Andrew Goldstein Profile picture
Sep 14, 2020 14 tweets 4 min read Read on X
I have patients who live near Kingsbrook. Its closure must be stopped.

Here's a THREAD on hospital closures.

This is relevant wherever you live. These forces are at work nationwide. Think: Hahnemann in Philly, Mercy in Chicago, countless rural hospitals. 1/
Why do hospital closures happen?

Is it because people no longer live in their area? That might make sense, but is not the case. 2/
Hospital closures are due to racist, anti-poor *intentional underfunding* of community and safety net hospitals, which are then blamed for being fiscally unsound. 3/
Chronic underfunding is manufactured by our political leaders and their austerity supporters, and are taken advantage of by private equity, real estate developers, and profiteering health systems. 4/
These profiteers pursue closure in order to pick apart these community institutions to make money, whatever the cost in terms of human health. E.g. close this "unprofitable" unit and turn it into condos, have this rich health system absorb this "profitable" unit. 5/
And the evidence is clear: closures keep people from necessary care, and are racist policies in how they worsen health outcomes across groups.

Check out this great report. 6/ bu.edu/sph/files/2015…
Now let's consider Kingsbrook specifically.

According to nurses I know there, this is not an unused hospital. They were hit hard by the pandemic. 7/
They told me ER nurses had 20 patients, worked 16 hours straight, and were left crying in their cars after shifts for the care they struggled to provide as they were understaffed.

This is a place that needs investment, not closure. 8/
And closure will further traumatize staff and a community that were so traumatized by the pandemic (and our failed response). 9/
Case rates and death rates were disproportionately high in East Flatbush.

Staff didn’t have enough PPE (as rich hospitals had private planes shipping in ample supplies).

The morgue was overwhelmed.

At least 6 health workers died. 10/
My patients, my colleagues, and other members of East Flatbush deserve better. When they get sick, they deserve timely, high quality care. 11/
Instead of closing Kingsbrook, we must equitably invest in community hospitals and we must ensure that healthcare is paid for as a right so that these hospitals aren't financially vulnerable in the first place. 12/
Please sign this to support these rank and file union health workers and the community. They are starting a campaign to pressure their union and members of the City Council and state legislature. 13/
If you're looking to learn more about hospital closures (or related topics like hospital corporatization and geographic disparities) or to take action, recommend:
@Arrianna_Planey
@OliviaWebbC
Nurses unions
@UniteThePoor
@DSA_HWC
@PNHP

Who has helped you learn more?
14/

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More from @AndrewMakeTweet

Mar 3, 2022
"Protecting the vulnerable"
"Protecting hospital capacity"
"Preventing variants"

Are good rhetoric, but do the policies make sense for these goals? Are these goals enough?

No. A mini-🧵.
The policies don't live up to the words once we consider the realities of:
– US healthcare inaccessibility
– pre-/asymptomatic spread
– people living with others
– chains of transmission
– exponential growth
– levels of immunity
This doesn't even include the issues with the continued shifting of responsibility to states, municipalities, and individuals, and the delay in implementation and effects of implementation once supposed policy/behavior triggers are met by indicators.
Read 5 tweets
Feb 25, 2022
CDC mask guidance change 🧵

1) Hospitalizations lag test positive cases which lag actual cases

2) Guidance based more on hospitalizations means willfully abandoning critical windows to act

3) So this guidance is less about new science or better public health, and more about…
... both justifying the relaxation of public health protections now and about justifying too little, too late policy responses in the future when surges re-emerge.
This is – in contrast to "evidence-based policymaking" – policy-based guidancemaking.

It is irresponsible and inappropriate for health experts and public health authorities to create this or champion it in their messaging work.
Read 24 tweets
Feb 24, 2022
War is bad for everyone except the wealthy and powerful.

It's pathetic and tragic that most of humanity has little it can offer except condemnation.

We deserve democratic global institutions capable of preventing and dealing with conflict. 1/
Borders and nations are artificial.

Powerful nations and the powerful within all nations use to these constructs to their advantage.

But there are other constructs that show how ridiculous this is. 2/
To me this invasion is as preposterous as Florida invading Georgia.

Just as one US state invading another is essentially inconceivable and impossible in 2022, we need democratic and representative global institutions empowered to prevent and deal with international conflict. 3/
Read 5 tweets
Feb 5, 2022
Let's highlight how "civility politics" operates in pandemic discourse. 🧵

1) Highly platformed health "experts" drive policy negligence with their incorrect, harmful messaging. They get bylines, journalist interviews, TV appearances, book deals, and wide rightwing celebration.
2) The health "experts" face a backlash. Some of it is admittedly unkind and personal, but most was civil, valid criticism or very fair sharing of real and raw emotion from people who have endured awful policy violence these experts have fostered.
3) These health "experts" have a choice. They can respond to substantive criticisms, they can show up for debates, they can reflect on if their prior predictions were accurate or prior prescriptions worked out well. Or they can seek to deflect the backlash.
Read 10 tweets
Dec 12, 2021
Here's a 🧵 reviewing this op-ed from @MonicaGandhi9 and @LeslieBienen.

Spoiler: incoherence, obfuscation, and omission that feeds pandemic inaction + promoting a data reporting approach that destroys opportunities to save lives and prevent suffering.

First off, why is the NYTimes continuing to platform voices that have consistently been incorrect?

Premature optimism, essentially calling the pandemic over, has driven real harm by degrading policy protections and public behavior.

Who was the editor here?
How's this essay start?

Highlighting Omicron, and what isn't known about.

What's neglected? Omitted? Ignored?

The current surge in *Delta* cases, hospitalizations, and deaths, with 1,000+ deaths most days for months, and projections of another 100,000+ dead in coming months.
Read 21 tweets
Dec 11, 2021
Rapid test are probably able to catch about half of presymptomatic cases.

They're neither perfect nor insignificant, which makes them a great layer of protection to use with others. 1/
That means at the population level, pre-gathering rapid tests may halve the rates of infectious people attending. 2/
But a more meaningful question, at the level of an individual gathering might be:

"What is the chance of anyone attending this gathering being infectious?"

I.e. the chance of one or more people being infectious. 3/
Read 5 tweets

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