COVID-19 Can Cause ARDS, And AFDS
AFDS, “Acute Financial Distress Syndrome, ” is plaguing humans world-wide.
The virus SARS-CoV-2 makes daily global headlines and has precipitated a de facto worldwide quarantine. When it began insidiously popping up in the United States, first in Seattle, then Los Angeles and Chicago, I thought, "Ok, this thing is here. We'll get it under control." As cases began to exponentially increase, I thought, "Quarantine, ok. It makes sense that to control the spread of this thing, we stay away from each other for a while."
I never anticipated that, within a month, we would find ourselves in an altered reality in which seemingly benign things like hugging our grandparents or going to a concert would be considered a massive health risk. In these last few weeks, I’ve seen terms like “social distancing” and “telemedicine” go viral (pun intended), and hashtags like #FlattenTheCurve, #RaiseTheLine, and #LowerTheBaseline sprinkled all over the internet.
Given that I am a second-year medical student, regardless of whether there was a pandemic or not, I would have found myself this season in “study quarantine,” given that my first board exam was scheduled for April 27. Even so, I never could have foreseen that things would become this extreme. Like everyone else, I saw my daily frequents close one by one – first my school, then church, part-time job, and gym. My board exam was pushed to the end of June due to test center closures, then canceled altogether after being rescheduled five times. Upcoming elective periods no longer may involve direct patient contact. Every student panel and meeting has moved to Zoom, and even my brother’s wedding ceremony scheduled for the end of May was canceled. Instead, it was live-streamed from the courthouse with just the officiant and photographer present!
All the changes, cancellations, precipitated layoffs, and daily updates on the virus left me thinking in circles about the state of my own health and the healthcare system in the United States. I suffered from severe asthma in childhood and had several bouts of pneumonia over the years, so shortness of breath and hospital emergency rooms are very familiar. I was young at that time, so I didn’t think a lot about the fallout, such as the bill. Regardless, I was aware even then that it was expensive to be sick, and my classes in my first year of medical school taught me how facets of our healthcare system favor those who can afford “good” insurance or paying out-of-pocket expenses, often leaving others with lesser care or none at all.
As a broke student with a lot of debt and a part-time job limited to 20 hours per week, I was appalled when I received the bill from my trip to the emergency room earlier this year after collapsing in my bedroom from extreme dehydration secondary to the flu. The number on paper wasn’t unexpected, but it still burned. And I do know that I’m one of the lucky ones; I am on my father’s insurance plan and, thankfully, had enough money from my job to pay the bill and be done with it. This did not change the fact that I felt nauseated thinking about all the folks that need care right now amid layoffs, chaos, and financial insecurity that may not be able to afford it (or at least not without making huge sacrifices).
On top of money issues for patients, doctors are taking hits as well. The overwhelming number of new cases coming into hospitals everyday forces cancellation of elective procedures and extensive use of resources, which burns through budgeting. There are some actions being taken to allocate and extend relief funds, but amid so many healthcare workers doing their jobs even without proper protection due to shortage of resources, there is still talk of pay cuts. One doctor in a recent article I read even described it as a situation of “shooting ourselves in the foot.” In the meantime, medical students like me are being recruited to volunteer to help with childcare, picking up groceries, pet-sitting, etc., for these heroic folks busting their tails every day so that they can’t manage these essentials themselves.
The question thus presents itself: There’s a problem of resource misallocation, but what is the solution? That was rhetorical actually; we know the solution. A deep-rooted problem requires deep-rooted changes. I’m not a politician, but given the infringement of our current system on basic human rights to life, it would seem that adequate access to medical care is not, nor should ever have been, a bipartisan issue.
It is unacceptable that we live in a state in which anyone with enough money can access life-saving medicines, but those who cannot afford it are faced with the decision of trading financial ruin for survival. Implementation of a system that provides healthcare for everyone is absolutely essential.
While the pandemic of this season is nothing short of a catastrophe, the response to and outcomes of it have highlighted this issue of health access disparity arguably more than ever, at least in my experience. There is a very palpable fear of requiring hospitalization, not just from the risk of contracting the virus, but because of the cost to be treated.
And don’t worry, I will not segue here to speak on behalf of or against any one political candidate or figure based on their plans for making this a reality. However, I will urge you to consider the position of those who currently have jurisdiction over maintenance and reformation of the healthcare field, as well as those who may come to have jurisdiction. This extends not just to those in federal seats such as the president, but state and local governing bodies as well. There has never been a more important time to be involved in investing for the future in terms of our everyday actions. That includes washing our hands, not touching our faces, physically distancing, staying home, and staying informed. The future of our local and global community depend on it, so let’s “stay woke,” my friends.
Stephanie Wottrich is a third-year medical student in Cleveland, Ohio, originally from Austin, Texas. She holds a bachelor’s degree in Microbiology, Immunology, and Molecular Genetics from the University of California, Los Angeles.