CREDIT: Office of the Vice President via Twitter https://twitter.com/Mike_Pence/status/1233881402527055875
There is a picture going around on Facebook that shows a White House meeting regarding the Wuhan Virus. The picture and the accompanying article are obviously meant to promote the idea that President Trump has no clue how to handle the threat of an epidemic the presence of Wuhan Virus in the United States poses. The picture comes from an article in the Daily mail showing that meeting. The lede
Is there a doctor in the house? Mike Pence unveils the White House’s coronavirus taskforce amid growing crisis and Wall Street plunge – with just FOUR medical experts out of 15 chiefs (and one of them isn’t even there)
The article promotes the idea that there aren’t enough doctors on the Wuhan Virus Task Force. Like many press outlets, The Daily Mail believes that dealing with the Wuhan Virus will be a doctor -centric effort. They could not be more wrong. Although doctors will play a big part in diagnosis and treatment while medical research will play a huge part in developing a vaccine, it will be supply chain logistics that will ultimately win the day.
Here are some of the things that will need to happen, not in any special order:
—First priority is to stop or greatly curtail the number of people being newly infected, especially health care workers who are at greater exposure risk. This will involve ramping up production and distribution of protective equipment. In this case, it’s not doctors we need, as the specifications are already developed. It’s contracting specialists, supply chain experts and believe it or not, lawyers. Why lawyers? Companies will need some liability protection for doing what the Federal government mandates as they fast track their processes and thus step outside of the usual manufacture, testing, and distribution regulatory process.
—Once a vaccine is developed and tested, we’ll need to distribute it. Again, this is a supply chain issue, not an issue for medical expertise. There is also a liability issue that needs amelioration as researchers fast track this process too.
—If this virus gets any real legs, we’ll need to select, staff and supply the quarantine facilities to hold larger numbers of people. This is a huge logistical task. If there is any doubt about that, ask the Border Patrol who ran into this very issue not too long ago.
—Across all of the above, there will be a training function for medical and support personnel at all levels. Some of this will involve the validation (of already developed) medical screening protocols. Training personnel in key professions to recognize symptomatic clues and how to deal with them. Many of these won’t be medical professionals, but rather laymen in other professions, such as Customs Inspectors at ports of entry, classroom teachers or even bus drivers.
I haven’t even come close to listing all the support effort that will be required over and above nursing or “doctoring.” The military has a concept called “tooth to tail,” which is the ratio of actual combat Soldiers (Airmen, Sailors, and Marines) doing the fighting, versus support personnel who bring them the bullets to shoot, the beans to eat and the bombs to drop. In our recent dust-up in Iraq, the ratio of combat to support personnel was 1:2.5.
Here we talk about the number of doctors & nurses actually delivering care versus all the support personnel that will be needed. Given all the “non-medical delivery” support that will be required, including all the supply chain and training issues, I cannot help but believe that ratio will be much higher than the military’s. I read one particular journal that recommends a 1:4 ratio in a doctor’s office to maintain max productivity. That number doesn’t come close to including all the other support elements the doctor touches, such as imaging services, consumable supplies and the like.
Back to the article that decried “only 4 out of 15” were doctors, I calculate a ratio of, 1:2.75 in that photo. Obviously that meeting wasn’t short doctors. Quite the opposite—there probably needed to be a few more support guys in the room. What a surprise. The anti-Trump media gets it wrong…again.