Should Youth Come First in Coronavirus Care?
Should Youth Come First in Coronavirus Care?
In March, the Office of Civil Rights reaffirmed that the Affordable Care Act and other federal statutes prohibit discrimination, in health facilities receiving federal funds, on the basis of age, disability and other characteristics.
Nevertheless, the coalition has argued that guidelines in Oregon, Arizona and northern Texas remain discriminatory. For example, Arizona, which activated its crisis guidelines in June, includes long-term mortality as a consideration, along with the ability to experience “life stages.” While those cases are pending, other civil rights complaints have brought changes in Tennessee, Pennsylvania and Alabama.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated July 27, 2020
Should I refinance my mortgage?
- It could be a good idea, because mortgage rates have never been lower. Refinancing requests have pushed mortgage applications to some of the highest levels since 2008, so be prepared to get in line. But defaults are also up, so if you’re thinking about buying a home, be aware that some lenders have tightened their standards.
What is school going to look like in September?
- It is unlikely that many schools will return to a normal schedule this fall, requiring the grind of online learning, makeshift child care and stunted workdays to continue. California’s two largest public school districts — Los Angeles and San Diego — said on July 13, that instruction will be remote-only in the fall, citing concerns that surging coronavirus infections in their areas pose too dire a risk for students and teachers. Together, the two districts enroll some 825,000 students. They are the largest in the country so far to abandon plans for even a partial physical return to classrooms when they reopen in August. For other districts, the solution won’t be an all-or-nothing approach. Many systems, including the nation’s largest, New York City, are devising hybrid plans that involve spending some days in classrooms and other days online. There’s no national policy on this yet, so check with your municipal school system regularly to see what is happening in your community.
Is the coronavirus airborne?
- The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
What are the symptoms of coronavirus?
Does asymptomatic transmission of Covid-19 happen?
- 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.
None of these efforts, however, prevent individuals like Dr. Churchill from voluntarily declining treatment to benefit the young, or for any other reason. Specifying one’s choices, using an advance directive, is of greater importance than ever during a pandemic.
For those who want to yield their place in the health care line, an organization called Save Other Souls has developed a document that takes effect during a declared state of emergency for Covid-19. Vetted by lawyers, it allows people of any age to cede medical equipment, drugs or hospital care to others. The directive lapses when the emergency ends, or after 18 months.
“It’s akin to the person who runs into a burning building or gives up the last seat on the lifeboat,” said Dr. Andrea Kittrell, an otolaryngologist in Lynchburg, Va., who created the organization in March. “There are those people who are selfless and generous and value other people’s lives as much or more than their own.”
Winnona Merritt, for example, works daily in her vegetable garden in High Point, N.C., sharing cucumbers and squash with her neighbors. Vigorous at 82, Ms. Merritt said she would welcome more good years. But in a pandemic, “I’m afraid I could go to the head of the line, ahead of someone younger, with a family,” she said. “I don’t need that. I’ve had a wonderful life.” With her family’s support, she signed an S.O.S. directive.
Research suggests that altruism and generosity increase at older ages. For example, in recruiting volunteers for Experience Corps, which trains seniors to assist in public schools, the most effective recruiting messages appealed to a person’s desire to help the next generation.