BillsFan4 Posted July 24, 2020 Posted July 24, 2020 (edited) https://www.beckershospitalreview.com/patient-flow/our-backs-are-to-the-wall-texas-hospital-to-turn-away-covid-19-patients-with-poor-survival-chances.html'Our backs are to the wall': Texas hospital to turn away COVID-19 patients with poor survival chances Quote Rio Grande City, Texas-based Starr County Memorial Hospital, implemented an ethics committee and a triage committee to review incoming COVID-19 patients, Starr County Health Authority Jose Vazquez, MD, said during a July 21 videoconference call. The committees will determine what type of treatment patients will likely require and whether they are likely to survive. Those deemed too fragile, sick or elderly will be advised to go home. Patients with low recovery chances will be better cared for at home with loved ones rather than dying at a hospital thousands of miles away, Dr. Vazquez said. "There is nowhere to put these patients. The whole state of Texas and neighboring states have no ICU beds to spare for us," Dr. Vazquez said. ? Edited July 24, 2020 by BillsFan4
K-9 Posted July 24, 2020 Posted July 24, 2020 33 minutes ago, BillsFan4 said: https://www.beckershospitalreview.com/patient-flow/our-backs-are-to-the-wall-texas-hospital-to-turn-away-covid-19-patients-with-poor-survival-chances.html'Our backs are to the wall': Texas hospital to turn away COVID-19 patients with poor survival chances ? Also hearing reports of oxygen shortages in this area as well. My heart goes out to these care givers and the sick people and their families they have to turn away. Fear porn, my ass.
plenzmd1 Posted July 24, 2020 Posted July 24, 2020 6 minutes ago, K-9 said: Also hearing reports of oxygen shortages in this area as well. My heart goes out to these care givers and the sick people and their families they have to turn away. Fear porn, my ass. the fear has always been when it gets to rural areas..these places just cannot handle more than a few cases of anything, let alone Covid. And sure as hell sucks for everyone involved...certainly most for those that die and their families, the doctors that need to make these ethical decisions, just everyone. Having said that, Starr County has a population of 66K, is very rural and is facing many of the same challenges from a health care perspective that rural hospitals are facing everywhere, way before Covid hit. Just a fact of life health care in rural counties in the US is dismal..but that's another debate for another time https://www.ajmc.com/conferences/academyhealth-2019/understanding-the-health-challenges-facing-rural-communities https://jamanetwork.com/channels/health-forum/fullarticle/2759647 And certainly understand the "fear porn" comment, but context is always important in these discussions Quote The county’s lone hospital, Starr County Memorial Hospital, is overwhelmed as COVID-19 hospitalizations continue to increase. A month ago, the hospital didn’t have a single coronavirus patient. Now, there are 28 patients and three are intubated — two in the COVID unit and one in their emergency department. The numbers fluctuate daily, he said. Yesterday, they had seven intubated patients but ow they have only three. “Some of these patients have died; some of them have been transferred out of the Valley to other, distant places,” Vazquez said, “including Lubbock, Amarillo and even outside of the state to Oklahoma City.” Those transfers had become complicated and come at a great cost to the hospital which had to find an available bed in order to transfer patients that required a more advanced level of care than was available in Starr. https://www.themonitor.com/2020/07/22/starr-county-issue-shelter-place-order-end-week/ Of course any death is one too many...but the reality is these are small hospitals just not equipped to handle many illnesses.
Gugny Posted July 24, 2020 Posted July 24, 2020 20 hours ago, Hapless Bills Fan said: Looks good so far. Well referenced . She has a talent for the bottom line: Remember the formula: Successful Infection = Exposure to Virus x Time Like most of us, it's hard to keep up and there's sometimes newer stuff that contradicts. She's a he. Who the hell names their son Erin??
Hapless Bills Fan Posted July 24, 2020 Author Posted July 24, 2020 5 hours ago, BillsFan4 said: https://www.beckershospitalreview.com/patient-flow/our-backs-are-to-the-wall-texas-hospital-to-turn-away-covid-19-patients-with-poor-survival-chances.html'Our backs are to the wall': Texas hospital to turn away COVID-19 patients with poor survival chances But wait, I thought Death Panels were anathema to those folks? Isn't that why we couldn't get Medicare for All type health insurance - the unsubstantiated claim was, it meant there would be "Death Panels"? "Rio Grande City, Texas-based Starr County Memorial Hospital, implemented an ethics committee and a triage committee to review incoming COVID-19 patients, Starr County Health Authority Jose Vazquez, MD, said during a July 21 videoconference call. The committees will determine what type of treatment patients will likely require and whether they are likely to survive. Those deemed too fragile, sick or elderly will be advised to go home. Patients with low recovery chances will be better cared for at home with loved ones rather than dying at a hospital thousands of miles away, Dr. Vazquez said. " Isn't that precisely a "death panel" - a group deciding who gets treatment, and who dies? And what does "too sick" mean? Of course, if they go home with loved ones, those loved ones may also be vulnerable to covid-19 and may die. Weren't we upset about sending covid-19 + back to a place where they could possible infect others with covid-19 and cause more cases/deaths? 1 1
Hapless Bills Fan Posted July 24, 2020 Author Posted July 24, 2020 3 hours ago, plenzmd1 said: the fear has always been when it gets to rural areas..these places just cannot handle more than a few cases of anything, let alone Covid. And sure as hell sucks for everyone involved...certainly most for those that die and their families, the doctors that need to make these ethical decisions, just everyone. Having said that, Starr County has a population of 66K, is very rural and is facing many of the same challenges from a health care perspective that rural hospitals are facing everywhere, way before Covid hit. Just a fact of life health care in rural counties in the US is dismal..but that's another debate for another time https://www.ajmc.com/conferences/academyhealth-2019/understanding-the-health-challenges-facing-rural-communities https://jamanetwork.com/channels/health-forum/fullarticle/2759647 And certainly understand the "fear porn" comment, but context is always important in these discussions https://www.themonitor.com/2020/07/22/starr-county-issue-shelter-place-order-end-week/ Of course any death is one too many...but the reality is these are small hospitals just not equipped to handle many illnesses. The reality is also, that Starr County officials had a plan to contain covid-19 And Governor Abbott overruled it, with deadly consequences https://www.theguardian.com/us-news/2020/jul/10/texas-starr-county-covid-19-model-greg-abbott?CMP=Share_iOSApp_Other But Starr county’s public officials knew months ago that is was especially vulnerable to the coronavirus pandemic: roughly one in three residents lives in poverty, a sizable slice of the population doesn’t have health insurance, and risk factors such as diabetes and obesity prevail. To protect their constituents, who are more than 96% Hispanic or Latino, they acted fast to curtail the contagion. They developed what officials said was at the time the only drive-through testing site south of San Antonio. They closed schools. They implemented a stay-at-home order, curfew and mandatory face coverings. Only when necessary, they flexed their authority to fine and even jail anyone who flouted the law. Their strategy worked. The first few coronavirus cases trickled into Starr county in late March, but for three weeks in April, there were no new infections. Before the end of May, weekly tallies of new confirmed positives never once reached double digits. Even seasonal influenza, coughs, colds and fevers that would normally travel through the community suddenly vanished. “What we did here was a model for the rest of the nation to follow, but it was lost,” said Joel Villarreal, the mayor of Rio Grande City, one of four small cities in the county. “In fact, I think we had it right.” The inflection point came when the Texas governor, Greg Abbott, unilaterally decided to reopen the state, and stripped local governments of their power in the process. 2 1
Buddo Posted July 24, 2020 Posted July 24, 2020 7 minutes ago, Hapless Bills Fan said: The reality is also, that Starr County officials had a plan to contain covid-19 And Governor Abbott overruled it, with deadly consequences https://www.theguardian.com/us-news/2020/jul/10/texas-starr-county-covid-19-model-greg-abbott?CMP=Share_iOSApp_Other But Starr county’s public officials knew months ago that is was especially vulnerable to the coronavirus pandemic: roughly one in three residents lives in poverty, a sizable slice of the population doesn’t have health insurance, and risk factors such as diabetes and obesity prevail. To protect their constituents, who are more than 96% Hispanic or Latino, they acted fast to curtail the contagion. They developed what officials said was at the time the only drive-through testing site south of San Antonio. They closed schools. They implemented a stay-at-home order, curfew and mandatory face coverings. Only when necessary, they flexed their authority to fine and even jail anyone who flouted the law. Their strategy worked. The first few coronavirus cases trickled into Starr county in late March, but for three weeks in April, there were no new infections. Before the end of May, weekly tallies of new confirmed positives never once reached double digits. Even seasonal influenza, coughs, colds and fevers that would normally travel through the community suddenly vanished. “What we did here was a model for the rest of the nation to follow, but it was lost,” said Joel Villarreal, the mayor of Rio Grande City, one of four small cities in the county. “In fact, I think we had it right.” The inflection point came when the Texas governor, Greg Abbott, unilaterally decided to reopen the state, and stripped local governments of their power in the process. Hopefully, someone sues him. Seems to me that unnecessarily removing local government powers, has directly impacted those communities. In a very bad way. In far too many places, around the world, politics has got well in the way of attempts to mitigate covid. A classic case of 'if it ain't broke, don't fix it'.
plenzmd1 Posted July 24, 2020 Posted July 24, 2020 @Hapless Bills Fan, good points. Again, I am not justifying or condoning or dismissing what is happening there. My only point was the article seemed to indicate that many many decisions were going to be needed to made in a daily basis, when in fact they have 3 people in ICU at the moment. as I mentioned and I talk to my wife all the time, I think this virus is following a pattern of going where it has not been before , and seems to me rural areas could be next. For all the reasons mentioned above, plus, and I am making a generalization here , the propensity of the rural population to be more “independent “ when it comes to some “ rules” scares the bejesus out of me. I worry for all the folks in rural areas now, I think that is where true carnage could happen with flu season.
K-9 Posted July 24, 2020 Posted July 24, 2020 (edited) 54 minutes ago, Hapless Bills Fan said: But wait, I thought Death Panels were anathema to those folks? Isn't that why we couldn't get Medicare for All type health insurance - the unsubstantiated claim was, it meant there would be "Death Panels"? "Rio Grande City, Texas-based Starr County Memorial Hospital, implemented an ethics committee and a triage committee to review incoming COVID-19 patients, Starr County Health Authority Jose Vazquez, MD, said during a July 21 videoconference call. The committees will determine what type of treatment patients will likely require and whether they are likely to survive. Those deemed too fragile, sick or elderly will be advised to go home. Patients with low recovery chances will be better cared for at home with loved ones rather than dying at a hospital thousands of miles away, Dr. Vazquez said. " Isn't that precisely a "death panel" - a group deciding who gets treatment, and who dies? And what does "too sick" mean? Of course, if they go home with loved ones, those loved ones may also be vulnerable to covid-19 and may die. Weren't we upset about sending covid-19 + back to a place where they could possible infect others with covid-19 and cause more cases/deaths? 40 minutes ago, Hapless Bills Fan said: The reality is also, that Starr County officials had a plan to contain covid-19 And Governor Abbott overruled it, with deadly consequences https://www.theguardian.com/us-news/2020/jul/10/texas-starr-county-covid-19-model-greg-abbott?CMP=Share_iOSApp_Other But Starr county’s public officials knew months ago that is was especially vulnerable to the coronavirus pandemic: roughly one in three residents lives in poverty, a sizable slice of the population doesn’t have health insurance, and risk factors such as diabetes and obesity prevail. To protect their constituents, who are more than 96% Hispanic or Latino, they acted fast to curtail the contagion. They developed what officials said was at the time the only drive-through testing site south of San Antonio. They closed schools. They implemented a stay-at-home order, curfew and mandatory face coverings. Only when necessary, they flexed their authority to fine and even jail anyone who flouted the law. Their strategy worked. The first few coronavirus cases trickled into Starr county in late March, but for three weeks in April, there were no new infections. Before the end of May, weekly tallies of new confirmed positives never once reached double digits. Even seasonal influenza, coughs, colds and fevers that would normally travel through the community suddenly vanished. “What we did here was a model for the rest of the nation to follow, but it was lost,” said Joel Villarreal, the mayor of Rio Grande City, one of four small cities in the county. “In fact, I think we had it right.” The inflection point came when the Texas governor, Greg Abbott, unilaterally decided to reopen the state, and stripped local governments of their power in the process. If you or another mod feels the need to delete this, I will understand. But I have to say that, given the sheer demographics of which groups suffer most from this pandemic, I firmly believe that a certain political group thinks it is just fine with these outcomes. Edited July 24, 2020 by K-9
Augie Posted July 24, 2020 Posted July 24, 2020 9 hours ago, plenzmd1 said: no matter what ya think of Fauci, this is pretty damn funny Please tell me he’s really a leftie with a great sense of humor....... Good thing he had that doctor thing as a fallback profession. 1
Saxum Posted July 24, 2020 Posted July 24, 2020 5 hours ago, BillsFan4 said: https://www.beckershospitalreview.com/patient-flow/our-backs-are-to-the-wall-texas-hospital-to-turn-away-covid-19-patients-with-poor-survival-chances.html'Our backs are to the wall': Texas hospital to turn away COVID-19 patients with poor survival chances? According to some COVID-19 is fake news - that is load of bull the size of Texas and that is a lot of bull.
The Dean Posted July 24, 2020 Posted July 24, 2020 1 hour ago, plenzmd1 said: @Hapless Bills Fan, good points. Again, I am not justifying or condoning or dismissing what is happening there. My only point was the article seemed to indicate that many many decisions were going to be needed to made in a daily basis, when in fact they have 3 people in ICU at the moment. as I mentioned and I talk to my wife all the time, I think this virus is following a pattern of going where it has not been before , and seems to me rural areas could be next. For all the reasons mentioned above, plus, and I am making a generalization here , the propensity of the rural population to be more “independent “ when it comes to some “ rules” scares the bejesus out of me. I worry for all the folks in rural areas now, I think that is where true carnage could happen with flu season. Possibly, I suppose. But I think it's much more likely the virus is going where it has easy access. Where people are going, unmasked, into public and indoors. 1
BillsFan4 Posted July 25, 2020 Posted July 25, 2020 1 hour ago, The Dean said: Possibly, I suppose. But I think it's much more likely the virus is going where it has easy access. Where people are going, unmasked, into public and indoors. I agree. We are seeing spikes in places that already dealt with covid cases and shut down once. People keep saying these states with large outbreaks are just dealing with covid for the first time but that’s not entirely true. Texas issued disaster and emergency declarations way back in March. Florida dealt with a large covid outbreak in April. And AFAIK All of these states currently dealing with outbreaks have had covid cases for months. So, what was the national “pause” for if it wasn’t to get covid under control and stop these large outbreaks/spikes? Am I wrong for thinking that these large outbreaks still going on in June and July didn’t have to happen? I get that some covid spread is unavoidable. We can’t keep the case count at zero. But I don’t think you need to have a big outbreak before you can then control the spread. I feel at this point in the pandemic we seem to have a pretty effective method to control the spread - wear masks, social distance and avoid the indoor activities that present the highest risk to be covid super spreader events. Oh, and reopen following the CDC guidelines. That also seems to be a big factor so far in these spikes. The places that have followed the reopening guidelines most strictly seem to be doing the best. The places dealing with spikes, it seems like for the most part, did not follow the guidelines nearly as strictly when reopening. We will see how long it holds. I feel like the #1 lesson we should have learned by now is if you let your guard down, this virus will spread and it can/will spread fast if allowed. We can’t just go back to acting like everything is normal as places reopen.
Saxum Posted July 25, 2020 Posted July 25, 2020 (edited) As long as we have asymptomatic people who still spread virus new outbreaks are inevitable. There will be people who will travel from one area to another and introduce another strain of virus which people will not have immunity to and those heavily exposed or weaker in health will succumb to and spread. Think of all the versions of the flu and number of different versions of virus in vaccines. The problem is until an effective vaccine and like the flu one which may be recreated every year. It will like spread from China since like US some will not change patterns / use safety equipment / good food preparation hygiene. I would say the ceiling for this virus is a lot higher and every year we will have people whose health will be damaged. i do not think we will have a massive change in this country like after 9/11. Changes were made in extreme after 9/11 because corporations saw way to turn it into an industry. Edited July 25, 2020 by Limeaid
Hapless Bills Fan Posted July 25, 2020 Author Posted July 25, 2020 4 hours ago, plenzmd1 said: @Hapless Bills Fan, good points. Again, I am not justifying or condoning or dismissing what is happening there. My only point was the article seemed to indicate that many many decisions were going to be needed to made in a daily basis, when in fact they have 3 people in ICU at the moment. How many ICU beds do they have? 3 may not sound like a lot, but if they have 4, they're almost full. And actually, the small rural hospitals I know of may have 4 beds, but what they're usually short of is the nursing staff to properly care for 4 patients week in week out.
Hapless Bills Fan Posted July 25, 2020 Author Posted July 25, 2020 1 hour ago, BillsFan4 said: I agree. We are seeing spikes in places that already dealt with covid cases and shut down once. People keep saying these states with large outbreaks are just dealing with covid for the first time but that’s not entirely true. Texas issued disaster and emergency declarations way back in March. Florida dealt with a large covid outbreak in April. And AFAIK All of these states currently dealing with outbreaks have had covid cases for months. Correct. 1 hour ago, BillsFan4 said: So, what was the national “pause” for if it wasn’t to get covid under control and stop these large outbreaks/spikes? It was supposed to do what was done in a handful of states - buy desperately needed time to build testing capacity, build contact tracing capacity, and then gradually turn the dial and open back up, stepwise, seeing what works and what is problematic. Instead, there was a loss of patience. People looked at the cases and said "why it's not that bad here, we have no reason to be shut down!", not making the connection that it wasn't that bad here BECAUSE of the shutdown. 1 hour ago, BillsFan4 said: Am I wrong for thinking that these large outbreaks still going on in June and July didn’t have to happen? I get that some covid spread is unavoidable. We can’t keep the case count at zero. But I don’t think you need to have a big outbreak before you can then control the spread. In fact the point was, to control the spread enough to where test-trace-isolate could KEEP it under control, which you can not do with a big out break. Instead, we got a message "fake virus" "99% harmless" "Oh it's infecting young people now, so we won't see the death rate" "we MUST reopen NOW for the sake of the economy!" A chap I follow on Facebook put it pretty well. Young people are the fuel. They will spread the disease and amplify the cases, until it infects enough vulnerable people that we see the hospitalizations rise. Then 3-4 weeks later, the deaths will follow. I don't think more young people are getting infected now than in Feb-March. I think they are asymptomatic or mildly symptomatic and were never tested back in Feb and March, but they're the reason the epidemic took off as fast as it did - it was already far more widespread than we knew. 1 hour ago, BillsFan4 said: I feel at this point in the pandemic we seem to have a pretty effective method to control the spread - wear masks, social distance and avoid the indoor activities that present the highest risk to be covid super spreader events. Oh, and reopen following the CDC guidelines. That also seems to be a big factor so far in these spikes. The places that have followed the reopening guidelines most strictly seem to be doing the best. The places dealing with spikes, it seems like for the most part, did not follow the guidelines nearly as strictly when reopening. We will see how long it holds. I feel like the #1 lesson we should have learned by now is if you let your guard down, this virus will spread and it can/will spread fast if allowed. We can’t just go back to acting like everything is normal as places reopen. This. As someone said, what NYS actually did while reopening was pretty much just follow the CDC guidelines. 1
Hapless Bills Fan Posted July 25, 2020 Author Posted July 25, 2020 4 hours ago, plenzmd1 said: @Hapless Bills Fan, as I mentioned and I talk to my wife all the time, I think this virus is following a pattern of going where it has not been before , and seems to me rural areas could be next. For all the reasons mentioned above, plus, and I am making a generalization here , the propensity of the rural population to be more “independent “ when it comes to some “ rules” scares the bejesus out of me. I worry for all the folks in rural areas now, I think that is where true carnage could happen with flu season. I too, am very scared for rural areas. It's where most of our relatives live. Several of them are nurses, one is a social worker with Senior Services. We hear a lot about hospital capacity or the lack thereof. And, many of the residents in rural areas are high risk - hypertension, diabetes, obesity, heart disease. I'm not so sure the virus is "going where it has not been before". As someone else pointed out, Florida AZ and Tx all had outbreaks. But they were contained with closures to the point where they didn't put a real scare into the population. I think what's happening is that wherever there are areas where people don't take it seriously and don't use masks or employ social distancing, all it takes is one infected person and We're Off. I saw this contact tracing chart from a Facebook follow. Someone asked me "is that a realistic situation?" It's not only realistic it's real. Near Quincy IL One index case. One family event, outdoors: spread to 18 cases across 3 states. At the point this chart was drawn up, it involved 84 cases, 5 places of business (one of them apparently a Senior Living facility). It could easily be 338 or 672 cases by now, if people don't follow instructions to quarantine or if test results are delayed for 1-2 infection cycles (6-10 days)
K-9 Posted July 25, 2020 Posted July 25, 2020 1 minute ago, plenzmd1 said: Love ya bro...but this is the kind of talk that just divides our country to point of chaos.I am as anti Maga as you can get. However, I am great friends with several MAGA supporters, have family members, including my son, that i love dearly that are Maga, and to suggest they want to see people to die to advance a political ideology is just beyond the pale to me. I mean christ, you think my son wants to see people die??? the very thought that people would people would think this make me sick. We have got to stop this rhetoric..it is not what we are about as a country. We are all friends with MAGA supporters; I understand that. And I won’t go as far as saying they all advocate all of the same aims as their political leaders. Regardless, when it comes to certain things, including the idea that a pandemic which disproportionately sickens and kills a constituency of an opposing ideology that they otherwise seek to silence at the polls by other means, then I think that leadership is fully on board. No, I don’t think your son wants to see people die. But I don’t think the leadership of his political party cares one way or the other. What else explains the lack of a unified national plan to combat this thing after nearly seven months IN SPITE of the best advice from our own experts otherwise? While the very thought of my having these thoughts might sicken you, the very thought that our MAGA friends aren’t front and center in condemning what we see occurring on a daily basis sickens me even more. I’m sure this post will get deleted and perhaps it should if it crossed a boundary. But I’m not apologizing for it. I hope you can understand that.
K-9 Posted July 25, 2020 Posted July 25, 2020 Just now, plenzmd1 said: its just wrong dude...different political views does not mean they want to see people die. To say people of either party do not care if people die is just flat out wrong to me. To me, the very thought that Democratic leaders and followers do not see who lockdowns affect the most, why and who closing schools against all scientific evidence affects the most, who refuse to acknowledge that minorities and immigrants are being absolutely used and abused by their policies..is absolutely disgusting to me. It is not about what is best for the country for so many, It is what is best for my political point point of view. Unfortunately, what is best for both parties seems to be the the absolur worst for those that have the least. but But for so many on the left, all that matters is what is best to get Trump out of office...and it is freaking criminal to this never Trumper. I will never abandon my principals for advancement of political ideals. My principals are at the very CENTER of my dissent. Make it about republicans vs. democrats if you must, but I can assure you I am not. This is about so much more than that. Anyway, I’ve said too much for this forum. I’ll let it go at that.
Buddo Posted July 25, 2020 Posted July 25, 2020 10 hours ago, plenzmd1 said: you good with suing Cuomo and Murphy for making nursing homes takes positive cases against local objections? I can assure the Republicans fear this hitting rural areas more than any other..that is their base from a pure politics perspective. No problems with people anywhere, trying to hold any politician to account, whatever their stripe. Any sort of pandemic is not the time to be partisan, but unfortunately politicians the world over, really don’t seem to get that. There are exceptions, and oddly enough, those are places where things seem to be under far greater control.
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