The Patients Left Behind

want to know. Leave us a voicemail with your question at six four six three two four three four zero. We'll answer some of your questions and we may use your voice on a future show. And now today's show, it's day forty two since coronavirus was declared a global pandemic. Our main story, patients who are seriously ill from diseases besides COVID nineteen are finding themselves in a strange limbo.

Getting treatment in hospitals is riskier than ever, and doctors are forced to delay procedures without knowing for sure whether patients will suffer long term harm. But first, here's what happened today. New York is building a tracing Army to attract the origin of individual coronavirus cases, according to Governor Andrew Cuomo at his daily press conference today, the governor said that doing this kind of so called contact tracing will reduce the spread and let the state focus on

reopening UH. And we've been talking about testing, tracing and then isolating UH and that is going to be the key going forward. That's how you are educated and have some data points as you're working your way through this reopening calibration. And we set as a goal yesterday to double the number of state tests, to go from twenty thousand on average to that almost at the state would

work with Connecticut and New Jersey on the initiative. Former New York City Mayor Michael Bloomberg volunteered to help the state implement the program and will donate ten million dollars to the effort. Michael Bloomberg is the founder and majority owner of Bloomberg LP, the parent company of Bloomberg News. New evidence suggests the new coronavirus may have been spreading

in the US earlier than previously thought. In California, to Santa Clara, residents who died in early February were infected with the virus. According to the Counties Public Health Department, the first death on February six was twenty days earlier than what was previously believed to be the first US fatality, and it came three weeks before health officials identified the first infection that didn't have a known tie to other cases. The deaths were also weeks before cities and states started

implementing widespread social distancing measures. At the time, US attempts to track the virus were limited, Tests were scarce, and the criteria for who could be tested was tightly limited. It's not the only thing the US may have gotten wrong about the spread of the virus. The Trump administration's projections for how many in the country will die from

the coronavirus maybe short by about a hundred thousand. According to the American Civil Liberties Union, that's because it hasn't fully accounted for the high prison population in the country. Models that account for the hundreds of thousands of incarcerated people suggest there will be many more deaths than projected

unless inmate populations are rapidly reduced. The A C. L. You said, and how Speaker Nancy Pelosi said, the House will pass the emergency four hundred and eighty four billion dollar relief package tomorrow, giving small companies quick access to additional loans. Pelosi also said on Bloomberg Television that a major package of aid for state and local government will

be in the next stimulus legislation considered by Congress. That sets up a conflict with Senate Majority Leader Mitch McConnell, who was urging a slowdown in dolling out federal help. And now our main story, the waves of coronavirus patients flooding hospitals across the country have put an unprecedented strain on our healthcare system. But it doesn't mean other diseases just go away. The crisis is putting care on hold for a lot of people with other serious health conditions

like cancer. Doctors are delaying procedures and surgeries in order to save resources like hospital beds and ventilators for COVID nineteen patients and prevent the infection from spreading. But as Bloomberg News reporter and Accord explains, doctors are forced to make often difficult choices about what constitutes an urgent procedure, and experts worry that we're feeding another kind of healthcare crisis one with consequences we're only beginning to see. Jenny

Alstrom has had a type of blood cancer since. Jenny is fifty two and lives in Salt Lake City with her family. In early April, she needed to see the doctor for some tests that would help her understand the status of her cancer, but she was worried. I had to make this risk benefit analysis. Is it worse for me to wait and then how my numbers go up and not know what I could be doing about it, even if I had to start treatment, or do I wait and maybe have a disease that's growing more out

of control. So I was really holding off on doing that just because I didn't want to put myself at risk. Jenny did decide to go to the hospital. Her doctor recommended a seven am appointment as the safest time to go in. She didn't sleep well the night before. I woke up really early and I had an in ninety five mask, put that on, put my gloves on, and went in And the streets are pretty quiet. There was no traffic going up to the university, which there usually

is even at that time of the morning. Jenny says. Now, even getting into the hospital to receive care is different going into the facility. You know, I walked in, they took my temperature. They were taking everyone's temperature that was walking in the facility. There were signs everywhere that basically there are no visitors or very few visitors, a single visitor. And I went up to the floor and I was the only patient that I saw on the entire floor.

No one's getting routine testing right now, no mamograms, no stuff you would normally schedule for primitive care or even just part of your regular care. They were cleaning off all the chairs and surfaces when I got in, and there were very few people working in the lab. So it's truly changing normal cancer care, and I think that's the case for every other disease to Jenny says she's glad she went in for the tests. The doctor told her she won't have to start treatment immediately, but it's

not always up to the patient. Hospitals are still doing surgeries that are considered emergencies, but in many cases are pushing off other kinds of procedures. Those procedures include lots of things the average patient wouldn't consider optional, like cancer surgeries or a knee replacement. John Hick is an emergency medicine doctor in Minneapolis, Minnesota. He says doctors often make the decision to delay this kind of care based on three things. How much time it will take, how much

expertise is needed, and what the treatment involves. You know, if we needed to take those resources altogether, what's the overall investment that we're going to have to make, you know, in the patient, And then what are we investing in, you know, so kind of cold hard economic terms, what's the return on investment here for this particular patient. So we have to try to bring the best evidence that we can to bear on the situation. But nothing's perfect,

you know. And I think that's the thing with medicine is I used to tell people who wanted a firm answer, and I get that all the time. Doctor, you have to tell me, you know, I need to know, I need to know a hundred percent. And I always say, there's nothing that's in medicine. Doctors in the US are delaying care for some in order to avoid what happened in China and Italy. Hospitals there were overwhelmed by COVID

nineteen patients. This led doctors to have to make agonizing decisions about who to treat and where to put resources. Matthew Winnia is a bioethicist at the University of Colorado. He says the situation presents major ethical questions. We're almost certainly going to have some people with non COVID disease who are harmed as result of delays in the care that they receive. There's no perfect way to do this, because no matter how you slice up that pie, someone's

not gonna like how much they got. Many doctors are turning to virtual visits with their patients to fill the gap, but not everything can be done that way. Jason Fung is a kidney specialist based in Toronto, Canada. He says he worries that people are staying home even when it poses health risks. Many of Fung's patients are elderly and have other health problems. They're more vulnerable to COVID nineteen

and they're afraid of getting it. The other day, I admitted a patient who was so scared about COVID that they didn't get their blood pressures checked, they didn't get it taken care of, and I admitted that patient with a stroke. That's not reversible, like they will suffer from that. They can't see properly, so they will suffer from that for the rest of their life. M bioethicist Matthew Whinia says access to medical care has always been an issue

in our health system. The pandemic has just thrust these subjects into even clearer view. But he does see a silver lining here. Things like virtual visits are becoming much more used and accepted. So there are ways in which because of a disaster you develop new ways of thinking and new ways of doing things that will then carry on afterwards. You know, they're saying that necessity is the

mother of invention. We're having to invent a lot of things right now because we have to, and some of those will lead to long term improvements, I hope in the health care system. The US is starting to talk about reopening states that would include non COVID procedures, but until then, patients and doctor will still have to make the difficult choices about when and where care happens. And that was Emma Court and that's it for our show today.

For more on the outbreak from one and twenty bureaus around the world, visit Bloomberg Dot com slash Coronavirus, and one small favor. If you appreciate the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is hosted by Me Laura Carlson. The show was produced by Me, top foreheads Jordan Gospore and Magnus Henriksen. Today's main story was reported

by Emma Court. Original music by Leo Sidrin, and our editors are Francesco Leady and Rick sh Francesco Levi is Bloomberg's head of Podcasts. Thanks for listening. H