Asunto(s)
Defensa Civil , Industria Farmacéutica , Medicamentos Esenciales , Planificación en Salud/organización & administración , Reserva Estratégica , Capacidad de Reacción , COVID-19/epidemiología , Defensa Civil/métodos , Defensa Civil/organización & administración , Planificación en Desastres/organización & administración , Industria Farmacéutica/organización & administración , Industria Farmacéutica/normas , Industria Farmacéutica/estadística & datos numéricos , Medicamentos Esenciales/clasificación , Medicamentos Esenciales/economía , Medicamentos Esenciales/provisión & distribución , Humanos , Legislación de Medicamentos , Evaluación de Necesidades , SARS-CoV-2 , Reserva Estratégica/legislación & jurisprudencia , Reserva Estratégica/organización & administración , Capacidad de Reacción/legislación & jurisprudencia , Capacidad de Reacción/organización & administración , Capacidad de Reacción/normas , Estados UnidosRESUMEN
It is thought that there are not enough mechanical ventilators in the United States for every patient who may need one during the novel coronavirus disease (COVID-19) pandemic. However, there has been no analysis that measures the potential magnitude of the problem or proposes a solution. In this article I combine the pandemic forecasting model used by the federal government with estimates of ventilator availability from the literature to assess the expected shortage under various scenarios. I then propose that the federal government organize a national effort for ventilators to be exchanged between states to take advantage of the intertemporal differences in demand peaks. I evaluate versions of this proposal, including use of the national stockpile, to estimate the potentially substantial number of lives that could be saved. In the absence of other viable solutions, the government should begin this effort in earnest, or else make preparations for such coordination should the country face another pandemic in the future.
Asunto(s)
Infecciones por Coronavirus/prevención & control , Unidades de Cuidados Intensivos/provisión & distribución , Evaluación de Resultado en la Atención de Salud , Pandemias/prevención & control , Neumonía Viral/prevención & control , Reserva Estratégica/legislación & jurisprudencia , Sobrevivientes/estadística & datos numéricos , Ventiladores Mecánicos/provisión & distribución , COVID-19 , Causas de Muerte , Infecciones por Coronavirus/epidemiología , Enfermedad Crítica/mortalidad , Enfermedad Crítica/terapia , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Prevalencia , Medición de Riesgo , Análisis de Supervivencia , Estados Unidos/epidemiologíaRESUMEN
Asthma is a significant public health issue, impacting quality of life, morbidity, and health care costs nationally. Stock asthma rescue medication policies authorize school districts to maintain unassigned albuterol and enable trained staff members to administer the medication in response to asthma symptoms, exercise premedication, and asthma emergencies. Stock asthma rescue (or reliever) medication laws serve as an important fail-safe measure. Such laws provide districts with the ability to respond if a student has an asthma emergency at school but either lacks a diagnosis or does not have access to their own medication. As of September 2019, 13 states have enacted either a law or regulation authorizing the stocking of asthma rescue medication in schools: Arizona, Colorado, Georgia, Illinois, Missouri, New Hampshire, New Jersey, New Mexico, Oklahoma, Ohio, Texas, Utah, and West Virginia. Three additional states provide stock albuterol asthma guidelines but do not have legislation: Indiana, New York, and Nebraska. Some states have found that these policies reduce the need for 911 calls and emergency medical services transports as a result of asthma exacerbations. Initial data also demonstrate that these policies reach populations in need and improve health outcomes. This case study will describe the current state of asthma in Illinois, an innovative policy solution to address asthma emergencies in schools, and the steps taken to advocate for stock asthma rescue medication in Illinois. Legislation for stock albuterol in Illinois was signed into law in August 2018.