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Simple explanation of why Covid-19 is so Dangerous
This is a simple explanation as to how Covid-19 became such a dangerous highly contagious pandemic. This explains why, as an emergency medicine physician, we emphasize the importance of social distancing while medical protocols are developed.     COVID-19 This is a post from a respected Infectious disease doctor that gives a nice simple explanation of why COVID-19 is so contagious. Please take note as to why social distancing is so important as we have time to develop medical protocols. Feeling confused as to why Coronavirus is a bigger deal than Seasonal flu?  Here it is in a nutshell. I hope this helps. Feel free to share this to others who don’t understand. It has to do with RNA sequencing ... i.e. genetics. Seasonal flu is an “all human virus”.  The DNA/RNA chains that make up the virus are recognized by the human immune system.  This means your body has some immunity to it before it comes around each year. You get immunity two ways: through exposure to a virus, or by getting a flu shot.   Novel viruses come from animals. The WHO tracks novel viruses in animals (sometimes for years ... watching for mutations). Usually these viruses only transfer from animal to animal (pigs in the case of H1N1) (birds in the case of the Spanish flu). But once one of these animal viruses mutates and starts to transfer from animals to humans ... then it’s a problem. Why? Because we have no natural or acquired immunity. The RNA sequencing of genes inside the virus isn’t human, and the human immune system doesn’t recognize it so we can’t fight it off. Now .... sometimes the mutation only allows transfer from animal to human; for years the only transmission is from an infected animal to a human before it finally mutates so it can now transfer human to human. Once that happens, we have a new contagion phase.  And depending on the fashion of this new mutation, that’s what decides how contagious, or how deadly, it’s going to be. H1N1 was deadly, but it did not mutate in a way that was as deadly as the Spanish flu. The RNA was slower to mutate, and it attacked its host differently, too.   Fast forward. Now, here comes this Coronavirus ... it existed in animals only, for nobody knows how long ... but one day at an animal market, in Wuhan China, in December 2019, it mutated and made the jump from animal to people.  At first only animals could give it to a person ... but here is the scary part ... in just TWO WEEKS it mutated again and gained the ability to jump from human to human. Scientists call this quick ability, “slippery”. This Coronavirus, not being in any form a “human” virus (whereas we would all have some natural or acquired immunity) took off like a rocket.  And this was because humans have no known immunity and doctors have no known medicines for it. And it just so happens that this particular mutated animal virus changed itself in such a way the way that it causes great damage to human lungs. That’s why Coronavirus is different from seasonal flu, or H1N1 or any other type of influenza. Coronavirus is slippery and it’s a lung eater, and it’s already mutated AGAIN so that we now have two strains to deal with, strain S and strain L ... which makes it twice as hard to develop a vaccine. We really have no tools in our shed with this.  History has shown that fast and immediate closings of public places has helped in the past pandemics.  Philadelphia and Baltimore were reluctant to close events in 1918 and they were the hardest hit in the US during the Spanish Flu. Factoid:  Henry VIII stayed in his room and allowed no one near him, till the Black Plague passed ... (honestly, I understand him so much better now). Just like us, he had no tools in his shed, except social isolation... And let me end by saying ... right now it’s hitting older folks harder ... but this genome is so slippery ... if it mutates again (and it will) who is to say what it will do next.   Be smart folks ...
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A “Non-Medical” Medical Response From The Church
I often find myself wishing I could do more to help when there are crisis situations around the world. When I see pictures and hear stories of hospitals in Italy overwhelmed with patients, running low on supplies, beds, and healthcare workers, I wish I could roll up my sleeves up and jump in to help. As a non-medical person, however, my engagement on the front lines of this medical crisis is limited. I can check in with the elderly in my neighborhood, offer to buy groceries for those more susceptible to this virus, and fulfill my personal civic responsibility to avoid the spread of the virus. But there’s not much I can do on the medical front. However, during this COVID-19 outbreak, God has reminded me that everyone has a significant role, regardless of profession or skill set. Remember the story of Moses? In Exodus 17 when Joshua was leading the Israelites in battle against the Amalekites, Moses, Aaron, and Hur went to a nearby hilltop. When Moses held up his hands, the Israelites were winning. When he lowered them, the Amalekites began to win. When Moses began to get weary, Aaron and Hur literally held up his arms, and the Israelites won! For some reason, God chose to work through Moses in this way for this particular battle. He led the battle, but Aaron and Hur played a significant role by ensuring Moses’ hands stayed up! In the same way, non-medical people can support and care for those in the medical community. God will use them in this battle against COVID-19. What could this look like? Prayer-walking around neighborhood hospitals. Making provisions for single parents working in area hospitals and emergency rooms. Ordering food for healthcare workers during the crisis. Mowing the lawn of an overworked caregiver in your neighborhood. Putting a card or note of encouragement in the mailbox of a caregiver. Creative possibilities are endless. Think of ways to make healthcare workers feel loved and supported as they sacrifice to care for patients. As the COVID-19 crisis progresses, Christians cannot retreat in fear. With worship services and Bible studies being cancelled everywhere, it can feel like the Church is sidelined. I believe that we can, and should, continue to find opportunities to show Christ’s love for others, to point them to One who provides a peace that surpasses all understanding, and support those on the front lines of healthcare. Download full ebook "A Healthcare Worker's Response to COVID-19" here
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God’s Providence Through COVID-19
We don’t talk much about God’s providence until we get into moments in history like this, and then we start becoming more interested in these types of topics. John Frame defines providence as, “God’s works of providence are, his most holy, wise, and powerful preserving and governing all his creatures, and all their actions.” This definition challenges our thoughts while presenting us a great hope for God’s active role through all of life.   Lord over the Natural World Proverbs 16:33 tells us about a lot being cast, while making it clear that “every decision is from the Lord” proposing a narrative that all things are under God’s control. If anything, we see that God is intensely personal in all of life. He isn’t aloof or distant, He is constantly active and deeply personal with all of His creatures through all things.   Lord over Human History Joshua 21:44-45 paints a picture that “not one word of God’s has failed” leading us to a deeper understanding that God is not only Lord over the natural world, but also over human history. We’re reminded here of the birds and the flowers of Matthew 6, that is God is in control of every event in nature, how much more would He care for us, His children?   Lord over Individual Human Lives Jeremiah 1:5 and Psalms 139:13-16 both capture this picture that our Father has knit us together before time and in our mother’s womb... far before any of us could personally engage in our own lives. God has been doing something miraculous in each of our lives before we existed and He continues that Lordship over our lives all through the lives we now live.   Lord over the Good and the Bad Lamentations 3:37-38 then challenge us with these words, “Is it not from the mouth of the Most High that good and bad come?”. For some of this, the concept of God being Lord over the good and the bad is uncomfortable. We’re challenged in our thought of His Lordship and what we even mean by His Lordship. All the while, scripture is filled with over 6,000 verses of God’s Lordship over all things as He is in control of, has authority over, and is present in all things.   Present in His Lordship So what’s the point in all of this? For me, it’s simple. His Lordship and Providence all point to the overwhelming reassurance that He is present with us in and through all things. As each of us navigates COVID-19 with our family, our work, our finances, and every other aspect of life, we can rest assured that He is present with us in all things. He is Lord over the natural world. He is Lord over human history. He is Lord over our personal lives. He is Lord over the good and the bad. And He is present in every aspect of His Lordship.   May we all rest assured that not even the most remote and minor aspect of our current circumstance are out of His control, and rest in His absolute presence in our lives. Download full ebook "A Healthcare Worker's Response to COVID-19" here
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How Can Those Stateside Support Those Overseas Working In High Prevalence Areas?
International healthcare workers are accustomed to making nuanced decisions. We routinely consider various cultural perspectives, resource limitations, and spiritual insights. Now, the current COVID-19 pandemic is calling all our decision-making skills into action. How can supporters in home countries help those serving in hot zones overseas? Pray! Thinking of decisions the overseas workers face, pray for them! Medical missionaries live in settings of varied perspectives. Cultures and values differ between international teammates, and between those serving and those being served. As COVID-19 began spreading, some people in Europe scoffed at American worriers and paraded through crowded streets. When Americans were settling in to a phase of social distancing, one pastor encouraged large gatherings, saying “the safest place is in God’s house.” We all need to realize that overseas workers like the rest of us, are confronted with varied beliefs stemming from divergent cultural perspectives. Pray that they will listen respectfully, and that their own comments will be seasoned with grace. Medical missionaries are accustomed to dealing with limited resources. Now, in their settings of service, they grapple daily with limited supplies, decisions about allocation of costly resources, and outside advice about how to implement interventions that simply aren’t available. Pray that they will focus on caring for people instead of just bodies. Pray that they will see value in their ministry, even when resources are limited. Pray that healing and hope will come to their patients, even if oxygen and ventilators are not readily available. Most medical missionaries sensed a call that propelled them to their places of service. Sometimes, though, they need to be reminded that they were called to ministries of salvation and sanctification, not just to live in safety and security. We need to pray that medical missionaries will remember Who they serve and to which Kingdom’s growth they are contributing. We can pray that we all face the current pandemic with eternal perspectives. We need to pray that medical missionaries will be graced with divine wisdom as they discern which risks to their own security and safety are worth taking for the greater good of providing care to people in need. We need to pray that they will stay humble rather than seeking heroism, that they show compassion to individuals while not endangering the populations they intend to serve. How can we help those serving overseas? They know that Paul sometimes fled danger, escaping hostility by sneaking over a wall, and that he sometimes faced angry crowds. They also know, though, that Paul changed his mind after listening to godly counsel and didn’t run into a rioting crowd in Ephesus. Pray for overseas workers, and be willing to bounce thoughts around with them. Stay or go? They know that Jesus once slipped away from a crowd wanting to kill Him and that at another time He welcomed those coming to arrest and crucify Him. Supportively praying for overseas workers, we need to realize the truth of Ecclesiastes, that there are different times for different responses to events. International medical workers are facing daily decisions during rapidly changing situations. We should pray that they will discern God’s specific will for each specific time. How can those stateside support those overseas working in high prevalence areas? Pray for them. Pray that they will wisely sift through conflicting opinions while maintaining excellent cross-cultural relationships. Pray that they will focus on the good God is doing, even when they are confronted with discouraging resource limitations. Pray that they will have specific guidance as they make specific decisions – about “big” questions of whether to stay or go and about “little” decisions about when to implement versus withhold interventions. And, remember we are all in this together. No human knows all the right answers. None of us has truly unlimited resources. Even those who feel safer today might be in the pandemic’s hot zone tomorrow. Even as we pray for those working overseas, we need to be open to the guidance they might have for us as we face similar situations. How can those stateside support those overseas working in high prevalence areas? Pray with open ears, minds, and hearts. We need to pray, while listening to God ourselves. We need to pray, while listening to the godly counsel of others. We need to pray, while realizing we truly are in this together. Download full ebook "A Healthcare Worker's Response to COVID-19" here
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Short Term Medical Mission Produces Long Term Fruit
We want to highlight another story from the field today. This story comes from Guatemala and we hope you are challenged by how your own short term trips might produce long term fruit! In June 2018, a GO InterNational medical team visited the village of La Libertad. Late that afternoon, as the doctors and nurses ended to the remaining patients, team members Nic Cabrini and Nestor Gomez spent a good bit of time with a man from the village named Juan. They shared the gospel but the man was not interested. Despite their efforts, he was very resistant. That night they shared with the team their burden for Juan. The team prayed for him and committed to continue to pray for him as they began heir journey home the next day. Nic returned to Guatemala as one of our Community Health Evangelism trainers in October 2019.  One of the first people to come up to him was Juan. He couldn’t wait to tell Nic what had happened. After our team left, our partner Jorge Camposeco continued to return to the village regularly to witness to him. Eventually his resistance was broken and he came to faith in Christ. His life was totally changed. He told us that even his garden was more productive His wife had no interest in becoming Christian but she began to go to church with him and also became a Christian. The two of them are now key people for Jorge’s ministry in that village and have now completed our Community Health Evangelism training so they can continue to impact their community. Often our teams don’t get to see the fruit of their work. This was one of those rare times for Nic to be able to see the fruit of the seed he had planted over a year before.  And it also shows the value of “short-term missions through long’-term partnerships,” a phrase we use often at GO InterNational. Nestor and Nic planed the seed and God used Jorge to water and harvest. What a beautiful picture of the body of Christ working together across the nations. 
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The Challenge Of Faith
Christians face the same challenge every day of their lives, namely, the challenge of living by faith. We perceive that challenge differently depending on our circumstances, but it is no more or less real regardless of what we face on any given day. These days, however, the challenge can be overwhelming. The current challenge is no further away than a quick swipe or touch on a phone. As COVID-19 sweeps the world, we are inundated with news of rising case numbers, death tolls, social and economic crises, lockdowns, sheltering in place, hoarding of food and supplies, and often conflicting and confusing predictions of worst case scenarios as well as less than comforting best-case scenarios. Early assurances from some government officials and a few news outlets that the virus is nowhere near as bad as some “experts” in the media make it sound, have all but evaporated. The Pollyanna hope that we’ll soon turn the corner and find that it was really nothing more, or even less, than seasonal flu is gone. Now we are all facing an uncertain future in both the long and short term. To say that COVID-19 and all its ripple effects is a “challenge” for every human being is an understatement, but for Christians there is a particular issue at stake, namely, whether we will be shaped and conformed by what we hear and see, or whether we will live, as we say we do, by faith. In times of uncertainty, tragedy, and loss, we often turn to one of the more well-known verses in the Bible for comfort, “And we know that for those who love God all things work together for good, for those who are called according to his purpose” (Rom. 8:28,ESV). The reasons we love this verse are easy to recognize. The Apostle Paul assures us that, no matter what, God is on our side, and even working for our good. Why is it, then, that such a profound and glorious verse sometimes brings (if we’re honest) cold comfort? For one, we often use that verse like a spiritual Band-Aid we offer one another, and to ourselves, in times of trials. Not of course, that we shouldn’t remind ourselves of it, but we do need to be thoughtful of its meaning and application. The big problem is what we think the word “know” means. Paul is not offering knowledge of a spiritual blueprint that will explain the behind the scenes work that God is doing in our lives. Neither is he saying that we will “know” how God is at work for our good like the way we know the latest COVID-19 case stats. That latter is knowing by “sight”—what we see, hear and experience. The knowing Paul speaks of is the knowing of faith. In other words, Paul is not saying that given enough time, we will see exactly what God was up to in our lives and one day say, “Now I see what God was doing!” Sometimes that happens, but not all the time. What he is saying is this: faith believes that God is who he says he is, has done all he says he has done in Christ, and is, therefore trustworthy. God can be trusted even when everything around us would line up as evidence against his promises. Faith in Christ is not the absence of doubt, fear, anxiety, or stress—it is believing in the face of doubt, fear, anxiety, and stress. Here’s why you, as a Christian, can believe that God is on your side and working for your ultimate good. Later on in Romans 8, Paul gives a long list of things in verses 38-39 that he says “will never separate us from the love of God in Christ.” The list needs to be read primarily as painting a holistic picture rather than trying to break down each part and find individual parallels: “For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, nor height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.” All those things represent what we may see, hear, encounter, experience, sense, and perceive. Some are physical and some are spiritual in nature. All together they represent a vanguard of realities that would line up to attack and ultimately destroy our faith (not unlike the news lately). COVID-19, and all its related effects, fits into that list. Paul offers us the hope that regardless of what we see, we may know by faith that God really is on our side. He is at work always conforming “us to the image of his Son” (8:29). We can have assurance of that by faith because God has already given us the supreme gift in the ultimate sacrifice for us: “What then shall we say to these things? If God is for us, who can be against us? He who did not spare his own Son but gave him up for us all, how will he not also with him graciously give us all things” (8:31-32). That’s how God is at work for our good. That is the knowledge, the ultimate knowledge, of faith. Romans 8:28 is not for a spiritual burying our heads in the sand, or an offer of easy answers—faith is never easy—in our current difficult times. It is, rather, a biblical call to understand and react to COVID-19 specifically as Christians. Romans 8:28 does not magically wipe away concern and replace it with casual complacency, but offers the freedom of faith so that we can live as Christ in the world, witnesses to God in Christ in a world gripped with fear, doubt, and death. Download full ebook "A Healthcare Worker's Response to COVID-19" here
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The Church Responds To COVID-19
Challenges for the church just keep coming in an onslaught that is fierce and seemingly unending. Now, the church faces a pandemic. Throughout time God has used catastrophic tragedies to bring people to himself. Every crisis is an opportunity to love people. Every church has shortcomings. Crisis exposes weakness and tests strength. How well the church has equipped members to be disciples who reach out is put in full view during crisis. There are key questions. How fast does the church respond to those in need? Do people feel inspired and empowered to act and respond in their own neighborhoods? Is the church actively looking for opportunities to serve the most vulnerable? Is the church willing to hang with these folks when the crisis is over? Will church outreach projects transition to development and lasting transformation? This COVID-19 crisis is unique in that it has forced the church to go online with worship services, prayer meetings, leader’s meetings, and Bible studies. This has been a huge win! A senior pastor of a church in Champaign, Illinois, has been hosting a weekly prayer gathering on Wednesdays at noon with attendance hovering around 100. The first week the crisis hit and church services were forced online, the noon prayer gathering, hosted online, had 3,000 participants. Online nights of prayer were not part of the program at Southeast Christian Church until COVID-19 made it impossible to meet. Now the church’s vision to be a praying church is taking a big step forward due to the crisis. During times of crisis, the Gospel can be demonstrated most beautifully. God gave us the Great Commission (Matt. 28:18-20), the great commandment (Matt. 22:37) and the great concern (Matt. 25: 34-46) as the full Gospel. As the church responds as Jesus commands in Mark, the church becomes relevant to the community. During a crisis, the “least of these” among us suffer most. In the case of this crisis, it’s the elderly, the poor, single moms and their children that are hit first and hardest. Across the U.S., 45% of single moms live in poverty. Mark 25: 34-46 describes praying for the hungry, thirsty, lonely, naked, sick, and those in prison. This could be expanded to those are anxious, giving hope. A crisis can also expose a lack of unity within the body of Christ. For years, pastors have been praying that God will unite the body of Christ in cities across the country. Prayer can demolish strongholds that divide, such as racism, denominationalism, politics, poverty, affluence, and more. Every part of the body of Christ needs the other parts. Each part of the body has blind spots. As we submit to one another, blind spots are exposed and God is glorified. Download full ebook "A Healthcare Worker's Response to COVID-19" here
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Faith, Fear, Caution, Reality: A Balanced Mindset
Eleanor Roosevelt, wife of our thirty-second president, Franklin Delano Roosevelt, famously said “A woman is like a tea bag; you never know how strong it is until it’s in hot water”. Mrs. Roosevelt was cleverly restating what we’ve learned from experience: the pressures of stress and danger reveal our true character. This truism applies to individual disciples of Jesus and also to the collective American church. Today’s hot water is an invisible virus that’s sickening and killing people. For a time it was a distant abstraction endangering the other side of the world, but now it’s striking our cities and states. At this writing, more than 100 Americans have died from COVID-19. Despite the implementation of quarantine and distancing strategies, many, many more will die. While most Americans are being asked to withdraw from settings where the virus might be transmitted, health care workers are actively engaging the people and places where the virus can attack. By caring for ill patients, we’re potentially exposing ourselves and our families to illness and even death. For many Western health care workers, especially those under forty, this is new, anxiety-provoking territory. I started medical school in 1986, just a few years after a Los Angles physician described a mysterious cluster of deaths from Pneumocystis carinii pneumonia, an infection that only affects patients with weakened immune systems. Reports of similar deaths grew more numerous across the country, especially among gay men, injection drug users, and those dependent on blood transfusions. For some time, there was not scientific consensus about how the infection could be spread. As late as 1984 The New York Times cited a study suggesting AIDS could be contracted by exposure to infected saliva, leaving many healthcare workers with fear and uncertainty surrounding HIV and AIDS. By 1985 the first HIV blood tests became commercially available, but it would be another decade before effective drug therapy changed HIV into a potentially manageable chronic disease. Nearly forty years since HIV’s emergence, over 700,000 Americans have died from AIDS-related illnesses. Many remain without effective anti-viral treatment and we’re still waiting for an effective HIV vaccine. Many Christians and churches allowed fear to dictate their response to the HIV crisis. There were notable exceptions, but most of the American church quietly distanced itself from the suffering and dying. Regrettably, there were even instances of Christian leaders making public pronouncements of condemnation over those who had contracted AIDS. This was a tragic missed opportunity with long-lasting consequences—akin to nineteenth century Christian support for slavery and twentieth century opposition to the Civil Rights Movement. Imagine if a different story could have been told. What if Christians and churches in the mid-1980s had mobilized people and resources to San Fransisco, New York, and other HIV hotspots, to care and advocate for the sick? What if more Christians had taken risks and shared the epidemic’s front lines with those holding moral and political convictions different from their own? What if our evangelical medical and missions organizations had convened summits that led to sustained meaningful efforts to slow the disease and care for the sick and dying? Would not God have been glorified? Would not the watching world have seen a glimpse of the justice and righteousness that characterize the Kingdom of Jesus? The Church and Christian healthcare workers have another chance. A dangerously deadly, virus, not yet fully known, is achieving global pandemic status. Unlike the rest of the world, Christian disciples have powerful advantages. Jesus Christ has freed us from the fear of death (Hebrews 4:15), allowing us to prudently face danger. We believe Jesus’ promise that every hair on our heads is numbered and that no sparrow falls to the ground apart from our heavenly Father’s will (Luke 12:7). If we or our family members suffer in our bodies—even if life is lost—we know that God will meet the needs of our families, for He has promised never to leave or forsake us (Hebrews 13:5). Knowing all that to be true, we can courageously step forward to serve the sick and dying. The water is hot and getting hotter. For the glory of God and the advancement of Jesus’ Kingdom, let’s individually and corporately rely on our risen Lord and the Holy Spirit to show the world how strong we are. Download full ebook "A Healthcare Worker's Response to COVID-19" here
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The Ethical Approach To Limited Resources
Can’t get a desperately needed lab test? Not enough healthcare staff? Running out of patient beds? Worried a respirator might not be available? As you work without adequate protective equipment, are you thinking that you’re putting your life at risk taking care of your patients? Overwhelming need and limited resources. Sounds like life as a medical missionary, but third world realities may come to the United States with COVID-19. Let me share some practical ethical guidelines I’ve taught to more than 500 new healthcare missionaries while I pray that you don’t have to apply them. Allocating limited resources raises the ethical issue of justice—how do you treat patients fairly? First, you always want to be as impartial as the situation allows. Second, do the best you can for the most people with the resources you have. Third, without enough time, personnel, supplies or equipment, at some point you will be forced to decide who gets and doesn’t get your limited resource. Let me give you a real life example. When I arrived on the mission field, our 135-bed hospital only had electricity 11 hours each day, because the price of fuel for our big generator consumed 25 percent of the hospital’s budget. At night we ran a small generator that could power one isolette and allow us to turn on the operating room lights. We had a high incidence of multiple gestations, one in 28 births, and we had lots of premature babies. You can put three preemies in one incubator, but what do you do when a fourth is born and there is no place for the baby? You hope one infant is doing well enough to be replaced, but if not, you take the one who has little chance of survival out and give it comfort care. This is an extreme example, but it makes my point. You are forced into using a utilitarian ethic decision-making process under these conditions: There are limited resources. There are no moral absolutes for or against an action. (You don’t give the baby with the poor prognosis a lethal injection. You still want this child to survive.) You know your moral duty but are not sure how to fulfill it. (Save lives. Heal the sick.) There is a conflict between two moral duties and both cannot be fulfilled. (I can’t save all four babies). You must prioritize duties. (If I put the latest preemie in the isolette it will probably make it. The one I removed is likely to die whether it is in the isolette or not.) When you are forced to employ a utilitarian ethic, you constantly reevaluate your allocation decisions based on changing circumstances. If the last baby put in the isolette is going downhill the next morning and the baby with comfort care is improving, I would reverse my decision. When you have limited resources, you can never be satisfied with that status. You have the moral obligation to be constantly working to get the resources you need so you won’t have to make a utilitarian decision, because you now have enough personnel, equipment and supplies. We solved the electricity problem by building a hydroelectric project on the 42-foot high waterfall below the hospital and got 24-hour cheap electricity. A large NICU followed at the hospital. These type of allocation dilemmas can be heartbreaking. If possible, seek a second opinion from your colleagues as you make your decision. Then explain your reasoning for what you are doing to other staff involved. When available, seek a clear policy from your ethics committee to guide you and all staff for the situations you are facing. Most of all, ask God for wisdom, insight, courage, and peace as you navigate through the storm. He understands. He has been there. Download full ebook "A Healthcare Worker's Response to COVID-19" here