Flu… A Martian’s View

From the article Doctors in SLO County seeing an influx of patients with flu:

“If you start to feel those flu-like symptoms, like high fever, really bad body aches, headaches, and/or congestion, Lepp says people should see their doctor, stressing that It’s important to get treated early.”

“The health department adds that for the majority of people who come down sick with the flu, they can rest and recover at home and do not need to seek out additional medical help.”

Que?

To recap, if you start feeling bad then go get help so you can get treated with something that only works early in the course of the illness… But most of you really should stay home because you’ll be just fine. Oye!

It’s that time of year again when I’ll be hacked on by 20-30 patients per shift, and I’ll drive home feeling like a Martian, wondering who’s in charge.

To be fair, we’re about a century since the deadliest epidemic ever, and since it hasn’t happened again we’re probably doing some things right. But I do wonder how much “we” medical folk are taking credit for “they” plumbing folk. Hard to say.

Questions:
  • Why do waiting rooms mix hacking/sneezing people with non sneezing people?
  • Why aren’t flu swabs and strep tests readily available OTC next to urine and yeast dipsticks, and pregnancy tests?
  • I get a yearly flu shot so I don’t have to wear a mask at work for 6 months. But do those masks actually help anyone other than the mask manufacturers?
  • Or do masks actually make staff over confident about coming to work sick?
  • Staff who get needle sticks or back injuries get covered by workers comp. Why not those who get hit by flu so they’re more willing to stay home?
  • This year the vaccine seems to have been a mishit. I know it’s not an easy task, but any warrantees/refunds? Ah well. Maybe next year.
  • What’s the backstory on Tamiflu? Why is Monterey County out of it?
  • … and why does EMTALA stop me from telling that to patients at the door before they check in for $1k ER visits?
  • When pharmacies run out of Tamiflu why is no alternative suggested? Are there no worthy competitors? There’s ofloxacin, ciprofloxacin, moxifloxacin, levofloxacin… tetracycline, minocycline, doxycycline… acyclovir, famcyclovir, valacyclovir… What gives?
  • Is our approach really slowing Tamiflu resistance?
  • Why is Tamiflu a prescription anyways when it’s clearly being dispensed like candy?
  • Why does it cost $5-10 a pill?
  • … even when it’s so marginally effective and downright ineffective after 3-4 days of illness?

$

On my preferred planet…

Open your Care Circles app to find an available doc in a box (or in a house or a Yaris like me). Then with Facetime, Skype or some other platform have a long conversation about flu, the utility of Tamiflu (or lack thereof when taken late), the weather, ice hockey, and any number of other topics, because doc isn’t beating a hasty retreat for the door.

Once determined that the problem seems viral, then kiddo, hubby or wifey then heads to CVS to get the home flu test kit. If positive, result is brought back to a pharmacist who dispenses Umcka, Ricola, echinacea, Vit C, acetaminophen, ibuprofen, chicken soup, peppermint and chamomile teas, all in a nicely wrapped care package… +/- Tamiflu and a memory stick with every old episode of Mash, Cheers and Seinfeld… all paid for by a universal healthcare “lite” plan which covers all that plus vasectomies.

On my planet the sickest get house calls or admission to mobile isolation units, which lie ready and waiting for every new scary infection outbreak; and between outbreaks they’re used for street medical outreach.

Call me crazy.

Beam me to bed Scotty.

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