“There’s nothing we can do to change the trajectory of the pandemic in the next several months.” Statement by President Biden in a White House Speech, January 23 2021.
Mr. President, all Americans hope in time of a national health crisis that you cannot be allowed to fail. Therefore, in the spirit of suggesting bi-partisan Presidential action it is offered that the trajectory of the COVID pandemic can be changed.
Sadly the phrase “trust the science” tragically became a partisan talking point that hurt it’s true meaning.
However, there is a medical field of scientific care and treatment that can objectively set the priorities of those that should consistently receive available COVID vaccines regardless of state and if activated on could immediately save lives.
These are the statistically leading underlying health issues that can lead to increased adverse effects of COVID including premature death.
Who is most at risk of dying from coronavirus?
COVID-19 can effect people of all ages. Recent data shows that the older people are, the higher their risk of severe illness from COVID-19. Age is an independent risk factor for severe illness, but risk in older adults is also in part related to the increased likelihood that older adults also have underlying medical conditions.
You are more at risk if you are obese, have chronic disease such as heart disease, diabetes, lung disease, or are being treated for cancer. We know that anyone having a weak immune system will also be at a higher risk of infection, severe disease, and death. In addition, there might be an increase risk for those with asthma, high blood pressure, neurologic conditions such as dementia, cerebrovascular disease such as stroke, or who are pregnant, who are pregnant, who are obese, have liver disease, have cystic fibrosis or who smoke
The problem for such a mix of underlying health issues is the objective and subjective nature of building priority lists to help save the most vulnerable can get murky and confusing fast.
Note that age is an objective measure “independent risk factor” but availability of vaccine even makes an age cut off as the single criteria a difficult call.
For example in the Department of Veterans Affairs medical system, the age for vaccine cut off at the Washington VA Medical center is 85 and above while in neighboring Virginia it is 75 and up.
Consequently, it is not surprising that sates vary greatly by their efficient effectiveness in delivering vaccines to the most needy to save their life.
For those readers interested in that area of analysis here is the most current rank ordering of States from most effective, North Dakota to least Virginia:
I fully understand the huge can of worms that can open if medical criteria below a cut-off age determines the priority of who gets vaccinated.
It is simple, by looking at underlying adverse health criteria of the many listed above, including heart disease everything is on a sliding subjective scale.
For example being fat puts one at risk, but how fat is fat?
And who makes that subjective decision?
If fat becomes an issue then those that can afford doctors can declare their patients a fat risk for COVID and bingo head of the line.
Consequently, if excessive adipose tissue and other clever medical gaming risk factors come into play inequalities will most definitely be accentuated.
To complicate everything, I realize America has an official population of approximately 330 million citizens, but with smart pro-active advisors President Biden can make a difference by immediately initiating a nationwide policy change in order of vaccine priority that can save countless lives.
One can focus on rank order the neediest patients suffering from heart disease.
Throughout America there are medically validated treatment centers that have the full credibility to put their patients at head of the vaccine line and they are cardiac rehab centers. Hospital Cardiac Rehab Centers are focused on compiling very objective measures of successful treatment of Heart Disease and should have significant reach into establishing vaccine priority for their patients. Those medical centers transcend subjective judgments by establishing very rigorous criteria of objective measures of treatment success.
Heart disease is a killer for many Americans: This year’s report said 121.5 million adults in the U.S. have cardiovascular disease.
Heart disease was the No. 1 cause of death in the U.S:
- Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States.
- One person dies every 36 seconds in the United States from cardiovascular disease.
- About 655,000 Americans die from heart disease each year—that’s 1 in every 4 deaths
Worrying about 121.5 million Americans with heart disease is not the point of this article, rather allowing only those who needed Cardiac Rehab to go on the list most definitely is:.
Taking a specific example of Virginia such patients are currently ranked last. Looking how Virginia Governor Northam M.D. designed his state wide categories on queuing up for COVID vaccines he stopped at an objective measure of age 75 and up.
Virginia health professionals then published lists of vaccine eligibility by occupational categories. So for example if one is a Virginal resident and Vietnam veteran, average age 74, with a DVA medically validated combat derived heart disease disability (combat connected to Agent Orange), Virginia school support staff would currently get a higher priority.
Again using Virginia as an example this time for a civilian; a 72 year old woman having undergone open heart surgery, heart lung machine included, would have a very low vaccine priority.
Tragically with a high risk of COVID death that person who has successfully completed Doctor and Hospital cardiac rehab is currently behind a 25 year old totally healthy employee of a Virginia School.
President Biden’s team has a real chance instead of managing grim expectations of there is nothing we can do,
President Biden can fully embrace the optimism that American do not give up and never ever quit to hope as a nation as we constantly are flexible in adjusting to a better way in times of adversity.
It is time for President Biden’s medical advisory team to use his nationwide power of the Presidency to allow cardiac rehabilitation units in every state to put their patients on the priority list.
Why successfully complete a medically validated cycle of heart rehabilitation only to have the patient die of COVID?
A nationwide effort to empower Cardiac Rehab Unit Doctors to make vaccine decisions can and will change the trajectory of the impact of the pandemic immediately.