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Posts published in “Day: July 16, 2021”

Banning health protocols

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For many years pilots of American aircraft, small as well as large, routinely have executed a protocol before takeoff, often written-down, often spoken aloud: “Landing gear position lights - checked, altimeter - set, directional gyro - set, fuel gauges - checked …” It slows things down a minute or two, and probably mildly aggravates some experienced pilots. But partly as a result, American aviation has for decades had a remarkably excellent record of avoiding accidents.

In 2001, a parallel thought hit a Johns Hopkins physician who was looking into the large number of patients who died or nearly died because of infections. He came up with a checklist protocol - a series of mostly simple things medical personnel could do to avoid infections - things usually done but sometimes missed; the approach called for a specific check to see that all those things were done. The end result was a dramatic improvement, far fewer infections, far better health.

Each of those things - proper patient cleaning, draping sterile covers in the right place, and so on - meant that medical personnel were in various ways circumscribed. But those little requirements turned out to be highly helpful.

No government agency required any of this. There was no need: Once better procedures were found, not just in this case but in many others, medical providers tended to adopt them as standard practice.

Consider: If we had known that many thousands of lives could be saved by a simple checklist procedure and medical providers weren’t using it, might we then want to require it, even governmentally? Probably, if the trade off is thousands of lives against minor inconvenience … but again, we haven’t had to go there.

This relates to Idaho’s biggest current political dustup.

One of the largely unheralded aspects of the Covid-19 pandemic is the degree private businesses and notably medical providers have gotten on board with taking steps, understood and accepted through long medical experience, to avoid contributing to the problem: masking in stores, social distancing in public spaces, and so on. Much of it was never formally mandated by a government; often, these private organizations simply did what they needed to keep their customers, employees and other people safe. (Many deserve far more credit for this than they’ve tended to get.)

And while it’s a short-term annoyance for us all, I’ll count myself among those who do appreciate it, and pay attention to who is keeping my safety in mind, and who isn’t. I wouldn’t go to a doctor’s office or medical center, for example, that wasn’t taking reasonable steps to keep the people there - staff, patients, visitors, others - safe.

In Idaho, as in most places around the country, medical professionals largely have been doing just that. Headlines popped up when a few of them (I imagine there are many more), including the St., Luke’s and St. Alphonsus medical centers said they would be requiring staff to be vaccinated against Covid-19.

And why not? They don’t (I presume) allow into work staffers who are sick with something contagious, or filthy, under the influence, or otherwise presenting themselves as a hazard to the people around them. Protection against Covid-19 really is little different, and the inoculation requirement probably ought to be a standard across many kinds of organizations wherever many staffers, customers and others routinely interact. As an employer or employee, I wouldn’t think twice about it. It makes sense. People have a right to decide what to put into their bodies, but they have no right to endanger other people.

This is by way of context for the current proposal by Idaho Lieutenant Governor Janice McGeachin to call the Idaho Legislature (of which the state already has seen altogether too much this year) into a special session largely to ban hospitals from taking steps to keep people from getting sick. And there have been public protests in support of that: One sign said “Mandatory Vaccination is a Human Rights Violation.”

If it is, then so is any kind of requirement - from sterile procedures to driving on the right hand side of the road - that inhibits our actions in the interest of keeping us safe. Any of those could be on the legislature’s hit list next (but only if they join the never-ending rotisserie of culture war outrage de jour).

Whether the health and safety of Idahoans is of any interest to most of Idaho legislators is an unsettled question. In the days to come, legislators will decide (they haven’t yet as this was written) whether to return to session to ban hospitals from setting life-saving procedures.

Just don’t tell them about aviation checklists, or Idaho might start seeing planes dropping from the sky every day.