This masterful epic by Comment of the Day auteur Steve-O-From-NJ needs no introduction, so I’m just going to say, here is Steve-O-From-NJ’s Comment of the Day on the post, “Afternoon Ethics Warm-Up, 3/23/2020: Examining The—OH NO! I TOUCHED MY FACE!!”
I just read this on Facebook. Frankly it made me angry, but not for the reasons you might think. I don’t believe for a minute a real doctor wrote this. I have a few comments of my own to add, and then I’ll have more to add at the end.
“CDC recommending hospital staff use bandanas when masks run out. Hospitals are asking the public to sew masks. Here is a physician responding:
“Please don’t tell me that in the richest country in the world in the 21st century, I’m supposed to work in a fictionalized Soviet-era disaster zone and fashion my own face mask out of cloth because other Americans hoard supplies for personal use and so-called leaders sit around in meetings hearing themselves talk. I ran to a bedside the other day to intubate a crashing, likely COVID, patient. Two respiratory therapists and two nurses were already at the bedside. That’s 5 N95s masks, 5 gowns, 5 face shields and 10 gloves for one patient at one time. I saw probably 15-20 patients that shift, if we are going to start rationing supplies, what percentage should I wear precautions for?”
Comment 1: Your job is to save and treat patients, using whatever means necessary. If supplies run out in the middle of something, then you make do until they can get you more. If the single-use nature of things is no longer tenable, then get those that can be used repeatedly until the supplies can be replenished. Oh, and cut the drama. The Soviet Union went out of existence 29 years ago, maybe even before you were born. You don’t know what went on there, except maybe by what you read.
“Make no mistake, the CDC is loosening these guidelines because our country is not prepared. Loosening guidelines increases healthcare workers’ risk but the decision is done to allow us to keep working, not to keep us safe. It is done for the public benefit – so I can continue to work no matter the personal cost to me or my family (and my healthcare family). Sending healthcare workers to the front line asking them to cover their face with a bandana is akin to sending a soldier to the front line in a t-shirt and flip flops.”
Comment 2: You signed on for this. There’s not a single healthcare worker out there who can’t walk away from the job right now, except those in the military. This is the life you chose. The fireman fighting the blaze at 3 a.m., started by a careless squatter, the cop answering the domestic violence call to face some crazy husband with a gun who thinks he has nothing to lose, the coastguardsman pointing his bow into the storm knowing he has to go out, but he may not return, they all signed on for it too. So did the teacher buying supplies out of her own pocket because the budget got cut, the manager who has to find some way to do twice as much with half as much, and the attorney working his third weekend on a trial because it has to get done. They don’t get to complain because their duties ramped up, and neither do you.
“I don’t want talk. I don’t want assurances. I want action. I want boxes of N95s piling up, donated from the people who hoarded them. I want non-clinical administrators in the hospital lining up in the ER asking if they can stock shelves to make sure that when I need to rush into a room, the drawer of PPE equipment I open isn’t empty. I want them showing up in the ER asking “how can I help” instead of offering shallow “plans” conceived by someone who has spent far too long in an ivory tower and not long enough in the trenches. Maybe they should actually step foot in the trenches.”
Comment 3: And I want a trip to Europe, and a Cadillac, and a mansion. Doesn’t mean I’ll get them. Most of all I want this crisis to be over so I can get on with my life. Wanting and demanding do not make it so, and I think if you told any of these people this is what you want, so hop to it, they’ll tell you to go take a run and jump at yourself.
“I want billion-dollar companies like 3M halting all production of any product that isn’t PPE to focus on PPE manufacturing. I want a company like Amazon, with its logistics mastery (it can drop a package to your door less than 24 hours after ordering it), halting its 2-day delivery of 12 reams of toilet paper to whoever is willing to pay the most in order to help get the available PPE supply distributed fast and efficiently in a manner that gets the necessary materials to my brothers and sisters in arms who need them.”
Comment 4: OK, here’s where we seriously take a sharp turn out of reality. Do you really think that Amazon is delivering reams of toilet paper in 2 days to anyone willing to pay? Have you looked? Amazon isn’t doing that, because there’s no toilet paper to be had, and certainly not in 2 days, not even in a week. Neither is there any hand sanitizer, or paper towels, or a host of other things. A lot of ordinary folks are freaked out because they can’t get these basic things and they don’t know when or if they will be able to again. You want to talk about the Soviet era, there it is. Oh, and that’s just ordinary folks. People with young children are going absolutely bonkers because diapers, baby wipes, formula, and a lot of other products critical to infant care and toddler care are just not to be had anywhere. And you want to commandeer manufacture and shipping just for your part of this crisis? Tell that to these folks.
“I want Proctor and Gamble, and the makers of other soaps and detergents, stepping up too. We need detergent to clean scrubs, hospital linens and gowns. We need disinfecting wipes to clean desk and computer surfaces. What about plastics manufacturers? Plastic gowns aren’t some high-tech device, they are long shirts/smocks…made out of plastic. Get on it. Face shields are just clear plastic. Nitrile gloves? Yeah, they are pretty much just gloves…made from something that isn’t apparently Latex. Let’s go. Money talks in this country. Executive millionaires, why don’t you spend a few bucks to buy back some of these masks from the hoarders, and drop them off at the nearest hospital.”
Comment 5: How fast do you think these companies can ramp up or divert production? Do you think that happens overnight? Do you know exactly how these items are made? I’m guessing you don’t. You do your job, and let the manufacturers do theirs, when they can, since every worker is now at risk. Oh, and as for the high level people buying back those masks you are sure are out there, dream on. They are kinda busy overseeing manufacturing.
“I love biotechnology and research but we need to divert viral culture media for COVID testing and research. We need biotechnology manufacturing ready and able to ramp up if and when treatments or vaccines are developed. Our Botox supply isn’t critical, but our antibiotic supply is. We need to be able to make more plastic ET tubes, not more silicon breast implants.
Let’s see all that. Then we can all talk about how we played our part in this fight. Netflix and chill is not enough while my family, friends and colleagues are out there fighting. Our country won two world wars because the entire country mobilized. We out-produced and we out-manufactured while our soldiers out-fought the enemy. We need to do that again because make no mistake, we are at war, healthcare workers are your soldiers, and the war has just begun.”
Last comment: This crisis caught everybody by surprise. Don’t act like the biotech companies are somehow to blame because they were working on products that were wealth generators when it hit. The business of business is business, and if a business could generate more wealth by producing products to feed rich women’s vanity than to heal, then you really can’t fault them. Netflix and chill? What are you talking about? Those of us who can are working from home, as awkward as that is. Those of us who can’t, have been furloughed or laid off outright. That means no paycheck coming in, and all that goes with that. We aren’t sitting at home looking at movies and binge-watching NCIS. It really isn’t fair to imply that’s what we’re doing.
Now, let’s talk about that history lesson you seem to want to give the rest of us. The whole country didn’t mobilize for WWI, although there was a great mobilization. Life at home went on much as it had before, save the nerve-wracking worry about soldiers in the field and ships facing U-boats. This country alone certainly didn’t win that war. France, Belgium, Russia, Italy and the UK had been fighting it for three years before we got involved, and the Allies won only because our soldiers got there in force faster than the Germans could move their eastern armies west. “The whole country” did in fact mobilize for WW2, to the point where ordinary folks were extremely limited in the amounts of meat, gas, and other things they could buy. I submit to you that would not be acceptable now, especially not in light of the current struggles. Oh, and, but for the remarkable bravery of the UK people and the RAF, we probably couldn’t have won in Europe. Japan, I’ll grant you, was all us. However, there’s a big difference between fighting an enemy who intends to wipe you out, and an illness spread mostly by stupid behavior. I studied the Greatest Generation, I knew members of the Greatest Generation. Doc, you guys are no Greatest Generation, so don’t reach yet for the honor that belongs only to them. In fact don’t reach for any. I don’t recall any of the rescue workers at ground zero demanding that everyone make their lives easier, either.
As Churchill said, brace to your duties.
Ethics Alarms 
Thank you, Jack, for taking this selfish person down a notch. Everyone these days is so … tribal. We fostered this thinking and romanticized it in fiction and documentary, the whole “brothers in arms” thing. This person is asking for America to abdicate to communism so they can be safer, and using the occasion to slander genuine camaraderie with his/her anti-capitalist grievances.
They don’t see the sacrifice of every day people who are out of work, out of money, and out of prospects for the immediate future of regaining the means to pay their mortgage or car payment or insurance or children’s clothing, needs and food. The government will step up and help, but to many that means a tiny portion of their salary or income, and not enough to keep all their needs funded.
Nobody is asking health workers to work for free. They get paid very well for what they do, and nobody can make them work if they don’t want to. So if you are afraid of catching the disease, then quit your job and join one of my bests friend in the unemployment line. That, at least, shows you are willing to sacrifice your livelihood for your safety — certainly understandable in some cases. In many other cases, it is simple cowardice, but I won’t even judge. Just stop demanding others sacrifice more on your behalf than you are willing to sacrifice yourself.
I risked my life at depths greater than 200 feet and speeds greater than 15 knots in places where enemy forces were willing and able to send me and my 100+ shipmates on a one-way tour of Davey Jones’ Locker. I didn’t demand the government send us on safer missions, or add a layer of armor to the hull of the ship. I didn’t moan because the air quality sucked and everybody smelled like sweat, cigarettes, machine oil, and CO2 scrubber. I didn’t demand a radiation suit to go into the reactor compartment to perform maintenance in order to avoid doses of ionizing radiation, or to stand port and starboard watch rotations, or sleep in a box even a mortician wouldn’t dignify with the word “coffin” that I shared with another guy who kept it warm while I was on watch and vice-versa.
I didn’t tell the captain to knock off the exercises in a North Atlantic storm where we took rolls greater than 40 degrees for eight straight hours with gallon cans of bug juice and Coke syrup breaking lose from their storage and exploding on the bulkheads in the mess hall, or the 60 or so men who power-puked their way through that ungodly hell — all for an excercise. We did it because we were ordered to, and we did what we were ordered to do for the good of all our brothers and sisters back home.
I just did my damned job, for damned little, and I’m damned proud of the work I did. And I’d do it again tomorrow if I were called. Why? Because nobody held a gun to my freaking head and made me join the Navy, or volunteer for the submarine force. Just like nobody held a gun to your head and made you become a doctor — a profession which, by the way, makes more on average in a month than I did in a year.
So in other words, sod off, swampy. A lot of us have risked our lives. Learn to deal with it, or become a dentist or cosmetic surgeon — something safe where you can lose your job at a time like this and get in the unemployment line with so many others.
I salute you Glenn.
Thanks for that, Glenn. Put me in mind of my father, just old enough to get into the last year of WWII, who was forever thankful that he wound up in the Navy in the Atlantic rather than as a Marine in the Pacific. The nearest to a complaint I ever heard from him was commenting that being on a small ship (PG69) in the north Atlantic in winter wasn’t the most fun he’d ever had.
Boy, howdy. The North Atlantic in the winter is bad for any ship within 100 feet of the surface. I recall coming up to periscope depth during that storm, and the rolls were incredible even 30 feet under. When we surfaced, it was … well, it was indescribable, really. We were cleaning Coke, bug juice syrup and digestive system contents from under and around the deck plates for months after that evolution, and I don’t even want to talk about how the place smelled.
Being on a surface combatant smaller than a Harper’s Ferry or San Antonio class amphibious landing ship would be even more miserable. The old PG-69, I believe, was about 200 feet long and 33 feet wide, which is about 150 feet sorter than my old boat (USS Olympia, SSN-717), but surface ships have an actual keel, whereas modern subs… don’t. With the sail out of the water, the sub has virtually no horizontal stability, and you can’t look at the horizon from a steel tube. 🙂
(Applause) and thank you for your service, Glenn.
Steve-O, I didn’t realize that was your comment until this morning, because I stupidly did what I so often do — glossed over the introduction. I’m sorry.
What a great job you did on that! You have my applause, and my gratitude for the outstanding comment.
Thanks to all. It was a privilege to be able and permitted to serve, and I’ve never been anything but grateful for the opportunity.
Jack…
What is the name of the unbelievable painting at the top of this post?
Mike ‘n’ Carolyn
“Serving the Nation” by Dean Cornwell.
https://books.google.com/books?id=6sZVp41FVOsC&pg=PA114&lpg=PA114&dq=%22Serving+the+Nation%22+by+Dean+Cornwell.&source=bl&ots=xU6zyQ2fii&sig=ACfU3U1946pfa2nEvN4LUKZeKsGezBa3zQ&hl=en&sa=X&ved=2ahUKEwiB0aGvybToAhUalnIEHbFtBWUQ6AEwEXoECAoQAQ#v=onepage&q=%22Serving%20the%20Nation%22%20by%20Dean%20Cornwell.&f=false
RE: “Serving the Nation,” I have a print of this painting in my train shed (housing my model railroad and home office). I believe it was commissioned by the Pennsylvania Railroad during WW2. Small world!
Great post Steve in NJ
This doctor seems to think antibiotics are effective against viruses. Ten to one this was written by a first year nursing student who has watched one too any episodes of ER.
You could be right about a doctor not writing this, Chris. It’s someone with more of a political than a medical point to make. However, the cases he’s talking about (intubating, using respirators/ventilators, etc.) points up the reason seniors are the most at risk when attacked by Covid-19 because of the strong likelihood that it will lead to pneumonia. Pneumonia occurs when an infection — of any sort, not just this new virus — inflames the lungs’ sacs. In severe cases the lungs fill up so oxygen can’t get through.
The older we are, the less reserve capacity our lungs have, so even with an otherwise sturdy immune system, the worse the damage can be. Impaired lungs and reduced capacity will result swiftly (within 24 hours in some cases) in severe pneumonia, with either or even both a viral pneumonia and a secondary bacterial infection at the same time. The results can be shock, the blood can begin clotting abnormally and other organ damage ensues, especially in people with heart disease both from the lack of oxygen and the inflammation. Regardless of age, people with chronic health problems, such as lung or heart problems, liver disease or diabetes can move quickly to severe pneumonia. The treatment medications – whether anti-viral (that’s not anti-virus but anti-viral pneumonia) or antibiotic – are both required in quantity.
As of now there is nothing yet to stop the virus from gaining hold in the first place. Our own immune system, perhaps with some emphasis on the status of lungs and heart, is the best protection.
Yes, a great comment Steve-O, and also Glenn.
I particularly love the line, from the subject post: “I want billion-dollar companies like 3M halting all production of any product that isn’t PPE to focus on PPE manufacturing.”
Clearly you need to stick to doctoring (??), because you have no idea how production lines work! Quite apart from not having a clue at the scale and diversity of ‘billion-dollar companies like 3M’.
He also is a snob. A hand-sewn mask filled with Kleenex is roughly as effective as an N95 mask. It is a fun trivia fact that Kleenex was invented as a gas-mask filter.
https://www.nationthailand.com/news/30362393
Good work, Steve-O. You’re on a roll !
How many of these doctors go out of their way to buy ‘Made in America’ products? Did they complain when all the medical mask manufacturing went to China (it did) and we sent vital pharmaceutical manufacturing there as well to save a few bucks? Did they mock Trump when he stated that China was a threat to this country? Now, when the Chinese stop sending us masks, when they threaten to cut off shipments of medicine, they want American industry to rush to their rescue as they drive to work in German cars. I wouldn’t be surprised if these same people are prescribing hydroxycloroquine to all their friends and family ‘just in case’.
There have been a lot of people warning for decades that shipping vital manufacturing to hostile nations is stupid and dangerous. Most of those people have been mocked by the elites who are making a lot of money off Chinese slave labor. Now these same people are indignant that American manufacturing isn’t doing enough. These people are complaining that we don’t have 350 million test kits for a disease that we didn’t even know about 4 months ago (the test had to be developed, tested, and mass produced in months). Sorry, I don’t want to hear a peep out of such people.
My sister-in-law is a nurse. She spends her days among sick people and other stressed-out nurses; she spends her evenings sewing masks. My brother is taking care of the kids, cooking all the meals and trying to figure out how to e-teach his classroom of kids learning from home.
I’ve not heard a complaint out of them. My sister-in-law says this is why she went into nursing and, echoing the book of Esther, that perhaps she was made for this particular time.
Americans are stepping up. On Facebook, homeschooling parents are reaching out to offer advice, support, and links to online resources and lesson plans to parents who have no idea how to teach their kids. Folks are also sharing face mask patterns online and are picking up free cotton fabric at craft stores to sew masks that can be dropped off at hospitals. Restaurants are providing meals to grocery store workers. A few days ago, a fire station with no toilet paper had to send someone to the store who was then advised of a limit on the number of packages. Customers began purchasing the packages for him and donating them to the station.
There is good out there.
It’s a near-certainty that there are no hoarders with garages or warehouses full of masks they’re just sitting on. People don’t realize how little slack there is in a modern supply chain. Companies have to pay taxes on inventory, on top of paying for the physical space and the personnel to maintain it, so in modern Lean Manufacturing terms it’s viewed as a form of waste. Building spare manufacturing capacity that you don’t put to productive use is likewise a form of waste. The end result is that anything beyond a mild increase in demand will lead to shortages in the short term. It’s true of everything from toilet paper to Tickle-Me Elmo.
And of course, nowadays these things are all manufactured in China. How do you think they’ll prioritize production in case of a shortage? They’ll see to their own, of course. After that, if they’re behaving ethically, they’ll prioritize the worst outbreaks, like Italy and Spain.
But what if they don’t act ethically? The Chinese Communist Party is desperate to shift the focus (and blame) for the pandemic from themselves to the West, and they’re ruthless about saving face. Maybe they’d prefer the virus spread out of control in the US. Maybe they’ll wait for an opportune time to swoop in to “rescue” America with PPE they had secretly withheld. This is what comes of making ourselves dependent on a despotic regime for critical infrastructure.
I would love to see the United States invest in Central and South America rather than continue to deal with governments like the PRC.
DaveL,
Thank you! Your comments re. lean manufacturing, just-in-time deliveries, etc. are what I have been trying to explain to friends about all the recent shortages of consumer goods in the stores. This applies to foods as well. A few miles from where I live sits a huge warehouse that used to belong to a regional grocery chain. Thirty years ago I was told there were about two weeks worth of shelf-stable packaged foods stored there for their stores. Now, deliveries from regional distribution warehouses are made to the stores daily. In many stores, if an item is not on the sales floor, there is no “back room” stock. You just have to wait on the next delivery.
The market will respond to demand, but it takes time. The only thing that could take more time is if the government got involved in the process!