科学的扭曲以抑制采用传染病策略

2020年,一些政府无视自己的医疗保健建议,在美国,高级官员公开炫耀了面具的戴面具,这对他们对危机的反应产生了什么影响?在这个博客中,Kevin Kavanagh博士扩展了他的最近的报告讨论该国如何到达现在的位置,以及要摆脱这种情况需要做什么。

科学对政治和经济目的的扭曲已经阻止了所需资源的分配,以阻止危险病原体的传播。这使整个社会都处于危险之中,但对我们的一线医疗工作者以及我们最脆弱的人口造成了无法忍受的死亡和残疾造成的损失。Covid-19证明了这种情况变得多么危险。

We have seen United States top officials publicly flaunt the wearing of masks and use substandard infection control practices. A super-spreader event was even created at the White House’s Rose Garden when rapid testing was used to prevent the spread of SARS-CoV-2. This type of test is known for high false negatives especially with trying to detect asymptomatic carriers. And a security guard for the president was seen wearing an N95-mask with an exhalation value, a setup for spreading the disease.

这种缺乏基本防护装备的影响可能永远不会知道,因为没有人会在前线工人中计算SARS-COV-2感染和死亡。

There also have been reports that the federal government has impeded or mitigated CDC recommendations for cruise ship无销订单, and to pressure the CDC regarding学校开放。Having consistent scientifically based messaging on a national level is of utmost importance. The messaging in the United States can be characterized as nothing short of bizarre.

CDC具有翻动- 流行关于使用的指导masks关于公共交通,无症状携带者的测试,并且迟到了强调用病毒气溶胶传播的重要性 - 我们太多的建筑物不健康。需要进行重大的基础设施变化,以允许适当的社会距离,通风增加和空气消毒。基础设施升级很昂贵,到目前为止,美国还没有实现这些变化的政治意愿。

不用说,这是警告说,放弃基于科学证据的建议几乎阻碍了美国有效的公共卫生反应。

对于许多患者来说,捕获SARS-COV-2的最大机会是在入院的那天,因为被放置在刚翻转过的房间里,并可能穿过急诊室进行初步治疗

卫生保健工作者和患者安全至关重要
美国反应最糟糕的方面之一是未能提供足够的人员保护设备(PPE)。美国联邦政府尚未调用《国防生产法》to assure an adequate supply of N95-masks for our workers. These masks require a key ingredient ‘melt blown textile’ which is difficult to manufacture. Relying solely on the free market is ill-advised since, similar to the N1H1 pandemic, industry is reluctant to retool for manufacture when they may not recoup their startup costs. This reluctance has its roots in the ideology and the desire of leaders not to create excess mandates and government overreach.

有些人认为,识别气化的延迟是SAR-COV-2的一种主要传播方式,与N95面具的匮乏有关,并且渴望不警告工人。截至撰写本文时,N95面具仍在供不应求。

这种缺乏基本防护装备的影响可能永远不会知道,因为没有人会在前线工人中计算SARS-COV-2感染和死亡。缺乏与工作有关的疾病的强制性报告导致医疗人员报告不完整;死于Covid-19的医疗人员人数可能在752至4000以上。最重要的是,我们需要做得更好。

We have stressed in the past the importance of establishing a surveillance system and regular screening of healthcare workers for endemic dangerous pathogens and those pathogens在设施中经常爆发,包括病原体Cre,Clostridioides difficile,MRSA和SARS-COV-2。

医护人员还需要为自己和家人提供经济和医疗安全网。带薪病假至关重要,因为让医疗保健工作者在患者的安全和将食物放在家人的桌子旁之间做出站不住脚的选择是不道德的。在爆发或大流行期间发生的危险病原体的收购应使工人有资格获得推定的残疾。

此外,没有人在医院环境中计算签约Covid-19的患者。美国卫生与公共服务部SARS-COV-2医院获得感染的定义is unforuntately next to useless; “Total current inpatients with onset of suspected or laboratory-confirmed COVID-19 fourteen or more days after admission for a condition other than COVID-19.” Unfortunately, this definition is next to useless.

病原体不关心政治或个人的需求,而是在基因编程中传播。

对于许多患者而言,捕获SARS-COV-2的最大机会是在入院的那天,因为被放置在刚翻转过的房间里,并可能穿过急诊室进行初始治疗。因此,很少有几个SARS-COV-2 HAI被捕获。最准确的度量是诊断出入院后5天发生的SARS-COV-2采集,包括出院后的情况。该指标将平衡假阳性和负面结果,并可以更好地估计整体系统性能。对SARS-COV-2数据的缓解使人想起过去的大流行,其中国家有很长的历史隐藏了数字,而不是举报它们纠正问题

需要照顾不同的人群,甚至是老年人
Initially, the virus emerged in the northwest region of the United States and devastated Nursing Homes where infectious disease regulations were all too lax. In 2019, the CDC attempted to strengthen infection prevention in nursing homes by enacting the strategy ofEnhanced Barrier Precautions.。“增强”一个欺骗性的词,因为这些预防措施不如接触预防措施严格(这些预防措施是为了控制CDC的“紧急威胁”的碳青霉烯耐药性肠杆菌科(Cre)和Candida Auris和can also be applied to patients colonized with MRSA).建议for Enhanced Barrier Precautions state: “Residents are not restricted to their rooms and do not require placement in a private room.”

增强的障碍预防措施使运营商能够参加疗养院活动,并且只要求医疗保健工人实施高危活动的接触预防措施,但即使是低风险的活动,例如通过药物,也可以经常发生频繁的医疗工人污染

这些预防措施似乎不是基于MDRO的传播方式,而是基于避免更严格和资源强烈的策略。

此类策略将包括:医护人员筛查和大量PPE的可用性,以及确定患者的微生物组,如果存在危险的病原体,非殖民化,以及作为专用设施中具有相似病原体的患者的最后一个度假胜地。病原体不关心政治或个人的需求,而是在基因编程中传播。

结论

Dangerous pathogens are genetically programmed to spread. Strategies need to be based upon the pathogen and not the political expediency of our leaders or to lessen the economic impact on our healthcare system. The COVID-19 pandemic has taught us the need for public support and embracement of scientifically based public health strategies to stop the spread of dangerous pathogens (proper building ventilation, widespread testing, social distancing, wearing masks and hand hygiene). These strategies can be expensive to implement and may cause a severe short-term economic burden but are the fastest path to a full economic recovery.

无论是处理MRSA还是Covid-19,筛查和非殖民化或对医护人员的自我校正至关重要。他们的健康,家庭的健康以及患者的健康。

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