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Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.

A Time For Comfort

Thank you for your thoughtful piece on palliative care, “Shortfall Of Comfort Care Signals Undue Suffering For Coronavirus Patients” (March 26). The new stimulus package passed by Congress should make it easier to access palliative care via telemedicine during this crisis. The new provisions expand Medicare’s ability to provide telemedicine and expand grant funding for evidence-based telehealth networks and technologies. These provisions will help those in underserved communities access palliative care and all telehealth services.

We must ensure that terminally ill people are not forced into a hospital setting where they are made more vulnerable to contracting the coronavirus, dying more quickly or in pain; that’s why these provisions are so crucial during this time. Terminally ill people need access to end-of-life care options to minimize their suffering, including hospice and palliative care, and telemedicine provides a clear path forward for doctors and patients to achieve this goal.

― Dr. David R. Grube, national medical director for Compassion and Choices, Corvallis, Oregon

— Julie Fairman, Philadelphia

How Long Has The Coronavirus Been Around — Really?

One of the last things my brother did before being diagnosed with “bronchitis” on Aug. 3, 2019, was fly on a plane from San Diego to New York City. By Aug. 20, he was admitted to the ICU at Stony Brook University Hospital. On Aug. 21, a shocked doctor told us my brother had an ejection fraction (EF) of just 10% and his heart was catastrophically failing. Later that night, he went into cardiac arrest. He was on an ECMO machine until Sept. 6, 2019, dying at 43 years old.

They said he had myocarditis from an unknown viral infection. The infectious disease specialists ran so many tests and found nothing concrete. What are the chances?

It is important for anyone who survives this virus to have a heart and lung scan done, later. Will there be any implementation of that? I just don’t see how you can survive this and not have any long-term damage. And I am always going to wonder what really killed my brother seven months ago.

― Trini Olsen, Patchogue, Long Island, New York

Sensational — And Not In A Good Way

The April 6 story on possible heart damage associated with the coronavirus was shocking and is beneath what I expect from Kaiser Health News (“Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients”).

First of all, the exploding-heart illustration was overly graphic. At a time when many are emphasizing how delicately and honestly we should be sharing information, it shocked me to see. Totally out of line. It takes a fair story and frames it as alarmist. This set me, the reader, off on a bad note.

Then, the first two authorities interviewed did not seem to have a direct connection to the story. Were they involved in assessing the cardiac impact of COVID-19? The story fields a set of generalities, with quotes from willing, go-to cardiologists, as flavor and spice, before getting to actual source information: 1) the Dr. Shaobo Shi / China JAMA article, and 2) Dr. Sahil Parikh, who seems to actually be involved. His view, and his role in examining cardiac health dimensions of coronavirus, were obvious.

Overall, I think the alarming, unrelated heart cartoon sets a misleading spin, and that it was a challenge until late in the article to determine who was the source of the heart dimension of the story.

— Paul Rowan, Houston

Stop The Madness

Instead of lambasting doctors, how about a story on who is sitting at home collecting health care dollars: health maintenance CEOs, hospital administrators, health insurance execs (“Why Hoarding Of Hydroxychloroquine Needs To Stop,” March 25)? They do so from the comfort of their safe homes while pontificating on ways to generate more income, limit costs, tell health care providers how to do their jobs while failing to provide a safe environment for them to work. Doctors have every right to do what is necessary to protect themselves and their families — especially when no one seems to care about their lives but is concerned only with the care they provide.

Health care providers should not have to work in unsafe conditions. Physicians are at risk due to hospitals, administrators and health insurance companies not caring about anything except the money that flows into their pockets based on health providers’ work. Stop the madness! This is the main reason doctors are “hoarding” meds. Tell the whole story, not just the part that makes physicians look bad.

— Dr. Patricia Perry, Burbank, California

https://twitter.com/Lisa_skinnypig/status/1243935850792128512?s=20

— Lisa Skinner Escalante, Chattanooga, Tennessee

Meals On Wheels Keeps On Rolling

Thank you for your article regarding Meals on Wheels (“Inside Meals On Wheels’ Struggle To Keep Older Americans Fed During A Pandemic,” April 7). We are so proud of our kitchen staff, office staff, drivers and volunteers who come out of the safety of home to ensure that our 1,300 (and increasing) meal recipients receive meals and wellness checks. Thank you to Meals on Wheels programs across America, in every state, doing the same, serving healthy nutrition and caring face to face contact with our frail elderly neighbors. We honor the front-line health care staff in hospitals and emergency services who deserve the utmost recognition. We hope our role as Meals on Wheels providers is protecting many who might otherwise be among the vulnerable.

― Joseph Tornello, Staten Island, New York

— James Conner, Kalispell, Montana

To Stay On The Safe Side Wearing Masks …

Your article “To Curb Coronavirus, What’s Behind The Wearing Of A Mask? (April 7) missed several points that should be made about trying to protect oneself from the COVID-19 virus with masks or gloves.

Using masks incorrectly can actually increase the risk of contracting the virus. People who are not used to wearing masks constantly touch and reset the mask. Therefore, if the mask really did catch any virus particles that were headed toward their mouth, the contamination will immediately spread to their hands, glasses, face, etc.

People must know that if they have no choice but to leave the house, they must use a disposable mask, or better yet something reusable that covers your mouth and nose (e.g. bandana, scarf, homemade cloth mask, etc.). They should not touch it while they are using it, and must wash their hands before and after touching it, adjusting it or removing it. Upon returning home, the used mask or accessory must be immediately discarded or washed/disinfected.

It is also important that people recognize that wearing a pair of gloves all day long does not decrease the risk of getting infected, much less the risk of spreading the virus; it increases it. Gloves give a false, unwarranted and dangerous sense of security. It makes people careless, so they touch surfaces all day long without taking care or cleaning themselves and the surfaces.

COVID-19 is non-irritating to the hands and does not penetrate the body through the skin of the hands! Therefore, it makes more sense, for most people, to do away with the gloves, stay alert and paranoid, and frequently wash hands and surfaces. Unless they are a health professional or first responder, or someone who cleans using harsh chemicals, wearing a pair of gloves all day (without changing them repeatedly), doesn’t make sense. It is as inappropriate as putting on gloves to pick up dog poop in the backyard, and then continuing to use the same gloves to arrange the patio furniture, open and close doors and, after returning indoors, clean and cook.

If people have to go out, they should avoid touching people and surfaces with their hands and must wash your hands frequently and repeatedly. Laypeople should leave gloves to the health care providers who need to wear them and change them thousands of times a day, before and after each patient interaction, to avoid spreading the virus.

― Dr. John M. Pagán, Guaynabo, Puerto Rico

Free Flow Of Ventilator News

Thanks for your article on nursing home surpluses of coronavirus ventilators (“Nursing Homes Have Thousands Of Ventilators That Hospitals Desperately Need,” April 7). As you know, ventilators are one of the keys to solving COVID-19, and everything related to ventilators is in extreme flux ― where they are and where they are needed, who is working with whom to scale up production, what protocols are needed to use them effectively, what experimental devices are in the pipeline, how staffing and meds are scaling, whether ventilators can be shared, whether BiPAP/CPAP machines can be upgraded, etc.

To help folks keep up, my company has posted a collated news page at http://CoronavirusVentilator.com. This is a public service; we have no other motive in doing this and receive no compensation. If the page is of use to you, please consider linking to it or publicizing it in whatever way is appropriate.

— Joel Lown, Knoxville, Tennessee

https://twitter.com/ResnickLR/status/1242197087565070337?s=20

— Lindsay Resnick, Chicago

On ACA’s 10th Anniversary, Let Us Eat Cake?

I just browsed through your coverage on the 10th anniversary of the ACA (“Listen: The Hard-Knock Health Law Turns 10 Amid Pandemic,” March 23), and I cannot disagree more with what that health bill has done to our health care system. Thousands of pages of legalese and pork fat that could only be passed by nuclear option, and no, it is not popular, though you will say it is because you only poll a certain demographic.

Go poll a group of patients who use the services of non-government-funded clinics that operate on donations only. Talk to my patients who were sold on the ACA then couldn’t afford it. They were promised health insurance but forgotten after the election. They are the working poor. Those who have two to three jobs to make ends meet, living paycheck to paycheck, but cannot get Medicaid because they make too much yet too little to afford the ACA and cannot qualify for subsidies. I love my free clinic with minimal staff — the Greenville Free Medical Clinic — and almost overflowing with volunteers. Our patients know they are getting the best care available — sometimes quicker than any staff member or volunteer could. We treat them with the dignity they deserve, and not like pawns on a chessboard.

The ACA was a farce to purposefully destroy the health care system in America, not fix it. It was a wrecking ball aimed at the base of it in order to allow for a socialistic model to be built from the rubble. Unfortunately for those who passed the bill, they learned it was not as popular as they wanted, and have subsequently been attacked since Day One. I am not putting in here empirical evidence because if you have eyes and a decent brain you can see what has been happening. I will let you think on the “22 million” that are now insured, actually underinsured, and the other unaccounted for people who were left out in the cold during one of the largest scams the U.S. government has ever run.

― Frances Watson, RN, BSN, Greenville, South Carolina

Between A Rock And A Hard Place

Your ongoing reporting on affordable insurance hits home. I, too, am caught between a rock and hard place. At 60, I am too young for Medicare yet my family’s AGI is above the threshold set by the feds for any subsidy. Employer-sponsored insurance is not a viable option because I need to be available at home to assist my spouse, who has a progressive degenerative neurological condition, which in my opinion is not only the loving thing to do but the most cost-effective.

I do not want a subsidy in order to pay for an individual health care policy. I simply want an affordable policy as I had before the Affordable Care Act. I also do not want to be forced to pay for a policy that covers things that do not affect me, like pregnancy or birth control. How about a policy priced to reward good health habits, like a healthy diet, exercise, etc.? What has happened to applying common sense to the way people purchase health insurance and the way health care costs are managed so that these costs are in line with most blue-collar workers’ wages? Layers and layers of federal bureaucracy bloat costs, and partisan politics keep the cycle of the dog chasing its tail alive and well.

I, for one, greatly appreciate all at KHN who appear to be on the front lines fighting for those of us who want logical solutions to the high cost of medical insurance policies and health care costs. It is tragic that in the greatest country in the world you have millions of hard-working citizens who go without health insurance and increasing numbers who postpone or forgo medical care because they worry about incurring these outrageous costs.

In my humble opinion, the solution will be that which gives financial incentives for everyday Americans to provide for themselves and their loved ones. Why does this government insist on making it so difficult for hard-working folks to be responsible and take care of themselves and their loved ones?

The poor and disadvantaged will always be among us, and when most Americans are allowed to be prosperous, be charged reasonably for goods and services, and keep more of what they earn, they always show generosity and endless compassion. None of this is complicated, yet it continues to be out of reach because those making the final decisions are too worried about that next election!

― Teresa Killion, Mount Vernon, Washington

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