Leaked Draft Letter Reveals Michigan Hospital’s Policy to Ration Ventilators for Coronavirus Patients

People are tested for coronavirus at the Arab Community Center for Economic and Social Services (ACCESS) center in Dearborn, Michigan on March 26, 2020. - The US was quickly becoming a new epicenter of the global coronavirus pandemic Thursday as new infections soared and unemployment claims skyrocketed to a historic …

By Rebecca Mansour – 27 Mar 2020

A draft letter by one of southeast Michigan’s major hospital systems was leaked online Thursday revealing the hospital’s policy to prioritize care for “patients who have the best chance of getting better” in the event of a shortage due to the coronavirus pandemic.

The letter was drafted by officials at the Henry Ford Health System and is addressed to “our patients, families and community.” It outlines the criteria for which patients will be eligible for care if the hospital reaches capacity and is forced to ration limited resources. “Patients who have the best chance of getting better are our first priority. Patients will be evaluated for the best plan of care and dying patients will be provided comfort care.”

The letter explains the policy in the event of a shortage of ICU beds and ventilators: “If you (or a family member) becomes ill and your medical doctor believes that you need extra care in an Intensive Care Unit (ICU) or Mechanical Ventilation (breathing machine) you will be assessed for eligibility based only on your specific condition.”

Some of the conditions that may make a person ineligible are listed as “severe heart, lung, kidney or liver failure; Terminal cancers; Severe trauma or burns.”

A statement issued Thursday night by Dr. Adnan Munkarah, executive vice president and chief clinical officer of Henry Ford Health System, confirmed the authenticity of the draft letter, but stressed that it reflects a “worst case scenario.”

“With a pandemic of this nature, health systems must be prepared for a worst case scenario,” Munkarah said. “Gathering the collective wisdom from across our industry, we carefully crafted our policy to provide critical guidance to healthcare workers for making difficult patient care decisions during an unprecedented emergency.”

He added, “These guidelines are deeply patient focused, intended to be honoring to patients and families. We shared our policy with our colleagues across Michigan to help others develop similar, compassionate approaches. It is our hope we never have to apply them and we will always do everything we can to care for our patients, utilizing every resource we have to make that happen.”

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The draft letter was leaked online Thursday when Nicholas Bagley, a University of Michigan law professor, tweeted out an image of the letter on what appeared to be official hospital letterhead.

The full contents of the letter was printed by the Detroit Free Press (emphasis in original):

To our patients, families and community:

Please know that we care deeply about you and your family’s health and are doing our best to protect and serve you and our community. We currently have a public health emergency that is making our supply of some medical resources hard to find. Because of shortages, we will need to be careful with resources. Patients who have the best chance of getting better are our first priority. Patients will be evaluated for the best plan of care and dying patients will be provided comfort care.

What this means for you and your family:

1. Alert staff during triage of any current medical conditions or if you have a Do Not Resuscitate (DNR)/Do Not Attempt Resuscitation (DNAR) or other important medical information.

2. If you (or a family member) becomes ill and your medical doctor believes that you need extra care in an Intensive Care Unit (ICU) or Mechanical Ventilation (breathing machine) you will be assessed for eligibility based only on your specific condition.

3. Some patients will be extremely sick and very unlikely to survive their illness even with critical treatment. Treating these patients would take away resources for patients who might survive.

4. Patients who are not eligible for ICU or ventilator care will receive treatment for pain control and comfort measures. Some conditions that are likely to may [sic] make you not eligible include:

  • severe heart, lung, kidney or liver failure
  • Terminal cancers
  • Severe trauma or burns

5. Patients who have ventilator or ICU care withdrawn will receive pain control and comfort measures.

6. Patients who are treated with a ventilator or ICU care may have these treatments stopped if they do not improve over time. If they do not improve this means that the patient has a poor chance of surviving the illness — even if the care was continued. This decision will be based on medical condition and likelihood of getting better. It will not be based on other reasons such as race, gender, health insurance status, ability to pay for care, sexual orientation, employment status or immigration status. All patients are evaluated for survival using the same measures.

7. If the treatment team has determined that you or your family members does not meet criteria to receive critical care or that ICU treatments will be stopped, talk to your doctor. Your doctor can ask for a review by a team of medical experts (a Clinical Review Committee evaluation.)

Michigan has become an emerging hot spot for the coronavirus pandemic in the United States. The state’s top health official, Dr. Joneigh Khaldun, said hospitals in southeast Michigan are “at or near capacity.”

The Henry Ford Health System is one of the major hospital providers in the Metro Detroit area, along with the William Beaumont Health System. Both providers have said they were caring for more than 1,000 COVID-19 patients at their 13 hospitals. Due to the sudden surge, operating rooms were being converted into intensive care units, and clinics had been turned into rooms for patients needing other medical care.

On Wednesday, Beaumont Health said its hospitals were swamped with 650 patients who had tested positive for the COVID-19 virus and more than 200 with tests pending. It said it would transfer more people to its hospital in Wayne County and get help from other health care providers.

“The number of patients coming to our emergency rooms continues to grow rapidly,” Beaumont CEO John Fox said.

Fox told the Detroit Free Press on Wednesday that the pandemic is proving to be healthcare providers’ “worst nightmare,” noting that Beaumont is admitting 100 new coronavirus patients per day, at that time.

“What we all need to remember is that we got our first patient two weeks ago. So this is coming on hard and fast. This is definitely a biological tsunami,” he said.

“In my lifetime, we’ve never had a pandemic like this,” Fox said.

“Across our system, we are facing limitations and nearing capacity with our staffing, personal protective equipment, and mechanical ventilators,” said Beaumont’s chief operating officer Carolyn Wilson.

“The numbers are changing and increasing even in two-hour intervals,” said Bob Riney, the chief operating officer at Henry Ford, whose flagship hospital is in the city of Detroit.

Dr. Betty Chu, the chief clinical officer and chief quality officer at Henry Ford, predicted an “upcoming surge.” Chu noted that the hospital was already reallocating resources because the Henry Ford hospitals in West Bloomfield and Detroit have reached capacity due to COVID-19 patients.

“Today our capacity is quite full at those two hospitals — West Bloomfield and Henry Ford Hospital in Detroit,” Chu said Wednesday. “We fortunately have the luxury right now of having additional capacity at some of our other campuses.”

On Wednesday, Mary Macdonald, an Oakland County ER nurse, posted a viral video on Instagram detailing the harrowing conditions at southeast Michigan hospitals where medical staff are combating shortages of essential supplies and equipment to care for this surge of coronavirus patients.

“It’s getting to the point now that it’s going to be just like Italy,” Macdonald said. “From 10:00 PM last night to this morning, we intubated two of my patients within a half-hour. And upwards of 10 patients were put on ventilators. My patient took the last ventilator available in the hospital,” she said.

“Normally, if a patient was to pass away, it would be because we tried everything that we could, we did everything that we could, we had all the resources and all the people that we needed to help save this patient’s life, and it was just their time. And now we aren’t giving the patient the time to choose whether it’s their time or not. We’re choosing for them,” she said.

Macdonald also noted that the hospital is short of even basic supplies.

“Resources are very slim. We have no medications to keep these patients even ventilated, let alone ventilators,” she said, adding that they are out of medications like propofol to keep people sedated when they are intubated. She said they are even running out of Tylenol.

“There are no masks. There are no gowns. They’re running low on gloves because everyone has panicked and stockpiled this, so that medical staff doesn’t have it,” she said and then showed the disposable N95 mask she was required to stow in a brown paper bag after every workday to be reused for the rest of the year.

Macdonald urged her fellow Michiganders to take the social distancing instructions seriously in order to protect themselves and their neighbors from spreading the virus, otherwise the overwhelmed hospital system won’t be able to care for all the sick.

“We don’t have any ventilators to put these patients on,” Macdonald stressed. “So, we’re going to start making life or death decisions in regards to people’s care. So you’re going to come in and you’re going to get tagged whether you [are] deem[ed] necessary to even get intubated or are you being sent home to die. This is truly scary, and nobody is taking it seriously.”

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Khaldun, the chief medical office for Michigan’s Department of Health and Human Services, said the state is “probably a few weeks out” from hitting a peak in coronavirus cases. Michigan reported nearly 2,900 cases by Thursday and 60 deaths, both an increase of Wednesday’s statewide numbers.

Wayne County, home to Detroit, accounted for nearly half of the cases. Dr. Deborah Birx, the White House coronavirus response coordinator, called Wayne a “hot spot” nationally and said she was concerned the county was “having a more rapid increase.”

Southeast Michigan, like New York City, is a hub for international travel. As the capital of the world’s auto industry, Metro Detroit has daily direct flights to and from major cities in Europe and Asia.

Although the virus is hitting the entire metro area hard, the city of Detroit is uniquely vulnerable to the pandemic. Despite its dramatic economic rebound in recent years after its municipal bankruptcy in 2013, the city is still one of the poorest in the nation, with a poverty rate three times higher than the national average, and the city’s population suffers in greater numbers from underlining conditions like diabetes and heart disease.

“Part of what we’re seeing in Detroit is that there’s such a high number of individuals who have those underlying conditions, who have diabetes and the heart disease, who may have obesity,” Khaldun explained.

On Tuesday, Marlowe Stoudamire, 43, one of the young entrepreneurs involved in rebuilding the city, died from complications from COVID-19. According to health officials at Henry Ford Health System, Stoudamire had “no known underlying health conditions or recent travel.”

The city of Detroit’s police force has also been hit especially hard by the coronavirus pandemic, as 331 Detroit officers and 70 civilian police employees have been quarantined since the outbreak, and two members of the force have died this week due to COVID-19.

The Associated Press contributed to this report.

TEXAS ORDERS 14-DAY QUARANTINE FOR NY-NJ-CT & NEW ORLEANS TRAVELERS

Texas Orders 14-Day Quarantine For NY-NJ-CT & New Orleans Travelers

The Big Apple is Coronavirus epicenter of the US, with cases flaring up in New Orleans as well

By Kit Daniels – March 27, 2020

Texas is now requiring air travelers from Coronavirus hotspots to quarantine for 14 days.

Gov. Greg Abbott has ordered travelers from New York, New Jersey and Connecticut – the tri-state area around New York City – and from New Orleans to isolate themselves for no less than 14 days and may only have direct contact with health care providers.

Abbott’s executive order came in response to White House recommending anyone who just visited the New York City area to self-quarantine as the Big Apple is Coronavirus epicenter of the US.

“Every person who enters the State of Texas as the final destination through an airport, from a point of origin or point of last departure in New York, New Jersey, Connecticut, or the City of New Orleans, or in any other state or city as may be proclaimed hereafter, shall be subject to mandatory self-quarantine for a period of 14 days from the time of entry into Texas or the duration of the person’s presence in Texas, whichever is shorter,” Abbott declared.
“This order to self-quarantine shall not apply to people traveling in connection with military service, emergency response, health response, or critical-infrastructure functions, as may be determined by the Texas Division of Emergency Management.”

“Each person covered under this order to self-quarantine shall be responsible for all associated costs, including
transportation, lodging, food, and medical care.”

Affected travelers are to notify the Texas Dept. of Public Safety of their quarantine location upon disembarking from their flight, the executive order added.

A order will likely to reduce air travel severely from these areas.

Leftist Journo Takes Pleasure In US Becoming Worst Hit Coronavirus Nation: ‘Who’s The S***hole Country Now?’

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“If you needed anymore evidence these people hate America.”

By Steve Watson

A leftist columnist seemingly took pleasure in the fact that the US has become the country with the most confirmed cases of coronavirus by mocking President Trump and proclaiming “Who’s the shithole country now?”

Julia Ioffe, who writes for GQ, tweeted out the inane comment along with a link to a New York Times story on the development.

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Of course, Ioffe provided no salient facts or useful information, such as President Trump’s assertion that the spike in confirmed cases is down to more robust testing being rolled out.

Nor did Ioffe indicate that in comparison with other hard hit countries, the mortality rate in the US stands at 1.5%, which equates to much fewer deaths per confirmed cases than Italy (10%), Spain (8%), Iran (7.6%) and France (6%).

No, Ioffe simply wanted to vent her pent up Trump derangement syndrome.

Americans are not amused:

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Italian Mayor Threatens to Send “Police With Flamethrowers” to Break Up Graduation Parties

Some continue to ignore social distancing rules.

By Paul Joseph Watson – 26 March, 2020

An Italian mayor has threatened to send police armed with flamethrowers to break up graduation parties as some people continue to ignore social distancing rules despite a nationwide lockdown.

“I’m getting news that some [people] would like to throw graduation parties,” said Vincenzo De Luca, mayor of the Italian town of Campania. “We will send police. With flamethrowers.”

Meanwhile, Massimiliano Presciutti, the mayor of Reggio Calabria, accused some Italians of behaving as if they were in the dystopian sci-fi movie I Am Legend by walking their dogs too much.

“Where the f*** are you all going? You and your dogs… which must have an inflamed prostate?” asked Presciutti.

The mayor said he had personally confronted one such individual.

“I stopped him and said, ‘Look, this isn’t a movie. You are not Will Smith in I Am Legend. Go home.”

Antonio Tutolo, the mayor of Lucera, also slammed people for arranging for mobile hairdressers to visit their homes.

“Getting in mobile hairdressers? What the f*** is that for? Who the f*** is supposed to even see you with your hair all done in a casket? Do you understand the casket will be closed?” he said.

At least 40,000 people were fined for being outside without good reason during the first week of the lockdown in Italy, with some facing 21 years in prison.

“Even gatherings like funerals have also been banned,” reports Zero Hedge. “At least 50 people in Sicily are facing serious criminal charges after breaking the quarantine order after having a funeral for a loved one.”

Meanwhile, across Europe, one particular demographic appears to be paying no attention to lockdown laws whatsoever – migrants.

Wicked, Immoral Woman: Pelosi Tried to Ram Illegal Ballot Harvesting into Coronavirus Stimulus Bill

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By Jim Hoft – March 26, 2020

For Speaker Pelosi, it was never about helping people. It was only about power.

Speaker Nancy Pelosi tried to ram illegal voter harvesting into the $2 trillion coronavirus stimulus bill.

The illegal ballot harvesting provision was removed from the final package but only because Pelosi got caught.
What an evil, wicked woman.

Democrats know cheating by voter harvesting works.
The Democrat Party flipped 7 of 14 Republican House seats in California in 2018 thanks only to voter harvesting tactics.

Ballot harvesting is illegal in most states. In Texas, New York and Pennsylvania they arrest people for ballot harvesting.
Pelosi wants to make to stuff this into the coronavirus stimulus plan.

The Daily Caller wrote about ballot harvesting in 2018.

Passed as a barely noticed change in the state’s vote by mail procedures in 2016 and signed by then-Governor Jerry Brown, California’s AB 1921 allows voters to give any third party — not just a relative or someone living in the same household, as was previously the law — to collect and turn in anyone else’s completed ballot.

Called “ballot harvesting,” critics say the practice is ripe for fraud. Consider “Lulu,” who was recorded trying to “harvest” what she thought was a Democratic voter’s ballot in Rep. Knight’s district.

 

Army Asks Retired Soldiers in Health Care Fields to Come Back for COVID-19 Fight

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By Hodge Seck

The Army has a message for its retirees: Uncle Sam wants you to help fight the novel coronavirus.

A message sent by Defense Finance and Accounting Services, which processes and dispenses retiree pay, asked troops who had previously served in specific health care specialties to consider “re-joining the team” to address the current pandemic crisis. It’s signed by Lt. Gen. Thomas Seamands, deputy chief of staff for U.S. Army Personnel, G-1.

“We need to hear from you STAT!” reads the message, obtained by Military.com.

The Army, it states, is gauging the interest of retired officers, noncommissioned officers and more junior enlisted soldiers in assisting service efforts to treat the sometimes-deadly disease. The message does not specify whether retired troops would be returned to active status or serve in some other capacity.

“These extraordinary challenges require equally extraordinary solutions and that’s why we’re turning to you — trusted professionals capable of operating under constantly changing conditions,” the message states. “When the Nation called — you answered, and now, that call may come again.”

The call was addressed to retirees from the following health care-specific military occupational specialties:

  • 60F: Critical Care Officer

  • 60N: Anesthesiologist

  • 66F: Nurse Anesthetist

  • 66S: Critical Care Nurse

  • 66P: Nurse Practitioner

  • 66T: ER Nurse

  • 68V: Respiratory Specialist

  • 68W: Medic

The message came with a caveat: retired personnel now working in a civilian capacity in a hospital or other medical facility should make that known. Army officials said they did not want to pull personnel from service they were “providing to the Nation” in that role. They added that former soldiers from a different specialty who were interested in supporting Army efforts should also reach out to communicate that interest.

The call-out directed interested retirees to contact Human Resources Command, Reserve Personnel Management Directorate at Fort Knox, Kentucky, providing contact info and MOS.

As of Wednesday, the Pentagon reported 227 cases of Coronavirus among U.S. troops and 435 total among Defense Department-connected personnel. U.S. cases on Wednesday passed 64,000.

This week, the Pentagon announced that military medical and dental treatment facilities would postpone the majority of elective surgeries, dental procedures and invasive procedures for 60 days as it shifts most resources to fighting the pandemic. A massive relief package moving quickly through Congress Wednesday would triple the number of hospital beds available at these facilities and give the DoD $1.5 billion to open expeditionary military hospitals.

The call to retirees also comes on the heels of a recommendation from the National Commission on Military, National and Public Service for the creation of a “critical skills Individual Ready Reserve” that would serve essentially as a roster of qualified individuals in high-demand fields, likely including health care, on standby to support the Defense Department in times of national emergency. It’s one of 164 recommendations that will be considered by Congress in coming months.

The U.S. Selective Service System also owns a yet-to-be activated standby plan known as the Health Care Personnel Delivery System, colloquially known as the “doctor draft,” that would “provide a fair and equitable draft of doctors, nurses, medical technicians and those with certain other health care skills if, in some future emergency, the military’s existing medical capability proved insufficient and there is a shortage of volunteers.”

That proposed mechanism, however, is designed for use only in wartime and in connection with a broader national mobilization effort, with the approval of Congress and the president.

In a briefing at the Pentagon Wednesday, Air Force Brig. Gen. Paul Friedrichs, Joint Staff surgeon, said he felt generally comfortable that the U.S. military had the resources it needed to continue to fight the virus.

“I’m very comfortable that we’ve analyzed the communities where we have military bases. We’ve looked at what we think their medical requirements would be when an outbreak occurs or if an outbreak occurs in that community,” he said. “Do we have enough health care resources there? Is it the right mix of health care resources? That’s then allowed us to identify what medical capabilities from the military we can offer to help support the whole of government, or to support combatant commands in other parts of the world.”

Interested retirees can contact Human Resources Command, Reserve Personnel Management Directorate, at usarmy.knox.hrc.mbx.g3-retiree-recall@mail.mil or call 502-613-4911.

WATCH: Huge Detroit Gang Fight Occurs in Streets Amidst Coronavirus Lockdown

There was some wildin’ in the Detroit streets on Sunday.

By Shane Trejo – 3/23/2020

A huge fight took place on the streets of Detroit on Sunday with over one hundred residents engaging in the massive skirmish that is the latest stain on the beleaguered and desolate town.

The video of the proceeding can be seen here:

The video has garnered a great deal of shock as Michigan attempts to maintain social distancing and take other precautions to stop the spread of Chinese coronavirus. Even individuals who attended the melee were making exasperated comments about the shameful, violent ordeal.

“What in the corona and boxing is going on here?” the individual shooting the video said.

Everyone seemed befuddled about the reasoning behind the fight, which apparently happened for no good reason.

“This is some kind of rivalry,” a man in the video said. “I mean the whole street.”

“We’re supposed to be quarantined and we’re out here watching a gd*** boxing match on the street … quarantine and fight,” said the videographer.

“This why school needs to be still goin on,” an individual wrote in response to the video on Facebook.

Meanwhile, Democrat Governor Gretchen Whitmer announced a mandatory lock-down throughout the entire state on Monday, with all “non-essential” businesses being forcibly closed. It is expected to be in effect for at least three weeks.

“You can go outside. Get some fresh air, walk your dog. Just be smart about it. Maintain that 6-foot distance,” she said on Monday.

“Let me give you a little perspective here,” she added. “We have about 25,000 acute care beds in Michigan. … That means without aggressive additional measures, more people will get sick, more people will die and our economy will suffer longer.”

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“On a personal note I know the lack of control can be disorienting, so I urge you to focus on what you can control,” Whitmer said while addressing the public. “This crisis can take a toll on your mental health. Check in with family, call your loved ones, go for a walk, read those books on your list, even go outside and put your holiday lights back up.”

“We must keep our wits about us. That means all of us. Be sensitive to how our kids are feeling. They are not immune to the stress of this environment. Check in with them and help them understand, and give them the reassurance that they need,” she added.

These irresponsible Detroit residents, by wildin’ out on the streets during a pandemic, have given the Democrat governor the excuse she needed for another unconstitutional power-grab using coronavirus as the pretense.

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