aristocrat Posted March 25, 2020 Posted March 25, 2020 7 hours ago, Hapless Bills Fan said: First of all bless and keep your GF. I hope she has all the protective equipment she needs This is a failure of infection control. Everyone coming in needs to be treated as potentially infected. And we badly need a 15 minute point-of-care test. that patient came to the floor at 6am, dead by 10. She’s gonna get tested but they think it was a pulmonary embolism 1
Hapless Bills Fan Posted March 25, 2020 Author Posted March 25, 2020 55 minutes ago, aristocrat said: that patient came to the floor at 6am, dead by 10. She’s gonna get tested but they think it was a pulmonary embolism Rest in peace. I'm glad she'll be tested. I am a bad person: when I read "pulmonary embolism" my first thought was "well that's a relief!" Sad times
Sundancer Posted March 25, 2020 Posted March 25, 2020 7 minutes ago, Hapless Bills Fan said: Rest in peace. I'm glad she'll be tested. I am a bad person: when I read "pulmonary embolism" my first thought was "well that's a relief!" Sad times I have to tell a lot of people in a few days that a close family member has passed away and I know I’ll have to lead with “It had nothing to do with what’s going on...” Strange days indeed. (Keep the thread clean—no need for condolence posts and thank you because I know people are sending thoughts and prayers. If you pray, pray for someone’s peaceful passing.) 1
Hapless Bills Fan Posted March 25, 2020 Author Posted March 25, 2020 Oh geesh, here we go: https://www.forbes.com/sites/carlieporterfield/2020/03/24/coronavirus-spreads-on-us-navy-ship-in-pacific-ocean/#30de38c97a80 "It is unknown yet how the sailors may have contracted the illness, noting that aircraft land on the ship regularly from outside the command, Gilday said, but that the Navy is trying to trace the sailors’ movements and isolate sailors they’ve been in contact with." (...) “We’re not in a position right now where we need to pull that ship in or take that ship off the front line, so this will be a day-by-day evaluation,” Gilday said. Here is what retired USN Jim Wright Chief Warrant Officer has to say on his Facebook timeline: "Over 5000 crew and air wing in close quarters. There is no way to socially isolate. On a warship you basically live in each other's pockets. There is no personal space. Berthing compartments are 100 Sailors sleeping stacked on top of each other, sharing toilets and sinks and what little public space there is. Officers, especially on a carrier, don't have it much better. You eat on the mess deck, or the Wardroom, literally shoulder to shoulder. You stand watches in at duty stations shoulder to shoulder, sharing headphones and binoculars and duty equipment. Underway, you're in each other's space all the time. And to be honest, sanitation isn't all that great no matter how much you clean. It's just not possible with 5000 people living on top of each other. A carrier has fairly decent medical capability, but it's geared more toward battle casualties and not plague. They don't have a thousand ventilators or any way to isolate more than a handful of the infected." And you also have to remember that a carrier is the heart of a strike group, meaning there is a constant movement of personnel to and from the carrier to other vessels of the fleet. Meaning that this is likely to spread to the smaller ships in the group, who have very limited medical capability. Worse, they're in the South China Sea. It's unlikely foreign nations will allow the vessel to make port. If it was me, I'd turn east and make a high speed dash for Pearl while I still had enough able crew to operate the ship. But, it's not up to me. 3
Augie Posted March 25, 2020 Posted March 25, 2020 4 minutes ago, Hapless Bills Fan said: Oh geesh, here we go: https://www.forbes.com/sites/carlieporterfield/2020/03/24/coronavirus-spreads-on-us-navy-ship-in-pacific-ocean/#30de38c97a80 "It is unknown yet how the sailors may have contracted the illness, noting that aircraft land on the ship regularly from outside the command, Gilday said, but that the Navy is trying to trace the sailors’ movements and isolate sailors they’ve been in contact with." (...) “We’re not in a position right now where we need to pull that ship in or take that ship off the front line, so this will be a day-by-day evaluation,” Gilday said. Here is what retired USN Jim Wright Chief Warrant Officer has to say on his Facebook timeline: "Over 5000 crew and air wing in close quarters. There is no way to socially isolate. On a warship you basically live in each other's pockets. There is no personal space. Berthing compartments are 100 Sailors sleeping stacked on top of each other, sharing toilets and sinks and what little public space there is. Officers, especially on a carrier, don't have it much better. You eat on the mess deck, or the Wardroom, literally shoulder to shoulder. You stand watches in at duty stations shoulder to shoulder, sharing headphones and binoculars and duty equipment. Underway, you're in each other's space all the time. And to be honest, sanitation isn't all that great no matter how much you clean. It's just not possible with 5000 people living on top of each other. A carrier has fairly decent medical capability, but it's geared more toward battle casualties and not plague. They don't have a thousand ventilators or any way to isolate more than a handful of the infected." And you also have to remember that a carrier is the heart of a strike group, meaning there is a constant movement of personnel to and from the carrier to other vessels of the fleet. Meaning that this is likely to spread to the smaller ships in the group, who have very limited medical capability. Worse, they're in the South China Sea. It's unlikely foreign nations will allow the vessel to make port. If it was me, I'd turn east and make a high speed dash for Pearl while I still had enough able crew to operate the ship. But, it's not up to me. I guess it was just a matter of time, right? Ugh.........
Hapless Bills Fan Posted March 25, 2020 Author Posted March 25, 2020 And well, Here we go with a nursing home... Two more residents of a nursing home in St. Charles have tested positive for the coronavirus on Wednesday a day after officials announced the first case there. (...) The St. Charles nursing home (...) houses 113 elderly patients recovering from medical procedures. (...) On Tuesday, Frontier announced that an elderly woman residing at the home tested positive for COVID-19 at a hospital. The woman was taken to the hospital Saturday for symptoms of a heart condition and had not shown symptoms typically associated with the coronavirus. (...) Frontier, which operates six facilities in the St. Louis region, banned outside outside visitors as early as two weeks ago. Frontier also then canceled group events within the building and closed the dining room. Frontier has also screened residents and patients daily for signs of or symptoms of the coronavirus, according to Workman. The St. Charles facility where the woman tested positive for COVID-19 has about 135 staffers. Per MO DHSS (health and senior services), there are 356 cases of covid-19 in MO. 304 list the source of the disease as as "unknown" or "no contact". Age distribution: 1
HappyDays Posted March 25, 2020 Posted March 25, 2020 This is what really concerns me. Until a vaccine is developed, even prolonged social distancing will only be effective in stopping the current cycle. This thing could turn out to be seasonal.
BillsFan4 Posted March 25, 2020 Posted March 25, 2020 According to that on screen graph in the video it shows Almost 62,000 confirmed cases in the U.S. (and I’m sure the number is actually much higher than that). Just a week ago the US had about 6,300 confirmed cases.
Sundancer Posted March 25, 2020 Posted March 25, 2020 14 minutes ago, HappyDays said: This is what really concerns me. Until a vaccine is developed, even prolonged social distancing will only be effective in stopping the current cycle. This thing could turn out to be seasonal. That is why we need massive testing and impeccable tracking. I hear lip service to the former and crickets about the later. 2 1
Warcodered Posted March 26, 2020 Posted March 26, 2020 Tales from the crypt: Washington cathedral digs up 5,000 respirator masks https://www.msn.com/en-us/news/us/tales-from-the-crypt-washington-cathedral-digs-up-5-000-respirator-masks/ar-BB11HX59?ocid=msedgntp With respirator face masks in short supply, the Washington National Cathedral dug deep underground to find its long forgotten stash -- in its crypt.
HappyDays Posted March 26, 2020 Posted March 26, 2020 This is shocking. 10 new deaths an hour. I'm not usually an alarmist but this is pretty terrifying. Things could get really bad really fast. 1
Hapless Bills Fan Posted March 26, 2020 Author Posted March 26, 2020 2 hours ago, BillsFan4 said: According to that on screen graph in the video it shows Almost 62,000 confirmed cases in the U.S. (and I’m sure the number is actually much higher than that). Just a week ago the US had about 6,300 confirmed cases. PSA because others may not have noticed: I am updating the Covid cases-by-country graph from Financial Times, every day about 7 pm. It's in the 2nd post of the Covid facts-only thread (link above) USA current case count 65,778 today. None of our hospitals have reported being overloaded or needing to triage ventilators (that I have heard) as yet. Case fatality rate in US 1.4% currently (and likely to rise, as critically ill patients can take a few weeks to recover or take a turn and die). South Korea, 1.4% (v. good medical care, not overwhelmed). Italy case fatality rate 9.8%. Wuhan, China during Jan/early Feb (when hospitals overwhelmed) was >5%. Since then and outside Wuhan, 0.7-0.9%. Anyone who tells you categorically the "real death rate" for this disease is 1% then proposes a course of action likely to overwhelm the medical system in many areas, is not speaking truth to you because the hard experience of countries/regions where the medical system is overwhelmed do not support that. 1
Sundancer Posted March 26, 2020 Posted March 26, 2020 3 minutes ago, Hapless Bills Fan said: Anyone who tells you categorically the "real death rate" for this disease is 1% then proposes a course of action likely to overwhelm the medical system in many areas, is not speaking truth to you because these facts do not support that number. On top of which, a swamped system not only can’t care for CV-19 patients, it can’t care for others. I have tried to find estimates of the side effect of lack of care costs and fatalities. Nothing yet.
Hapless Bills Fan Posted March 26, 2020 Author Posted March 26, 2020 50 minutes ago, HappyDays said: This is shocking. 10 new deaths an hour. I'm not usually an alarmist but this is pretty terrifying. Things could get really bad really fast. Deep breath. Two possibilities: 1) Critical patients who came in very ill several weeks ago and have been supported on ventilators or ECMO, are now beginning to deteriorate and fail. This could cause a "bump up"; patients who need ventilator support can take several weeks then either heal, or fail. If this is the case, but there are still ICU beds available, it will be higher but stay stable. 2) NYC hospitals just ran out of ventilators and have started to triage Unfortunately, it's already bad, it's just like an iceberg at present - most of the bad is still hidden from view. St Charles county, the county adjacent to St Louis which did NOT impose a stay-at-home order, just reported its 3rd covid-19 case in the same nursing home of 133 elders. The nursing home closed to visitors more than 2 weeks ago, canceled group activities, and closed the dining room (meals carried to patient rooms only). Your conclusion? Mine is that covid-19 is widespread enough in a county with only 12 diagnosed cases, that one or more of the ~135 person staff at the facility has an asymptomatic or presymptomatic case and has been unknowingly spreading the disease. Or perhaps has fever, and is suppressing it and continuing to work because they can not afford to take unpaid leave and they hoped it was just allergies, or a little cold.
Hapless Bills Fan Posted March 26, 2020 Author Posted March 26, 2020 https://www.newyorker.com/news/our-local-correspondents/*****-really-going-to-hit-the-fan-inside-new-yorks-overburdened-hospitals "New York City has become an epicenter of the crisis, with more than ninety-six hundred confirmed cases as of Sunday, and hospitals are struggling to keep pace. BronxCare workers were in the process of setting up a separate triage tent, to manage COVID-19 patients. Until then, the E.R.’s waiting room would be crowded with (..) the worried sick—people with coughs and flulike symptoms that might or might not be signs of COVID-19, who’d come because they wanted to get tested. Most were sent back home, with orders to self-quarantine. Tests were being reserved for people sick enough to be hospitalized." "Jessica van Voorhees, a forty-three-year-old E.R. doctor at Methodist Hospital (..) was working night shifts on March 8th, 9th, and 10th, when the first patients started trickling in. “At first, it was a big deal. Like, ‘I think we just had a COVID patient!’ Then we had three. And every day it more than doubled.” When I spoke to her on Thursday, the E.R. was getting hundreds of patients with coughs, fevers, and sore throats—most of whom just wanted to be tested for the virus. As in the Bronx, they were being sent home, with orders to self-quarantine. Testing had to be reserved for the very sick. For that reason, van Voorhees had concluded that the official numbers are “totally off. Way off!” She went on, “I think we’re probably testing a small percentage of people who come in here and are clearly positive.” " In other words, even with the rapid rise in covid-19 cases in NYC, they are still only testing the very sickest patients, the ones they hospitalize. They were starting to see “bounce-backs”: people who came to the E.R. with a mild illness and returned days later, having swiftly deteriorated. A forty-two-year-old schoolteacher came in, with the usual symptoms: fever, body aches, sore throat, cough. “He was super fit, healthy, and worked out all the time. Never smoked,” van Voorhees said. “We said, ‘Look, we think you have the virus. Go home and self-quarantine.’ ” The man returned three days later, weak and disoriented. “He walked into triage and then fell out of his chair,” van Voorhees said. X-rays revealed a severe viral infection in both lungs. He was hospitalized and put on oxygen. “It’s so weird to see these people who are basically healthy struck down by it,” van Voorhees said. Again, note: 40 year old, fit, non-smoker, exercises.
Hapless Bills Fan Posted March 26, 2020 Author Posted March 26, 2020 More from New Yorker article: Hospital authorities hadn’t provided information about the supply of items like protective masks and gloves, but the gear was clearly being rationed. “If we don’t get the proper equipment soon, we’re going to get sick,” she said. Since the first week of March, when the virus arrived in the city, there had been “confusion and chaos” around safety protocols, she said. At first, the hospital mandated that COVID-19 patients be put in “negative-pressure” rooms, which keep contaminated air from circulating. Then word came down that regular rooms were O.K. Nurses were told to use only N95 masks, which more efficiently filter out airborne particles. “Then they said on Sunday we no longer need N95 masks,” Gonzalez said. “We’re going to switch to surgical masks and a face shield.” It didn’t seem likely that the surgical masks had become safer overnight; it was the hospital’s way of managing the equipment shortage. In a “donning and doffing” class, in which nurses were shown how to put on personal protective equipment, an instructor introduced a new rule: store your used mask in a plastic bag, so you can reuse it later. Gonzalez pushed back. “I said, ‘What kind of infection control is this? Isn’t that just incubating germs?’ ” The instructor seemed embarrassed. “He said, ‘Listen, I’m only telling you what the hospital is recommending.’ And he added, kind of under his breath, ‘Doesn’t mean I agree with it.’ ” Gonzalez was scared. “My manager told me, ‘Michelle, you’re fine—you’re thirty. You don’t have anything to worry about.’ But I live with my ninety-year-old grandmother, and my dad, who is sixty-two, diabetic, and immunocompromised. I want to be able to go home and sleep at night, knowing I didn’t give it to them.” She decided to take matters into her own hands, along with her fellow I.C.U. nurses. “I started organizing us early,” she said. They obtained a stash of N95 masks and devised a system of working in pairs, so that they could better conserve them. She began to acquire a reputation. “Medical doctors from different specialties, and my own doctors, keep coming by and asking me for protective gear, because they have nowhere else to get it.” She was most concerned about colleagues in the emergency room, which was short-staffed even before the outbreak. “It’s always overpacked,” she said. “Nurses there have sixteen patients.” A new screening tent had been set up, and “suspected COVID” patients were being shuffled to a waiting area along one wall, where they sat on stretchers, shivering and coughing into the open air. An E.R. nurse had told Gonzalez that she was still wearing a surgical mask. None of the hospital staff had been tested for the virus. They were supposed to be monitoring themselves for symptoms. “It’s almost like we’re desensitized to it,” Gonzalez said.
TigerJ Posted March 26, 2020 Posted March 26, 2020 I suspect the greater population density in NYC makes it a lot harder to get everybody to comply with social distancing. It is going to be a bigger problem for the rest of the state with each passing day, but I don't really think it will rise to NYC's levels. I'm hoping at least. 1
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