We All Need A Plan to Deal with COVID

It’s more than two years since we were first confronted with a new pandemic. There have been very difficult times and less difficult times, but most of us have reached the point where we want this whole COVID thing to be over. But COVID will most likely be with us forever and we need to learn how to deal with it.

People have started to act more “normally” in the past few months because the number of COVID cases and deaths has been decreasing and the number of vaccinated people is high. Unmasked is the more common attire these days and it scares me.

Local Pharmacies Are Losing The Battle

The town of Brattleboro recently lost one of its only two remaining local pharmacies not owned by national chains. Small independent pharmacies will soon become dinosaurs in an industry whose operations are convoluted and opaque.

I would like to explain why this problem exists but it is so complicated that it would take volumes to scratch the surface. A simple explanation might be helpful. The problem for small pharmacies is that their profit margins have been reduced to three or four percent in many cases. That is an unsustainable business model and something that keeps independent pharmacy owners awake at night.

Is Insurance Company Long Term Stability More Important Than The Financial Stability of Seniors?

The February 19 edition of the Vermont Business Magazine carried a piece written by Dawn Schneiderman, Vice President and Chief Operating Officer for Blue Cross and Blue Shield of Vermont, claiming that if Vermonters are allowed to enroll in Medicare supplemental plans after their initial six month eligibility period costs will rise for everyone else. She does a poor job of defending her position.

To make this issue real look at the current cost of a Vermont Medigap Blue Plan G policy for someone initially enrolling during the initial six month window. It will cost that person $152.33 a month. If that person wants to enroll in that same plan after the six month window it will cost them $268.91 for the same coverage under Vermont Blue 65 Plan G.

Brattleboro Walk-In Clinic Providing Primary Medical Treatment at No Charge to Persons Ages 18-64

A reminder that the Brattleboro Walk-In Clinic is open Tuesday evenings with sign-in from 5:00 – 6:30 PM. We’re a non-profit that provides primary medical treatment to persons ages 18-64 in our community, thanks to a pool of volunteer physicians, nurses, nurse practitioners, and receptionists.

Even if you have health insurance, you may hesitate to get medical care because your policy has high deductibles or co-pays. Remember that the Brattleboro Walk-In Clinic does not charge our patients for the medical care we provide.

The Continuing Threat To Medicare

A few months ago I talked about a threat to the traditional Medicare program beyond the threat that Medicare Advantage poses to the public nature of the program. That threat is called Direct Contracting Entities (DCEs).

The Trump administration initiated the DCE change to push Medicare in the direction of privatization. That kind of move is going to chip away at the equality and near-universal access that Medicare offers because private insurance companies will be more in control of how health care is delivered and paid for.

Politics Before Science

There was a time when scientists would err on the side of caution and make decisions based on the best outcome for the most people. In the case of how long to isolate or quarantine after a positive test for COVD-19, the CDC has caved-in to politics and shortened the isolation period to five days.

If you look at the science and try to examine all of the available information it is clear that five days is not enough to provide safety to people you come in contact with. The CDC does suggest that after five days of isolation an infected person get re-tested and then wear a mask for another five days. That is almost a concession to the fact that there is a high likelihood they can transmit the virus beyond five days.

Which Test When

People are flocking to testing sites to find out if they have COVID. That is a good thing and it means that a good number of people are taking responsibility for their safety and the safety of others. But when it comes to testing, there are options and it can be difficult to decide when to get tested and which test is best under certain circumstances.

The state of Vermont made over 300,000 rapid diagnostic testing (RDT’s) kits available a few days ago and they were grabbed up within a short period of time. Before people use them it would be a good idea to do some research and find out how to use the kits and when to use them. I will be getting some and I hope the instructions in the kits are useful.

The Nursing Shortage Needs New Solutions

News reports during our times with COVID point to a worsening of a nursing shortage. Clearly, the epidemic has made the shortage worse because of a host of problems, not the least of which is burnout. But the nursing shortage has been with us, and the rest of the world, for a very long time and there are no signs of it letting up anytime soon.

When I was in nursing school in the late 1970’s we were told there would always be a job for us and that the demand for nurses was greater than it had ever been. Things have not changed much in all these years and politicians, nursing leaders and policymakers have been pointing to the problem for just as long. The situation never seems to get any better.

Masking Smartly Makes A Difference

Are people who are getting infected and re-infected with COVID using masks? Are they using masks correctly? When we hear about numbers of cases or individual cases there does not seem to be any reporting about mask use. This got me to wondering if people who use masks are using them to maximum benefit.

I have read a number of peer-reviewed medical journal articles and I also looked at data from the CDC and the EPA(Environmental Protection Agency) to determine the most effective masks and how they should be used.

COVID’S Bigger Lessons

It is two years since the emergence of the first versions of the COVID virus. The world was slow to figure out what was going on and even slower to figure out ways to deal with this new deadly disease. Despite all of the technology and science that we have developed over the years, COVID continues to make fools of the humans who are trying to beat it.

On the surface it may seem that the best way to contain COVID and to make it less of a threat to humans is to develop effective vaccines and get those vaccines to as many people as possible. It sounds like a simple plan and it makes sense from a scientific perspective.

False Hope and Deadly Consequences

Just when it seemed that the validity of science was gaining credibility among the masses the story of Aducanumab (Aduhelm) shows that profit still rules. Aducanumab is a drug that claims to slow the progression of Alzheimer’s Disease.

The Federal Drug Administration (FDA) approved the drug in June despite the fact that an advisory committee of experts outside of the FDA, as well as many Alzheimer’s specialists, said that that it was not clear if the drug provided benefit to patients. They noted that the drug presented a high level of risk because of serious side effects.

Are Vermont’s Hospitals Capable of Big Changes?

The Green Mountain Care Board, the entity that oversees and regulates Vermont’s health care system, commissioned a consultant’s report, “Green Mountain Care Board: VT Hospital Quality Review and Capacity Planning in Preparation for Value-Based Care October 27, 2021” to point the way for long-overdue systemic reform. Hospitals do not take kindly to being told what to do. They have become institutions that have been resistant to big change because of the power they wield in local communities. But pressure is mounting for real change. That is what this report points out.

We hear talk about the high cost of health care and about how something needs to be done. The only way this country is ever going to control health care costs is for there to be bold change and bold change in not something hospitals are good at. The consultant’s report calls for bold change.