'To Fight the Coronavirus, Cut the Red Tape' diff viewer (4/5)

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To Fight the Coronavirus, Cut the Red Tape	To Fight the Coronavirus, Cut the Red Tape
2020-06-09 00:53:01 UTC	2020-06-10 01:28:20 UTC (1 day later)
These are scary times. The world is living through the double whammy of a pandemic health care crisis and a possible global economic depression.	These are scary times. The world is living through the double whammy of a pandemic health care crisis and a possible global economic depression.
Fighting the coronavirus is hard enough. Government regulations shouldn’t make it any harder. But that’s exactly what’s happening.	Fighting the coronavirus is hard enough. Government regulations shouldn’t make it any harder. But that’s exactly what’s happening.
We have identified five kinds of regulations that we believe are hindering us in what amounts to a war of survival. They should be paused for now, and some might be usefully eliminated forever.	We have identified five kinds of regulations that we believe are hindering us in what amounts to a war of survival. They should be paused for now, and some might be usefully eliminated forever.
There are undoubtedly others we have missed, and we ask for your suggestions about those, too.	There are undoubtedly others we have missed, and we ask for your suggestions about those, too.
We face an acute shortage of medical workers, yet red tape is keeping people who could help on the sidelines.	We face an acute shortage of medical workers, yet red tape is keeping people who could help on the sidelines.
One example is medical licensing, which, in the United States, is done at the state level. Qualified professionals licensed in one state cannot practice if they happen to have moved somewhere else. Let’s instead treat medical licenses like we do driver’s licenses. New York State has already implemented this policy.	One example is medical licensing, which, in the United States, is done at the state level. Qualified professionals licensed in one state cannot practice if they happen to have moved somewhere else. Let’s instead treat medical licenses like we do driver’s licenses. New York State has already implemented this policy.
Other regulations restrict who can do which tasks. In this emergency, licenses should be extended across specialties. All doctors begin by receiving the same general training, but then go on to specialize in a particular form of medicine. But when someone on an airplane is having a heart attack, the flight attendant doesn’t ask if there’s a cardiologist on the plane.	Other regulations restrict who can do which tasks. In this emergency, licenses should be extended across specialties. All doctors begin by receiving the same general training, but then go on to specialize in a particular form of medicine. But when someone on an airplane is having a heart attack, the flight attendant doesn’t ask if there’s a cardiologist on the plane.
The same principle can be expanded more broadly. Nurses, physician assistants and even advanced medical students are capable of doing more than the law allows them to do. Let’s use everyone’s skills and also provide crash training programs to provide emergency help when we get swamped.	The same principle can be expanded more broadly. Nurses, physician assistants and even advanced medical students are capable of doing more than the law allows them to do. Let’s use everyone’s skills and also provide crash training programs to provide emergency help when we get swamped.
If a patient will die without medical help, she will care more about the competence than the educational degrees of the person aiding her. We are not suggesting that plumbers be allowed to do surgery, but rather that health systems be able make the call about who can help in the heat of battle.	If a patient will die without medical help, she will care more about the competence than the educational degrees of the person aiding her. We are not suggesting that plumbers be allowed to do surgery, but rather that health systems be able make the call about who can help in the heat of battle.
The times require all qualified hands on deck.	The times require all qualified hands on deck.
In the United States and most other countries, anyone who helps out in a roadside accident, earthquake or similar medical crisis is protected from subsequent legal second-guessing by good Samaritan laws. Without such laws, doctors fearing a medical malpractice suit might fail to help.	In the United States and most other countries, anyone who helps out in a roadside accident, earthquake or similar medical crisis is protected from subsequent legal second-guessing by good Samaritan laws. Without such laws, doctors fearing a medical malpractice suit might fail to help.
The same principle should be applied throughout the Covid-19 crisis. Many difficult decisions will have to be made regarding who receives treatment and by whom. Medical workers are already volunteering for hazardous duty; why expose them and their employers to the additional risk of a lawsuit?	The same principle should be applied throughout the Covid-19 crisis. Many difficult decisions will have to be made regarding who receives treatment and by whom. Medical workers are already volunteering for hazardous duty; why expose them and their employers to the additional risk of a lawsuit?
A hospital in Brescia, Italy, had an urgent need for valves necessary to hook up a patient to a ventilator. An enterprising start-up figured out a way to produce the valves with a 3-D printer and made 100 of them in a day, which it donated to the local hospital. Ten patients were treated immediately.	A hospital in Brescia, Italy, had an urgent need for valves necessary to hook up a patient to a ventilator. An enterprising start-up figured out a way to produce the valves with a 3-D printer and made 100 of them in a day, which it donated to the local hospital. Ten patients were treated immediately.
That raw creativity was rewarded with the threat of a lawsuit by the owner of the patent on these valves even though they had been unable to supply them.	That raw creativity was rewarded with the threat of a lawsuit by the owner of the patent on these valves even though they had been unable to supply them.
Suppliers that cannot meet the demand for their product, be it ventilators, masks or gowns, do not lose any money if others figure out ways to jump in and temporarily fill the gap. Let’s not punish creative heroes.	Suppliers that cannot meet the demand for their product, be it ventilators, masks or gowns, do not lose any money if others figure out ways to jump in and temporarily fill the gap. Let’s not punish creative heroes.
Patents should be briefly suspended for the production of anything deemed necessary to fight this virus. Each country — including the United States — should look into suspending their patents globally. After the crisis is over, intellectual property rights can be restored, and any firm that decides to stay in the industry should then be required to start paying normal patent license fees. Those Italian valve innovators said they had no intention of continuing in that business. They were just trying to help.	Patents should be briefly suspended for the production of anything deemed necessary to fight this virus. Each country — including the United States — should look into suspending their patents globally. After the crisis is over, intellectual property rights can be restored, and any firm that decides to stay in the industry should then be required to start paying normal patent license fees. Those Italian valve innovators said they had no intention of continuing in that business. They were just trying to help.
The strict “stay-in-place” rules that have been adopted around the world are imposing enormous economic and emotional costs. It is essential that we fight the spread of the virus as quickly as possible. Tragically, this process been severely handicapped by a shortage of tests in many places, including much of the United States. Now that testing is beginning at scale, a crucial step to speed the fight is to identify the network of people who have had contact with those who newly tested positive.	The strict “stay-in-place” rules that have been adopted around the world are imposing enormous economic and emotional costs. It is essential that we fight the spread of the virus as quickly as possible. Tragically, this process been severely handicapped by a shortage of tests in many places, including much of the United States. Now that testing is beginning at scale, a crucial step to speed the fight is to identify the network of people who have had contact with those who newly tested positive.
One expeditious way to accomplish this task is to give epidemiologists access to anonymized data that is being created by the GPS tracking on our smartphones. If companies can use this data to market services to you, shouldn’t health agencies use it to track the spread of this disease?	One expeditious way to accomplish this task is to give epidemiologists access to anonymized data that is being created by the GPS tracking on our smartphones. If companies can use this data to market services to you, shouldn’t health agencies use it to track the spread of this disease?
Updated June 5, 2020	Updated June 5, 2020
	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
One example of how smartphone data could be taken another step forward comes from Singapore, which has been one of the most successful countries in fighting the coronavirus, deploying numerous tools including widespread testing. Lately authorities there have added a new tool to their arsenal. As reported by The Financial Times, the government started TraceTogether, an app that uses Bluetooth technology to record distance between users as well as the duration of their encounters. People consent to give the health ministry the information, which is encrypted and deleted after 21 days. The department can then contact users in case of “probable contact” with an infected individual.	One example of how smartphone data could be taken another step forward comes from Singapore, which has been one of the most successful countries in fighting the coronavirus, deploying numerous tools including widespread testing. Lately authorities there have added a new tool to their arsenal. As reported by The Financial Times, the government started TraceTogether, an app that uses Bluetooth technology to record distance between users as well as the duration of their encounters. People consent to give the health ministry the information, which is encrypted and deleted after 21 days. The department can then contact users in case of “probable contact” with an infected individual.
Note that this is a service people opt into. Both of us would gladly sign up. We don’t think anyone should be forced to use it, but we do think it should be legal.	Note that this is a service people opt into. Both of us would gladly sign up. We don’t think anyone should be forced to use it, but we do think it should be legal.
Many countries have adopted data privacy regulations, some of which can prevent the creation of tools that use data to help fight the pandemic. Of course, like all of our other suggestions, we recommend this only as a temporary change, although similar measures might be necessary in another health crisis.	Many countries have adopted data privacy regulations, some of which can prevent the creation of tools that use data to help fight the pandemic. Of course, like all of our other suggestions, we recommend this only as a temporary change, although similar measures might be necessary in another health crisis.
Although we have tried to educate ourselves about the issues raised here, we are not experts in medicine or health care, so our suggestions might not be the best ones. The people on the front lines are better suited to identify the factors inhibiting their progress.	Although we have tried to educate ourselves about the issues raised here, we are not experts in medicine or health care, so our suggestions might not be the best ones. The people on the front lines are better suited to identify the factors inhibiting their progress.
It is standard practice in the federal government (and some state governments) to request comments before new regulations are issued. This ensures that regulators receive proper feedback before laws are written.	It is standard practice in the federal government (and some state governments) to request comments before new regulations are issued. This ensures that regulators receive proper feedback before laws are written.
Ideally, governments would do the opposite now: open up sites to request comments not on new regulations, but on existing ones that are limiting our ability to fight the virus. Let people on the front lines report the regulations that are hindering them. Of course, everyone is busy right now, so to help we have set up a website where anyone with a possibly useful idea can make suggestions for ways to eliminate the red tape that is making it harder for medical workers to do their jobs. We hope readers will submit their ideas and add comments on the ideas of others.	Ideally, governments would do the opposite now: open up sites to request comments not on new regulations, but on existing ones that are limiting our ability to fight the virus. Let people on the front lines report the regulations that are hindering them. Of course, everyone is busy right now, so to help we have set up a website where anyone with a possibly useful idea can make suggestions for ways to eliminate the red tape that is making it harder for medical workers to do their jobs. We hope readers will submit their ideas and add comments on the ideas of others.