ageism, Charlson Comorbidity index, comorbidities, Coronavirus, COVID-19, First they came for, Healthcare, Italy, medical shortage, New York, New York Presbyterian, Prince Charles, Queen Elizabeth, Queen of England, triage, UK, ventilators
Britain’s Prince Charles tested positive for Coronavirus. They say he’s doing fine. However, if he were to worsen and get Coronavirus pneumonia does he have his own ventilator? He’s 71 years old. Will he be denied care due to age? And the Queen? In triage systems age appears to be considered a “comorbidity”.
“UK health minister Matt Hancock has acknowledged the existing stock of 5,000 ventilators is inadequate… About 50% of those with coronavirus in Italy accepted into intensive care units are dying, compared with typical mortality rates of 12% to 16% in such units. Wieland said a similar outbreak in Britain, now with more than 2,600 cases and about 100 deaths, would swamp the system there, too. “They are not well equipped with ventilators and intensive care stations,” he said. “They invested very little, and I think now they will pay the price.” See: “UK faces ‘massive shortage’ of ventilators – Swiss manufacturer” By John Miller, Reuters, March 18, 2020 http://archive.is/dZUQE
Right now some parts of Italy reportedly only give ventilators to those 60 and under. New York favors those 17 and under in their triage system. With dire shortages the age may keep dropping.
People need to think: First they left the 80 year olds to die and you said nothing because you weren’t 80; then they left the 70 year olds to die and you said nothing because you weren’t 70; then they they left the 60 year olds to die and you said nothing because you weren’t 60 — when they leave you to die, there may be no one left to speak up. We fear that there may be “mercy” killings of the elderly, as happened at Memorial Hospital during Katrina, as well. What’s the point of paying into a medical system that does not plan and fails you when you need it the most? Remember that Italy and the UK have “socialized medicine”. At issue is lack of planning, not type of system.
From VOA News:
Britain’s Prince Charles Tests Positive for Coronavirus
By VOA News
Updated March 25, 2020 08:30 AM
Britain’s Prince Charles has tested positive for the coronavirus.
A statement Wednesday said he “has been displaying mild symptoms” but is otherwise in good health.
His wife, Camilla, tested negative for the virus.
The couple are in self-isolation at a home in Scotland.
The statement said it is not possible to determine how the prince was infected given the large number of engagements he attended in recent weeks.
A royal source said the 71-year-old prince received the confirmation on Tuesday after being tested the day before.
Prince Charles, the oldest son of Queen Elizabeth, last saw his mother on March 12, prior to the earliest time he would have been able to expose others.
Buckingham Palace said, “Her Majesty the Queen remains in good health.” The queen is 93 years old.”
One region of Italy cited the “Charlson Comorbidity Index”, in plan to deny care. It is unclear if Dr. Charlson approves of this sort of use. Its use appears to have changed over time. She is currently “the Chief of the Division of General Internal Medicine at Weill Medical College of Cornell University/New York Presbyterian Hospital.” https://archive.li/qHk31 Why Presbyterians need a hospital, if Calvinists “don’t die before their time”, remains an abiding mystery. They should donate their ventilators to other non-Calvinist hospitals.
“Italians over 80 ‘will be left to die’ as country overwhelmed by coronavirus: Hardest-hit region drafts new proposals saying who will live and who will die” By Erica Di Blasi, TURIN, 14 March 2020 • 4:38pm, The Telegraph: http://archive.is/z2u1I
The version of the Charlson Comorbidity Index Mentioned in the article says that the number must be less than five. According to Chang et al., age is a “comorbidity”: “For each decade after 40 years of age, a point is added until 4 points (1 point for age 41–50, 2 points for age 51–60, 3 points for age 61–70, 4 points for 71 years of age or older).” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744039 Italy appeared to have added an additional point for 81 and up to make the total five.
References mentioned by the calculator
Charlson ME, Pompei P, Ales KL, MacKenzie CR. (1987) “A new method of classifying prognostic comorbidity in longitudinal studies: development and validation“.J Chronic Dis; 40(5):373-83.
Frenkel WJ, Jongerius EJ, Mandjes-van Uitert MJ, van Munster BC, de Rooij SE. (2014) “Validation of the Charlson Comorbidity Index in acutely hospitalized elderly adults: a prospective cohort study“.J Am Geriatr Soc; 62(2):342-6.
Charlson M, Szatrowski TP, Peterson J, Gold J. (1994) “Validation of a combined comorbidity index“. J Clin Epidemiol; 47(11):1245-51.
Chang CM, Yin WY, Wei CK, Wu CC, Su YC, Yu CH, Lee CC. (2016) “Adjusted Age-Adjusted Charlson Comorbidity Index Score as a Risk Measure of Perioperative Mortality before Cancer Surgery“. PLoS One; 11(2): e0148076.