Month: November 2019

Parents of students trapped at Hong Kong Polytechnic University (PolyU) after a violent weekend that set a significant percentage of the campus ablaze were reportedly “begging” police to let them see their children on Monday.

Hong Kong’s police forces raided the PolyU campus on Sunday, days after forcing the Chinese University of Hong Kong (CUHK) to shut down for the semester with a violent door-to-door operation seeking the arrests of pro-democracy protesters. Having the foresight of events at CUHK, students at PolyU appeared to prepare for an invasion with Molotov cocktails, coordinated use of umbrellas to defend from tear gas, and, in at least one attack, the use of a bow and arrow.

Images from the clashes on Sunday showed larges areas of the campus set aflame, covered in tear gas canisters, or otherwise destroyed. Police appeared to violently arrest students they believed were participating in attacks against officers, thrashing them on the group and leaving them bruised and bloodied.

Police returned to the campus early on Monday, blockading all roads around it to prevent the students from leaving. Students and parents protested that, without allowing bystanders on the campus to flee the violence, authorities would fail to restore order.

An anti-government protester puts out a fire at Hong Kong Polytechnic University on November 18, 2019, in Hong Kong. (Photo by Laurel Chor/Getty Images)

Protesters set a fire as they march to Hong Kong Polytechnic University in Hong Kong on November 18, 2019. (PHILIP FONG/AFP via Getty Images)

A student tries to extinguish a fire at the entrance of Hong Kong Polytechnic University in Hung Hom district of Hong Kong on November 18, 2019. (YE AUNG THU/AFP via Getty Images)

A protester lights a petrol bomb in front of a fire on a pedestrian bridge during clashes with police at Hong Kong Polytechnic University on November 18, 2019, in Hong Kong. (Laurel Chor/Getty Images)

The Hong Kong Free Press (HKFP) reported that police called the move a “dispersal and arrest” operation, leaving unclear how preventing anyone from leaving the campus would facilitate “dispersal.” Police had also made pleas to the protesters this weekend to leave campus, making their attacks on those attempting to do so confounding to the protesters.

Hong Kong Chief Executive Carrie Lam applauded the police, calling them “very courageous” for sieging the campus on Monday. Chinese state media backed the police move, claiming students had “gone completely hysterical and acted like terrorists.”

Hong Kong’s police have failed to suppress a protest movement that erupted in June in response to a proposed law that would have allowed China to extradite any individual present in Hong Kong if accused of violating communist laws. Under the “One Country, Two Systems” policy, China cannot impose communist law in the city.

Lam has since withdrawn the extradition bill but protesters continue to demand five other concessions from the government: freedom for protesters arrested during assemblies, an end to referring to peaceful assemblies as “riots,” an independent investigation into police brutality, and the direct election of lawmakers to better prevent a repeat of the extradition bill.

“I feel worried. As a parent, I feel helpless,” the mother of a student trapped at PolyU told the broadcaster RTHK on Monday at a sit-in organized by similarly concerned parents. RTHK reported the parents were “bursting into tears and begging police officers to allow the young people inside the university to come out,” noting that, given the chaos, it was impossible to guarantee that all the students trapped inside were involved in violence.
One parent said she was protesting for the freedom of her 16-year-old son, highlighting the fact that many of those trapped are underage.

A tearful mother is seen crying in Tsim Sha Tsui as she fears she may lose her children, who are now in PolyU. But one police officer questioned: “isn’t throwing bricks also hurting people?”

Video: SCMP/Alvin Lum pic.twitter.com/Mq6tMj7rrg

— SCMP Hong Kong (@SCMPHongKong) November 18, 2019

In addition to the parents, a group of secondary school principals organized a press conference in front of the Hong Kong Legislative Council (LegCo) to demand police open the PolyU campus to allow students to leave.

“We want you to be safe, we want to bring you out. It’s time for you to go home safely,” Lee Suet-ying, the former chair of the Hong Kong association of the Heads of Secondary Schools, said, addressing the students.
As many as 500 students are believed to be trapped on the PolyU campus, many with significant injuries from tear gas, rubber bullets, and water cannon fire. Police reportedly stationed in a cordon surrounding the campus at 5:30 a.m. Monday morning and have been shooting tear gas at students who attempt to escape since. Many of those seen attempting to flee were not wearing black, the color of the protest movement, or in any way indicating that they were protesters – they simply attempted to run off of campus.

Police also reportedly antagonized individuals on roads leading into campus, threatening them to stay out.

From telegram, #HongKongPolice arresting citizens “at will now” for simply driving cars near #PolyU pic.twitter.com/3tGI4APpkV

— Victor Ting (@VictorTing7) November 18, 2019

A group of about 100 students attempted to flee the campus early Monday, receiving a barrage of tear gas and rubber bullets. Some hit by water cannons reportedly exhibited signs of hypothermia. They reportedly decided to run because, early Monday morning, the president of PolyU claimed that police had agreed to a “ceasefire” to allow innocent students to flee.

Images and videos from Monday morning show police stomping on students, crushing their faces on the ground, and otherwise brutalizing them.

Police arrest anti-government protesters at Hong Kong Polytechnic University on November 18, 2019, in Hong Kong. (Laurel Chor/Getty Images)

Protesters are detained by police near the Hong Kong Polytechnic University in Hung Hom district of Hong Kong on November 18, 2019. (ANTHONY WALLACE/AFP via Getty Images)

Anti-government protesters clash with police at Hong Kong Polytechnic University on November 18, 2019, in Hong Kong. (Laurel Chor/Getty Images)

#HKPoliceTerrorists dragged an arrestee and then stepped on an the arrestee’s head! Such behaviours mustn’t be tolerated and these terrorists must be punished! pic.twitter.com/lRL1ZDqkPG

— Demosistō 香港眾志 😷 (@demosisto) November 18, 2019

Police confirmed the arrest of 61 medics on campus on Sunday, leaving almost no one on campus with the ability to offer professional first aid to the students they injured.

According to PolyU student union president Ken Woo, the students fear they are running out of food and have no access to medical care despite being attacked and significantly injured. Also reportedly trapped on campus are reporters stationed there to cover the clashes. RTHK claimed that police blocked their reporters sent it to take over from the Sunday shift and those working on Sunday were still trapped inside.

Police reportedly stormed the Hung Hom PolyU campus on Sunday, looking for individuals participating in the protest movement to arrest. Protesters had stationed themselves there for a week, emboldened to defend the campus by the attack on CUHK, which resulted in not only injured students but injured school administrators. The overwhelming majority of those in the PolyU protests are believed to be students.

The protesters responded to the invasion of the campus on Sunday with fire. Many used Molotov cocktails to firebomb police and attempt to keep them out of campus. At least one student was armed with a bow and arrow, as an officer was hospitalized with an arrow lodged in his knee.

In one shocking incident caught on video, students hurled Molotov cocktails into a police truck, sending it bursting into flames. Protest leaders on social media said some of those trucks appeared to be attempting to run over the students, Tiananmen-style, resulting in the desperate defense tactic.

Poly U entrance in flames as riot police try to storm in #HK #HongKongProtests #StandwithHongKong pic.twitter.com/egcKyS4X5j

— James Pomfret (@jamespomfret) November 17, 2019

Some of the dramatic footage from Poly University in Hong Kong last night.

This police truck was trying to go into campus but was instead lit on fire by Molotov cocktails pic.twitter.com/b9Yz2d5jju

— Joyce Karam (@Joyce_Karam) November 18, 2019

Chinese state media blamed the protesters completely for the police brutality on Sunday and Monday.

“Observers believed that rioters have gone completely hysterical and acted like terrorists as they attack police with lethal weapons, target innocent residents and turn campuses into battlefields,” the Global Times, a communist government newspaper, claimed on Monday, accusing protesters of making chemical weapons with laboratory materials stolen from science classes to use on police. The newspaper did not provide evidence for this accusation.

The Times disputed reports that students suffered symptoms of hypothermia after being attacked with water cannons, claiming the cannons proved “futile” against umbrellas.
Lam, the chief executive, applauded police in a Facebook post on Monday, calling the office recovering from an arrow wound “very courageous” and stating that, during a visit with him, the officer said he would return to work as soon as possible.

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Three weeks ago, I was struck with an intensely painful, and briefly highly dangerous, MSSA staph infection, with a full recovery underway.

The experience, plus time on my hands recuperating, has given me a personal appreciation of the coming nightmare of universal healthcare.

The month-long recuperating period has afforded me the opportunity to think holistically about my medical experience, especially as it relates to health care policy.

My conclusions are based solely on direct experience, in particular what I learned watching the system operate up close and personal.

Given my general conservative political views, I am mindful that I do not want to take advantage of “patient” status to discuss grander matters of health care.

So here goes, with apologies in advance if this post steps too far into the stream.

I leave from the story that it took eight days from the onset of the severe pain until I was under genuine medical care. As it turns out, the pain was due to a raging staph infection in my bloodstream, whereas my doctors to date had convinced themselves that it was a disc pull.

The unfortunate consequence was eight days without a blood test.  I was even discharged by the attending Emergency Room doctor with instructions to get a massage, which I did, to my walloping regret.

In retrospect, I believe it is fair to chalk up the missed diagnosis to normal bad luck and a difficult to diagnose condition. I focus instead only on the medical care received once I was properly admitted to one of the best hospitals in the U.S., in a luxurious (and expensive) private room, getting exceptional attention.

Here is the one thing I want to communicate, without being polemical or partisan.

Under Elizabeth Warren’s plan, or anything resembling a dramatic increase in demand for health care, inevitable once health is declared a “right,” no less a fundamental human right, I never would have left that hospital alive. Without any doubt.

Why?

For a couple of reasons that I want to share.

Most proximately, I saw firsthand how extremely limited already are the expensive diagnostics that were required to understand, and then treat, my condition.

In four days, I had two intensive MRIs, one Pet scan, two specialized ultrasounds, a swallow the camera procedure known as TEE, and an intensive Interventional Radiology procedure done inside a CAT scan (the actual interventional procedure that got me out of the danger zone).

To put it bluntly, the system is already stretched beyond capacity. Even my doctors were careful to say that they could not promise when I would be scheduled for each procedure.

Now add the huge increase in demand that is the whole point of universal health care. Starting first with these machines, the system will unequivocally break. In every other part of the world with a form of universal health care, the wait time for MRIs and the like has expanded to 30 days or more.

There is absolutely no chance I could have survived this type of delay, and when you consider the unusual quantity of such procedures that I received in a compressed four days, my personal outlook would have been a foregone conclusion.

Beyond the machine time, in the hospital you see the extreme forms of rationing already in effect for doctor time. In total, during the height of the crisis, I probably spoke directly with doctors for a total of fifteen minutes a day. Not to say they were not working on my behalf at other times, but you feel the unbelievable pressure they are under every second that they are speaking with you.

Add one more element that was the central problem in my case. No one knew where the true problem was hiding, and so they had to explore all, cardiac, pulmonary, neurologic, autoimmune, internal, chief among them. When I asked the supervising internist (whom I will return to in a moment), how they reached consensus decisions in this complex setting, she put a hard stop to my question. “I never meet these people, ever.”  Rather there is a central file that all specialists consult and, based on their reading of the evidence, recommend a course of action.

Put simply, in a universal health care system, anyone who happens to be suffering from a multi-dimensional set of ailments, or diagnostic complexity, is quite literally doomed. The system today, clumsy as it is, will assuredly be replaced with something orders of magnitude worse-unalterable authorized procedures. You will at best get what the system can afford, on average, for most patients. If you happen to fall outside of that world, tough luck.

The third area of rationing that is coming is with respect to prescribed medication. For reasons of cost, the reimbursed and allowable medications will be, on average, sharply reduced. In my case, I would never have received authorization for self-administered morphine, which even now required me to engage in a titanic struggle. No less would I have been given several times the typical fentanyl dosage during the vital, but unexpectedly long IR procedure.

Next we come to nursing services. It is inevitable that as much of doctoring and health care that seemingly can be offloaded to lower cost nurses, will be offloaded. In my case, the expensive luxury ward nursing services were quite good, and occasionally above and beyond compassionate care (you learn a great deal in the wee hours of a sixteen-day hospital stay how a hospital operates). But all that said, it still took time, sometimes quite long, for nursing to respond. They too are so obviously already working at capacity.

Now at last we are ready for the supervising, and therefore decision-making internist, who at bottom is entirely representative of the doctoring to come in universal health care. Once the crisis passed, her entire medical focus was on getting me discharged as fast as possible. In the future world, my hard-staring, pitiless internist will become yards more pitiless and the standards for discharge ever more stringent and stingy.

All of this is my directly observed experience. Independently the economic system will be eviscerated by new taxes, inevitably falling especially hard on the middle class (only so many 1%ers in the end, and not nearly enough to pay for what is coming).

Due to low reimbursement rates, innovation will suffer, the greatest cost of all, but also entirely unseen, in all phases, vaccines, medication, medical equipment and innovative procedures.

Last but not least, the harsh, inhumane conditions imposed on doctors will result in a declining supply of care, especially among the most valuable and experienced cohort of older doctors, who will inevitably choose retirement. This will yet further, alarmingly, increase the calamitous rationing about to descend upon us.

That’s it.

As I said at the outset, I do not mean to be provocative here in a political sense. It is simply my heartfelt observations after a particularly intense engagement in Health Care World as a patient. Usually, and hopefully, we read about such political proposals from a healthy chair at the table. Switching seats turns out to really matter. And since inevitably all of us will one day be there, opposition to universal health care ought to be a shared goal crossing partisan lines.

Graphic credit: Skyluke

Three weeks ago, I was struck with an intensely painful, and briefly highly dangerous, MSSA staph infection, with a full recovery underway.

The experience, plus time on my hands recuperating, has given me a personal appreciation of the coming nightmare of universal healthcare.

The month-long recuperating period has afforded me the opportunity to think holistically about my medical experience, especially as it relates to health care policy.

My conclusions are based solely on direct experience, in particular what I learned watching the system operate up close and personal.

Given my general conservative political views, I am mindful that I do not want to take advantage of “patient” status to discuss grander matters of health care.

So here goes, with apologies in advance if this post steps too far into the stream.

I leave from the story that it took eight days from the onset of the severe pain until I was under genuine medical care. As it turns out, the pain was due to a raging staph infection in my bloodstream, whereas my doctors to date had convinced themselves that it was a disc pull.

The unfortunate consequence was eight days without a blood test.  I was even discharged by the attending Emergency Room doctor with instructions to get a massage, which I did, to my walloping regret.

In retrospect, I believe it is fair to chalk up the missed diagnosis to normal bad luck and a difficult to diagnose condition. I focus instead only on the medical care received once I was properly admitted to one of the best hospitals in the U.S., in a luxurious (and expensive) private room, getting exceptional attention.

Here is the one thing I want to communicate, without being polemical or partisan.

Under Elizabeth Warren’s plan, or anything resembling a dramatic increase in demand for health care, inevitable once health is declared a “right,” no less a fundamental human right, I never would have left that hospital alive. Without any doubt.

Why?

For a couple of reasons that I want to share.

Most proximately, I saw firsthand how extremely limited already are the expensive diagnostics that were required to understand, and then treat, my condition.

In four days, I had two intensive MRIs, one Pet scan, two specialized ultrasounds, a swallow the camera procedure known as TEE, and an intensive Interventional Radiology procedure done inside a CAT scan (the actual interventional procedure that got me out of the danger zone).

To put it bluntly, the system is already stretched beyond capacity. Even my doctors were careful to say that they could not promise when I would be scheduled for each procedure.

Now add the huge increase in demand that is the whole point of universal health care. Starting first with these machines, the system will unequivocally break. In every other part of the world with a form of universal health care, the wait time for MRIs and the like has expanded to 30 days or more.

There is absolutely no chance I could have survived this type of delay, and when you consider the unusual quantity of such procedures that I received in a compressed four days, my personal outlook would have been a foregone conclusion.

Beyond the machine time, in the hospital you see the extreme forms of rationing already in effect for doctor time. In total, during the height of the crisis, I probably spoke directly with doctors for a total of fifteen minutes a day. Not to say they were not working on my behalf at other times, but you feel the unbelievable pressure they are under every second that they are speaking with you.

Add one more element that was the central problem in my case. No one knew where the true problem was hiding, and so they had to explore all, cardiac, pulmonary, neurologic, autoimmune, internal, chief among them. When I asked the supervising internist (whom I will return to in a moment), how they reached consensus decisions in this complex setting, she put a hard stop to my question. “I never meet these people, ever.”  Rather there is a central file that all specialists consult and, based on their reading of the evidence, recommend a course of action.

Put simply, in a universal health care system, anyone who happens to be suffering from a multi-dimensional set of ailments, or diagnostic complexity, is quite literally doomed. The system today, clumsy as it is, will assuredly be replaced with something orders of magnitude worse-unalterable authorized procedures. You will at best get what the system can afford, on average, for most patients. If you happen to fall outside of that world, tough luck.

The third area of rationing that is coming is with respect to prescribed medication. For reasons of cost, the reimbursed and allowable medications will be, on average, sharply reduced. In my case, I would never have received authorization for self-administered morphine, which even now required me to engage in a titanic struggle. No less would I have been given several times the typical fentanyl dosage during the vital, but unexpectedly long IR procedure.

Next we come to nursing services. It is inevitable that as much of doctoring and health care that seemingly can be offloaded to lower cost nurses, will be offloaded. In my case, the expensive luxury ward nursing services were quite good, and occasionally above and beyond compassionate care (you learn a great deal in the wee hours of a sixteen-day hospital stay how a hospital operates). But all that said, it still took time, sometimes quite long, for nursing to respond. They too are so obviously already working at capacity.

Now at last we are ready for the supervising, and therefore decision-making internist, who at bottom is entirely representative of the doctoring to come in universal health care. Once the crisis passed, her entire medical focus was on getting me discharged as fast as possible. In the future world, my hard-staring, pitiless internist will become yards more pitiless and the standards for discharge ever more stringent and stingy.

All of this is my directly observed experience. Independently the economic system will be eviscerated by new taxes, inevitably falling especially hard on the middle class (only so many 1%ers in the end, and not nearly enough to pay for what is coming).

Due to low reimbursement rates, innovation will suffer, the greatest cost of all, but also entirely unseen, in all phases, vaccines, medication, medical equipment and innovative procedures.

Last but not least, the harsh, inhumane conditions imposed on doctors will result in a declining supply of care, especially among the most valuable and experienced cohort of older doctors, who will inevitably choose retirement. This will yet further, alarmingly, increase the calamitous rationing about to descend upon us.

That’s it.

As I said at the outset, I do not mean to be provocative here in a political sense. It is simply my heartfelt observations after a particularly intense engagement in Health Care World as a patient. Usually, and hopefully, we read about such political proposals from a healthy chair at the table. Switching seats turns out to really matter. And since inevitably all of us will one day be there, opposition to universal health care ought to be a shared goal crossing partisan lines.

Graphic credit: Skyluke