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COVID-19 meatpacking

pdez90

Industrial meatpacking plants in countries all over the world (USA, Germany, Australia) have all become hotspots of COVID-19 (Link). 

The close proximity in which workers working in such plants, the gruelling hours, the lack of access to healthcare among workers (many of whom are immigrants, refugees and POCs), are all reasons why such plants have emerged as hotspots. This Propublica article talks about the amont of preparation that such an industry has for pandemic flu outbreaks that could wipe out animals, but failed to do the same for their workers (Link). Moreover, our desire of meat (bad for the environment and unsustainable), has resulted in these companies having a tremendous amount of clout which allowed some to go over the heads of local officials as the ProPublica article reports. 

Air Pollution <-> COVID-19

pdez90

A well publicised Harvard study reported an association between long-term exposure to fine particulate matter (PM2.5) and COVID-19 deaths (Link). Another recent study that consider multiple pollutants found a signficiant association between nitrogen dioxide (NO2), a traffic-related pollutant and COVID-19 deaths, and not PM2.5 (Link).

Air pollution and COVID-19 have intersected in other ways. The decreases in air pollution due to the lockdown were seen as one of the few silver linings of the crisis (Link). Although early optimism has been dashed as air pollution levels have jumped right back up in China (Link) and other places when the lockdown was lifted. Some may say that under the cover of COVID-19, the Trump administration also rolled back several environmental regulations (Link), and it is unclear yet what the long-term effects of such rollbacks will be.

Air pollution is also a carrier of COVID-19 (Link), and researchers have been investigating the transmission of the virus by simulating mundane activities such as speaking in the elevator and even flushing a toilet.

Some of the other ways however, in which air pollution and COVID-19 will intersect are at infrastructure such as warehouses, which we will see increase as more and more people move to shopping online. Already in the recent pasts of the building of massive warehouses have been challenged for environmental justice reasons, as they tend to be built in poor, minority communities and result in heavy freight traffic, which in turn burdens such communities with increased pollution (Link1, Link2). Amazon employees themselves have documented the nature of siting of warehouses (Link), and it is likely to become an even more fraught site of contention as we move forward.

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Sara_Nesheiwat

The Emergency Medical Treatment and Labor Act is a law requiring that anyone coming into the emergency department will be stabilized and treated no matter what their insurance situation is. In terms of women's health, it is important to note that this means for active labors, medical treatment is necessary and required, no matter the health insurance of the patient. The purpose of this law to prevent certain patients from being turned away in an emergency situation or refused medical treatments if they are unable to pay, putting their health at risk.

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Sara_Nesheiwat

EMTALA was enacted by Congress in 1986 and was part of the Consolidated Omnibus Budget Reconciliation Acts of 1985. Congress saw different cases around America where doctors were refusing medical care to patients who could not make a deposit at the time of their admittance to the ER. An example of this is a patient Eugene Barnes, who in 1985 suffered a stab wound and ultimately ended up dying because 6+ doctors refused to help him without payment or some form of compensation. This made national news and other cases began to come to light, such as at Baptist Hospital in Miami and many other areas. News outlets began to follow these cases and this caught attention of government officials. Shortly after, EMTALA was enacted.

http://www.pitt.edu/~kconover/ftp/emtala-draft.pdf

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Sara_Nesheiwat

This was touched upon a little in a previous question. Many cases of patient dumping were popping up around America. Patients in need  of emergency medical care were being cast aside, ignored and delayed due to their inability to pay. In addition to the stab patient, Eugene Barnes that sparked this law, there were dozens of other cases where patients needed to be transferred to larger hospitals but the hospital refused to take patients without insurance, so the patients died. There were cases of people being asked right before surgery for a deposit, and being unable to pay were discharged with no surgery. There was also a very high rate of dead babies that were arising due to the fact that mothers in labor were being turned away because the patient was uninsured. It was then realized by the government that there were no legal duties for a hospital to treat people who are in emergency situations but cannot pay, only ethical and moral duties, which apparently weren't enough in some cases. This led to the birth of the EMTALA, requiring medical attention to all ED patients as well as transfers if needed to stabilize, including mothers in labor.

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Sara_Nesheiwat

This policy greatly helped sculpt emergency medicine and public health. By giving the right to the patient to have emergency medical treatment required without proof of insurance or payment, astronomically influenced the amount of patients being turned away and their possibilty of developing worse illnesses or dying. In a paper I read, a young doctor in the late 70s and early 80s remembers watching a woman in labor give birth in the doorway of the hospital and proceed to borht her child in the parking lot after being turned away for not having insurance. By requiring hospitals and doctors to see that all ED patients get care, no patient was at risk of dying or complicating their baby's health and birth due to a lack of insurance, ultimately increasing public health efforts. Not all hospitals turned away their patients, but enough did to make it a public health concern and get Congress involved. EMTALA changed emergency medicine protocols but also public health expectations and actions.

http://www.hhnmag.com/articles/5010-the-law-that-changed-everything-and…

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Sara_Nesheiwat

This policy was explicitly made for vulnerable populations who couldn't afford or for whatever reason did not have health insurance. The vulnerable parties that did not have health insurance were at risk of being turned away at hospitals during crucial times of need and emergency situations. This act completely absolved the worries and fears of this vulnerable population without health insurance by making it a law that these ED patients were to receive care and stabilization. This act was made for this specific vulnerable population, to prevent discrimination.

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Sara_Nesheiwat

This policy was received in good light by the public for the most part. Patients were only to benefit from this, especially those who lacked insurance. Even those with insurance didn't have to waste time proving it any longer, they were treated and stabilized and insurance issues and payment were brought up later. Any ethically sound doctors, such as the ones working in hospitals that were already implementing the actions set forth by EMTALA (before it was law) had no issues with EMTALA. No doctor should have any issues with it due to their duty to act as well as ethical and moral standards they should be holding themselves up to, written in their oath they took to become doctor. The only people that would stand to receive this act negatively would be the doctors who were actively turning away patients in need, who are clearly morally compromised. Yet, media, patients, a majority of doctors and staff found and received this act positively or with little reservation.