After lobbying from Washington state officials, the Trump administration decided on Monday to issue an unprecedentedly broad order allowing hospital emergency rooms nationwide to divert patients away from their wards.
It was that no good west coast state that applied for this, so ignore it. Things get real in the power centers of the east coast and all of a sudden they start paying attention.
I would tend to trust the Washington state officials on this. It’s a major move, and of course we fear what the maladministration might do in the future, but if WA is asking for it, I’ll err on the side of trust.
There is a really valid financial reason for the basic rule, but in the pandemic there is a more important reason for the waiver. I am glad to here they are being proactive.
It’s getting real for the feds. And by feds, I mean the president. 
Wonder if this is going to conveniently remain in place if/when the Trump Pandemic subsides.
They have excellent leadership with Inslee:
Washington Gov. Jay Inslee is what real coronavirus leadership looks like
While necessary, what about those who have no health care options? No insurance or the homeless?
Diverting is only workable as long as the local medical system can divert them to a reasonable and equal alternative.
While we are all practicing distancing, etc., the curve will not flatten if those most at risk don’t have health care alternatives.
It may be up to us to make sure if ER’s in our own communities divert, there is a true alternative. Doctors won’t allow refusing care, but it will be up to local officials to think this through for all.
The only financial consideration that led to EMTALA was ERs at private hospitals avoiding the cost of treating uninsured emergency cases by dumping them on public hospitals. The current waiver was not triggered by financial concerns, it is meant to deal with ER overload.
The GOP hates EMTALA so I think your concern is valid at least until we replace the current occupant.
…retroactive effective date of March 1, 2020 through the end of the emergency declaration.
“You’re the mayor of Covid-19 City…They think YOU want the beaches (read Disease Pathways) OPEN!!”
The Emergency Medical Treatment and Labor Act was introduced because hospitals did such a poor job of policing themselves against patient “dumping”. In general, it has worked well.
Under the present situation, it is a hindrance. Take a recent I saw- patient “X”- a real person I saw last week. “X” called 911- “eeling anxious” about maybe having exposure to COVID19 but is otherwise without complaint. First responders were first on the scene followed by 2 paramedics and she was transported to the ER. “X” was seen by a check-in person and a triage nurse and directed to the ER. because of EMTALA not because of any medical emergency.
“X” consumed a crucial first responder team, an ambulance, an ER bed, an ER nurse and an ER physician. Her anxiety burned through a dozen sets of PPE.
With EMTALA suspended that person could have been re-directed to a telemedicine consult by the 911 dispatcher. She could have been evaluated at home.
In many cases in this pandemic the Feds need to get the fuck out of the way.
The major case where they’re needed is making sure a coming vaccine is safe and effective.But shilt like saying ya cannot use a mask because the label says it’s out of date is bullshit wasteful and costing lives.
So, when is the next trump dog n pony show lie spew supposed to happen?.. I wanna be sure to miss it.
this is a worldwide problem. countries need to be working together and with nationwide solutions not municipal or statewide guidelines. India is on the front end of the virus curve. they are in for a world of hurt.
Repost from Fauci thread
Just dove in the twitter thread that Josh referred to in his latest Edblog on rosy scenarios…
They assume Wuhan social distancing response for measures that are not even close…
The curves appear to be the confidence interval on the best-case scenario…
I wish I had the shit they are smoking in my steadily dwindling stash…
https://twitter.com/MaxCRoser/status/1243839603708252161/photo/1
and the link itself
The directions to go to the ER to get tested were repeated over and over. This is what drive through testing would be most useful for. If we had any tests, I mean.
I am a paramedic.
I’m pretty happy about this, hopefully it will mean dispatch can finally start telling the 911 callers with chief complaints of “My foot has been hurting for 3 days and I want to go to the ER” at 3am, “I’m sorry but that is not a medical emergency and we will not be dispatching an ambulance. Please contact your PCP or an Urgent Care in the morning.”
We’re stretched thin, have limited equipment and PPE and people are still calling for ambulances because they think “I’ll be seen quicker”. And now we get “I’ll definitely get a COVID test if I come in by ambulance, right?”
