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Our health system is not remotely prepared for a "post-Covid" America

Rhys Morton, 53, was enjoying his new job at a catering company. Moving from a remote cabin in Alaska to a small town in Evansville, Indiana after the divorce was a shakeup, but she liked to work, and it was only a few blocks away.

Then one day in March, her boss, concerned about Morton's Peak, sent her home. Indiana hadn't started to fade yet, and Morton's first symptoms were probably anything. It was strange that spring, freezing one day and warm the next, and I assumed her cold symptoms were.

But the disease progressed. Soon she was dealing with digestive problems, fever and cough. She couldn't breathe. Her voice changed. "You can tell, right?" She asked me when we spoke on the phone. "I have my own Covid voice." She seems to have smoked her whole life, smokes two cans a day, and has stopped a few times a minute during our conversation to catch her breath or move the phone from her face to cough. She told me it was "long term". That's what they call themselves on a Facebook group he joined for people struggling with what they believe long-term Covid-19 symptoms have not resolved.

Her symptoms disappeared after about three and a half weeks, but they did not go away completely. Soon new problems arose to tackle. Mysterious and painful bruises. Capillary burst. Joint pain Headache. exhaustion. These symptoms have been with him since May and there is no indication that they will disappear anytime soon.

Since Morton does not have health insurance and therefore does not have a primary care physician, he never received a positive diagnosis for Covid-19 because he could not get tested. When I got sick in March, tests were rare. His only interaction with the hospital was after his supposed recovery, when the joint pain and high blood pressure became so severe that he couldn't even walk three blocks to the emergency room. She says the nurses treated her like a "drug student" that amplified her symptoms.

Much has been written about how the failures of our institutions, such as the dismantling of the public health system, contributed to the unprecedented spread of the virus in our country. We have not discussed to a lesser extent how these institutions will not only need to be rebuilt, but reconfigured to accommodate the post-pandemic world. Caring for socially isolated travelers, those recovering from surgery, and debilitating caregivers will require a radical reinvention of healthcare in America.

We have some of the best hospitals in the world, but only a few privileged people can access them. The number of jobs that come with all the health benefits is shrinking. An increasing number of Americans cannot afford dental care, do not have a primary care physician, treatment is delayed due to cost, and do not have access to mental health services. Millions of people have medical debts and others die because they cannot access health services. Five million people lost their health insurance this spring alone.

The problem goes beyond health insurance and affordability. The symptoms that have been reported by many long-standing carriers of the Covid-19 virus are the types of chronic conditions that American medicine is not very good at controlling. The most debilitating symptom that long-term Facebook groups report is headache and fatigue, or "brain fog." Morton refers to her headache as "zombie pains", as something that "gnaws at my mind." You have had migraines in the past, but the feeling is different and more intense.

In 2005, Paula Kamen published All In My Head: An Epic Quest to Cure, a relentless, completely unreasonable and only slightly illuminated headache, her recipe for a headache that started when she was 24 and is not over yet. In her accounts, doctors have segregated and misdiagnosed her for years, prescribed a highly addictive drug without a plan to control her dependence on these pills, accused her of exaggerating pain, and apparently randomly changed treatment plans. Her headache still persisted.

Kamen is not alone. In a profit-driven healthcare system, physicians are encouraged to find ways to speed up interactions, prescribe certain medications to others, and ignore social issues like financial worries, debt, isolation, and alienation, all of which have been shown to have an impact. direct in health. Many of those who enter the US healthcare system seeking care are rejected, mocked, misdiagnosed, or presented with treatment plans they cannot afford. Their doctors are less likely than men to believe that women describe their symptoms or pain levels less accurately. Black patients are less likely to be confirmed than white patients. Patients without health insurance or a method of payment are often unable to receive care outside of emergency room visits, which means that their ailments and conditions are only seen when they are in crisis.

The pain is political. And pain was always disproportionately distributed among those with the fewest benefits. As Anne Case and Angus Deaton illustrate in Mortality of Despair and the Future of Capitalism (2020), there is a correlation between regions with high percentages of people suffering from chronic pain and high percentages of Trump voters. Chronic pain, and the opioid-related crisis, are high-unemployment groups, where manual labor is the primary form of work and thrives alongside suicide and addiction. The areas hardest hit by the coronavirus, specifically the southeast of the country and the oxidation belt, were already suffering disproportionately bad health outcomes, with shorter life expectancies and a lower quality of life.

Not just those with persistent symptoms. David Thomas, Johns Hopkins chief of infectious diseases, told me: "We know that the Covid-19 virus is much more than whether you live or die, and that focusing only on death rates avoids much of the misery caused by SARS-CoV-2 ". Many severe Covid patients require medical interventions, such as a tracheostomy or limb amputation, which require long-term and expensive pain management, rehabilitation, and aftercare.

how many? No one seems to count these patients yet. The suffering of Covid-19 patients is classified as "recovered" in official data reports and is invisible to hospitals and governments. Long-distance operators have started meeting online to offer each other companionship and information to self-treat their symptoms. The Survivor Corps group already has more than 80,000 members.

Morton's movement is limited not only by her fatigue, but also by other symptoms such as digestive problems. You have to plan walks on trails that include places to rest or use the bathroom. Your city's public transportation system is inadequate, like many cities in the United States, and the lack of a car hampers your ability to seek medical care. Disability activists and feminists have long protested the inaccessibility of public spaces, from the lack of elevators to accommodate wheelchairs and strollers on the subway to the lack of public toilets. Lack of access, or even the mere fear of needing a place to rest or quick access to the toilet or sink and not being able to find it, makes single mothers chronically ill.

Morton is a survivor and tough. She overcame the shock and financial difficulties. While living in a cabin in Alaska, she had to carry a firearm outside the building in case of bear encounters. But this disease, he says, is the hardest thing he has ever had to overcome.

"This really is the world of zombies," he told me. "We", the long-distance carriers, "are the living, the dead."