Yeah, I’m still figuring it out, but this. An ICU is the most complex place in a hospital and probably the *hardest* for improvised emergency clinics to replicate. To reduce load on hospitals, maybe we *first* scale up the *other* stuff.https://twitter.com/gallabytes/status/1238744523548667905 …
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What they do in India to make medical care available to the very poor without cutting quality of care is called *task-shifting*.
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You take the *simplest* tasks which are usually done by skilled experts (doctors & nurses) and delegate them to non-credentialed workers or volunteers who go through a brief training course.
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This increases the risk of those tasks being done wrong, but *carefully*, starting by delegating the lowest-risk, least-technical tasks first.
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US hospitals are already used to triage: treating urgent, fixable cases ahead in line of mild and hopeless cases. Task-shifting is triage for tasks.
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Medically skilled personnel are a scarce resource in a crisis like COVID19; the smart thing to do is to reserve them for those tasks that are most difficult to learn to perform safely.
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When people have life-threatening cases of COVID19, the treatments they need are the *hardest* to task-shift to the untrained. Very invasive, very easy to accidentally kill someone by screwing up. It might be easier to scale up routine care instead.
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What I’ve read from retrospectives of natural disasters and other emergencies is that there’s usually no shortage of volunteers and donations. People are actually very generous in a crisis. The bottleneck is more often getting those volunteers trained and organized.
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Top priority is getting someone with experience task-shifting hospitals (perhaps in poor countries) to give guidance on how rich countries with overwhelmed medical systems can do something similar.
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