion of the funding that paid only for services for students with disabilities.

Lloyd did not specifically address Tisler’s concerns, citing privacy protections, but the spokesperson said that the district’s spending plan was based on extensive community input and that learning loss was found to be a priority. She added that from the third wave of pandemic aid, which passed this year, the district has allocated $46.2 million, which is being used to extend the contracts of special education teachers by 30 minutes a day, and $500,000 to counter learning loss of students with disabilities.

In Texas, the McAllen Independent School District decided to spend $4 million of its education pandemic relief funds to construct a 5-acre outdoor learning environment connected to a local nature and birding center owned by the city. Tory Guerra, whose children attend McAllen’s schools, expressed concerns that the project, which will not be completed until December 2024, is not prioritizing the urgent learning needs of children who have been directly impacted by the pandemic.

“There are so many other programs that we could invest in that we could use immediately and see benefits immediately rather than years down the road,” Guerra said. She believes that the federal aid should directly address the pressing emotional and academic wellbeing of students, many of whom have struggled to keep up in the classroom. “Half the kids won’t even get to reap the benefit because the nature center isn’t even built.”

Mark May, a spokesperson for the McAllen independent district, said the cost of the project is a small fraction of the district’s $139.5 million in aid. He said the outdoor space will provide students with resources and experiences that will bolster children’s scientific knowledge.

Some states and districts have developed their own public reporting platforms. In Georgia, the education department built a dashboard that shows how much money each district has received and the programs they have spent it on. But other states have not offered as much visibility into districts’ spending. Indiana, for example, has so far made little information public, but it is currently developing an online portal.

In the provisional federal reports that categorize how aid money is spent, some of the largest districts in the nation marked all of their aid as going to the “other” category, including Los Angeles Unified, which spent $49.5 million, and New York City’s schools, which spent $111.5

Instead of spending the aid on summer school or technology, New York City’s district, the largest in the country, used its federal funds to plug a gap in its budget, which had been cut by the state. Katie O’Hanlon, a spokesperson for the district, told ProPublica that the district used the funds to cover the wages and operations of custodial workers. O’Hanlon said the district had followed state reporting requirements. J.P. O’Hare, a spokesperson for the New York State Education Department, said the state is using the “other” category until the federal government provides more direction on reporting requirements.

Shannon Haber, a spokesperson for Los Angeles Unified, said the district’s reporting was submitted based on the state’s requirements. Many districts categorized their spending as “other” initially, but as the school year progressed, the spending categories diversified, said Scott Roark, a spokesperson for the California Department of Education.

Even if the information is publicly available on a local level, the lack of standardization from state to state makes it impossible to get a national picture of how the funds are being directed.

Some experts said it may be too soon to get a larger view of how the aid was spent. “There’s going to be a natural lag between a district receiving the money, spending the money and reporting up to the state,” said Paige Kowalski, executive vice president for the education advocacy group Data Quality Campaign.

But other experts say that without real-time insight into district spending, schools will not be able to shift priorities if they find certain programs are working better than others.

“There can be an opportunity to do mid-course corrections, if we find something working well or not well,” said Dan Goldhaber, director of the Center for Education Data & Research at the University of Washington. “We will be in a bad place if we don’t have much evidence that $200 billion didn’t move the needle.”

This past July, the federal Education Department announced plans to increase its data collection from districts in 2022, but dozens of districts and state education agencies said that more oversight could leave them overburdened.

“It will take another block of time,” said Brenda Turner, the business manager of Haskell Consolidated Independent School District in central Texas, adding that her district already filed detailed plans to the state’s education department explaining how Haskell planned to spend its aid. “They need to figure out how to pull it out of their own system to report to the federal government instead of putting it on us.”

Has Your School Had a COVID Outbreak? Is Your District Following CDC Guidelines? Help Us Report.

As the Delta variant spreads across the country, ProPublica is reporting on the health and safety of students. Tell ProPublica whether your school is following CDC guidelines and whether any students, faculty or staff have gotten sick.Name *Email *Phone numberHow would you like to help our reporting?How would you like to help our reporting? *I have a specific story or concern to share.I work in or with schools and can volunteer my expertise.Are you over 18 years old?Are you over 18 years old? *YesNoSavedSUBMITPowered by CityBase.Expand

Jeff Kao contributed research.

Filed under —

Education

Annie Waldman

Annie Waldman is a reporter at ProPublica covering education.

Bianca Fortis

Bianca Fortis is an Abrams Reporting Fellow at ProPublica.

For Advocate of Voters With Disabilities, Polls Present Obstacles

itsme — Wed, 20 Jul 2022 20:39:10 +0000

Arlene Schulman | Tuesday, November 3,2020

Edith Prentiss wheeled across the ramp into her polling site in Washington Heights on Election Day and sighed.

She pointed to the incline between the ramp and doorway of the Moriah Senior Center in Washington Heights.

“This ramp,” the longtime advocate said, “is state of the art but there’s not sufficient coverage.”

A voter stumbled over the ramp as he entered.

Prentiss called poll workers over to inspect what might seem like a minor inconvenience but can hinder or prevent people with disabilities from entering polling sites.

The Americans with Disabilities Act 2016 checklist for accessible polling places includes accommodations for parking and stresses the importance of ramps, smooth surfaces, wide entryways, easy-to-open doors and available lifts and elevators.

Once voters with disabilities make it inside, the voting technology is required to include a Ballot Marking Device that can be utilized by touch screen, a braille keypad, a rocker paddle that allows a voter to press yes or no with hands or feet, or a sip and puff device that uses air pressure for those who have limited or no motor ability. The whole process takes two machines. A vote is marked on the ballot by one machine and then the completed ballot must be scanned by another to record the vote.

Prentiss, 68, who has used a wheelchair for 25 years, and other New Yorkers represent 38.3 million people in the U.S. with disabilities who are eligible to vote, representing 16.3% of the population, according to a Sept. 24 Rutgers University study. According the U.S. Census Bureau, 930,100 people with disabilities were living in New York City in 2017, which represents 11 percent of the total local population.

Prentiss, former president and current transportation chair of the 504 Democratic Club and former president of Disabled in Action of Metropolitan New York City, predicts that many people with disabilities and seniors are voting with absentee ballots or voted early.

Prentiss has voted at the Moriah Senior Center for the last 40 years. There was no line when she arrived there at 7 am, unlike early voting lines that were filled with voters with canes, walkers and wheelchairs at the Bronx County Courthouse.

Prentiss attempted to use the Ballot Marking Device but the battery appeared to be dead.

“This is what we’re doing,” she instructed poll workers. “We are going to call the technician, and then I will come back later.”

“This,” she added, “is why I arrive early.”

She passed her telephone number to a poll worker, a neighbor who lives in her apartment building two blocks away, and told him to call her when it was fixed.

“I’ll be returning at 4 pm,” she warned.

Prentiss declined to vote early citing long lines at uptown polling sites that circled the block and a compromised immune system. Sheila Mack, a 57-year-old retiree who uses a cane, voted early at Lincoln Center because of a bad hip. She showed a poll worker her New York Access-A-Ride card, which allows her to use New York’s paratransit systems for people with disabilities, and she was ushered to the front of the line.

Ana Heywood, 71, a retired teacher and breast cancer survivor who is Puerto Rican, also moved to the front of the line when voting early in the Bronx.

“How good it feels to have a voice,” she said. “Our ancestors got beat up, got bitten by dogs, and terrorized the right to vote.”

After 40 minutes, a poll worker found Prentiss outside determining how the ramp should be re-installed. A few minutes later, the ramp was adjusted with no gap between the ramp and entranceway.

The Ballot Market Device, as it turned out, only required a restart by turning the machine on and off.

Prentiss wheeled back in to vote. But one of two scanners was down for the count, a technician on the way.

“This current president,” she said, “has been doing his best to deconstruct law, policies and programs that are very important to all of us, except the billionaires. This has impacted people with disabilities and seniors.”

She voted for Joe Biden.

With additional reporting from Tricia Crimmins, Grace Benninghoff, Anna Grazulis and Andrew Little.

This story is the work of students at the Columbia University Graduate School of Journalism. Other news organizations are welcome to publish this story as long as they adhere to these guidelines.

A Boy Went to a COVID-Swamped ER. He Waited for Hours. Then His Appendix Burst.

itsme — Mon, 20 Jun 2022 18:41:13 +0000

Sepember 15, 2021

by Jenny Dean

What first struck Nathaniel Osborn when he and his wife took their son, Seth, to the emergency room this summer was how packed the waiting room was for a Wednesday at 1 p.m.

The Florida hospital’s emergency room was so crowded there weren’t enough chairs for the family to all sit as they waited. And waited.

Hours passed and 12-year-old Seth’s condition worsened, his body quivering from the pain shooting across his lower belly. Osborn said his wife asked why it was taking so long to be seen. A nurse rolled her eyes and muttered, “COVID.”

Seth was finally diagnosed with appendicitis more than six hours after arriving at Cleveland Clinic Martin Health North Hospital in late July. Around midnight, he was taken by ambulance to a sister hospital about a half-hour away that was better equipped to perform pediatric emergency surgery, his father said.

But by the time the doctor operated in the early morning hours, Seth’s appendix had burst — a potentially fatal complication.

As the nation’s hospitals fill and emergency rooms overflow with critically ill COVID-19 patients, it is the non-COVID-19 patients, like Seth, who have become collateral damage. They, too, need emergency care, but the sheer number of COVID-19 cases is crowding them out. Treatment has often been delayed as ERs scramble to find a bed that may be hundreds of miles away.

Some health officials now worry about looming ethical decisions. Last week, Idaho activated a “crisis standard of care,” which one official described as a “last resort.” It allows overwhelmed hospitals to ration care, including “in rare cases, ventilator (breathing machines) or intensive care unit (ICU) beds may need to be used for those who are most likely to survive, while patients who are not likely to survive may not be able to receive one,” the state’s website said.

The federal government’s latest data shows Alabama is at 100% of its intensive care unit capacity, with Texas, Georgia, Mississippi and Arkansas at more than 90% ICU capacity. Florida is just under 90%.

It’s the COVID-19 cases that are dominating. In Georgia, 62% of the ICU beds are now filled with just COVID-19 patients. In Texas, the percentage is nearly half.

To have so many ICU beds pressed into service for a single diagnosis is “unheard of,” said Dr. Hasan Kakli, an emergency room physician at Bellville Medical Center in Bellville, Texas, about an hour from Houston. “It’s approaching apocalyptic.”

In Texas, state data released Monday showed there were only 319 adult and 104 pediatric staffed ICU beds available across a state of 29 million people.

Hospitals need to hold some ICU beds for other patients, such as those recovering from major surgery or other critical conditions such as stroke, trauma or heart failure.

“This is not just a COVID issue,” said Dr. Normaliz Rodriguez, pediatric emergency physician at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida. “This is an everyone issue.”

While the latest hospital crisis echoes previous pandemic spikes, there are troubling differences this time around.

Before, localized COVID-19 hot spots led to bed shortages, but there were usually hospitals in the region not as affected that could accept a transfer.

Now, as the highly contagious delta variant envelops swaths of low-vaccination states all at once, it becomes harder to find nearby hospitals that are not slammed.

“Wait times can now be measured in days,” said Darrell Pile, CEO of the SouthEast Texas Regional Advisory Council, which helps coordinate patient transfers across a 25-county region.

Recently, Dr. Cedric Dark, a Houston emergency physician and assistant professor of emergency medicine at Baylor College of Medicine, said he saw a critically ill COVID-19 patient waiting in the emergency room for an ICU bed to open. The doctor worked eight hours, went home and came in the next day. The patient was still waiting.

Holding a seriously ill patient in an emergency room while waiting for an in-patient bed to open is known as boarding. The longer the wait, the more dangerous it can be for the patient, studies have found.

Not only do patients ultimately end up staying in the hospital or the ICU longer, some research suggests that long waits for a bed will worsen their condition and may increase the risk of in-hospital death.

That’s what happened last month in Texas.

On Aug. 21, around 11:30 a.m., Michelle Puget took her adult son, Daniel Wilkinson, to the Bellville Medical Center’s emergency room as a pain in his abdomen became unbearable. “Mama,” he said, “take me to the hospital.”

Wilkinson, a 46-year-old decorated Army veteran who did two tours of duty in Afghanistan, was ushered into an exam room about half an hour later. Kakli, the emergency room physician there, diagnosed gallstone pancreatitis, a serious but treatable condition that required a specialist to perform a surgical procedure and an ICU bed.

In other times, the transfer to a larger facility would be easy. But soon Kakli found himself on a frantic, six-hour quest to find a bed for his patient. Not only did he call hospitals across Texas, but he also tried Kansas, Missouri, Oklahoma and Colorado. It was like throwing darts at a map and hoping to get lucky, he told ProPublica. But no one could or would take the transfer.

By 2:30 p.m., Wilkinson’s condition was deteriorating. Kakli told Puget to come back to the hospital. “I have to tell you,” she said he told her, “Your son is a very, very sick man. If he doesn’t get this procedure he will die.” She began to weep.

Two hours later, Wilkinson’s blood pressure was dropping, signaling his organs were failing, she said.

Kakli went on Facebook and posted an all-caps plea to physician groups around the nation: “GETTING REJECTED BY ALL HOSPITALS IN TEXAS DUE TO NO ICU BEDS. PLEASE HELP. MESSAGE ME IF YOU HAVE A BED. PATIENT IS IN ER NOW. I AM THE ER DOC. WILL FLY ANYWHERE.”

The doctor tried Michael E. DeBakey VA Medical Center in Houston for a second time. This time he found a bed.

Around 7 p.m., Wilkinson, still conscious but in grave condition, was flown by helicopter to the hospital. He was put in a medically induced coma. Through the night and into the next morning, medical teams worked to stabilize him enough to perform the procedure. They could not.

Doctors told his family the internal damage was catastrophic. “We made the decision we had to let him go,” Puget said.

Time of death: 1:37 p.m. Aug. 22 — 26 hours after he first arrived in the emergency room.

The story was first reported by CBS News. Kakli told ProPublica last week he still sometimes does the math in his head: It should have been 40 minutes from diagnosis in Bellville to transfer to the ICU in Houston. “If he had 40 minutes to wait instead of six hours, I strongly believe he would have had a different outcome.”

Another difference with the latest surge is how it’s affecting children.

Last year, schools were closed, and children were more protected because they were mostly isolated at home. In fact, children’s hospitals were often so empty during previous spikes they opened beds to adult patients.

Now, families are out more. Schools have reopened, some with mask mandates, some without. Vaccines are not yet available to those under 12. Suddenly the numbers of hospitalized children are on the rise, setting up the same type of competition for resources between young COVID-19 patients and those with other illnesses such as new onset diabetes, trauma, pneumonia or appendicitis.

Dr. Rafael Santiago, a pediatric emergency physician in Central Florida, said at Lakeland Regional Health Medical Center, the average number of children coming into the emergency room is around 130 per day. During the lockdown last spring, that number dropped to 33. Last month — “the busiest month ever” — the average daily number of children in the emergency room was 160.

Pediatric transfers are not yet as fraught as adult ones, Santiago said, but it does take more calls than it once did to secure a bed.

Seth Osborn, the 12-year-old whose appendix burst after a long wait, spent five days and four nights in the hospital as doctors pumped his body full of antibiotics to stave off infection from the rupture. The typical hospitalization for a routine appendectomy is about 24 hours.

The initial hospital bill for the stay came to more than $48,000, Nathaniel Osborn said. Although insurance paid for most of it, he said the family still borrowed against its house to cover the more than $5,000 in out-of-pocket costs so far.

While the hospital system where Seth was treated declined to comment about his case because of patient privacy laws, it did email a statement about the strain the pandemic is creating.

“Since July 2021, we have seen a tremendous spike in COVID-19 patients needing care and hospitalization. In mid-August, we saw the highest number of patients hospitalized with COVID-19 across the Cleveland Clinic Florida region, a total of 395 COVID-19 patients in four hospitals. Those hospitals have approximately 1,000 total beds,” the email to ProPublica said. “We strongly encourage vaccination. Approximately 90% of our patients hospitalized due to COVID-19 are unvaccinated.”

On Sunday, The Washington Post reported that a hospital in Alabama called 43 others across three states before finding a bed for Ray DeMonia, a critically ill heart patient who later died. In his obituary his family wrote: “In honor of Ray, please get vaccinated if you have not, in an effort to free up resources for non COVID related emergencies. … He would not want any other family to go through what his did.”

Today, Seth is mostly recovered. “Twelve-year-old boys bounce back,” his father said. Still, the experience has left Nathaniel Osborn shaken.

The high school history teacher said he likes to stay upbeat and apolitical in his social media musings, posting about Florida wildlife preservation and favorite books. But on Sept. 7, he tweeted: “My 12-year-old had appendicitis. The ER was overwhelmed with unvaccinated Covid patients and we had to wait 6+ hours. While waiting, his appendix ruptured and had to spend 5 days in hospital. … So yeah, your decision to not vaccinate does affect others.”

The CDC Only Tracks a Fraction of Breakthrough COVID-19 Infections, Even as Cases Surge
It was retweeted 34,700 times, with 143,000 likes. Most comments were sympathetic and wished his child a speedy recovery. Some, though, went straight to hate, apparently triggered by his last line. He was attacked personally and accused of making up the story: “Good try with the guilt, jerk.”

Osborn, who is vaccinated, as are his wife and son, told ProPublica he only shared Seth’s story on Twitter to encourage vaccinations.

“I have no ill will towards the hospitals or the care received at either hospital,” he said this week, “but had these hospitals not been so crowded with COVID patients, we wouldn’t have had to wait so long and perhaps my son’s appendix would not have burst.”

Have you experienced or work for a hospital that is rationing care due to COVID-19 overcrowding? Contact Jenny Deam at jenny.deam@propublica.

Outrageous, ridiculous, unjust, just plain stupid – KMZ Digest

‘Diversity’ Doesn’t Include Disabled Veterans Like Me

AUTHOR

Matthew Winans

Leave a Comment

‘I’m So Burned Out’: Fighting to See a Specialist Amplified Pain for Riverside County Woman

The hidden extra costs of living with a disability

Calculating the cost

Unanswered questions

Supporting people with disabilities

Covid stole my Dad’s final months

A Teachers Union Shaped CDC School Guidance. Is That a Problem?

The Freeway Flag

The Federal Government Gave Billions to America’s Schools for COVID-19 Relief. Where Did the Money Go?

The Education Department’s limited tracking of $190 billion in pandemic support funds sent to schools has left officials in the dark about how effective the aid has been in helping students.

For Advocate of Voters With Disabilities, Polls Present Obstacles

A Boy Went to a COVID-Swamped ER. He Waited for Hours. Then His Appendix Burst.