Amid the heartening turnout to applaud the NHS yesterday all over Britain, I also read one of the scariest stories I've seen since the beginning of the Corona Virus pandemic.
According to the Washington Post, doctors are considering a universal Do Not Resuscitate order for Corona Virus patients, because resuscitation is simply too dangerous for the hospital staff.
From the WaPo:
Let's continue the conversation.
According to the Washington Post, doctors are considering a universal Do Not Resuscitate order for Corona Virus patients, because resuscitation is simply too dangerous for the hospital staff.
From the WaPo:
Health-care
providers are bound by oath — and in some states, by law — to do
everything they can within the bounds of modern technology to save a
patient’s life, absent an order, such as a DNR, to do otherwise.
But as
cases mount amid a national shortage of personal protective equipment,
or PPE, hospitals are beginning to implement emergency measures that
will either minimize, modify or completely stop the use of certain
procedures on patients with covid-19.
Some
of the most anxiety-provoking minutes in a health-care worker’s day
involve participating in procedures that send virus-laced droplets from a
patient’s airways all over the room.
“It’s extremely dangerous in terms of infection risk because it involves
multiple bodily fluids,” explained one ICU physician in the Midwest,
who did not want her name used because she was not authorized to speak
by her hospital.
Another scary development: Finland, a country very near me, has decided to block off the capital city of Helsinki entirely for either entry or exit.
There have been suggestions that New York City or London should be blocked off similarly.
Another scary development: Finland, a country very near me, has decided to block off the capital city of Helsinki entirely for either entry or exit.
There have been suggestions that New York City or London should be blocked off similarly.
Let's continue the conversation.
Comments
All motorways in and out of London would have to be blocked at their exits from the M25 - all London-bound trains stopped, and all Underground trains on lines extending beyond the M25 would have to have their routes terminated early.
How many people would all that need?
NY looks 3 times the area of London but could the Hudson river be useful boundary for present purposes? I haven't a clue.
Meanwhile in UK, and predictably, Jeremy Corbyn (leader of Labour Party) is trying to make party political capital out of a national crisis, effectively saying `I told you so, the Govt's got the money after all'.
Presumably, the cash that's due to appear in response to the emergency comes out of the pocket marked `Contingencies', ring-fenced for real emergencies (eg war, plague, famine).
What a good job it hasn't been used for day-to-day general public spending...
I hope that's not too political, Nutty...
Has anyone else read this or heard about it? If so, doesn't it seem too coincidental? Or is it a hoax?
They run these test-drive things all the time; they also do them for terrorist attacks and bio-terror attacks. I've seen them in my city.
They frequently need civilians to play "victims."
Relax, no need to panic.
It's safe and respectable - a John Hopkins University project, a Tabletop- or `paper-exercise' as the military would say. These things go on all the time but we don't otherwise hear about them.
See http://centerforhealthsecurity.org/
No pathogens were used.
It's one of those coincidences that's bound to happen. The BBC did a simulation using smart phones in March 2018, repeated this year, BBC4 14th March: `Contagion - The BBC Four Pandemic'. It highlighted how quickly these things can spread.
It's still online at:
https://www.bbc.co.uk/programmes/p059y0p1
It was very clever but I don't remember the details.
The possibility of a pandemic has been on the cards for a long time but it was always thought it would be some sort of influenza virus that would be responsible. That's why there was such anxiety over SARS
For example, John Oxford has been investigating Spanish flu (so-called) for a very long time. There's a radio broadcast he did for the BBC World Service on
https://www.bbc.co.uk/programmes/w3cswdhh
"Professor John Oxford, one of the world’s leading virologists, looks at how the 1918-19 flu pandemic affected every corner of the world. Over 50 million people died in the three outbreaks which hit in 1918 and 1919. It is one of the most devastating pandemics in history and to this day scientists are still trying to pin point its origins in the hope of learning lessons for fighting such catastrophic epidemics in the future. More people died in the so called ‘Spanish Flu’ of 100 years ago, than perished in World War One. It even killed more than the bubonic plague, yet in many parts of the world it is virtually forgotten about. We hear how otherwise healthy soldiers returning safely from war would be dead within three or four days, how whole families would be wiped out in a week and how the authorities in different parts of the world struggled to cope with looking after the sick and burying their dead on such a huge scale. John looks through the archives and traces its emergence and spread through every continent. We hear real and dramatised testimony from people who lived through it (some still alive today) in countries like South Africa, Britain, France, America and New Zealand. He present his own hypothesis, gleaned from years of work in the area, on where it may have all begun and how we might prevent it from happening again."
Cheerful stuff.
A pandemic is like the `Big One' on the San Andreas Fault - inevitable, but we didn't know when.
My approach to what looks like a conspiracy is to remember the 3 Cs - it could be conspiracy, cock-up or coincidence. Which is most likely?'
Coronaviruses haven't been known very long. I think I said I first heard of them in a veterinary context about 17 years ago.
It was fairly predictable, almost by definition, that the cause of a pandemic would be something we hadn't come across before. It it was familiar, we'd be immune or have a vaccine - it wouldn't go global in the same way.
This particular coronavirus is `new' in the sense that it's new to science, in the way that we talk about the New World, which no newer than the Old, we just didn't know about it. has it been lurking in pangolins all this time? Is it a fresh change in the structure, like a mutation in DNA?
Dunno!
The US now has the most coronavirus cases.
Andrew Cuomo is musing whether he took the right approach to order people to stay at home.
https://spectator.us/deadly-coronavirus-still-far-clear-covid-19/
The DNR discussion is of concern to me also, mainly because there is no family or patient consult required. If there is no possibility of recovery, then for me, I would agree it is reasonable to DNR. I’m. It real comfortable with docs giving the family AFTER they have not resuscitated someone. I would want family input and patient input if possible. Most of the time, docs and staff can discuss this IN ADVANCE with both the patient and the family, even during an emergency admission. That is also one of the purposes of a a legal advance directive, which I, my family, and my doctors have all discussed. The hospitals where I have received treatment also have copies.
But lots of other criteria have also been discussed as possibilities: age, quality of life, and so forth. I think they are very difficult issues that there hasn’t been enough discussion about. There is certainly no consensus in the US. A pandemic isn’t the best time to have those discussions.
There has been a movement for years to reduce services to some classes of people under specific circumstances. This comes from mostly people in academia.
My friend brought me a bottle of wine yesterday. We got to visit, staying very far apart. The weather has perked up and it isn’t quite so depressing to be inside.
Dy 1 of the lockdown in South Africa is actually quite predictable. The country has a long history and present problem of daily protests, strikes and so on. In those communities where protests and civil disobedience are rife, people are refusing to comply with the regulations of the lockdown. On day 1 they are being warned but have been told arrests and prosecutions will start shortly. These are the very communities that will be hardest hit when the virus goes into stage 4 and spreads from and through communities.
Some businesses (e.g. hairdressers) in the townships are defying the regulations and have not shut down. They will probably be arrested as from tomorrow.
In the last 24 hours, two people have died from the first round of infections - a 48-year old and an 18-year-old, both women. They would have been infected overseas and returned with the virus.
A group of tourists where one person has been tested positive have been put under house arrest after refusing to self-isolate, presumably at a hotel and no doubt will be deported; another tourist was tracked down after testing positive and then ignoring the directive to self-isolate and continuing his tour of the country across provinces, infecting dozens along the way. I don't want to pick on Germans but in both cases it is Germans who are behaving like arrogant idiots.
Religious folk from the USA and Israel travelled to Bloemfontein for some kind of religious festival, brought the virus with them and infected a whole lot of people (all infections in that province originate from this incident). Like the USA, South Africa has a lot of 'alternative', non-mainstream charismatic preachers who may become a problem (promising cures and ignoring lockdown rules).
Homeless people are being taken off the streets and put into shelters where they are given blankets and food. I wonder why under normal circumstances people can't do that for the many thousands of homeless people in the country. South Africa has a rights-based culture so some homeless people know their rights and are refusing to be herded by the police/army to a place of safety!
Politicians, the police and the army are not following the rules for maintaining a physical distance and are thus not setting a good example. No one is distancing themselves in queues (Africans have a very different concept of personal space and are finding it difficult to change a mindset). Inside shops (only for sales of medicines, toiletries and food), signs are up instructing people on safety guidelines (including 'speak as little as possible'), limiting how many people go into a shop at one time, and limiting quantity people can buy.
Of course, there are some who are ignoring the alcohol ban and so are having the alcohol confiscated and poured out onto the street. I assume that in their own home people can drink the alcohol they stockpiled in the few days between the announcement and enforcement of the lockdown. In the UK people stockpiled toilet paper; in South Africa, they stockpiled alcohol!
One man was stopped cycling on the highway just outside Johannesburg. He said he was 'going to Cape Town', a 10-hour trip by car on the main highway with only brief stops for the toilet, and restocking for food, refreshments and petrol! Taxis are ignoring the regulations about how many passengers they may carry and overloading as usual.
Stay safe and congrats to the USA fr the mobile testing unit!
As of 11 a.m. on March 27, 2,900 positive cases and 35 deaths. The residents of Jacksonville are going to have to do their part and stop gang-related shootings and stabbings because soon there won't be room in the hospitals for their youthful high spirits. Perhaps a veterinary practice would be happy to sew them up if they can provide proof of a negative COVID-19 test and cash in advance.
If your average summer temperature is in the 80s (F), with low temps in the 70s (F), I think we can say at this point that that will not slow the virus spread at all. Next week, we're going to hit the mid 90s (F). Of course, those cases that are testing positive contracted the virus 1 to 2 weeks before. We *should* be seeing a slowdown soon due to social distancing. I don't see many people in masks, gloves, or goggles.
The number of those infected keeps going up and is over 1000 now (just over 3 weeks since the first infection).
I just can't get over how ill prepared our hospitals are with the lack of equipment and medical supplies. The only thing I can see so far that the CDC is doing is partnering with the military to set up fema camps. If our countries are practicing by staging these fake pandemics regularly, we seem woefully unprepared, imo, for the most basic supplies such as PPES.
I have seen staged terror attacks but no staged pandemic attacks. Also, I feel the WHO was late in declaring it a pandemic.
Also read in the news today that a postman tested positive and so have amazon workers. Im waiting for the grocery store announcement here as people are crowding into trader joes like they are going to a concert.
They have shut parks in SC, but here in my county everyone is at the parks like the town is on a permanent vacation. An MD on Reddit said it wasn't even safe to walk in the neighborhood. Only if you lived way out in the country. SO is still going on jogs, but I am trying to do more yoga which I don't really like.
This is not helping with the clinical depression at all. Lol.
On a happy note, my momma bkue bird is on the nest🙏❤
'Even if Cuomo gets 30,000 extra ventilators, he isn't going to have the staff to run them.
March 27, 2020 at 7:53 PM'
This is so true!! Where are all the masks and PPES these "staged events" have known would be needed? It is insane. We can't even get masks for ourselves and they do help a lot to protect
people. Japan has less cases experts are saying and they believe thr masks are responsible.
Who is was responsible for making sure our medical carers have what they need to fight this?
Your state and department of health. To be fair, there are arbitrary expiration dates on things like masks and protective equipment and funds expended on them are generally thrown in the trash when they expire. I think I relayed to you that daughter got PPE for her entire department that was going to be thrown in the dumpster from a local hospital a couple months before anybody heard about the China Wuhan Biolab virus. Sadly (for her and her coworkers), it was given to the fire department.
The only number I am concerned with is the ratio of death to infection, which remains extremely low. NYC is still slightly below the average national death average, although I imagine that will change soon. I agree with Swamp Woman that maybe that a parade wasn't the best idea with a pandemic raging. Ditto the asinine mayor of New Orleans who let the good times roll despite a national health emergency being declared on January 31st. New Orleans will probably be the next hotspot, and who knows how many people everywhere else were infected by a Mardi Gras attendee.
There is no way to prepare for every eventuality, especially a worse-case scenario. There will never be enough vents for every person in the country. Medicines expire, hell, a LOT of medical supplies have expiration dates...even the masks... so it is not a case of being able to store everything for everyone, even if there were enough money and storage to do so.
The largest hospital workers union in the US (SEIU) just miraculously found 39 MILLION N95 masks, and are graciously offering to sell them for 5 dollars a piece. (The price at Home Depot is $1.20) Methinks some of these supplies were being held back by people who are led by politicians who famously believe they should never let a good crisis go to waste.
The government can only do so much. It's far easier to have a certain amount of food, water and basic medical supplies on hand for you and your family and pets, than to depend on the government to be able to immediately supply so much as a bottle of water when an emergency strikes. And even then, you can have the world's best emergency supplies and still have them all washed away in a flood, hurricane etc.
I agree with you. A well stocked mountain cabin sounds good right about now.
I wonder how long people can self isolate, especially in places like NYC, before their mind cracks. SO is doing better than I am but he has his job to focus on.
Our business depends heavily on the postal service which we now know paper carries the virus. We all need a hazmat suit for daily trip to the mailbox!
Thanks for your answer!
https://wsvn.com/news/us-world/4-guests-dead-on-port-everglades-bound-cruise-ship-with-138-ill-people/
MIAMI BEACH, FLA. (WSVN) - Several cruise ship workers believed to be sick with COVID-19 have been transported off the ship and brought to get medical attention in Miami Beach.
Miami-Dade Fire Rescue crews responded to the U.S. Coast Guard Station to help transport the crew members who were aboard the Costa Magica ship on Thursday morning.
“We have several of these cruise ships that were allowed to dock,” Miami Commissioner Joe Carollo said. “Some of them it was confirmed that people had been infected.”
...After transporting the suspected sick patients, the paramedics could be seen being decontaminated.
Jackson Health System said they could not abandon the sick crew members.
In a statement, they said while they are “committed to preserving resources for our own residents, an international community like Miami would never turn our backs on board ships at our shores.” https://wsvn.com/news/local/multiple-crew-members-believed-to-be-sick-with-covid-19-arrive-in-miami-beach/
I cannot fathom those poor folks who live in small apartments in NYC ( or anywhere else) with school children at home! I've got enough weeding and planting and pruning and fence mending to keep an army of kids busy through the end of the year, but you can only make them clean an apartment for so long before there's nothing left to do! ;0)
>>>I just can't get over how ill prepared our hospitals are with the lack of equipment and medical supplies.<<<
It's not that hospitals are per se ill-prepared, its that this is an absolute unprecedented event which is not able to be planned for and thus not equipped for. It would be like if your home got flooded by a hundred year flood and you were not able to save your house. A single ventilator costs $20,000 so needing 40,000 of them for NYC alone (which is what Cuomo says) would cost $800 million dollars or $800,000,000. So how and why would a hospital have that kind of money and need to stockpile $800 millions dollars for ventilators alone?
The same with adequate hospital beds. Why and ho0w would a hospital system have the required beds for this crisis? Taxpayers could have never afforded building that many hospitals and beds to accommodate the unprecedented tragedy this is?
Then think about rural areas, where there is no need for such expense ever...should they have built hospitals and bought ventilators for a pandemic that no one saw coming. Keep them mothballed for years to come, never having used them until a once in a lifetime pandemic hits that no one could have predicted (not even the greatest scientific and medical minds?
The average American gripes about paying their mandatory income tax or property tax...what if the Feds, the State, and the regional and local authorities would have jacked taxes up a hundred fold (maybe 1,000 fold) so all these extra hospitals and ventilators could be built when there was no COVID=19 for the last 100 years (since the Spanish Flu perhaps). Would Amercians pay such taxes (in Dallas my taxes in 1996 were $3,000/yr, what if they were jacked up 100% to $300,000/yr to pay for these things...there would be a revolution.
Be prepared folks, in the future Health Ins. Co's and Life Ins. Co's might jack their rates up. Then there will be a hue and outcry from the customers screaming it is not fair. Well it is a reality, this crisis may change our lives in many ways for years to come. It is possible some of these companies will go out of business due to the heavy losses and some will voluntarily shut down or quit selling certain policies and it might get hard to be insured unless you are on a government program like Medicare and Medicaid. However, the Gov't system is not well funded and this can be a huge problem in the future after they suffer their losses too.
I've said it before here that I do not envy any leader, regardless of their affiliation, in this situation. They're all doing what they think is best. The situation in the US has definitely gotten political, (several major networks won't even show Trump's daily C19 pressers right now) but I still think that Trump and the Governors of every state are doing their best, based on the info they're being given.
One person has died and four others are in ICU, battling with the coronavirus, Health Minister Zweli Mkhize said late on Friday.
It was earlier on Friday announced that two people had died, but one person's coronavirus test returned negative.
There are a total of 1 170 confirmed cases as of Friday night.
Mkhize said four patients with Covid-19 were in ICU, three on ventilators.
A further 31 patients have recovered.
Here is some more info about that church gathering in the Free State that infected so many people:
The majority of 61 patients infected arose from the church conference which had five international visitors who subsequently tested positive for Covid-19.
It seems that South Africa is creating quarantine sites (various organisations are offering buildings to be used). It makes sense as especially the poor in South Africa cannot observe the safe rules of self-isolation as they live in overcrowded situations. So it seems that if you test positive (and local infectious spread has started so the numbers are going to escalate) and cannot self-isolate at home, you will become a 'guest of the government'.
Are the UK and the USA considering doing the same thing?
Does anyone know why the UK press is reporting that there isn't a testing kit that can be used to speed up tests but the South Africans have put in a huge order (to be delivered in April) for newly developed tests from the USA that can give a result in 45 minutes and is a mobile unit?
AND in just a few hours, we blew above 3,000 and those deaths and hospitalization rates? Yeah, going WAAY up. Total Cases
3,198
Positive Residents
3,054
Hospitalized
503
Deaths
46
The Governor is putting up checkpoints along I-10 to keep out New Orleans folk. Vacation rentals have been prohibited for 14 days. Y'all know the S is about to HTF now.
>>>I've said it before here that I do not envy any leader, regardless of their affiliation, in this situation. They're all doing what they think is best.<<<
Agree wholeheartedly. I was mad at that lone holdout congressman Massie (R-Ky) who mad all the representatives come back to DC to have a voice vote on this last stimulus pkg. The jerk put lives of his fellow members at risk. I was so incensed I tried to call his office and let his staff know what I thought but of course no one answered the phone and the voice mail was full, So I wrote him an email expressing my disapproval.
Likewise we need to let the good politicians know of our support. I just wish there were stronger orders in place to prevent the travel of people from one region to another unless there was a legitimate need.
1 - the problem is there aren’t enough ventilators for everyone who will need them.
2- even if they had enough ventilators, there aren’t enough medical personnel qualified to operate the machines and monitor them, and
3- there aren’t enough icu rooms/ beds for everyone who will need them.
It’s why they want to flatten the curve, keep people at home to reduce the spread, while they ramp up production of medical supplies. But there still aren’t enough people.
I’ve read interesting articles on cpap machines, they think they can be converted slightly to assist with opening airways to people breath better. Maybe some milder cases can manage with the cpap instead of a ventilator.
Italy has modified the vents and has up to 8 people on the same ventilator.
They’ve also modified snorkel masks so they can be used as vents or oxygen masks.
Your best option is to stay home and away from people so you don’t get the virus.
The news media turning it into a political event for ratings is annoying me more than any of the dem or repub governors or president.
The national media almost seems gleeful and hyped up when they get to report on the latest breaking disaster, death toll number, infection number, etc. reminds me of the weather channel reporters that get off on chasing the tornados, hurricanes, snow-mageddons.
I’m actually amazed that the scientific community, china, us, europe, and world, were able to identify this virus so quickly, and learn so much about it this quickly. It normally takes years for things to get identified and find treatments.
I think a state travel ban is theoretically the best way to go, as well, but not sure how enforceable it really is. There are not enough cops or troops to keep people in place, and I am honestly not sure I'd want that to change.
Staying home is the best bet, for sure.
>>>I’ve read interesting articles on cpap machines, they think they can be converted slightly to assist with opening airways to people breath better. Maybe some milder cases can manage with the cpap instead of a ventilator.<<<
Interesting you mention the possible use of a cpap machine. I owned one for several years and now I have a bipap machine. The cpap machine blows one pressure (usually used for sleep apnea) to allow the user to keep breathing. The bipap has one pressure for exhale and a different pressure for inhale. In my situation, my oxygen level is so low at night and I stop breathing that the bipap ensures I keep breathing so I don't inadvertently die. I had already thought if I come down with COVID-19 and I can't get hospitalized I will hook up to my bipap to ensure breathing. The settings can be adjusted to provide a pretty strong flow of air forced into you.
>>> yea wth was up with that? Did he say why he wanted to do it? I don't even believe in stimulus packages, but his is no time for grandstanding!<<<
Massie is known for being "Mr. No" a contrarian. He is a stickler for making sure procedural rules are followed to the extreme. He thought the rules were being bent and he objected legally and they has to call all of the congressional representatives back to town to have a 'quorum' and a voice vote, thereby jeopardizing the health of them together for a voice vote. He ended up voting yes for the legislation he was just being a stickler to the rules. Like an old saying he was putting form over substance, the blockhead. Trump SAID Massie was "grandstanding" and that he should be kicked out of the Republican party! lol. He got his 15 minutes of fame over this. He is up for reelection and I hope he loses to Todd McMurtry )Kentucky)
I can’t even watch the political tit for tat coverage. It has no bearing in my reality at all.
I read recently that “next week’s critical patients don’t know they are sick yet” as I’ve mentioned before. I’m so scared it will be me, being held captive with shoppers’ germs at my store.
Today at work, I was sick. Sweating, chills, horrible aching. No fever though. Our owner came out, told me to go sit down for a bit, then back to work. I think I was just stressed and overheated, but what if it’s Coronavirus? I’m home now and my feet and legs and neck feel like a toothache. When do I sacrifice myself vs losing my job? What if it’s not the virus and I am just suggesting it to myself?
We are isolating (more or less here) but I still worry (like you) and feel that I having an increase in my temperature (ah, so it hasn't gone up a full point yet but I can feel something) and then I feel some chills later in the day. I worry but I'm trying to focus on what I can control what happens inside this house, what happens inside my body (yogurt, probiotics in a pill, still not so good about the exercise), washing my hands, not wearing outside shoes much inside and cleaning high touch places.
I was in some meeting and they were talking about stress about this. One of the things that was brought out is the quote from Carl Jung about how trying to resist doesn't make it go away but how it grows in size. They talked about trying to reorient by recognizing those feelings, taking some deep breaths, and see what you can see (trying for nature), hear, smell and taste. They also mentioned not getting into trying to get information from every possible source but instead only 1 or 2 "reliable" sources like WHO, John Hopkins.
I have a few essential worker friends. They too are burned out by the public attitude and stuck working to their possible detriment. But where does one shit or get off the pot? Unknown here yet.
I think I am just feeling sorry for myself, busting my ass and I have coworkers who aren’t as committed as I am. Just a vicious circle.
I am just stressed because I try so hard, good work ethic instilled in me by parents who came to the USA from Latvia via displaced persons camps in Germany.
The battle is all in my head and it’s really killing me.
No protective gear here, the few who have masks are talked about behind their backs. It’s so weird.
Here is a suggestion. You can make a mask by 'fan' folding a paper towel and stapling it to a piece of elastic (which is easily purchased).
If you really want a pair of gloves, buy a hair bleach/dye kit, they usually come with a pair of gloves. Carefully use them as they aren't the strongest. I buy L'Oreal hair bleach and the gloves are decent. Maybe you can feel free to get a different color of hair at the same time and feel a little ego lift, lol
The elastic is pretty much gone here, CatEyes (people using it to make masks for the emergency/health service people). My BFF in Idaho is complaining that everything is gone from the stores, probably a combination of (a) people having to sew protection for HC/emergency services, and (b) Supplies coming from, wait for it, China.
I've seen videos of people making one-time use disposable masks by layering coffee filters, using a straightened paper clip for the nose wire for shaping, and stapling in rubber bands. They use masking tape to line the edges, cover the wire, and seal the stapler holes. It isn't perfect, of course, but better than nothing. Maybe. I believe Tennessee has told their doctors to use a double layer of (cloth) diapers as emergency masks.
Florida is essentially closed down to tourists and checkpoints will be going up on highways soon. We HAVE to get this under control before hurricane season; can you imagine thousands of evacuating COVID-19 positive people that are supposed to be sheltering at home having to evacuate?