For anyone who still hasn't gotten it through their skull just how dire the situation is...

The following memo has been floating around Twitter since last night. I was concerned that it might be a hoax, but this response Tweet from the official Henry Ford Health System account can only be interpreted as confirming that it's very real...just not public as of yet. It appears to be a legitimate internal policy memo being prepared in the event of a worst-case scenario:

With a pandemic, we must be prepared for worst case. With collective wisdom from our industry, we crafted a policy to provide guidance for making difficult patient care decisions. We hope never to have to apply them. We will always utilize every resource to care for our patients.

— Henry Ford News (@HenryFordNews) March 27, 2020

@charles_gaba retweet this, your national audience needs to see this

— Alan Fosnacht (@AJFosnacht) March 27, 2020

Here's the full memo verbatim:

To our patients, families and community:

Please know that we care deeply about you and your family's heatlh and are doing our best to protect and serve you and our community. We currently have a public health emergency that is making our supply of some medical resources hard to find. Because of shortages, we will need to be careful with resources. Patients who have the best chance of getting better are our first priority. Patients will be evaluated for the best plan for care and dying patients will be provided comfort care.

What this means for you and your family:

1. Alert staff during triage of any current medical conditions or if you have a Do Not Resuscitate (DNR)/Do Not Attempt Resuscitation (DNAR), or any other important medical information.

2. If you (or a family member) becomes ill and your medical doctor believes that you need extra care in an Intensive Care Unit (ICU) or Mechanical Ventilation (breathing machine) you will be assessed for eligibility based only on your specific condition.

3. Some patients will be extremely sick and very unlikely to survive their illness even with critical treatment. Treating these patients would take away resources for patients who might survive.

4. Patients who are not eligible for ICU or ventilator care will receive treatment for pain control and comfort measures. Some conditions that are likely to may make you not eligible include:

  • Severe heart, lung, kidney or liver failure
  • Terminal cancers
  • Severe trauma or burns

5. Patients who have ventilator or ICU care withdrawn will receive pain control and comfort measures.

6. Patients who are treated with a ventilator or ICU care may have these treatments stopped if they do not improve over time. If they do not improve this means that the patient has a poor chance of surviving the illness--even if the care was continued. This decision will be based on medical condition and likelihood of getting better. It will not be based on other reasons such as race, gender, health insurance status, ability to pay for care, sexual orientation, employment status or immigration status. All patients are evaluated for survival using the same measures.

7. If the treatment team has determined that you or your family member does not meet crieteria to receive critical care or that ICU treatments will be stopped, talk to your doctor. Your doctor can ask for a review by a team of medical experts (a Clinical Review Committee evaluation.)

One thing I find especially surreal is that not a single person accused me of "deliberately fearmongering" or "itching for clickbait" when I originally posted the memo last night (though a few did suggest I verify it first)...but when I deleted it a few minutes later and explained that I wanted to do just that first, suddenly I was a bloodthirsty goon who gets off on gleefully scaring people into thinking We're All Gonna Die.

I guess the Detroit Free Press is also guilty of "irresponsible journalism" here, then?

Henry Ford Health System has officially confirmed the accuracy of a detailed letter being circulated by doctors and others on social media outlining life and death guidelines for use during the pandemic. 

The @HenryFordNews Twitter account responded at 11:22 p.m. Thursday  to Nicholas Bagley, a University of Michigan law professor, who shared content that appeared to be on hospital letterhead outlining how doctors would make decisions at the Michigan hospital network about who gets treated during the COVID-19 crisis with limited resources.

People had immediately replied with shock and sadness and challenged the authenticity of the letter.

...The hospital network responded directly to a Free Press request for confirmation, providing a statement explaining that the Henry Ford Health System letter is part of a larger policy document developed for an absolute worst case scenario. It is not an active policy within Henry Ford, but a part of emergency response planning, as is standard with most reputable health systems.

The hospital network provided the following statement after midnight Thursday from Dr. Adnan Munkarah, executive vice president and chief clinical officer of Henry Ford Health System:

“With a pandemic of this nature, health systems must be prepared for a worst case scenario. Gathering the collective wisdom from across our industry, we carefully crafted our policy to provide critical guidance to healthcare workers for making difficult patient care decisions during an unprecedented emergency. These guidelines are deeply patient focused, intended to be honoring to patients and families. We shared our policy with our colleagues across Michigan to help others develop similar, compassionate approaches. It is our hope we never have to apply them and we will always do everything we can to care for our patients, utilizing every resource we have to make that happen."