Coronavirus COVID-19 *Global Health Emergency* #17

[Recidivist]

Borrow TP?

Ummm....people might prefer you just take it.



jmo

I thought I might be judged poorly if I said steal it.

 

[dotr]

Debbie Downer moment here...I don’t think I can take the anxiety of this anymore. It saps the energy right out of me. Everybody (hubby, two grown daughters think I’m being a nutter) my husband travels (air) on to the east coast for the week and comes home on most weekends. So I worry that he could get it, and we could then infect our granddaughter, and daughter who is due in May. He has diabetes, I’ve been through hell with breast cancer and have HBP, pre diabetes, etc.
I’m usually a fighter, but tonight I feel very defeated.

Distraction..
Holi celebrated with face masks and color explosions amid coronavirus fears
Holi celebrated with face masks and color explosions amid coronavirus fears
''Bright powders and water balloons are launched in the air by participants of "the Festival of Colors" with the aim of smearing and throwing as much gulal -- a fine powder offered in several shades -- as possible on friends and family.
Celebrated for centuries, the festival symbolizes the triumph of good over evil and commemorates new beginnings.''

• 
• 
  .

 

[otto]

HMM... interesting!

Outbreaks and Pandemics

"For this reason, the United States has stockpiled mechanical ventilators in strategically located warehouses for use in public health emergencies, such as an influenza pandemic. The Centers for Disease Control and Prevention (CDC) manages this Strategic National Stockpile (SNS) and has plans for rapid deployment to states during critical events."

Stockpiling Ventilators for Influenza Pandemics

From the same article:

"Our retrospective analysis of the 2009 influenza A(H1N1) pandemic in Texas suggests that hospitals had enough ventilators on hand to treat all patients requiring mechanical ventilation throughout the pandemic. Although these quantities are expected to suffice for a moderate (1957- and 1968-like) pandemic, in which hospitalization rates roughly triple, they would fall far short in a severe (1918-like) pandemic."

 

[nightowl1975]

HMM... interesting!

Outbreaks and Pandemics

"For this reason, the United States has stockpiled mechanical ventilators in strategically located warehouses for use in public health emergencies, such as an influenza pandemic. The Centers for Disease Control and Prevention (CDC) manages this Strategic National Stockpile (SNS) and has plans for rapid deployment to states during critical events."

Stockpiling Ventilators for Influenza Pandemics

The total number of ventilators available in the entire US is roughly 60k including stockpiles. Assuming (and this is a BAD assumption) we have the staff and supplies to effectively run all 60k vents AND assuming (a 100% bad assumption) that not one single soul in the US is already on a vent for any other reason whatsoever, we simply cannot mechanically ventilate the sheer volume of patients that would need it if this thing spreads too quickly.

We must slow it down. We won’t stop it, but we must slow it down. Otherwise, people will absolutely die that would have otherwise survived if we had been able to take care of them. This includes people who will die of other things like car accidents because if the vents are all in use... what happens then?

 

[tabitha111]

Sharing a very important tweet re: Italy:

Jason Van Schoor
@jasonvanschoor
·
From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:
1/ ‘I feel the pressure to give you a quick personal update about what is happening in Italy, and also give some quick direct advice about what you should do.

2/ First, Lombardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Aus and don’t make the mistake to think that what is happening is happening in a 3rd world country.|


3/ The current situation is difficult to imagine and numbers do not explain things at all. Our hospitals are overwhelmed by Covid-19, they are running 200% capacity

4/ We’ve stopped all routine, all ORs have been converted to ITUs and they are now diverting or not treating all other emergencies like trauma or strokes. There are hundreds of pts with severe resp failure and many of them do not have access to anything above a reservoir mask.

5/ Patients above 65 or younger patients with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.

6/ My friends call me in tears because they see people dying in front of them and they con only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on NIV. PLEASE STOP, READ THIS AGAIN AND THINK.

7/ We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won’t be the same everywhere, this is the pattern:

8/ 1)A few positive cases, first mild measures, people are told to avoid ED but still hang out in groups, everyone says not to panic

2)Some moderate resp failures and a few severe ones that need tube, but regular access to ED is significantly reduced so everything looks great

9/ 3)Tons of patients with moderate resp failure, that overtime deteriorate to saturate ICUs first, then NIVs, then CPAP hoods, then even O2.

4)Staff gets sick so it gets difficult to cover for shifts, mortality spikes also from all other causes that can’t be treated properly.

10/ Everything about how to treat them is online but the only things that will make a difference are: do not be afraid of massively strict measures to keep people safe,

11/ if governments won’t do this at least keep your family safe, your loved ones with history of cancer or diabetes or any transplant will not be tubed if they need it even if they are young. By safe I mean YOU do not attend them and YOU decide who does and YOU teach them how to.

12/ Another typical attitude is read and listen to people saying things like this and think “that’s bad dude” and then go out for dinner because you think you’ll be safe.
13/ We have seen it, you won’t be if you don’t take it seriously. I really hope it won’t be as bad as here but prepare.

 

[Midgie2]

(((((((( @Midgie2 ))))))))). I think this is a stressful situation for all of us. Sometimes I have to turn away from my computer and do something else. Maybe watch some silly TV show that makes me laugh. I think a constant, steady diet of the CV news is very difficult on our psyche. Try something that will distract you from the current state of affairs.

Thank you, you have no idea how much it helps to just write down my feelings and share. You don’t feel so alone then.
All of you are amazing people and I’m so blessed to have a place to learn what is going on, share our thoughts and get virtual hugs!
Off to watch some Downtown Abby.

 

[tabitha111]

Christopher Mims



@mims
·IANAE (I am not an epidemiologist) but I did just interview the co-author of a report for the Center for Health Security on the impact of Coronavirus, he believes the ultimate number of infected / hospitalized in U.S. will be somewhere between the two estimates on this table 1/

 

[otto]

The total number of ventilators available in the entire US is roughly 60k including stockpiles. Assuming (and this is a BAD assumption) we have the staff and supplies to effectively run all 60k vents AND assuming (a 100% bad assumption) that not one single soul in the US is already on a vent for any other reason whatsoever, we simply cannot mechanically ventilate the sheer volume of patients that would need it if this thing spreads too quickly.

We must slow it down. We won’t stop it, but we must slow it down. Otherwise, people will absolutely die that would have otherwise survived if we had been able to take care of them. This includes people who will die of other things like car accidents because if the vents are all in use... what happens then?

That seems to be the message we're getting from places that are overwhelmed with the virus. People who need regular medical care, like stroke victims, are put on hold, and elderly people with pre-existing medical conditions, are probably put in a wing without respirators. Medical staff have to prioritize when medical facilities and equipment are limited, and there are too many people who need care.

 

[gngr~snap]

The total number of ventilators available in the entire US is roughly 60k including stockpiles. Assuming (and this is a BAD assumption) we have the staff and supplies to effectively run all 60k vents AND assuming (a 100% bad assumption) that not one single soul in the US is already on a vent for any other reason whatsoever, we simply cannot mechanically ventilate the sheer volume of patients that would need it if this thing spreads too quickly.

We must slow it down. We won’t stop it, but we must slow it down. Otherwise, people will absolutely die that would have otherwise survived if we had been able to take care of them. This includes people who will die of other things like car accidents because if the vents are all in use... what happens then?

Triage happens. <not good, in a pandemic (or similar) situation.
Moo

 

[otto]

It seems that the only way to stay safe is to isolate and avoid the virus. The number of cases across Europe are skyrocketing, not slowing down anytime soon. North America has a very small window to prepare, but they don't seem to understand what it means to prepare. I have the dystopian perspective, but this thing scares me.

 

[Lilibet]

Debbie Downer moment here...I don’t think I can take the anxiety of this anymore. It saps the energy right out of me. Everybody (hubby, two grown daughters think I’m being a nutter) my husband travels (air) on to the east coast for the week and comes home on most weekends. So I worry that he could get it, and we could then infect our granddaughter, and daughter who is due in May. He has diabetes, I’ve been through hell with breast cancer and have HBP, pre diabetes, etc.
I’m usually a fighter, but tonight I feel very defeated.

Big hugs, @Midgie2. You have a lot on your plate. And you’re right that anxiety/worry saps your energy. It can also feel in your mind like you’re stuck in one of those hamster balls running around aimlessly. And then we start catastrophizing about every possible thing that can go wrong. The thing is, we’re no good to anyone if we don’t take care of ourselves. And we can’t control what our loved ones do, even if it raises their and our risk. Worry changes nothing. So, take a break and know that you’ve done all you can for yourself and for them. That’s really all any of us can do. More hugs.

 

[Lilibet]

I have my own business and love it. I have several clients in the medical field, emergency room drs in our busiest hospitals, cdc people...I carry alcohol on a spray bottle with me and use it often but if the virus lingers in the air...
I will not stop working, people depend on me. But when I think too much late at night..kinda scary.

I feel the same way. I will stop if I become symptomatic but otherwise......it's my job to be there for people.

Thank you both!

 

[margarita25]

USA / CDC / Audio:
https://www.cdc.gov/media/releases/2020/t0309-covid-19-update.mp3

WS / Thread 1
Coronavirus Global Health Emergency, 2019-nCoV

WHO:

 

[LaborDayRN]

Thank you, you have no idea how much it helps to just write down my feelings and share. You don’t feel so alone then.
All of you are amazing people and I’m so blessed to have a place to learn what is going on, share our thoughts and get virtual hugs!
Off to watch some Downtown Abby.

LOVE Downton Abbey!

 

[cody22]

I thought I might be judged poorly if I said steal it.

I have never sleuthed a missing toilet paper thread before. It might have been fun............moo

 

[mickey2942]

There is an odd "denial" about the virus, at the same time, there is public concern with toilet paper hoarding.

Conventions have been cancelled all over, yet, "March Madness" will go on. It is definitely, "March Madness". Must be a full moon. https://www.si.com/college/2020/03/08/march-madness-tournament-sites-coronavirus-outbreak

The Pattern That Epidemics Always Follow

 

[otto]

This article has more stats for those who are curious

"The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission."​

https://www.nejm.org/doi/full/10.1056/NEJMoa2002032

 

[margarita25]

Yeah this is crazy moo

 

[otto]

My son's attitude towards the virus is carry on, business as usual, worst case scenario he becomes a statistic. For those who have family members who seem unconcerned, it's possible that they are at peace with all possible outcomes.

There were 4 or 6 Italian prisoners who broke into the infirmary and overdosed on methadone. Perhaps that was their way of controlling the outcome when the alternative is mortally sick in a concrete box.

 

[margarita25]

This is (again) what I think everybody just needs to take right now:

—-

Doc T voice:
“We can help stop the spread”..

Mooooo

College campuses, sporting events, it’s already started (thankfully), but like I said nobody cares up here moooooooo , yet.

Hopefully people’s bosses will be cool...everyone has to pay the bills but what I would like to note is that the individual local containment and mitigations will very and form these clusters, etc... like the different provinces in China.

For China it was “Hubei” (and Guangdong, etc.),

Looking forward to see what DRASTIC Economic Plans might happen tomorrow.