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The Battle Against Covid

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I expect I’ll get some negative comments here, but that’s never stopped me before.

We are doing far better against this virus than the media and general public believe.

The lock downs might have been necessary early on when science really didn’t know what was going on. It was reasonable back in late February to be pessimistic about the prognosis moving forward. Certainly we were mislead by the Chinese Communist government as to what was going on in the country of origin.

The World Health Organization (WHO) was either woefully ignorant or deliberately vague in their statements on the virus. Maybe both.

What we knew then lead us to believe that this was a very deadly virus that could kill anyone it infected.

We know better now, or should. We know that people seventy and older have elevated risk. The more comorbidities a person has, the more ill and likely to die they are. People eighty five and older, independent of of all other factors have a higher mortality rate.

Children and young adults have a much greater chance of surviving. In fact, many of them don’t een know that they are infected until they are tested. People under 60 share similar results.

Which means that our approach of making everyone quarantine until summer started and then imposing ridiculous and economy crushing restrictions on businesses had done nothing to save lives and in fact has resulted in increased mortality in America.

Between people afraid to go to the hospital when they are sick with other illnesses, people who lost their jobs and couldn’t afford medications, people who became depressed and killed themselves, people driving like maniacs, and other causes, it’s likely that more people died from non Covid causes than from Covid itself.

Here is a pretty good article on why the death toll from Covid appears to be higher than it actually is. Note that this was from May and the over counting continues to this day.

U.S. COVID-19 Death Toll Is Inflated

“The case definition is very simplistic,” Dr. Ngozi Ezike, director of Illinois Department of Public Health, explains. “It means, at the time of death, it was a COVID positive diagnosis. That means, that if you were in hospice and had already been given a few weeks to live, and then you also were found to have COVID, that would be counted as a COVID death. It means, technically even if you died of [a] clear alternative cause, but you had COVID at the same time, it’s still listed as a COVID death.”

What this means is that there is a vast difference between dying “of” Covid and dying with “Covid.” The United States uses “dying with” as the standard while the rest of the world uses “dying of” Covid.

Here is an article that outlines the WHO standard versus what is used in the US.

COVID and the CDC

How does one determine the severity, danger, or threat to society that a SARS virus poses? In the past, the CDC determined the severity of a SARS virus by looking at evidence and incidence of pneumonia and acute respiratory distress syndrome. A SARS case was designated to be “severe respiratory illness” if a patient had the following:

  • Temperature higher than 100.4°F (38°C), AND
  • One or more clinical findings of lower respiratory illness (e.g., cough, shortness of breath, or difficulty breathing) AND
  • Radiographic evidence of pneumoniaOR
  • Acute respiratory distress syndromeOR
  • Autopsy findings consistent with pneumonia or acute respiratory distress syndrome without an identifiable cause

For some reason, the CDC has abandoned their long standing criteria of requiring a death to include pneumonia or ARDS. The rest of the world still requires those components to be present for a death to meet the “died with Covid” criteria.

The numbers are not the issue per se. The issue is that in order for the numbers to be valid, the criteria need to be standardized in order for the results to be valid.

Garbage In, Garbage Out as they say in the computer worlds.

So, an approach that may well have been prudent early on is now shown to be ineffective at preventing deaths while at the same time increasing non Covid deaths.

Another link describing the discrepancy in US versus WHO criteria. This one might be a bit more clear.

Are America’s Wuhan virus death rates lies, damn lies, and statistics?

It’s entirely likely, though, that if the CDC were suddenly to start counting virus deaths in America according to the WHO standard, which would drop the death count from 200,000 (“Trump is going to kill you”) to 86,000 (“it’s just a bad flu season”), the tech giants would scream more loudly than anyone else.

And of course, the number of deaths from the virus would drop even more if we were able to subtract all the other deaths that found their way into the statistics because someone died from another cause entirely, but tested positive for the virus:

If I were a suspicious sort, which you all know I’m not, I might suspect that there is a financial incentive to pad the numbers. As in the government will send money to states and hospitals that have high rates of “Covid deaths.”
I don’t know that that is the case, but I do know that our “Covid death” count is inflated compared to the rest of the world. If you don’t believe me, maybe you’ll believe Doctor Birx.

Dr. Deborah Birx, the response coordinator for the White House coronavirus task force, said the federal government is continuing to count the suspected COVID-19 deaths, despite other nations doing the opposite.

“There are other countries that if you had a pre-existing condition, and let’s say the virus caused you to go to the ICU [intensive care unit] and then have a heart or kidney problem,” she said during a Tuesday news briefing at the White House. “Some countries are recording that as a heart issue or a kidney issue and not a COVID-19 death.

“The intent is … if someone dies with COVID-19 we are counting that,” she added.

Two last points for those who are still reading.

First, there is some very sloppy reporting of the latest “surge” in Covid cases. If you read the reports in the popular media, you would not be wrong in believing that every positive tests results in someone going to the hospital with many dying.

It’s not true. Because of the much wider testing being done today a lot of asymptomatic cases are being discovered. Many of those people would not even know that they were “infected” if not for the test.

Look at some of the “infections” among professional athletes. They test positive not because they don’t feel well, but because it’s policy. They are then required to self quarantine even though they are not the least bit ill. Most professional athletes are very health and fit and fit into the “young” demographic least likely to get sick and die.

Accurate reporting would break the test results down as follows,

Tested positive.

Tested positive and were ill.

Tested positive, were ill, and admitted to the hospital.

Tested positive, were ill, were admitted to the hospital, and went to the ICU.

All of the above and died from Covid 19.

If you’ve seen that, please let me know because I’ve yet to see a story that contains all of that data. Or any beyond “tested positive.”

Finally, there is this.

Great Barrington Declaration.

I won’t be surprised if you’ve never heard of it as it’s received no news of this. For a while over the weekend, Google suppressed it’s search results so that it didn’t show up. It’s since been restored with Google claiming that their ranking algorithms took a while to catch up to the reality.

You can make your own decisions on that, but I don’t use Google as my search engine because I think that they put their thumb on the scale too often.

This is the conclusion of the declaration, but the entire document is not long and you should read it.

Those who are not vulnerable should immediately be allowed to resume life as normal. Simple hygiene measures, such as hand washing and staying home when sick should be practiced by everyone to reduce the herd immunity threshold. Schools and universities should be open for in-person teaching. Extracurricular activities, such as sports, should be resumed. Young low-risk adults should work normally, rather than from home. Restaurants and other businesses should open. Arts, music, sport and other cultural activities should resume. People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.

The list of signatories is diverse representing several nations and several political view points. One thing that they have in common is that the lock downs and restrictions in nations around the world are harming far more people than they are helping.

The science, as some people admonish us, is settled on Covid 19. It was not as bad as was projected and the consequences of the efforts to “fight” it are far worse than the benefits.

If you’re one of my friends with a more widely read blog (that would be all of you), I’d appreciate it if you’d link to this. I’m not patting myself on the back, but I think the information is pretty well laid out.

Thanks.

Nineteen Years Ago

I’m sitting in the same place I was Nineteen years ago. The desk, chair, even the TV I’m watching are different than the ones I was using that day. I don’t remember what I had on TV, if anything, but I saw a post on line by someone on some forum about a plane crash into one of the World Trade Center towers in New York City.

I turned the channel to Fox News and there was an image of the top floors of one of the towers burning furiously. The commentators were trying to figure out what had happened. A wayward small plane? A wayward military jet? That had happened to the Empire State Building shortly after the end of World War 2.

As I, and millions of other people watched, we got our answer. A commercial jetliner slammed into the other tower. That was no accident, it was an act of terrorism, and act of war. The nation watched dumbfounded as the towers burned and the ultimately collapsed. I was on the phone with my partner from work and we both estimated that around 10,000 people had been killed in when those buildings when they fell.

Fortunately, we were wrong. Due to the valiant, and all too often fatal, efforts of police officers, fire fighters, EMTs, paramedics, and others thousands of people who otherwise would have died were evacuated in time.

The FAA had already ordered every airplane flying over the US to land immediately at the nearest airport. While that was happening we had no idea how many passenger liners had been turned into cruise missiles and by whom.

Then, another plane flew into the Pentagon. Then another crashed into the ground in Somerset County, PA. Passengers on that plane fought with the terrorists and thwarted their plan to crash into the U.S. Capitol Building. Their actions cost them their lives, but saved the lives of hundreds, maybe thousands more.

The US has changed drastically since then. We’ve been in what can be considered a persistent state of war. Then President G.W. Bush warned us that it would be a long time before we won, but we would win. I have to say that we are finally winning, but we have not yet won.

It all seems like a long time ago and maybe it was. One thing I do know is that we should never forget what happened that day and what has happened since. A lot of people who were at the scene or rushed to the scene to try and help have also died. The toxins in the air have caused cancers, respiratory illnesses, cardiac illnesses, digestive tract illnesses, and other ailments. Many have died from those illnesses, and many more will. They too were victims of the attacks, especially in New York City.

The long dead terrorists are still killing people. The war is still not over.

For my kids, this is history that they lived through. For my grand kids this is something that they will ask their parents about and hopefully learn about in school. Many people would rather we forget this attack on our nation and its people, but hopefully we won’t.

Japan Has Enough

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It took two Atomic bombs and a raging, almost violent, discussion in the Japanese War Cabinet, but on this day in 1945 the Emperor of Japan spoke to his nation by radio.

He declared that continue to fight the war would be futile and result in the death of more Japanese subjects.

With that, World War 2 was over.

The formal Instrument of Surrender was signed by all parties on September 2, 1945 in Tokyo harbor. The surrender was unconditional except that the Emperor would not be deposed or subject to trial for war crimes.

Many of the other high ranking Japanese officials were not so lucky. They were tried, convicted, and hung for various crimes against both military personnel and civilians.

The United States then embarked on rebuilding Japan and establishing a democratic government in its former enemy.

 

In EMS, Some Things Never Change

While desperately looking for something to watch on TV while I worked out, I came across this interesting movie from 1933. 1933, is a long time ago, but some of the things in the movie made me laugh because they are still pretty much the same to this day.

Early in the movie “Steve” and his intern partner “Joe” go on an ambulance call. When the arrive, there is a woman screaming almost incoherently. Joe starts to move into the apartment when Steve stops him.

Steve tells him about sick people, “They’re always at the top floor and they always weigh 300 pounds.”

This made me laugh out loud because it was true then and it’s still true. Although 300 pounds good well be on the light end these days.

The plot is a bit thin, but the movie is still enjoyable for the historic background.

Another funny bit is was Steve and his date are driven Lights and Sirens to a restaurant. I never did that exactly, but I can say that I hitched a ride now and then when I was in Sorta Big City off duty. That doesn’t count the times we gave Sailors on leave (it always seemed to sailors) who had imbibed a bit too much rides back to their ships. A couple of times that saved them from encounters with the local police as  well, but that’s a different story.

Anyway, you can watch the movie here or on You Tube.

Enjoy.

Oh, by the way, “Bill Boyd” went on to considerable fame in western movies. If you don’t recognize the name, you might be too young to appreciate this film.

Hiroshima

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Today marks 75 years since the United States dropped the first of two Atomic Bombs on the Empire of Japan.

It was well understood at the time that the bombings were necessary to end the war without the tremendous number of casualties on both sides that a land invasion of the home islands would have entailed.

The war would have dragged on well into 1946 before enough Japanese were killed to make further killing a moot point.

Japan had never been invaded by an outside power in it’s history. The Japanese, military and civilian, were prepared to fight until the last Japanese was dead. They still believed that they could defeat the United States and British Commonwealth forces on land.

Once President Truman was informed of the Manhattan Project and the successful Trinity test in New Mexico, he was presented with two choices.

He could continue preparations for an invasion of Japan or he could order the first Atomic Bomb to be dropped on Japan. Based on the horrendous losses at Iwo Jima and Okinowa, he chose the latter.

Keep in mind that the fire bombings by the United States Army Air Force had already killed over 100,000 people and injured another million. The USAAF flew over Japan with impunity bombing and strafing at will. The Japanese had dispersed production of military items into individual homes turning most of them into military targets under the rules of warfare.

So, the bomb was dropped, followed by another on August 9. The second one convinced the Emperor that continuing the war was futile. It was a close thing as there were still those in the Japanese military and government who wanted to continue fighting.

All of which was well understood until sometime in the early 1990s. At which point some elements in the US decided that the bombing was unnecessary and based on “racism.”

They forgot, or maybe never knew, that the original goal of the Manhattan Project was to develop a bomb that could be dropped on Berlin to end the war in Europe. The Russians advanced more quickly than expected and Germany capitulated before the Atomic Bomb was ready.

Speaking of racism, people should look at the behavior of the Japanese against not only American, Commonwealth, and European civilians and military, but against the other Asians in countries Japan conquered.

Research the way the Japanese treated the Chinese, Koreans, and Filipinos, while occupying those nations. Not to mention the Pacific Islanders who lived on captured islands.

The Japanese waged war with a viciousness rivaled only by that between the Germans and Russians.

The bombings of Hiroshima and Nagasaki saved hundreds of thousands, if not millions, of lives on both sides.

America and Americans need make no apologies for using a new weapon to end a war that Japan had started.

July 4, 1776

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Action of Second Continental Congress,
July 4, 1776.
The unanimous Declaration of the thirteen united States of America,

WHEN in the Course of human Events, it becomes necessary for one People to dissolve the Political Bands which have connected them with another, and to assume among the Powers of the Earth, the separate and equal Station to which the Laws of Nature and of Nature’s God entitle them, a decent Respect to the Opinions of Mankind requires that they should declare the causes which impel them to the Separation.

WE hold these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness—That to secure these Rights, Governments are instituted among Men, deriving their just Powers from the Consent of the Governed, that whenever any form of Government becomes destructive of these Ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its Foundation on such Principles, and organizing its Powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient Causes; and accordingly all Experience hath shewn, that Mankind are more disposed to suffer, while Evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long Train of Abuses and Usurpations, pursuing invariably the same Object, evinces a Design to reduce them under absolute Despotism, it is their Right, it is their Duty, to throw off such Government, and to provide new Guards for their future Security. Such has been the patient Sufferance of these Colonies; and such is now the Necessity which constrains them to alter their former Systems of Government. The History of the present King of Great-Britain is a History of repeated Injuries and Usurpations, all having in direct Object the Establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid World.

He has refused his Assent to Laws, the most wholesome and necessary for the public Good.

He has forbidden his Governors to pass Laws of immediate and pressing Importance, unless suspended in their Operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them.

He has refused to pass other Laws for the Accommodation of large Districts of People, unless those People would relinquish the Right of Representation in the Legislature, a Right inestimable to them, and formidable to Tyrants only.

He has called together Legislative Bodies at Places unusual, uncomfortable, and distant from the Depository of their public Records, for the sole Purpose of fatiguing them into Compliance with his Measures.

He has dissolved Representative Houses repeatedly, for opposing with manly Firmness his Invasions on the Rights of the People.

He has refused for a long Time, after such Dissolutions, to cause others to be elected; whereby the Legislative Powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the Dangers of Invasion from without, and Convulsions within.

He has endeavoured to prevent the Population of these States; for that Purpose obstructing the Laws for Naturalization of foreigners; refusing to pass others to encourage their Migrations hither, and raising the Conditions of new Appropriations of Lands.

He has obstructed the Administration of Justice, by refusing his assent to Laws for establishing Judiciary Powers.

He has made Judges dependent on his Will alone, for the Tenure of their Offices, and the Amount and Payment of their Salaries.

He has erected a Multitude of new Offices, and sent hither Swarms of Officers to harrass our People, and eat out their Substance.

He has kept among us, in Times of Peace, Standing Armies, without the consent of our Legislatures.

He has affected to render the Military independent of and superior to the Civil Power.

He has combined with others to subject us to a Jurisdiction foreign to our Constitution, and unacknowledged by our Laws; giving his Assent to their Acts of pretended Legislation:

For quartering large Bodies of Armed Troops among us:

For protecting them, by a mock Trial, from Punishment for any Murders which they should commit on the Inhabitants of these States:

For cutting off our Trade with all Parts of the World:

For imposing Taxes on us without our Consent:

For depriving us, in many Cases, of the Benefits of Trial by Jury:

For transporting us beyond Seas to be tried for pre-tended Offences:

For abolishing the free System of English Laws in a neighbouring Province, establishing therein an arbitrary Government and enlarging its Boundaries, so as to render it at once an Example and fit Instrument for introducing the same absolute Rule into these Colonies:

For taking away our Charters, abolishing our most valuable Laws, and altering fundamentally the forms of our Governments:

For suspending our own Legislatures, and declaring themselves invested with Power to legislate for us in all Cases whatsoever.

He has abdicated Government here, by declaring us out of his Protection and waging War against us.

He has plundered our Seas, ravaged our Coasts, burnt our Towns, and destroyed the Lives of our People.

He is, at this Time, transporting large Armies of foreign Mercenaries to compleat the Works of Death, Desolation, and Tyranny already begun with circumstances of Cruelty and Perfidy, scarcely paralleled in the most barbarous Ages, and totally unworthy of the Head of a civilized Nation.

He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the Executioners of their friends and Brethren, or to fall themselves by their Hands.

He has excited domestic Insurrections amongst us, and has endeavoured to bring on the Inhabitants of our Frontiers, the merciless Indian Savages, whose known Rule of Warfare, is an undistinguished Destruction, of all Ages, Sexes and Conditions.

In every stage of these Oppressions we have Petitioned for Redress in the most humble Terms: Our repeated Petitions have been answered only by repeated Injury. A Prince, whose Character is thus marked by every act which may define a Tyrant, is unfit to be the Ruler of a free People.

Nor have we been wanting in Attentions to our British Brethren. We have warned them from Time to Time of Attempts by their Legislature to extend an unwarrantable jurisdiction over us. We have reminded them of the Circumstances of our Emigration and Settlement here. We have appealed to their native justice and Magnanimity, and we have conjured them by the Ties of our common Kindred to disavow these Usurpations, which, would inevitably interrupt our Connections and Correspondence. They too have been deaf to the Voice of Justice and of Consanguinity. We must, therefore, acquiesce in the Necessity, which denounces our Separation, and hold them, as we hold the rest of Mankind, Enemies in War, in Peace, Friends.

We, therefore, the Representatives of the UNITED STATES OF AMERICA, in General Congress, Assembled, appealing to the Supreme Judge of the World for the Rectitude of our Intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly Publish and Declare, That these United Colonies are, and of Right ought to be, FREE AND INDEPENDENT STATES, that they are absolved from all Allegiance to the British Crown, and that all political Connection between them and the State of Great-Britain, is and ought to be totally dissolved; and that as FREE AND INDEPENDENT STATES, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which INDEPENDENT STATES may of right do. And for the support of this Declaration, with a firm Reliance on the Protection of divine Providence, we mutually pledge to each other our Lives, our fortunes, and our sacred Honor.

Social Media Assisted Career Suicide Syndrome

One of the blogs that I used to read just about every day and plan to start reading again is “Statter 911.” There is a link to Dave Statter’s blog over on the side bar.

Dave is the person who came up with the highly appropriate and accurate phrase that is the title of this post.

It’s a great term for the stupidity that some people display on Twitter, Instagram, Facebook, and other social media platforms.

Which more and more are turning into anti social media platforms.

They also enable the Cancel Mob to ruin a persons career and life with a high rate of efficiency.

It doesn’t matter that a person posts a 2 second video clip of someone doing something that looks bad, but isn’t

It doesn’t matter that a joke gone bad can ruin someone’s life and even that of their family.

It doesn’t matter that a bad Tweet can not only cost you your job, but that of your parents, siblings, spouse, or even your kids.

The current political climate is to punish first and then look at the evidence later on, if ever. Once ruined it’s nearly impossible to regain your reputation. It’s so hard that a cottage industry has popped up to help people salvage their business, reputations, and lives which have been ruined by bad publicity.

Search the term “Reputation Restoration” on your favorite search engine and see the results.

If you run a business, a few bad Yelp reviews can ruin it. Or a rant on your Facebook page for that matter.

If you are employed by any government agency, even your off duty, private (or so you thought) comments can be used to terminate you. The magic phrase for that is that your comments “undermined the public’s confidence that you would carry out your public duties without bias.”

Think about that. You make an off the cuff comment at a party about, let’s say Black Lives Matter. Someone over hears you and takes offense. They know who you work for and the next thing that you know you are being accused of potential (not actual) discrimination against a protected class.

And you are fired for it.

If you think I’m making that up, then you might want read this article. Note that it’s from 2011, so the situation is definitely worse now. While that article covers public sector employees there is some mention of private sector employees as well. Almost all police officers and the vast majority of fire fighters are government employees. Some EMS providers also work for government agencies, so there is wide application in EMS.

That’s a long article, but this quote is significant,

In determining what sort of First Amendment rights government
employees should enjoy when they are off duty, the distinction
between speech “as an employee” and speech “as a citizen” is
ultimately not as useful. Employees do not stop being citizens when
they are at work; likewise, they do not stop being employees when
they are not. Furthermore, it does not help to compare off-duty
government employees to off-duty non-government employees.
Outside of the government context, private employers can discipline
their employees for their off-duty expression with impunity, absent a
state-statutory or constitutional requirement to the contrary. In that
way, employees for private employers are always employees in terms
of the precariousness of their speech rights. They enjoy the robust
speech rights of citizens only vis-à-vis the government. The problem
is that for public employees their employer
is the government.

On or off duty, public employees represent their government employers to some extent. Speech that undermines the public’s trust in the ability of the agency to fairly and without bias fulfill it’s duties can result in discipline, up to and including termination.

Some years back a police officer was fired (actually allowed to resign) from his job for allowing a stripper to have a picture taken sitting on the hood of his police cruiser. That was bad enough, but he lied about it when confronted by the chief of the department.

He likely would have been suspended for the picture, but then lying about it when the picture had already been published was just the capper on that escapade.

This isn’t particularly new as Dave identified SMACSS as far back as 2011. It’s just got worse since then.

Here is a post of Dave’s from three weeks ago. Notice, it’s not just rank and file or lower level employees. Even chief level employees can add to the stupidity.

And the SMACSS pandemic grows with 11 more cases

How is it that there are still people in the fire service who don’t get the concept that what you say on social media can come back to bite you? Raise your hand if you don’t know this yet.

Last week we brought you ten cases. Here are 11 more incidents of Social Media Assisted Career Suicide Syndrome (SMACSS). Of the 21 cases, 14 involve chief officers. There’s a clear trend here when two-thirds of the people getting into trouble are chiefs. I get that it’s a difficult and emotional time. But you won’t make it any better jeopardizing your position in the fire service by sharing those emotions publicly.

My former agency came out with it’s policy back in 2010. It was simple.

1) No pictures of anything while on duty.

2) No texting or posting while operating a department vehicle.

3) No posting of any ongoing incidents while on duty.

To my knowledge, that hasn’t changed. Oddly enough, there was no policy about writing blog posts while on duty. Then again, if management knew that I was writing posts during those lulls in action while I was working, they’d have come up with a new rule, I’m sure.

Facebook is good for posting and viewing cute pictures of grand kids and pets, and catching up with old friends. It’s also good for looking at pictures of old ambulances, fire trucks, and police cars. Even at that, there are useless Facebook groups like “Dinosaurs of EMS” full of old fools who think that “Mother, Jugs, and Speed” was some sort of EMS how to movie.

If you’re in EMS, your best route is stay away from social media. On or off duty anything you post can (and likely will) be used against you.

NOT The Way To EMS

This is verbatim the narrative of a call I recently reviewed for a client.

dispatched to a 51 yr old male with positive covid 19. On arrival pt was waiting outside. pt tested states that he had tested positive for covid 19 8 days ago and was in hospital. Pt states that he still is showing symptoms and would like to be reevaluated. Pt was explain that the hospital is not going to retest. Pt states that he is staying in his hotel room and has no more money and would like to go to noble so he has a place to stay. Pt was told that the hospital is not a free hotel. Pt was advised to find a way to pay for another week on hotel room. Pt was told to rest in his room while he can. Pt vitals not taken due to positive covid 19. Pt was told to call back if symptoms worsen. Pt was left in hotel room.
signature not obtained due to covid 19

I was so flabbergasted that I had to read this hot mess twice to believe that it was a real PCR.

It would be easier to list all that was done right in this report than all that was done wrong.

The total of things that were done right is zero. NOTHING that is documented here is within any protocol I’ve ever seen.

One of the first things I teach people when documenting patient refusals is to NEVER, EVER, under any circumstances suggest to the patient that you don’t think that he needs to go to the hospital.

Provider initiated refusals are a very good way to end an EMS career. Even if no one complains, if your employer has any sort of Quality Improvement or Quality Assurance program, whoever does the reviews is going to have their hair set on fire by this sort of thing.

Now, this call took place at the height of the Covid Panicdemic back a couple of months ago. The state released temporary special protocols for dealing with potential or actual exposure cases. There were some steps temporarily authorized that would not be allowed during normal times.

I won’t go into them, some of which I considered pretty unreasonable.

Suffice it to say that telling a patient that he wasn’t sick enough to go to the hospital, refusing to do an assessment, and abandoning the patient are not among them.

I completed the review, assigned a score to it, and sent it on to their medical director for her review. I also notified our operations manager as he may want to suggest to the agency manager responsible for EMS that this might, just might, be a reportable incident.

That’s a decision that the agency medical director and agency management make and fortunately, my company stays out of it.

Also fortunate is that this is the only egregious incident that I’ve come across in several hundred case reviews for several different agencies.

 

Two Junes, Two Years

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One June 4, 1942 the United States Navy won one of the greatest sea battles in history. It wasn’t supposed to happen, but the Navy cryptographers had broken the Imperial Japanese Navy code and knew the exact time and place of the attack. As a result, the United States was able meet and destroy much of the Japanese fleet.

That fleet had planned to accomplish two things. The first objective was to draw the few remaining US Aircraft Carriers into an ambush and sink what remained of the USN air offensive capabilities.

Once that was done, the Japanese would land troops on Midway Island, defeat the US Marines and Sailors there, and seize the island. That done, they could directly threaten the US Mainland and Hawaii.

A victory at  the United States to sue for peace on terms favorable to the Japanese. That would leave the Japanese free to concentrated on defeating Australia and New Zealand. The Pacific would then be their territory and Japan would conceivably rule half the world.

It was another meant to be another in an unbroken string of Japanese victories that started even before they attacked Pearl Harbor and bought the US into the war.

Despite a costly victory at the Battle of the Coral Sea, the US was still on the defensive. This was perhaps the lowest point in the War in the Pacific. The Japanese stood on the verge of total victory.

All of that was naught to be because the US defeated the Japanese at Midway.

All of that was for naught as the United States Navy defeated them.

Back in December, I mentioned “A Dawn Like Thunder” in the post Day of Infamy.  I recommend that book to you again. It covers the Battle of Midway quite well, especially the sacrifice of Torpedo Squadron 8.

Here is a short film, made by the great director John Ford featuring those doomed sailors.

On the morning of June 4, these men likely knew that the odds of their seeing the sunset were slim at best. Yet, in the best tradition of the U.S. Military they carried their attacks forward.

Here is a another Ford film, a documentary about the battle itself.

The US victory at Midway did not end the war. It did not even stop the Japanese from attacking. What it did do was save the United States from defeat at the hands of the Japanese.

The remaining members of Torpedo Eight would go on to fight at Guadalcanal which turned out to be a close battle that the Japanese almost won. Along the way to victory, there were victories and defeats on both sides, but the United States finally captured and held the island. From there, the Navy and Marines fought island to island to island defeating the Japanese a great cost in lives.

Fast forward two years to June 4, 1944.

The United States Army liberated Rome, Italy from the Germans. Italy had already capitulated, but the Germans had simply started to treat the Italian people as subjects, not allies.

Liberating Rome had taken six months of hard fighting and the victory should have been widely celebrated. In fact, it was for about 24 hours.

Often forgotten is that the campaign in Italy went on for several more months as the Germans slowly retreated up the peninsula back towards Germany. Liberating Rome was significant, but like Midway it wasn’t the end of a war or even a campaign.

The main reason that many people don’t remember the Liberation of Rome is that something that another momentous event took place on June 6, 1944.

The Allies invaded France and started the roll back of German forces that would end up winning the War in Europe.

That too was a near thing as the United States Army forces who landed at Omaha Beach were almost thrown back into the seat. A defeat here would likely have meant that no further attempts to liberate Europe would be attempted for years, if ever.

Here is a nice documentary that mixes footage from the invasion with an interview of a man that landed on the beach that day.

Two Junes, two years apart and the world had changed. Japan and Germany were now on the defensive. By June 1945, the War in Europe would be over, and in August 1945 Japan would surrender.