Coronavirus COVID-19 - Global Health Pandemic #75

[10ofRods]

Another stupid school opening - in my district.

First problem is the district TODAY announced the plan. That gives parents about 3 weeks to find child care.
The real problem is the plan. Elementary kids go to school M, Tu, Th, F. Whiskey, Tango, Foxtrot! May as well go to school all five days. What's with one day off in the middle of the week? Classes will still be crowded. Hallways will be crowded. Cafeteria will be crowded. I though the idea was to REDUCE distances among children.

That way, all the teachers can go get tested on Wednesday afternoon, to see if they caught CoVid on Monday (after the kids were busy socializing with their families - naturally, everyone is having the largest possible social gatherings they can every weekend....not really joking).

Then, they can go again on Saturday? Learning early that one has CoVid is crucial to survival, IMO.

Actually, the real reason is probably so that teachers have time to solve the HUNDREDS OF PROBLEMS that arise immediately in this new context. I cannot even tell you how many extra emails I get about the most mundane things to the most intricate (none of my business really) kind of things. People are desperate for social interaction, for opinions about life, for reassurance, etc. Parents use phone email to bombard K-12 teachers as it is (especially K-4), and the students have the ability to interact via email as well.

The phone calls are the worst. I got an unknown number that was calling and leaving super long voice mails and at work, there's no transcription. People leave 5 minute voice mails. Then they want a call back. They don't answer. On to the next one. When the parent calls back, they assume the teacher remembers all the intricate details about their situation when in fact the teacher is still learning the kids' names and has about 12 similarly long voicemails to answer. It usually comes down to, "Oh, Johnny seems to be having a hard time with long division. I'll work with him individually more." Parent wants to reiterate about 50 times that they know how to teach long division (Johnny hasn't learned it from them, though).

The other thing that teachers are going to do on Wednesday is...have time to work individually with Johnny (usually online, but of course in some districts, at school).

Oh, and if we want our classrooms cleaned...we do that ourselves on "off days." That may be one of the purposes in many districts right now.

I agree, the whole thing is messed up, but I am not surprised, as even the tiniest amount of change disrupts school districts, due to the need for research, self-study and reasonable people to disagree. Eventually a plan emerges, but it usually takes about a year. Or two. There was no pandemic planning anywhere in California that I know of (it was all active shooter planning, day after day, week after week, for a couple of years).

I feel for the parents. I feel for the teachers. I worry less for the kids, having grown up in times and circumstances where there were disruptions - not as grand as a whole school shutting down for months, but certainly individual kids and individual schools had issues.

And at least, we're not living through World War II again.

 

[imstilla.grandma]

TOP Data E-Commerce Behavior Report — TOP Agency
New study finds COVID-19 pandemic is changing American's shopping habits

 

[10ofRods]

They are more than ready, but I will double check with my sister. She kinda hops around the islands for work.

Kaiser is big. They send scans, MTI everything they can and network with a larger Kaiser facilitate in California We have much experience from the patient's perspective with my BIL and my sister in nursing admin. I've been impressed. Medical personnel easily and quickly shift to help Island sisters. Its an amazing culture to live and experience there.
Moo

No hospital is ready until it hits. This is what I hear over and over from doctors and nurses. Three patients coding at once in the ER? Unprecedented at the hospitals on Big Island. 27 patients all needing stat bloodwork? Unprecedented on Kauai and not able to be collected via computer. Naturally, all doctors on staff get "repurposed" to draw blood, but there's still a learning curve. And a sense of incredible urgency that can lead to mistakes in labeling and transport (not to mention immediate backlogs in the lab itself). Machines that get very little use (PCR machines, if they exist) now operate at full capacity 24/7. The operators are used to a 8-6 work week - and in the midst of that, all the health personnel are starting to get symptoms too. PPE runs out faster than anyone predicted.

Intubations are over-prescribed at first, as doctors panic when the breathing problems set in. As good as UCLA is, front line doctors do not know every treatment or how to match it clinically to the patients. After a while (and a lot of patient-specific literature searches), things get better. Doctors develop small sub-specialties. Triage becomes easier.

Just the issue of what "Covid EKG's" look like (as compared to regular heart abnormalities) is a big one and ER docs and primary docs are not cardiologists. There aren't a lot of on-site cardiologists on the Big Island or Kauai. Transmitting the results to Kaiser on Oahu (which will be overwhelmed by elderly EKG results) takes more time - and that's why so many hospitals, early on, developed ad hoc methods of "treating it as CoVid." (Doctors got really good at diagnosing before the bloodwork came in).

Then, of course, there's patient management and social distancing in the waiting rooms. A good friend who is a CoVid ward nurse (since about the first week of March) said that even her ward wasn't really ready for what happened. At first, they had a manageable number of patients, although it was quite busy. There were always available beds and the pulmonologist was not completely overused.

That changed as her county went exponential. Patients had to be moved out of another ward so that it too could be a CoVid ward and that space wasn't as great as the first one (no negative pressure rooms, for example). Nurses with no CoVid experience being mentored by my friend (but that takes time away from patient care and it has to be rapid). She's very calm and highly organized. And energetic.

And AFAIK, there's only one hospital in the islands that can deal with things like young diabetics with CoVid, the neurological complications of CoVid. The induced coma thing...well, I'd sure prefer to be in an induced coma in a place with truly experienced neuro-nurses (and in Hawaii, that would be just one place for me).

None of my family is part of Kaiser, but there is one person who has needed frequent specialist care since childhood, so they know the ropes. The big difference between our situation here on the mainland and theirs is that...I have been able to research the 10 or so big hospitals within an hour of me (one is the hospital where my friend works...it may be where I go if I test positive). 30 minutes away is a hospital that has a UCLA hospitalist (a person who has all your medical records if you've signed up before, and who can immediately call in a UCLA specialist if needed). The hospitalist knows about more esoteric treatments, whereas my PCP does not.

Everyone should have their medical records together and in digital form so that if necessary, the new docs or the telemedicine docs can have them immediately (drug allergies, notable family history, previous illness, vaccination status) as well as a summary of recent social contacts, and if possible, an hour by hour or day by day summary of symptoms since onset.

Some of my family members are certain "they will remember" everything necessary to "tell the doctor," but if speed matters, this method will just slow down the process for everyone. And I'm betting they won't remember everything, nor will they necessarily be in the room with the patient or the doctor when trying to remember. So much easier if there's a script to read from.

For example, many people are presenting with diabetic symptoms in the ER, with CoVid. Some of them are actual undiagnosed diabetics, but it also appears that CoVid itself messes with both blood sugar and with blood pressure. An at home blood pressure cuff is a great thing to have, so that one can assure the doctor that BP is usually normal (if it is). It's harder with blood sugar, but if a patient has their most recent bloodwork results, that's helpful. If the doctor knows you're already diabetic, that's different than if you are "newly diagnosed" in the ER and also CV+.

 

[Trino]

So true. I looked it up when VA governor gave the example of shirt and shoes in a restaurant. Found the same site.

I can't be believe folks didn't challenge this. But times were different back then. We seemed to question less in those days.

Question less. Except masks.

 

[ilovewings]

Fauci, as well as the surgeon general, and others, early on were advising against the public wearing masks.

That was a huge mistake and set the stage for chaos with respect to wearing
masks

 

[HongKongPhooey]

That was a huge mistake and set the stage for chaos with respect to wearing
masks

Same here in the UK

 

[astheworldfallsdown]

Coronavirus: 200 new cases as daily figures reach highest level since May

HEALTH OFFICIALS HAVE confirmed that there have been no new deaths related to Covid-19 in Ireland.

The Department of Health also said that 200 new cases of the disease have been confirmed here.

Dr Ronan Glynn, Acting Chief Medical Officer, Department of Health, said today’s increase is the largest number of cases in a single day since the beginning of May.

“We now have multiple clusters with secondary spread of disease and rising numbers of cases in many parts of the country,” he said.

 

[tmar]

UK coronavirus death toll rises by three as 1,000 new cases confirmed

UK coronavirus death toll rises by three as 1,000 new cases confirmed

Imogen Braddick

3 hrs ago
The coronavirus death toll in the UK has risen by three.

The Government said 41,361 people have died in the UK within 28 days of testing positive for Covid-19, as of 9am on Saturday.

This up by three from the day before.

A further 1,012 cases of coronavirus have also been confirmed in the same period.

This brings the total number of cases in the UK to 317,379.

Separate figures published by the UK’s statistics agencies show there have been 56,800 deaths registered in the UK where Covid-19 was mentioned on the death certificate.

 

[astheworldfallsdown]

Coronavirus: Britons miss France quarantine deadline amid signs of second wave in Europe

Many British holidaymakers have opted to remain in France after missing the deadline to return home ahead of new quarantine rules, amid signs Europe is suffering a second wave of coronavirus.

Tens of thousands of Britons scrambled to make it back across the Channel on Friday, with anyone entering the UK from France after 4am on Saturday required to self-isolate for 14 days.

And as a number of governments in Europe imposed new restrictions on people crossing their borders from certain neighbouring countries, fears are growing that the continent's second coronavirus wave is under way.

 

[Rose in SC]

SOUTH CAROLINA Update - Saturday, August 15

DHEC: 986 new COVID-19 cases, 51 more deaths announced in SC

104,874 confirmed positive cases (+986)
2,156 confirmed deaths (+51)
Percent Positive - 16.7 %

COVID-19 HOSPITALIZATION
As of Friday morning, DHEC says 80.51% of inpatient beds in South Carolina are in use while 76.74% of ICU beds are in use. There are 1,246 hospitalized patients who have tested positive for COVID-19 or are under investigation for having the virus, DHEC said. Of those, 311 COVID-19 patients are in the ICU. DHEC is reporting 1,549 ventilators available in the state with 526 of them in use. COVID-19 patients account for 181 of those.

SC Testing Data & Projections (COVID-19) | SCDHEC

 

[tmar]

Virginia has a mask mandate,

Its unenforceable. The governor finally allowed the HD to follow up on complaints on restaurants and bars only.

We have a restaurant that is not complaint, HD revoked the food permit. Restaurant refused to close and is operating. The owners attorney said, can't site and close a restaurant over a mandate that not in the regulations and no law to back it up.

Yup, the VA General Assembly meets next week and it NOT even on the agency !!!!

Governors are on thr fence with the mask. Most say wear a mask, but do not provide the legal tools for HD or LE to enforce.

Why does the public NOT realize, mandates are worthless, it takes LAWS to make people do anything.

Its like saying don't drive over 65mph. but having NO law for speeding. LE pulls you over for driving 90 mph and says....hey, we really WISH you would only drive 65 mph. Have a nice day.

Why are folks not calling Governors and their legislators and demanding legislation to wear mask. We've argued over mask since day one !!! Why is no one calling out congress on no mask law, they've been in session till this week?

If governors want masks. Call and emergency session and pass a law. We elected these folks, pay them, they need to step up to the plate and put some action behind those words.

The media's covered the mask problems nationwide NOT once have I heard any news reporter say.... Hey, call your elected officials and pass a law. They are smart and know the government process. I'm mad at the media for not stepping up to educate folks for the only real fix for this problem.

Shaking my head..,,

Look at Melbourne.
By law we wear masks, and FINED if you don't.
Numbers coming down in our Lockdown, thank goodness.
Everything helps.

 

[24Roses]

Iowa news today: As of 10:30-11:00 a.m. today we had 832 new confirmed cases for a total of 51,640 confirmed cases of which 40,369 are recovered (+567). 9 more had passed away for a total of 973. 9 more COVID-19 deaths as cases jump amid large number of tests
Iowa COVID-19 Information
Iowa Department of Education says no fall sports for schools that go virtual
Iowa State says 75 more students test positive for COVID-19
Pollard: Fall Football Plans Still in Flux, Winter Sports May Not Start Until 2021

 

[Trino]

I don't think it's a PR stunt, I think they are doing this to keep their employees out of harm's way.

If so, why aren't these companies enforcing wearing masks. See previous post.

 

[tresir2012]

No hospital is ready until it hits. This is what I hear over and over from doctors and nurses. Three patients coding at once in the ER? Unprecedented at the hospitals on Big Island. 27 patients all needing stat bloodwork? Unprecedented on Kauai and not able to be collected via computer. Naturally, all doctors on staff get "repurposed" to draw blood, but there's still a learning curve. And a sense of incredible urgency that can lead to mistakes in labeling and transport (not to mention immediate backlogs in the lab itself). Machines that get very little use (PCR machines, if they exist) now operate at full capacity 24/7. The operators are used to a 8-6 work week - and in the midst of that, all the health personnel are starting to get symptoms too. PPE runs out faster than anyone predicted.

Intubations are over-prescribed at first, as doctors panic when the breathing problems set in. As good as UCLA is, front line doctors do not know every treatment or how to match it clinically to the patients. After a while (and a lot of patient-specific literature searches), things get better. Doctors develop small sub-specialties. Triage becomes easier.

Just the issue of what "Covid EKG's" look like (as compared to regular heart abnormalities) is a big one and ER docs and primary docs are not cardiologists. There aren't a lot of on-site cardiologists on the Big Island or Kauai. Transmitting the results to Kaiser on Oahu (which will be overwhelmed by elderly EKG results) takes more time - and that's why so many hospitals, early on, developed ad hoc methods of "treating it as CoVid." (Doctors got really good at diagnosing before the bloodwork came in).

Then, of course, there's patient management and social distancing in the waiting rooms. A good friend who is a CoVid ward nurse (since about the first week of March) said that even her ward wasn't really ready for what happened. At first, they had a manageable number of patients, although it was quite busy. There were always available beds and the pulmonologist was not completely overused.

That changed as her county went exponential. Patients had to be moved out of another ward so that it too could be a CoVid ward and that space wasn't as great as the first one (no negative pressure rooms, for example). Nurses with no CoVid experience being mentored by my friend (but that takes time away from patient care and it has to be rapid). She's very calm and highly organized. And energetic.

And AFAIK, there's only one hospital in the islands that can deal with things like young diabetics with CoVid, the neurological complications of CoVid. The induced coma thing...well, I'd sure prefer to be in an induced coma in a place with truly experienced neuro-nurses (and in Hawaii, that would be just one place for me).

None of my family is part of Kaiser, but there is one person who has needed frequent specialist care since childhood, so they know the ropes. The big difference between our situation here on the mainland and theirs is that...I have been able to research the 10 or so big hospitals within an hour of me (one is the hospital where my friend works...it may be where I go if I test positive). 30 minutes away is a hospital that has a UCLA hospitalist (a person who has all your medical records if you've signed up before, and who can immediately call in a UCLA specialist if needed). The hospitalist knows about more esoteric treatments, whereas my PCP does not.

Everyone should have their medical records together and in digital form so that if necessary, the new docs or the telemedicine docs can have them immediately (drug allergies, notable family history, previous illness, vaccination status) as well as a summary of recent social contacts, and if possible, an hour by hour or day by day summary of symptoms since onset.

Some of my family members are certain "they will remember" everything necessary to "tell the doctor," but if speed matters, this method will just slow down the process for everyone. And I'm betting they won't remember everything, nor will they necessarily be in the room with the patient or the doctor when trying to remember. So much easier if there's a script to read from.

For example, many people are presenting with diabetic symptoms in the ER, with CoVid. Some of them are actual undiagnosed diabetics, but it also appears that CoVid itself messes with both blood sugar and with blood pressure. An at home blood pressure cuff is a great thing to have, so that one can assure the doctor that BP is usually normal (if it is). It's harder with blood sugar, but if a patient has their most recent bloodwork results, that's helpful. If the doctor knows you're already diabetic, that's different than if you are "newly diagnosed" in the ER and also CV+.

This is the data dashboard for Hawaii that shows total hospitalizations have been about 270.

Experience

Lots of other stats on here too.

https://covidtracking.com/data/state/hawaii

Covid tracking project numbers for Hawaii.
Cases NegativeTests PendingTests CurrentlyHospitalized CumulativeHospitalized CurrentlyIn ICU CumulativeIn ICU CurrentlyOn Ventilator CumulativeOn Ventilator RecoveredOutcomes DeathsOutcomes Positive + NegativeTotal Test Results
4,543 151,723 N/A 173 277 41 N/A 22 N/A 1,756 40 156,266
State’s last reported update time:
8/14/2020 22:38 ET

173 currently hospitalised
41 currently in ICU
22 on ventilator

 

[tresir2012]

If so, why aren't these companies enforcing wearing masks. See previous post.

They don't want their employees killed for enforcing something that is unenforceable by law. That has been explained by several posters.

 

[SouthAussie]

NZ now has 37 cases in the community (56 cases in all .. presumably the others are travel-related hotel quarantiners).

But due to those 37 community cases, seven schools are already affected.

Covid 19 coronavirus: Positive case attended Ōtāhuhu Primary School, principal says

 

[SouthAussie]

They don't want their employees killed for enforcing something that is unenforceable by law. That has been explained by several posters.

I think Trino's point is that if they are protecting their employees, how does that work if the unmasked customers are carrying covid and infect the store's staff (and other customers)?
How do you keep a store relatively sanitised with possible covid-positive, unmasked people walking around breathing on and touching things?

It is really a precarious position. Protect the staff from violence, or protect the staff from covid.

I guess they could do both and pay for real security at the front door.

 

[Trino]

They don't want their employees killed for enforcing something that is unenforceable by law. That has been explained by several posters.

IMO if a business doesn't mean what it's posting, i.e. wear a mask, why even bother to post it? This could go the other way with someone insisting a mask must be worn.

 

[HongKongPhooey]

I think Trino's point is that if they are protecting their employees, how does that work if the unmasked customers are carrying covid and infect the store's staff (and other customers)?
How do you keep a store relatively sanitised with possible covid-positive, unmasked people walking around breathing on and touching things?

It is really a precarious position. Protect the staff from violence, or protect the staff from covid.

I guess they could do both and pay for real security at the front door.

My parents went to a garden centre this week. They were giving out free masks on the door to those without them. One man took his, and walked round the centre twirling it round his fingers

Edited 1000 typos

 

[tresir2012]

Schools have been back for a week in Scotland and this article mentions some cases at 2 schools.

Scotland records 51 new coronavirus cases

"The latest figures were published after it emerged pupils at two North Lanarkshire schools have tested positive for coronavirus.

There was no update on Saturday on the Coatbridge cases which come after another cluster in north-east Glasgow was linked to a number of pupils from Bannerman High School in Baillieston."