The platform that I have chosen to build my e-portfolio on is Wix. I chose this platform because when I was playing around with the design templates and experimenting with the website itself, it was very easy, and I found a template that would work well with my e-portfolio. It also had the aesthetic I was looking for. I want the website to be simple and elegant, but also visually pleasing, and I feel as though Wix was the best option to fully encompass these criteria.
The purpose of my website will be more professional. I am thinking of applying to medical school in the future and would like to show all that I have accomplished in an organized and professional way, and I believe this is a good place to start. So, my audience would be professionals reviewing my work when I am applying to medical schools. I would like them to see my interest in the sciences while also getting a feel for who I am as a person, not just a student.
So far, I have thought of a few options for the tabs on my website. There will be a home page, which would include an “about me” section and a general summary of the site and how to navigate it. A “science” tab will include a brief description in my interest in the scientific field and also include my pieces about scientific topics, like my paradigm shift essay (which could also go under healthcare) and ted talk essay from last semester, my biology project in which I mapped Drosophila genes, a lab report. The next tab, “healthcare” would describe my interest in the healthcare field and would include my pieces pertaining to that topic, with my issue brief, advocacy project, and some of my civic issue blog posts. The “environment” tab would include my civic artifact essay comparing forest fire propaganda from last semester and a few of my civic issue blogs. The final tab would be called “culture/identity” and would include my this I believe and my passion blogs. I think these tabs with the included selections give a summary of my academics, while also adding elements of my personality into the portfolio.
For my advocacy campaign for my issue of solving the lack of personal protective equipment for healthcare officials in the COVID-19 outbreak, I have several ideas of how I should present my ideas. First, I was thinking of creating an infographic. Upon examining the different examples of infographics on the link, a few types caught my eye. The “how-to-guide” would be interesting to implement since there are a few sequential actions that would solve this crisis, so organizing it in a step-by-step manner would break it down to the essentials. Another type of infographic that could lend itself to my issue is the visualization of the statistics relating to this problem to accentuate the need for change while supplying numerical arguments. The “visual guide on an important issue” also seemed relevant since it would also break down the content into easily identifiable contributors to the problem and the steps to take to reduce the problem. The audience for this issue is mainly the United States government, but also the CEO’s of major manufacturing companies in the United States, so an infographic would be able to adequately communicate the main ideas in a media form that would apply to both groups.
I think that “Photographer as Witness: A Portrait of Abuse” is a piece of advocacy. I think that people are extremely influenced by images and yes, we all hear stories about domestic abuse, but sadly, does that change much? It is one thing to hear about something, versus actually seeing it in person, or within an image. I think that the images captured by this photographer demonstrate the issue in the most raw and basic way that is so powerful that it forces people to pay attention. Yes, it may be gruesome, but so is the issue. I am not quite sure on the ethical portion, as it is a touchy subject. But I think that if the photographer received approval from Maggie, the victim of the abuse, then it would be okay to share these photos to gain attention for the issue of domestic abuse.
In pandemics, like the current COVID-19 outbreak, the first concern is to stop the spread of the virus. The administrative decision by President Trump to limit the travel from Europe to the United States is not exactly effective in decreasing the rate of the virus spreading because it is already in our country. The CDC just recently issued a statement urging residents from New York, New Jersey, and Connecticut to refrain from non-essential domestic travel for 14 days, along with other travel restrictions in other areas in the United States.[1] Although the spread from citizen to citizen is important to control, the main focus should be on preventing the spread of the virus to healthcare professionals, which none of these current mandates have worked to achieve.
Without healthy doctors, nurses, and other healthcare workers, the death rates would increase significantly, and hospitals would not be able to function or treat the high-risk people that are in desperate need of care in these times. Personal protective equipment, or PPE, is especially important when working with contagious viruses, like COVID-19. Since this virus spreads by direct contact with fluids from an infected patient, health care workers must reduce this contact as much as possible.[2] Already, hospitals around the country are reporting a major lack of PPE including respirators, gloves, face shields, gowns, and hand sanitizer. This situation is so drastic that a new hashtag, #GetMePPE has been trending around the country, urging a change to the lack of PPE in hospitals.[3] In Italy, health care workers experienced high rates of infection and death due to a lack of PPE, so if the United States wants to protect its workers and prevent a similar occurrence, there needs to be immediate action in supplying PPE to hospitals.[4]
There are a few ways that would increase the availability of necessary PPE to protect the health care workers. The Defense Production Act (DPA) allows the President to direct private companies to produce equipment needed for a national emergency. By utilizing this act, companies could halt the production of other products and focus all attention on the production of PPE. Their suppliers should also be encouraged to maximize the raw material available to these companies to increase production, which would, in turn, increase the output of PPE.
Since only a few companies would have the expertise to produce these devices, the federal government needs to rope in other industries in the production effort. The automobile industry and the fashion industry could have the adequate materials to make PPE and contribute to these efforts, ensuring that United States healthcare workers have the adequate means to provide care to infected individuals while also protecting themselves against infection.[5] After these companies begin manufacturing PPE, their suppliers will need to increase the raw materials necessary for these products to ensure a massive output of material to be distributed across the country.
The simultaneous activation of the DPA and a push for increased PPE production would monumentally change how the United States is trying to combat the pandemic of COVID-19. As the country is facing new challenges economically and socially, the United States government and major manufacturing corporations need to utilize their power and implement the necessary means to flatten the pandemic curve and protect its citizens.
A Global Increase in Lack of Personal Protective Equipment
Personal protective equipment is one of the most widely used method of disease prevention in hospitals and daily life. But, with surging rates of infections in more than 200 countries, the demand for PPE has risen.[6] Since the start of the COVID-19 outbreak, prices of surgical masks have seen a six-fold increase, N95 respirators have tripled, and gowns have doubled.[7]
The available limited stocks then are frequently sold to the highest bidding country, leaving countries without the necessary PPE. The World Health Organization (WHO) has tried to help these countries by shipping almost half a million sets of personal protective equipment to 47 countries, but supplies are rapidly depleting. Based on predictions by WHO, an estimated 89 million medical masks are required for the COVID-19 response each month. For examination gloves, 76 million are required, while international demand for goggles stands at 1.6 million per month. To meet rising global demand, industries must increase manufacturing by 40 percent. This means that no additional aid will be provided to the United States, and the country as a whole needs to take responsibility for its PPE deficit by altering its manufacturing practices.
Figure 1: A summary of the common necessities of healthcare workers taken from “Shortage of Personal Protective Equipment Endangering Health Workers Worldwide.” World Health Organization, March 3, 2020.
Taking the Issue into Its Own Hands: How the United States Should Respond
Without the ability to rely on outside sources for PPE supply, the United States needs to step up and take up the challenge of increasing PPE manufacturing. This can be achieved through several steps. The first step needs to include the implication of the Defense Production Act (DPA). The ability to designate the production of necessary PPE to private companies that can contribute to help in a national emergency is a powerful tool that the United States government has not taken full advantage of. With all private and public medical supply companies working together on PPE production, the gap between the current deficit of supplies and the amount needed to keep the United States healthcare workers safe could be closed. Although President Trump just recently activated the DPA in response to COVID-19 on March 18, 2020, encouraging General Motors to make ventilators, it concerned many public officials how postponed the reaction was to such a widespread issue.
Conflicts with the Defense Production Act
It has come to the attention of many that the DPA has finally been pushed in the United States to order private companies to produce ventilators, but there are several issues tied to this decision. It is being argued that this lackluster and delayed response is signification that the United States government is leaving citizens to fend for themselves and taking a more hands-off approach. There is evidence that the Trump administration has used the DPA over the past three years to prioritize issues for national security, from rare earth metals to building lasers to constructing body armor for Border Patrol agents. It is estimated that the Defense Department alone uses the power of DPA around 300,000 times every year, while the Department of Homeland Security prioritized 1,000 orders in 2018 for disaster response efforts.[8] The prioritization of defense over responsiveness to the pressing pandemic on hand is somewhat concerning and needs to be addressed.
Figure 2: The Disparity Between DPA Usage of Differing Sectors of the United States Government
The U.S. Chamber of Commerce and the heads of major corporations have convinced the administration against using the DPA. They say that it could be counterproductive, imposing limitations on companies when they need the flexibility to deal with closed borders and shuttered factories. Although this may help companies deal with their economic troubles associated with the decline in the stock market, it does not help the safety of United States doctors and medical workers. By not encouraging more companies to produce PPE, the lack of protective equipment will continue to be a problem, healthcare workers will continue to get sick, in turn altering the productivity of hospitals and likely causing the death rates of patients to skyrocket due to unavailable care. It is a terrible snowball effect that needs to be taken on immediately by more heavily employing the DPA.
More Supplies, More PPE—How Other Industries Can Contribute
Reports show that it was predicted that the United States would dislodge China as the most competitive manufacturing industry in the world.[9] This should be an indication of the United States’ incredible power as a manufacturing powerhouse. This incredible capacity for producing goods needs to be harnessed. If the DPA is activated, it will likely only focus on designated medical supplies manufacturers, not on companies who have the materials to produce PPE but are not specifically part of the medical manufacturing umbrella. In this case, major wealthy companies must realize their stake in the issue and also step up to solve the PPE crisis. Although many argue that these companies are already feeling the effects of the downward spiral of the stock market, companies have proven successful in their endeavors towards aiding medical manufacturers by producing more masks and other PPE.
The fashion industry has already made a considerable commitment and effort to trying to solve this issue. Eddie Bauer, an outdoor apparel company, said it had shifted production to making protective medical equipment at capable vendors that typically make its technical outerwear. Nordstrom, which calls itself the largest employer of tailors in North America, is working with Kaas Tailored, a clothing manufacturer in Washington state, to sew masks made by cutting up and restitching surgical wrap provided by Providence, a healthcare organization asking for help making masks.[10] These few examples alone demonstrate how protective medical equipment production is not just the responsibility of the healthcare field, and if companies and organizations work together, more PPE could be manufactured and sent out to hospitals around the country.
As with any product, more raw material supplied to the manufacturer, the more supplies can be produced. To make this chain of action completely successful, the materials necessary for manufacturing masks, other PPE, and medical supplies need to be readily accessible to the companies who are taking on this challenge along with the medical suppliers that are desperately trying to meet the demands. The initial problem stems from the dependence on China, for most of the medical supply manufacturing responsibilities along with material export were placed on a single country. For future crisis similar to the PPE deficit, the United States should use this as an example to realize that the capability to be a similar manufacturing giant as China is there, it is just not being acknowledged.
The Time for Change Has Passed—Action is Needed NOW
Figure 3: The Global Distribution of COVID-19 Cases taken from The World Health Organization
As the epidemic curve is continuing to rise in the United States and other regions across the globe, the push for medical PPE is more desperate than ever. The United States government, along with CEOs of major manufacturing companies, have the power to make a change, but many are not taking full advantage of their resources and incredible power.
To provide the protective equipment that the healthcare workers need to keep healthy and safe to properly care for the infected, PPE productions need to skyrocket. This can feasibly be achieved by a three-step process of first, the United States government activating the DPA heavily, second, major corporations with medical equipment manufacturing capabilities switch production focus from their usual goods to medical supplies, and third, the raw material suppliers of these corporations increase access to the materials necessary for making the PPE. If the United States works as one united force, the PPE crisis can be solved. But there is no more time for waiting. It is only a matter of time before hospitals begin to lack adequate staff due to sickness. The time is now.
Bibliography
“Coronavirus and Travel in the United States.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, March 30, 2020. https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-in-the-us.html. [1]
“How Coronavirus Spreads.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, March 4, 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html?CDC_AA_refVal=https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html. [2]
Padilla, Mariel. “’It Feels Like a War Zone’: Doctors and Nurses Plead for Masks on Social Media.” The New York Times. The New York Times, March 19, 2020. https://www.nytimes.com/2020/03/19/us/hospitals-coronavirus-ppe-shortage.html. [3]
Ranney, Megan L., Valerie Griffeth, and Ashish K. Jha. “Critical Supply Shortages — The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic.” New England Journal of Medicine, March 25, 2020. https://doi.org/10.1056/nejmp2006141. [4]
Orvitz, Kevan. “PPE the Automotive Industry Needs to Invest In.” Occupational Health & Safety, April 1, 2019. https://ohsonline.com/Articles/2019/04/01/PPE-the-Automotive-Industry-Needs-to-Invest-In.aspx?m=1. [5]
“What Are Digital Therapeutics?” Digital Therapeutics Alliance, May 9, 2019. https://dtxalliance.org/dtx-solutions/. [6]
“Coronavirus Cases:” Worldometer. Accessed April 2, 2020. https://www.worldometers.info/coronavirus/. [7]
“Shortage of Personal Protective Equipment Endangering Health Workers Worldwide.” World Health Organization. World Health Organization. Accessed April 2, 2020. https://www.who.int/news-room/detail/03-03-2020-shortage-of-personal-protective-equipment-endangering-health-workers-worldwide. [8]
Stieb, Matt. “Trump Invoked Defense Protection Act All the Time, But Stalled for Coronavirus.” Intelligencer. March 31, 2020. https://nymag.com/intelligencer/2020/03/trump-used-defense-production-act-stalled-for-coronavirus.html. [9]
Selko, Adrienne. “Top 10 Manufacturing Countries in 2020.” Industry Weekly, December 9, 2015. https://www.industryweek.com/the-economy/competitiveness/media-gallery/22011658/top-10-manufacturing-countries-in-2020. [10]
Bain, Marc. “US Fashion Brands Having to Make Medical Masks Expose a Failure of the Health System.” Quartz, March 30, 2020. https://qz.com/1826057/us-fashion-brands-making-masks-expose-a-failure-of-the-health-system/. [11]
In pandemics, like the current COVID-19 outbreak, the first concern is to stop the spread of the virus. The administrative decision by President Trump to limit the travel from Europe to the United States is not exactly effective in decreasing the rate of the virus spreading because it is already in our country. The CDC just recently issued a statement urging residents from New York, New Jersey, and Connecticut to refrain from non-essential domestic travel for 14 days, along with other travel restrictions in other areas in the United States.[1] Although the spread from citizen to citizen is important to control, the main focus should be on preventing the spread of the virus to healthcare professionals, which none of these current mandates have worked to achieve.
Without healthy doctors, nurses, and other healthcare workers, the death rates would go up and hospitals would not be able to function or treat the high-risk people that are in desperate need of care in these times. Personal protective equipment, or PPE, is especially important when working with contagious viruses, like COVID-19. Since this virus spreads by direct contact with fluids from an infected patient, health care workers must reduce this contact as much as possible.[2] Already, hospitals around the country are reporting a lack of PPE including respirators, gloves, face shields, gowns, and hand sanitizer. This situation is so drastic that a new hashtag, #GetMePPE has been trending around the country, urging a change to the lack of PPE in hospitals.[3] In Italy, health care workers experienced such high rates of infection and death due to this lack of PPE, so if the United States wants to protect its workers, there needs to be immediate action in supplying PPE to hospitals.[4]
There are a few ways that would increase the availability of necessary PPE to protect the health care workers. The Defense Production Act (DPA) allows the President to direct private companies to produce equipment needed for a national emergency. By utilizing this act, companies could halt the production of other products and focus all attention on the production of PPE. Their suppliers should also be encouraged to maximize the raw material available to these companies to increase production. Since only a few companies would have the expertise to produce these devices, the federal government needs to rope in other industries in the production effort. The automobile industry and the fashion industry could have the adequate materials to make PPE and contribute to these efforts, ensuring that United States healthcare workers have the adequate means to provide care to infected individuals while also protecting themselves against infection.[5]
Another aspect to consider is the unnecessary contact of healthcare professionals to contagious individuals experiencing mild symptoms. The hospitals are open to treat severe cases of COVID-19, but patients with suspected cases of the virus and those strong enough to not need direct hospitalization should get care through an alternative method than doctor visits. Digital therapeutics, or DTx for short, is an emerging health discipline using a more hands-off approach, amplifying or even replacing active drugs in disease treatment using technology.[6] The use of DTx would help effectively treat patients who need care, but do not need the direct supervision of doctors, limiting healthcare professionals’ contact to exposed individuals and reducing the number of infected people from leaving the quarantine of their own houses.
The simultaneous push for increased PPE production along with the implementation of DTx would monumentally change how the United States is trying to combat the pandemic of COVID-19. As the country is facing new challenges economically and socially, the United States government needs to utilize its power and implement the necessary means to flatten the curve and protect its citizens.
Question: I focused mainly on two ways to reduce the exposure of doctors (increasing production of PPE and DTx). Would it be beneficial to solely focus on one of these or would both be necessary to the assessment of this issue?
It was an interesting experience both participating in a deliberation other than my own and planning and executing my deliberation. “Setting the Standard on Standardized Testing” allowed me to appreciate the work that goes into such conversations and attending “To Drink or Not to Drink: A Spirited Conversation of Binge Drinking on College Campuses” allowed me to view a different conversational experience to compare to my own. Overall, I thought that both deliberations that I will be discussing met most of the criteria stated in Gastil’s chapter on deliberation, although there were areas in which both groups could have improved upon to perfect their deliberation.
One of the most important elements in a productive conversation is respecting participants and adequately distributing speaking opportunities. In my deliberation, I do believe that these criteria were adequately met. The deliberation was held in Webster’s Bookstore Café, which had many downfalls and impeded our conversation. The arrangement of the café caused half of our participants on a stage, and the others surrounding us on a lower surface in rows. The people in the back row on the lower surface did not get to share their opinions as much, but after prompted by our deliberation moderators, were willing to share more than in the beginning. I also thought that everyone’s opinions were respected, and all participants were honest and acknowledged other’s unique experiences and viewpoints. Also, since the café was relatively loud, we tried using a microphone to make the speakers heard, but it ended up making the conversation turn into more of a presentation and somewhat annoyed the normal café-goers, who were not participating in the deliberation.
The binge-drinking deliberation did not have these barriers to overcome, and I thought that their conversation was able to run more smoothly because of it. It was easy to hear everyone, which allowed for a better, more adequately distributed speaking process. I think that there was a bit less respect in this conversation because some people were not open-minded in possibly changing their predetermined views on drinking in college and argued a bit more, but overall it was a respectful experience.
Both deliberations also identified a broad range of solutions and adequately weighed the pros, cons, and tradeoffs among the proposed solutions. With the SAT deliberation, since I was involved with choosing the three proposed solutions, I am somewhat biased in saying that they did cover a broad range. It was interesting to me that our solution to create a more strenuous college application process for applicants and reviewers by adding more elements was a more popular solution among participants than eliminating the SAT. These two solutions were quite opposites, and going into the conversation, it was interesting to hear how most participants did not enjoy the SAT, but afterward, gained a newfound appreciation for the exam due to our discussion. Each solution proposed by our deliberation assessed both the pros and cons of the proposals, although more than half of the time for each solution was spent on the pros, so it was not exactly even.
During the binge drinking discussion, I thought that the conversation also had a broad range of solutions. The proposal of lowering the age of drinking for beer and wine but keeping the age of 21 for hard liquor to have kids adjust to alcohol slowly was interesting to me. I did not know that some countries already implement this and already have a lower rate of teen-drinking incidents than the United States. The pros and cons were weighed well, although it was hard to assess the pros because it is known that anyone consuming alcohol under the age of 21 is breaking the law, so some people were reluctant to share their opinions due to the loaded capacity of the topic. There was a great discussion of the limitations to each solution proposed because none of the solutions will truly eliminate binge drinking.
Finally, both conversations seem to adequately provide a solid information base to build upon in the deliberation while also ensuring mutual comprehension. In the SAT deliberation, I feel as though team overview did a great job with the issue guide and the presentation of background at the beginning of the deliberation. The microphone did catch us a bit off-guard, but I think we adjusted well and adapted to the situation as best as possible. Since most students had to take the SAT to get into Penn State, all of the participants had background already on the subject, so by listening to us and reading the issue guide that we created, it was well understood what the deliberation was about. A few of the participants even told us afterward how much they liked our topic and how relevant it was. This ensured a mutual comprehension and participants did ask for clarification respectfully on several occasions when needed.
The drinking on college campuses presentation also provided well-explained background information. It was slightly overdone and took up a large portion of the time that would have been better used to further discuss the solutions, but it was thorough and relevant. I think they could have discussed the background of Penn State-specific information more and discussed less of the United States as a whole to make it more applicable and specific, but overall it was great. They also had an adequate mutual comprehension, although as I stated before since teen drinking is more of a touchy topic to some people, many participants did not speak plainly about their opinions. Also, there were many more people at that deliberation than the SAT deliberation, so this could also account for why more people shared during the SAT conversation than the binge drinking one. Despite the circumstances, I believe that both deliberations were successful and stimulated interesting conversations in their unique ways.
In terms of an issue brief focusing on COVID-19, there has never been a more relevant time to talk about this topic due to the current events surrounding this new virus and the havoc it is causing around the globe. I will address the exigence of this topic by addressing how COVID-19 is continuing to spread in current society and how solutions proposed by the United States government of simply shutting down travel from Europe to the United States is not enough. I will reference specific events and statistics relevant to the recent spread of the virus, making it especially relevant to this time period. Since every conversation in recent days seems to have the word “coronavirus” or “COVID-19” in it, Kairos of this issue is very relevant and applicable to modern society. By stating something containing these “triggering” words at the beginning of the issue brief, it will grab the attention of the audience due to the recent peaked interest in the subject.
Whether or not people get the virus or have nowhere to buy toilet paper or food, everyone in society will be impacted by this pandemic, making the audience for this issue everyone across the country, and in other countries worldwide. But, due to the extensive breadth of this issue and the fact that I am not able to accurately reflect issues catered to each area, I will only be addressing United States towns because I am more knowledgeable in these areas and have easier access to information relating to these areas.
Since my civic issue blogs previously have covered many controversies in the medical field, it is only fitting that my issue brief topic will be related to the relevant issue of coronavirus, or COVID-19. I will be discussing how individual towns need to enforce the social distancing policy more firmly to stop the spread of coronavirus and why this is beneficial to health and the environment itself. The administrative decision by President Trump to limit the travel from Europe to the United States is not exactly effective in decreasing the rate of the virus spreading because it is already in our country. If people continue to move around, from state to state on spring break trips, or even from town to town, the spreading rate will continue to increase exponentially, and we as a nation will likely run into the problem of limited hospital space and inadequate supplies, as seen in the recent “toilet paper shortage”. Not only would stopping these travels limit the spread of the virus, but it would also help the environment. There is already evidence that the pandemic, although terrifying, has a silver lining in that the air pollution has been reduced. For example, nitrogen dioxide emission levels across China have plummeted, in part due to travel bans with decreased usage of motor vehicles and domestic airplanes. A source discussing this pollution reduction amidst the coronavirus states that, “The two months of pollution reduction, Burke calculates, has probably saved the lives of 4,000 children under 5 and 73,000 adults over 70 in China. That’s significantly more than the current global death toll from the virus itself” (Bowler, 2020). If each town were to implement a no travel policy, it would in turn help stop the spread of coronavirus and decrease air pollution, saving lives on both ends.
Nitrogen dioxide levels in China through the course of COVID-19, as observed by NASA.
The cause of the issue of COVID-19 spreading is mostly inadvertent. People traveling as normal on spring break plans, preplanned vacations, or even to a restaurant a couple towns over could be spreading the virus. Since it is already in most of the larger cities in each state, bringing it to different places and even coming into contact with it and bringing it home from the airport is a dangerous risk, although people may be asymptomatic and not even know that they have the virus. Increased caution is needed to stop this spread.
Many ways could stop the spread of COVID-19, but the most feasible would be mandates and urgent capacity builders. By announcing mandates along with town-wide quarantines, the spread of COVID-19 could be slowed and controlled. An example of a mandate for this town quarantine would be to fine citizens who are found traveling to nonessential places. This would give incentive for people to stay home and reduce the likelihood that they would carry the virus to another place if they were carrying it and would separate those who have it from those who do not. Urgent capacity builders would also be effective because, amidst the COVID-19 panic, there are many misconceptions about the virus and its effects spreading throughout the media and from the mouths of politicians that we are supposed to trust, so if the public were properly educated on means to stop the spread other than singing a song while washing hands, it would further reduce the spread of coronavirus. Also, providing resources that show how quarantines and travel bans are helping reduce air pollution and also saving lives would give more incentive for people to follow the town-mandated rules.
References
Bowler, Jacinta. “New Evidence Shows How COVID-19 Has Affected Global Air Pollution.” ScienceAlert, 17 Mar. 2020, www.sciencealert.com/here-s-what-covid-19-is-doing-to-our-pollution-levels.
Bowler, Jacinta. “Nitrogen Dioxide Pollution Over China Plummets in New Satellite Images.” ScienceAlert, 2 Mar. 2020, www.sciencealert.com/nitrogen-dioxide-pollution-has-dramatically-dropped-over-china-because-of-the-coronavirus.
In terms of the health industry, it is clear that there have been many beneficial changes discussed in previous blog posts. However, a large issue has not been addressed thus far. Climate change in modern society is a controversial issue and one that needs immediate attention. But how can an industry focused on saving lives contribute to such a negative effect on the Earth? This blog post will be a discussion of this issue and the many caveats surrounding it.
Greenhouse gas emissions are a large contributor to the negative effects of climate change, like the depletion of the ozone layer in our atmosphere. In the United States alone, health care is responsible for about a tenth of the country’s greenhouse gas emission. Machinery necessary for certain medical procedures like CAT scanners, dialysis machines, and respirators come at a large energy expense, which is mostly met by fossil fuel usage. This is an incredibly tricky issue because although climate change is an immense problem, reducing some of the emissions produced by methods of care in hospitals comes at the expense of human lives. How far are people willing to go to save the environment? Although it seems like a daunting task to approach this issue, there are several approaches that could be effective in both reducing greenhouse gas emissions of the health sector and maintaining the level of intense care that is necessary to maintain hospitals. First off, hospitals could commit to 100% clean energy, or at least significantly decrease their fossil fuel usage. As we have seen in recent years, the research and funding for clean energy discovery have paid off and the United States is seeing a significant increase in clean energy usage with increased options to make a cleaner choice. Hospitals can commit to these means of clean energy, as exemplified by Gundersen Health Systems, a nonprofit hospital network operating in the Midwest who, in 2014, became the first health system to achieve energy independence by producing their energy from wind power, solar power, and capturing methane from landfills (Chen, 2019). Many other health care companies and hospitals like Kaiser Permanente, Partners HealthCare, and Boston Medical Center are also working towards carbon neutrality by reducing their emissions (Belluz, 2019). This approach would make the health care system significantly reduce their contribution to the total emissions, making the United States a much cleaner nation.Another approach is for doctors to educate policymakers about the health ramifications being caused by climate change itself. Not many people are educated on the different sicknesses increasing in prevalence due to climate change. An article describing the healthcare industry’s role in climate change explains that “…between 2030 and 2050, a quarter of a million deaths could be caused by climate change-related health problems — such as heat exposure, mosquito-borne diseases, and flooding. Air pollution, including household air pollution, already cause 6.5 million premature deaths each year” (Belluz, 2019). If people were more aware of how their energy and emission choices were directly affecting their health and the health of their future generations, they may be more motivated to ignite change. Groups like “American College of Physicians”, “Healthcare Without Harm”, the “Medical Society Consortium”, and “Physicians for Social Responsibility”, are groups of doctors and related individuals who are pushing for reduced emissions in their fields. Furthermore, health care organizations could divest from fossil fuel companies to cut off their financial dependence on them, making it easier to go green.
Although this issue seems like a double-edged sword, there truly are ways that could make a positive impact on the environment while also maintaining the procedures that make the healthcare system able to treat patients.
References
Belluz, Julia, and Umair Irfan. “Doctors Are Frightened by Climate Change. Their Industry Is a Big Part of the Problem.” Vox, Vox, 19 Jan. 2019, www.vox.com/2019/1/17/18184358/healthcare-doctors-climate-change-divesting.
Chen, Alice, and Vivek Murthy. “How Health Systems Are Meeting the Challenge of Climate Change.” Harvard Business Review, 19 Sept. 2019, hbr.org/2019/09/how-health-systems-are-meeting-the-challenge-of-climate-change.
Technology gives people instant data at the touch of a screen, button, or keyboard. Millennials, as the Boomers take care to mention as much as possible, make great use of these technological advances, using them as crutches to aid in many areas of life, including with medicine. The medical field has experienced a multitude of changes as a result of this technological boom, and medical care as it was known a decade ago has significantly changed and morphed into something completely unrecognizable. First, millennials visit the doctors’ offices and clinics more than previous generations, but they are more inclined to visit retail health clinics like CVS or Walgreens for example over visiting their own primary care physician (PCP). The shift from PCPs to retail care is quite beneficial, due to the reduced cost and increased ease of the visits, but many problems are also associated with this millennial practice.First off, visits to a CVS or a Walgreens walk in clinic is extremely easy. These retail clinics remove the need to call the PCP and wait a few days or weeks for appointments—one can simply show up, get seen, and leave. In general, there has been a lifestyle change and people these days tend to be busier, always working or bouncing from one activity to the next, so retail clinics appear as an obvious time and effort saver. However, this approach does fragment health records because when patients visit different retail clinics alongside of their visits with their PCP, miscommunication is highly likely, as each healthcare provider requires different levels of information that the patient needs to provide and also use different forms and online data bases to store this information. This could also undermine the patient-physician relationship and could possibly complicate the oversight in treatment plans due to conflicting views and multiple sources of input. An article about the threats of retail clinics explains that, “physicians often take a negative view of retail clinics because of the lack of communication between retail clinics and primary care practices, citing a lack of cooperation or ‘unwillingness or inability on the part of convenience clinics to share medical information about patients with primary care providers’”(Warren, 2017). This can also create a sticky situation for the patient because they could feel awkward mentioning that they received care at a retail clinic due to the aversion from their PCP and could exclude something necessary to their treatment.
Additionally, an important aspect of retail clinics is the cost effectiveness of this approach. A 2013 study out of Harvard University found that retail clinic utilization is tied to lower total costs of care. The study compared insurance claims for patients who received care at retail clinics versus those who did not and found that those who used retail clinics experience lower costs of care by $262 (Sussman, 2013). In today’s society, people are very motivated to search for good deals, and saving money on cheaper medical expenses is very appealing. Although these cost factors are important to consider, but it is also important to note the lack of personal connection with the health care professionals in retail clinics. When visiting these clinics, patients usually do not have a choice in what doctor they will be seen by. In PCPs on the other hand, it is not unusual for a patient to have seen the same doctor for many years, creating a safe environment for beneficial conversations about medical problems that the patient may be sensitive to. A trusting and comfortable environment is ideal when concerning medical care, so it is important to weigh all the options before choosing between a fast and inexpensive retail clinic, or a personal and thorough PCP.Without the boom in technology, retail clinics would not be in existence in today’s society. Overall, they have transformed the medical field in terms of how patients are treated. There are many conflicting opinions in terms of the benefits and drawbacks of this system in comparison to PCPs, and it is important for consumers and patients to thoroughly understand the different sides to make their own decision on healthcare method that fits their own lifestyle and supports their views.
References
Heath, Sara. “What Are the Pros and Cons of Retail, Urgent Care Clinics?” Patient Engagement HIT, 25 June 2019, patientengagementhit.com/news/what-are-the-pros-and-cons-of-retail-urgent-care-clinics.
Rege, Alyssa. “These Are the 8 Most Disruptive Issues in Healthcare: Presidential Healthcare Policy and the Rise of Health IT like Artificial Intelligence and Precision Medicine Will All Have a Significant Effect on How Healthcare Is Delivered in the U.S.” Becker’s Hospital Review, 18 June 2018, www.beckershospitalreview.com/hospital-management-administration/these-are-the-8-most-disruptive-issues-in-healthcare.html.
Sussman, Andrew L. et al. “Retail clinic utilization associated with lower total cost of care.” The American journal of managed care 19 4 (2013): e148-57 .
Warren, Amanda. “Five Reasons Why Retail Clinics Are a ‘Game-Changing’ Threat to Traditional Healthcare Providers That Could Strain Clinical Laboratories and Pathologists.” Dark Daily, 2 Oct. 2017, www.darkdaily.com/five-reasons-why-retail-clinics-are-a-game-changing-threat-to-traditional-healthcare-providers-that-could-strain-clinical-laboratories-and-pathologists-1002/.
Society today is changing in the way common practices are viewed. Especially in the medical field, common procedural techniques and even the way medicine as a whole is viewed is becoming more and more technologically advanced. As a society, the United States is one of the most technological dependent and innovative countries in the world. According to the Global Innovation Index, commonly referred to as GII, in 2019, the United States was 3rd in the GII top ten countries, only behind Switzerland and Sweden (Lanvin, 2019). This means that the United States has both an economy large enough to sustain innovative activities, like creating new technologies and researching new methods, and it has an economy with diverse products and services for export that are more innovative. In many cases, this technological boom in the United States solves many problems and makes life easier, like the many “smart products” available. But, controversies regarding technological advances in the medical field are in debate over many ethical reasons. This series of civic issue blogs will be focused on dissecting some of the controversial changes in the medical field relating to innovation. The main issue addressed in this blog post is the dispute over digital therapeutics, or DTx for short.
DTx, is an emerging health discipline that uses technology to amplify or even replace active drugs in disease treatment. This practice has the ability to revolutionize how common medical procedures are monitored and create a more accessible and easy recovery plan for patients. DTx could also make medical care and pharmaceutical purchases less expensive, while also providing a more personal approach, catering specifically to the patients’ needs. However, like many other technological advances, there are drawbacks to each benefit provided by DTx.
The main purpose of DTx is to deliver direct therapeutic interventions like ways to prevent, manage, or even treat medical disorders or diseases. This would mean that there would be less doctors’ visits, and more assessment through a network. Even simple data, like the health data stored on any iPhone could be considered DTx, when used in relation to treatment options. For example, in treating more chronic illnesses, physicians can use the number of steps taken per day to assess the individual’s activity levels. When treating patients with mental illnesses like depression, data like outgoing texts, number of calls, and sleep patterns can reveal to a physician or therapist how much the individual is engaging with activities in their daily life and if they are receiving adequate social support. These “treatment” options could be a touch away on an app or on your smartwatch, but since there are so many wellness apps available, it is difficult to discern which applications are actually useful for the treatment option a patient is pursuing. Furthermore, although a simple app for treatment sounds appealing, private medical details would need to be entered into the system that many people would prefer not to be released. And since DTx is all technology based, it could be relatively easy for a hacker to gather private data using DTx.
Other than the accessibility and ease of DTx, it can decrease the cost of medical care. By allowing patients to skip out on several doctors’ appointments, private therapists, and even medical consultants, DTx could save people lots of money in the long run. But, this technology does cost a lot of money to research, and since it is still in its up-and-coming phase, there are lots of unknowns. According to an article on Healthcare IT News, “$12.5 billion into digital health ventures in 2017 and 2018… Compared with 2013, this level of investment represents an increase in funding of 230 percent, while the average funding deal size grew 67 percent over the same period” (Siwiki, 2020). This immense growth of investment is costing companies billions of dollars, so in the end, DTx is not significantly reducing all cost factors, just the ones associated with the patient.
Less expensive healthcare options appeal to most citizens, but one of the greatest incentives for using DTx is the personal approach to care. The artificial intelligence incorporated into many of these apps allow the program to learn from actions, creating a treatment program specific for you. This is helpful because those who feel that physicians may be biased towards one treatment or another will be at ease with this method. But, this also reduces the amount of patients that physicians see, if DTx were to increase in popularity. This would cause a decrease in jobs for some of the most highly trained and educated professions out there. Artificial intelligence is in-and-of-itself a controversial issue regarding replacement of human workers with machines.
In an age of rapid innovation and technological dependence, it does make sense that the medical field is shifting towards a more tech-savvy approach to treatment, diagnosis, and disease management using digital therapeutics, or DTx. As comes with any technological advancement in its early stages, there are many arguments both for and against this shift, but it is important for people as consumers to be concerned with how their medical procedures are being dealt with and to be educated on the possibilities that could become of them.
References:
Chen, Cherry. “Innovation in Digital Therapeutics.” Plug and Play, www.plugandplaytechcenter.com/resources/innovation-digital-therapeutics/.
Lanvin, Bruno. “The World’s Most Innovative Countries, 2019.” INSEAD Knowledge, 24 July 2019, knowledge.insead.edu/entrepreneurship/the-worlds-most-innovative-countries-2019-12016.
Siwiki, Bill. “Here Are 6 Major Issues Facing Healthcare in 2019, According to PwC.” Healthcare IT News, 17 Jan. 2020, www.healthcareitnews.com/news/here-are-6-major-issues-facing-healthcare-2019-according-pwc.
“What Are Digital Therapeutics?” Digital Therapeutics Alliance, 9 May 2019, dtxalliance.org/dtx-solutions/.
