Thread by @JonMarronMD

A BRIEF THREAD: 🧵🧵🧵

Today, @PetrieFlom published a piece by @paulcmclean & I on their Bill of Health blog that explores sports, entitlement, #ethics, equity, and the doctor-patient relationship in the time of #COVID19:

blog.petrieflom.law.harvard.edu/2020/04/06/fav… (1/18)

It's been interesting to see the role of sports in #COVID. Sports pale in comparison to what we're seeing in EDs & ICUs around the country, but it's notable that COVID really entered US public consciousness when @NBA player @rudygobert27 got it
wsj.com/articles/it-st… (2/18)

Notably, Gobert just two days before had mocked people's concerns about the pandemic in this viral video (he's since apologized and been a strong public advocate for #SocialDistanacing)

(3/18)

Quickly, the NBA season (and soon after, other sports seasons) were cancelled, and many professional athletes were able to get COVID testing and self-quarantine, DESPITE BEING ALMOST ENTIRELY ASYMPTOMATIC
nytimes.com/2020/03/18/us/…
(4/18)

But at that same time, clinicians around the country were struggling to find tests for their patients and for other clinicians who fell ill. wsj.com/articles/coron…

This has improved in the weeks since that time, but only to a certain degree (5/18)

Important to be clear here - completely well, asymptomatic professional athletes (& other celebs) could get tested, but sick patients and clinicians could not (particularly early on, when testing criteria required known contact with someone who was known to be COVID+) (6/18)

So how could athletes like Gobert get tested when so many could not? You could argue that professional athletes are among those at *LOWEST* risk of harm from #COVID19 -- they're young, healthy, and wealthy enough to not suffer greatly from staying home and missing work (7/18)

The answer, unfortunately, is the same reason that celebs, government officials, and many others in the public eye have been able to get tested: money and influence. (8/18)

Trump actually acknowledged this fact in a press conference on March 18 on @cspan in a rare moment of honesty. When asked about why pro athletes could get tested when sick patients couldnt, he responded "Well, perhaps that's been the story of life"
c-span.org/video/?c486657…
(9/18)

Sadly, it's hard to argue with that. The "American Way" for far too long has ensured that the rich get richer & those who already have advantages get more advantages.

The other side of this coin is that the disadvantaged continue to get stepped on, pushed down, & hurt. (10/18)

This is unfortunately proving to be the case with COVID, as beautifully (but horrifically) described by @uche_blackstock in @Slate: slate.com/news-and-polit…
(11/18)

This isn't new, of course. The US has an ugly history of taking advantage of those who already are disadvantaged (often cuz we took advantage of them!). Sadly, medicine has been a key player in this, with atrocities like Tuskegee, Willowbrook, Holmesburg Prison, & others (12/18)

The end result is a systemic -but understandable- distrust in the healthcare system by our most vulnerable. We absolutely MUST do better if we hope to maintain the public trust in the healthcare system in the post-COVID world (13/18)

But back to sports for a second. Interestingly, some of the wealthy/privileged like Bob Meyers of @warriors @GSWFastBreak, chose not to use that privilege & DIDNT test their teams. “We’re not better than anybody, not worse. Just a basketball team"
nytimes.com/2020/03/18/us/… (14/18)

We're all struggling to know right now what the US (& the world) will look like post-COVID, and when that post-COVID world will begin.

But one thing that we can be sure of is that it's going to look different. (15/18)

The question is, different in what way.

The #COVID19 pandemic could widen disparities and worsen distrust in the healthcare system - personally, I worry that we're walking down that path now... (16/18)

But the alternative is that the pandemic could bring us together and serve as a driver for equity in healthcare access, regardless of income, insurance status, race, ethnicity, gender, sexuality, etc. Weve seen some signs that this could take place, but it will take work (17/18)

It's an easy choice, but not a simple one. But it will unquestionably impact the landscape of healthcare in the US on the other side of #COVID19.

Fingers crossed that we make the right choice... (18/18)

blog.petrieflom.law.harvard.edu/2020/04/06/fav…
/fin

@threadreaderapp compile

of course, only now do I notice that I shouldve said "@paulcmclean & me" not and I. My elementary school grammar teachers are all simultaneously shaking their heads disapprovingly... 🤦‍♂️🤦‍♂️🤦‍♂️