{"id":49085,"date":"2020-11-20T18:18:37","date_gmt":"2020-11-20T17:18:37","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=49085"},"modified":"2020-11-20T18:19:19","modified_gmt":"2020-11-20T17:19:19","slug":"covid-19-has-sparked-physician-built-response-systems-in-the-us","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/11\/20\/covid-19-has-sparked-physician-built-response-systems-in-the-us\/","title":{"rendered":"Covid-19 has sparked physician-built response systems in the US"},"content":{"rendered":"<div>\n<p dir=\"ltr\">As healthcare professionals, we have a responsibility to build a system that serves our patients, protects providers, and advances our profession. The role of government in maintaining those values in our countries has become increasingly clear in the past year. Safety is not partisan, although party lines have appeared among views of the role of governments in facilitating the safety of their citizens during the coronavirus pandemic. Nowhere are these lines more stark than in the United States, now the global leader in confirmed coronavirus <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__covid19.who.int_-3Fgclid-3DCj0KCQjwit-5F8BRCoARIsAIx3Rj5zOMEx8BfPMz8oAI7atIFJ38kYBHLTWtFJO5lMnvvBGWEztdA-2DqtYaAjWJEALw-5FwcB&amp;d=DwMFaQ&amp;c=WO-RGvefibhHBZq3fL85hQ&amp;r=hVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038&amp;m=mpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4&amp;s=vw2_yhGCj-WWmD3rasKuEbRxE62h0ShYNDlqbbzCOSE&amp;e=\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/urldefense.proofpoint.com\/v2\/url?u%3Dhttps-3A__covid19.who.int_-3Fgclid-3DCj0KCQjwit-5F8BRCoARIsAIx3Rj5zOMEx8BfPMz8oAI7atIFJ38kYBHLTWtFJO5lMnvvBGWEztdA-2DqtYaAjWJEALw-5FwcB%26d%3DDwMFaQ%26c%3DWO-RGvefibhHBZq3fL85hQ%26r%3DhVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038%26m%3DmpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4%26s%3Dvw2_yhGCj-WWmD3rasKuEbRxE62h0ShYNDlqbbzCOSE%26e%3D&amp;source=gmail&amp;ust=1605978110333000&amp;usg=AOvVaw0eac1oAM1o1YfNLQxV25Mq\">case loads<\/a>\u00a0and having among the <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__jamanetwork.com_journals_jama_fullarticle_2771841-3FguestAccessKey-3D0b2df654-2Db775-2D4691-2Dbf01-2Db6e762f46c6c-26utm-5Fsource-3DFor-5FThe-5FMedia-26utm-5Fmedium-3Dreferral-26utm-5Fcampaign-3Dftm-5Flinks-26utm-5Fcontent-3Dtfl-26utm-5Fterm-3D101220&amp;d=DwMFaQ&amp;c=WO-RGvefibhHBZq3fL85hQ&amp;r=hVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038&amp;m=mpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4&amp;s=VQsRQX0jf80Bk_juo8M1226ABv4EAH6RD_9tQiFbqHM&amp;e=\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/urldefense.proofpoint.com\/v2\/url?u%3Dhttps-3A__jamanetwork.com_journals_jama_fullarticle_2771841-3FguestAccessKey-3D0b2df654-2Db775-2D4691-2Dbf01-2Db6e762f46c6c-26utm-5Fsource-3DFor-5FThe-5FMedia-26utm-5Fmedium-3Dreferral-26utm-5Fcampaign-3Dftm-5Flinks-26utm-5Fcontent-3Dtfl-26utm-5Fterm-3D101220%26d%3DDwMFaQ%26c%3DWO-RGvefibhHBZq3fL85hQ%26r%3DhVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038%26m%3DmpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4%26s%3DVQsRQX0jf80Bk_juo8M1226ABv4EAH6RD_9tQiFbqHM%26e%3D&amp;source=gmail&amp;ust=1605978110334000&amp;usg=AOvVaw0hQzqSxItASESMOZXotOL1\">highest mortality rate<\/a> of covid-19 cases compared to our economic peers. The United States\u2019 federal response to the covid-19 pandemic has relied heavily on the leadership of state governors rather than a comprehensive public health approach. This choice, to coordinate covid-19 responses at the state level, has resulted in little centralized infrastructure to assist the medical community\u2019s response to the pandemic, compelling many physicians to occupy roles that stretch the typical boundaries of professional responsibility.<\/p>\n<p dir=\"ltr\">Leadership within medicine and other industries have risen to build the centre of the United State\u2019s covid-19 response. The coronavirus has compelled a political reckoning in medicine by disrupting the traditional boundaries of doctors\u2019 and other health professionals\u2019 participation in society. Prior to the declaration of a national state of emergency on 13 March, medical professionals and trainees across the United States had been developing <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__nsrnhealth.org_-23&amp;d=DwMFaQ&amp;c=WO-RGvefibhHBZq3fL85hQ&amp;r=hVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038&amp;m=mpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4&amp;s=J7z7BJITmhTfYp7jp_F_vOkL2LumuTApApm73V0eUAE&amp;e=\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/urldefense.proofpoint.com\/v2\/url?u%3Dhttps-3A__nsrnhealth.org_-23%26d%3DDwMFaQ%26c%3DWO-RGvefibhHBZq3fL85hQ%26r%3DhVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038%26m%3DmpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4%26s%3DJ7z7BJITmhTfYp7jp_F_vOkL2LumuTApApm73V0eUAE%26e%3D&amp;source=gmail&amp;ust=1605978110334000&amp;usg=AOvVaw1ugg5XRI8xC0098J1wDF3B\">volunteer networks<\/a>, <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__covidprotocols.org_&amp;d=DwMFaQ&amp;c=WO-RGvefibhHBZq3fL85hQ&amp;r=hVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038&amp;m=mpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4&amp;s=7i9nM86tNfsvuu526HElpHcnxhl8CsdHhb_q9b0H-_8&amp;e=\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/urldefense.proofpoint.com\/v2\/url?u%3Dhttps-3A__covidprotocols.org_%26d%3DDwMFaQ%26c%3DWO-RGvefibhHBZq3fL85hQ%26r%3DhVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038%26m%3DmpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4%26s%3D7i9nM86tNfsvuu526HElpHcnxhl8CsdHhb_q9b0H-_8%26e%3D&amp;source=gmail&amp;ust=1605978110334000&amp;usg=AOvVaw1ZbygQ1VMi-OgRVr115E0l\">shared resources<\/a>, and <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__getusppe.org_&amp;d=DwMFaQ&amp;c=WO-RGvefibhHBZq3fL85hQ&amp;r=hVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038&amp;m=mpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4&amp;s=_r13BkFp2sSDJf5_2NtvITB_lUREg9HBTlKojTm6tSg&amp;e=\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/urldefense.proofpoint.com\/v2\/url?u%3Dhttps-3A__getusppe.org_%26d%3DDwMFaQ%26c%3DWO-RGvefibhHBZq3fL85hQ%26r%3DhVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038%26m%3DmpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4%26s%3D_r13BkFp2sSDJf5_2NtvITB_lUREg9HBTlKojTm6tSg%26e%3D&amp;source=gmail&amp;ust=1605978110334000&amp;usg=AOvVaw1fPb6mr4lswDbQtRQsIe2p\">national logistics infrastructure<\/a>\u00a0to assist our nation\u2019s response to the <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__www.cdc.gov_mmwr_volumes_69_wr_mm6908e1.htm&amp;d=DwMFaQ&amp;c=WO-RGvefibhHBZq3fL85hQ&amp;r=hVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038&amp;m=mpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4&amp;s=AuN8sXJp-nbQhtlog3v09Uyual8gE084lh3ydFKsnv4&amp;e=\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/urldefense.proofpoint.com\/v2\/url?u%3Dhttps-3A__www.cdc.gov_mmwr_volumes_69_wr_mm6908e1.htm%26d%3DDwMFaQ%26c%3DWO-RGvefibhHBZq3fL85hQ%26r%3DhVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038%26m%3DmpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4%26s%3DAuN8sXJp-nbQhtlog3v09Uyual8gE084lh3ydFKsnv4%26e%3D&amp;source=gmail&amp;ust=1605978110334000&amp;usg=AOvVaw3rDyqKGymPskD3_s5JumRD\">novel coronavirus.<\/a> These innovations have spanned social, economic, and political divides. In response to dwindling supplies of personal protective equipment (PPE) and inadequate production, GetUsPPE.org was launched through the collaboration of physicians and software engineers. This digital platform coordinated the donation, request, and distribution of PPE throughout the United States; within 10 days, over 1800 hospitals and PPE suppliers were registered in a database that enabled the rapid coordination and distribution of scarce, in-demand supplies.\u00a0Similar to leaders of other initiatives, those who started GetUsPPE understood their work as an early stop-gap until a national response was marshalled. When no response came, they continued their efforts, which have now matured into a robust national infrastructure for the collection and equitable distribution of PPE. In order to honor the work of countless volunteers and advance the United States\u2019 response to future health crises, leaders throughout the United States must consider how to support these novel programs, sustain their infrastructure, and, if sought by these initiatives, offer pathways towards institutionalization.<\/p>\n<p dir=\"ltr\">Out of respect for our frontline workers and healthcare professionals, we can not ask them to again undergo the <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__www.ncbi.nlm.nih.gov_pmc_articles_PMC7273269_&amp;d=DwMFaQ&amp;c=WO-RGvefibhHBZq3fL85hQ&amp;r=hVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038&amp;m=mpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4&amp;s=j5Hyp-S8GtEphUu82w7lorS4p3bZs1znF19cBhlRUNQ&amp;e=\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/urldefense.proofpoint.com\/v2\/url?u%3Dhttps-3A__www.ncbi.nlm.nih.gov_pmc_articles_PMC7273269_%26d%3DDwMFaQ%26c%3DWO-RGvefibhHBZq3fL85hQ%26r%3DhVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038%26m%3DmpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4%26s%3Dj5Hyp-S8GtEphUu82w7lorS4p3bZs1znF19cBhlRUNQ%26e%3D&amp;source=gmail&amp;ust=1605978110334000&amp;usg=AOvVaw0q6rvk00PBpbrKVBigSPuK\">stress and lack of support<\/a> that compelled the creation of these new systems. The protection of public health requires broad coalition. Building relationships between other industries and healthcare will increase our creativity and reveal blind spots in our nation\u2019s approach to public health. These relationships may open through discussions of how to grow ongoing covid-response systems.<\/p>\n<p dir=\"ltr\">As other sectors look into supporting public health, healthcare professionals must raise their gaze and acknowledge the political interfaces of their roles. Providing high-quality healthcare involves engaging with the public and private lives of every patient, which are <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__www.who.int_social-5Fdeterminants_resources_mekn-5Freport-5F10oct07.pdf&amp;d=DwMFaQ&amp;c=WO-RGvefibhHBZq3fL85hQ&amp;r=hVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038&amp;m=mpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4&amp;s=mPmgFQk0vf5nG7PPVXCf5Wjd0QGW1r2c7K31Ba0KCLw&amp;e=\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/urldefense.proofpoint.com\/v2\/url?u%3Dhttps-3A__www.who.int_social-5Fdeterminants_resources_mekn-5Freport-5F10oct07.pdf%26d%3DDwMFaQ%26c%3DWO-RGvefibhHBZq3fL85hQ%26r%3DhVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038%26m%3DmpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4%26s%3DmPmgFQk0vf5nG7PPVXCf5Wjd0QGW1r2c7K31Ba0KCLw%26e%3D&amp;source=gmail&amp;ust=1605978110334000&amp;usg=AOvVaw2ODlKZvXiq8tUovV6zL-oJ\">shaped profoundly<\/a> by social determinants. Prior to covid-19, doctors have neglected this reality and have voted at <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__pubmed.ncbi.nlm.nih.gov_17443365_&amp;d=DwMFaQ&amp;c=WO-RGvefibhHBZq3fL85hQ&amp;r=hVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038&amp;m=mpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4&amp;s=PgfwN4B8DB_yPviYr0_FKLTixwua0ORY9T5DgfouIBQ&amp;e=\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/urldefense.proofpoint.com\/v2\/url?u%3Dhttps-3A__pubmed.ncbi.nlm.nih.gov_17443365_%26d%3DDwMFaQ%26c%3DWO-RGvefibhHBZq3fL85hQ%26r%3DhVOqOJaoPamv5NXwBgL1B0EqTs0HyEYn-P2xO9Lc038%26m%3DmpkcGXqs4npdWp7zfjbrp5tKhwNgmozz6_DI_kZThs4%26s%3DPgfwN4B8DB_yPviYr0_FKLTixwua0ORY9T5DgfouIBQ%26e%3D&amp;source=gmail&amp;ust=1605978110334000&amp;usg=AOvVaw0xt2anrLctMUaTKV6q_anX\">rates lower than the general population<\/a>. Given the far reaching impacts of covid-19 on the health of our patients, we must engage in far reaching solutions by participating civically. Voting-eligible healthcare professionals can inform public health decisions by voting consistently at the local, state, and national levels. This responsibility is non-issue based, and non-partisan, but may help to sustain many of the new systems that have been developed in response to the Coronavirus pandemic. Healthcare systems can magnify their missions of health promotion by developing ways to ensure that social, economic, and political solutions are informed by the vote of healthcare professionals; an actionable first step is to eliminate voting barriers for their employees. As healthcare professionals develop novel solutions to address the Coronavirus pandemic, our response will remain incomplete if we do not address healthcare\u2019s culture of political disengagement.<\/p>\n<p dir=\"ltr\">To preserve the integrity of our healthcare system and advance public health, the healthcare workforce must build coalition with leaders throughout other industries to maintain the progress that has been built during the medical response to covid. Voting is one method to make these changes durable. Within healthcare, voting has been underemphasized as one method to sustain and promote public health. Covid-19 has catalyzed changes throughout healthcare, including the creation of many valuable response systems. One change that may prove to be the most valuable response to covid-19 is the political awakening of healthcare, which holds promise to reimagine how healthcare contributes to the health, safety, and wellness of the communities we serve.<\/p>\n<\/div>\n<div><em><strong>Jon\u00a0<span class=\"il\">Kusner<\/span><\/strong>\u00a0is a fourth year medical student at Harvard Medical School. He serves a co-chair of the AMSA National MedOutTheVote Campaign that seeks to engage healthcare professionals and trainees in improving the health of our democracy.<u><\/u>\u00a0<\/em><\/div>\n<div><\/div>\n<div><em><strong>Shuhan He <\/strong>is an Emergency Medicine Physician and is the co-founder of GetUsPPE.org, a national organization that works to fulfill donations of PPE. Since its launch, the organization has delivered over 2 million pieces of PPE, and has served as a centralized authoritative source of demand data of PPE nationwide.<\/em><\/div>\n<div><\/div>\n<div><em><strong>Competing interests<\/strong>: None declared.<\/em><\/div>\n","protected":false},"excerpt":{"rendered":"<p>As healthcare professionals, we have a responsibility to build a system that serves our patients, protects providers, and advances our profession. The role of government in maintaining those values in [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/11\/20\/covid-19-has-sparked-physician-built-response-systems-in-the-us\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":48389,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-49085","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Covid-19 has sparked physician-built response systems in the US - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/11\/20\/covid-19-has-sparked-physician-built-response-systems-in-the-us\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Covid-19 has sparked physician-built response systems in the US - The BMJ\" \/>\n<meta property=\"og:description\" content=\"As healthcare professionals, we have a responsibility to build a system that serves our patients, protects providers, and advances our profession. 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