COVID-19 Impacts- No Conspiracy Theories

[Robotaz]

Wow. So the name of the virus is already made into being PC or not? Whatever. This society needs a good purge apparently.

The name of the virus is Coronavirus Disease 2019 (COVID-19). Crowing about not being able to call it a divisive name created by a member of congress because he considers it to be a "hoax" is not because anyone is being "PC".

Being "PC" would be allowing you to continue to spew this bile even after I have very kindly asked for it to stop. I've been kind thus far, and I would hope you would have the ability to show some respect for me, for that kindness, and for your fellow members and stop with the bullcrap.

If you're incapable of restraining yourself and abiding by a simple request, find another site to frequent.

I just saw this. Noted.

[yinzburgher]

Unfortunately I can't kick this notion that much of the United States could be in a pretty terrible situation 3-4 weeks from now. I think that healthcare systems in many areas could be overloaded and overwhelmed. And of course that will be right around the time of Thanksgiving, which certainly won't help suppress the prevalence of the virus in the weeks following the holiday. I imagine we will see some regional lockdowns in the worst areas. I don't even wanna think about Christmas yet. Of course, I hope I'm very wrong about all this.

One positive development is that we shouldn't see the high death rates like we saw in the early days in Wuhan, Milan, NYC and other hotspots. Unless, of course, healthcare systems are completely overwhelmed and don't have the resources and/or personnel to keep up with cases. But if nothing else, giving IV steroids to those with severe illness.....and keeping them off of ventilators until or unless absolutely necessary will keep the percentage of deaths lower than earlier this year. There are some other things we've learned and some other treatments with lesser degrees of efficacy but it's primarily those two thing driving better outcomes for the sickest patients.

Disclaimer: "Dammit Jim! I'm a nurse, not a virologist! If you want one thing to worry about a little less, worry less about contracting this coronavirus through touch/contact or surface transmission to mucous membranes. It has become more and more clear that the vast majority people that contract this virus do so by breathing in the air that has been exhaled by infected individuals.....inhaling the virus, which is contained in droplets and small aerosolized particles, directly into their lungs. Is it possible that some small percentage of people are getting infected through contact rather than inhalation? Yes, it's possible. And that is the reason that infectious disease specialists, doctors, virologists, epidemiologists, and public health officials (who have known for months that this virus' primary mode of transmission is via a respiratory pathway) have been slow or reluctant to tell people not to worry as much about it as much. Oddly, it's been science writers/reporters that have driven the conversation about the increasingly clear reality of transmission more than the aforementioned professionals. My point with all this isn't to lure you into a fall sense of security regarding dirty hands and dirty surfaces (in general I think it's good to keep yourselves and your surroundings clean). It's to say that I think people should be focusing on the more important precautionary measures that minimize exposure to other people's exhaled air. You guys already know all the things, you've been hearing them for months at this point.

Anyway, I hope everyone is well and that everyone here is thinking about what they can do and how they can act to actually enjoy their holidays this year.

@yinzburgher, thanks for the update. I had been meaning to post something asking for your thoughts since you're on the front lines. Thanks being out there and putting yourself at risk for us not working in the hospitals.

If you, or anyone, have a more specific question or thought about something, just ask here or PM me and I'll definitely respond when I can. Spending so much of my time in a hospital, I sometimes lose sight of what people do and do not know about what goes on in hospitals. So I just post what I'm thinking about, or some small fraction of it anyway. I'd like to post about vaccines and more about current and future medical therapies but I'm afraid I have too many thoughts and not enough clarity to post something coherent. But I guess if I waited until I had everything all figured out, you guys would never hear from me again.

[MoT]

Wow. So the name of the virus is already made into being PC or not? Whatever. This society needs a good purge apparently.

The name of the virus is Coronavirus Disease 2019 (COVID-19). Crowing about not being able to call it a divisive name created by a member of congress because he considers it to be a "hoax" is not because anyone is being "PC".

Being "PC" would be allowing you to continue to spew this bile even after I have very kindly asked for it to stop. I've been kind thus far, and I would hope you would have the ability to show some respect for me, for that kindness, and for your fellow members and stop with the bullcrap.

If you're incapable of restraining yourself and abiding by a simple request, find another site to frequent.

I just saw this. Noted.

Water under the bridge as far as I am concerned, [mention]Robotaz[/mention].

[The Sultan of SoWhat]

Second wave is upon us. In my township in NJ cases have risen to heights not seen since April.

[BostonCharlie]

The WSJ has a coronavirus data page that I find helpful, and there is no paywall:
https://www.wsj.com/articles/coronaviru ... 1594333471

I especially like their national heat map that normalizes the data by population. The pattern looks very different from the first wave, which I recall was denser near the coasts. Watching the progression over the past couple weeks, it seems to be moving southward, perhaps with the advancing colder weather. Here is a screengrab from today:

virus_heat_map.png (194.86 KiB) Viewed 4161 times

Stay safe everybody! And Thank You yinzburgher for your update!

[BostonCharlie]

This opinion piece in the WSJ (paywall) suggests upgrading to a more defensive mask when necessity requires traveling through risky areas:

... and while there are still some shortages of medical masks, health-care workers have dedicated supply chains. It’s time to revise the guidance to consumers.

A cotton mask offers far less protection than a surgical mask. If a cloth mask is all you can find, buy a thick one. Snug-fitting masks made of cotton-polyester blends will generally offer more protection. But even a very good cloth mask may only be about 30% protective; scarf or bandanna, 10% or less.

A surgical mask could offer you better protection, on the order of 60%. But here again, quality matters. Many of the masks sold on Amazon, which say they are for dust and allergens, aren’t surgical masks, even though they look like the blue masks worn by nurses and doctors. A real medical-procedure mask will be cleared by the Food and Drug Administration and designated as offering one of three levels of protection. Generally, a level 2 or level 3 medical mask is best.

An N95 or equivalent mask offers the best protection and, if used properly, will filter out at least 95% of infectious particles. Online resources can help you fit the mask. In China the equivalent mask is the KN95 and in Europe the comparable designation is FFP2. The FDA has authorized for emergency use a bunch of KN95 and FFP2 masks that have been tested to show that they offer comparable protection to an N95 mask. These options are listed on the FDA’s website [link here].

Masks may also be evaluated by the National Institute for Occupational Safety and Health, a part of the Centers for Disease Control and Prevention that certifies masks for industrial uses. Check to see if your mask is listed in the Niosh database [link here]. Many products claim to be N95 equivalent but haven’t undergone testing and may be counterfeits.

Better-quality masks can be expensive—perhaps $5 for a single N95 mask. But having a few available for high-risk settings such as the grocery store can reduce the risk of transmission. The Department of Homeland Security has published instructions online on disinfecting and reusing N95 masks that can extend their life [link here].

...

A side note. I know nothing about these things, but I've read that static electricity is part of what makes an N95 mask so effective. So decontaminating an N95 (as described in the linked article) wouldn't be enough to fully restore its effectiveness. Here is an article on the IEEE site that makes the point better:

N95 and other medical-grade masks rely on two filtration methods: mechanical filtering by mask fibers, and electrostatic filtering, in which stationary electric charges attract and ensnare tiny 0.3-micron particles such fluid droplets containing viruses. The masks are specified for single-use only because even after a day, the electrostatic charges in the mask leak out into the air and the mask becomes less effective at filtering out particles. That gradual loss of efficiency is even worse in countries like India where high humidity speeds the loss of static charge to the air.

The problem is exacerbated when healthcare workers turn to procedures to decontaminate and reuse masks, such as baking or boiling, UV light towers, even large fumigation machines, all of which can extinguish a mask’s electrostatic charge.

“We wondered, why can’t we recharge it?” says Dov Levine, a physicist at Technion-IIT in Haifa, Israel. “Well, it turns out you can.”

In a paper published this week in the journal Physics of Fluids, Levine, along with Shankar Ghosh and colleagues at Tata Institute of Fundamental Research in Mumbai, India, show that decontaminated N95 masks can be rejuvenated to have off-the-shelf filtration levels with a jolt of electricity that restores electrostatic charges. The team also made a prototype, battery-powered, smart mask with a removable filter that can be continuously charged to maintain high levels of filtration even after hours of use.

[Bbrou33]

Hope everyone is staying safe. As in most of the country, cases in the nyc area are rising. Though, not as drastically as some areas. As I said in the beginning, I'm very impressed with the people on NYC. Masks are a part of life here and we have accepted it knowing it's helping others more than us.
Gyms reopen in September and I've been going constantly. Masks are required the entire time (worn properly), workers are constantly cleaning, and there's ample cleaning products around for members to wipe down equipment.
Restaurants are at limited indoor capacity. Museums and galleries are open. The city is essentially operating normally with guidelines and restrictions but everyone is very compliant.
Still very odd at how quiet this busy city can be with lack of tourists. But I did notice there are more around the holiday.

Fear of surgery shutting down again in the NY/NJ area sometime in December is becoming real. But as of now, spiking isn't large enough to have that happen. Though the next 2ish weeks will reveal a lot.

For those who don't know, I work in surgery behind a computer. I visit several different hospitals in Long Island, NYC, and North Jersey. Work has been crazy busy and nonstop for months now. At first everyone was playing catch up from the initial shut down. Now everyone is cramming things in for the potential second shut down. Plus end of the year means deductibles are met so more surgeries are happening anyway.

I'm currently in an internal dilemma in whether I will go back to Louisiana (where I'm from) to see my family for Christmas. Not that my family isn't being safe, but I know the people in Louisiana most certainly are not. I'm not really worried about my health. It's practically infecting my family, or worse, the patients and people at the hospitals I work at. With NYs travel restrictions, I would need a test within 3 days of returning to NYC and then quarantine upon returning. On the 4th day of quarantine another test in NY. If both results are negative then I'm free.
While I know that's certainly no guarantee I don't have it (incubation period and whatnot), it would help with some reassurance. And ultimately I'd personally get another test around day 7-10 of my return.

Anyway that's my little covid update/vent session. Thanks for reading.

I hope everyone is staying healthy and safe asking with your family and loved ones.



Sent from my SM-G975U using Tapatalk

[yinzburgher]

This could be rambling and disorganized bc I'm not sure I really have any thoughts together.....but I just wanna spit some of this out before I go back to work again Thursday night. To be completely honest this is more about catharsis for me than it is about any useful information for anyone that might read it.

I had a little bit of time off. I got to see my parents (which was great for me) and I briefly saw one friend but that was about it. When you work with covid pts every day, it's a bit like wearing a scarlet letter.....I guess people are probably worried you could infect them. I'm certainly not trying to make anyone uncomfortable so I didn't really go out of my way to connect with anyone. They all have their bubbles at this point and I'm not a part of those bubbles. The irony here is that I'm probably one of the safer people you could be around. I see some of the sickest people so I have this cognitive bias that keeps me from behaviors that are considered risky with regard to covid. I certainly don't go to indoor locations with a lot of people. And I wear a PAPR when I'm with covid patients and a surgical mask around everybody else. Anyway..... On a related note, you find that most covid pts have a pretty good idea of how they got covid. They often know the setting or type of setting they got it, if not exactly who transmitted it to them.

After my break I worked six 12-hour nights in a row. One of those was an extra shift bc of how busy things are. I could probably work every single night if I wanted to. They asked me to work again tonight but my night off last night felt so good that I just wanted to do it again. And that would have been 11 out of 12 straight so I declined. They did bump my pay though, which is good. There is already plenty of motivation to do my best at work but the increased pay just adds to it.....and it keeps me from complaining about my assignment, workload, schedule, etc. Travel/contract nurses (particularly in ICU) are making crazy money right now but these hospitals need to make sure they're taking care of their own staff nurses too. For my part, I need to start getting better about bringing in food and coffee for my coworkers more often. They've been awesome and little things like that go a long way.

I'm working in a small ICU in a very small hospital. All six ICU beds are full. 5 out of 6 are covid and the last I knew there was another critical covid in the ER. At this point, if you're an ICU nurse, you're a COVID nurse. Speaking of....we have one travel nurse from NYC who was working there during the worst of it. He got out of there to "get away from COVID". I probably don't need to tell you that's impossible....especially in CA. A nice person and fairly bright but he's a newer nurse and gets very down when we have a pt that starts declining.....which I understand but we just need to be very cognizant and careful about. These people are already terrified bc of everything they've seen on the news. Some of them have family and friends that are sick or worse from covid. The last thing they need is somebody walking in with bad energy. So I spend a lot of time encouraging these pts and telling them (often in bad Spanglish) that they're doing a good job and they need to keep it up. Here's why in a quick snapshot of what could be your average ICU covid pt: Intubation and mechanical ventilation is sometimes necessary but it worsens a covid pt's prognosis so we try our hardest to avoid it. That means we have have a lot of pts on heated/humidified high-flow nasal oxygen (Airvo, Vapotherm, Optiflow) and some on BiPAP. And we often have to tolerate seeing their lower levels of oxygen bc we don't want to intubate them. And one thing that can really help these pt's oxygen levels is to turn them so they are laying face down on their stomach or at least their side. This can be uncomfortable for a lot of people, particularly many of the obese people that covid tends to hit hard. So now you have this pt who is not completely sedated bc they aren't on a ventilator. You isolate them from their family or any other visitors. You tell them they need to lay prone on their stomach and wear an uncomfortable mask that blasts O2 in their face. You put them on steroids which can make people anxious and emotional. You give them nothing but time to think about their predicament. They may also feel short of breath (although many of these COVID pts aren't short of breath which is another strange phenomena). Hopefully they can eat but some on BiPAP can't. Pills, injections, IVs, blood draws, getting tangled in their own monitoring wires, limited sleep, no privacy due to the constant monitoring, complete strangers in full PPE taking care of them, being told not to move too much bc their oxygen levels go too low.......it's **** miserable. So sometimes they need somebody to acknowledge that it sucks right now but that they're doing a good job and they need keep doing it....to give them a little motivation and encouragement and sense of agency and control over their situation. I won't lie to them or sugar-coat their medical status but they certainly don't need me walking in there with any sort of negative attitude.

OK, so all that said.....my confession is that I can't always keep it together on these video calls with family from inside the pt room. Often I can.....but some of these calls completely freaking destroy me. There is more to this than I can possibly explain here, but basically under normal circumstances my belief is that family members usually have other family members (that know them best) to console them. So while consolation and compassion is definitely a part of my job, it is more important that I educate them, that I communicate clearly and project calm, competence, and experience. That I can answer their questions at their level of understanding and tell them what's going on and what the game plan is. But it's all a little different now with covid and with almost no hospital visitation. Sometimes these families are relying on you for a little more. And seeing their faces rather than talking on the phone changes things too. I could probably keep it together if I let my mind be more distant or thought about baseball or some other little trick....but that doesn't seem entirely fair. Some of these family members have covid themselves. Often they are very worried, or grateful, or mourning. And like I said, I can usually keep it together.....but depending on the circumstances, sometimes these poor families are talking to a grown-ass man that can't even wipe away the tears or snot under his spacesuit. At one point a while ago somebody was saying a prayer on a video call and started crying. The prayer was in Farsi....I didn't understand a single word....but still the waterworks started on my end. If you asked a young yinzburgher what he thought he'd be doing for a living, nothing like this ever even enters the discussion. I'm no stranger to critical illness or death and dying......and my very first job years ago was probably good preparation for this, but things have just been different this year with covid. I'm optimistic overall, but I think I'm just sad for the way things are right now and will probably be for the coming months. Anyway, that's what I'm thinking for the moment. I hope everyone here is doing well.

[BostonCharlie]

This could be rambling and disorganized bc I'm not sure I really have any thoughts together..... ...

My heart goes out to you.

[MoT]

Everyone needs to read this and then read it again. Then think long and hard about how much of this was avoidable.

I am sorry you have to experience these things, and at the same time, I am grateful someone like you is doing this work. I loathe to toss around this word lightly, but you are a hero, and though you deserve more, someday I'd like to meet you, shake your hand, give you a hug and buy you a round or three.

This could be rambling and disorganized bc I'm not sure I really have any thoughts together.....but I just wanna spit some of this out before I go back to work again Thursday night. To be completely honest this is more about catharsis for me than it is about any useful information for anyone that might read it.

I had a little bit of time off. I got to see my parents (which was great for me) and I briefly saw one friend but that was about it. When you work with covid pts every day, it's a bit like wearing a scarlet letter.....I guess people are probably worried you could infect them. I'm certainly not trying to make anyone uncomfortable so I didn't really go out of my way to connect with anyone. They all have their bubbles at this point and I'm not a part of those bubbles. The irony here is that I'm probably one of the safer people you could be around. I see some of the sickest people so I have this cognitive bias that keeps me from behaviors that are considered risky with regard to covid. I certainly don't go to indoor locations with a lot of people. And I wear a PAPR when I'm with covid patients and a surgical mask around everybody else. Anyway..... On a related note, you find that most covid pts have a pretty good idea of how they got covid. They often know the setting or type of setting they got it, if not exactly who transmitted it to them.

After my break I worked six 12-hour nights in a row. One of those was an extra shift bc of how busy things are. I could probably work every single night if I wanted to. They asked me to work again tonight but my night off last night felt so good that I just wanted to do it again. And that would have been 11 out of 12 straight so I declined. They did bump my pay though, which is good. There is already plenty of motivation to do my best at work but the increased pay just adds to it.....and it keeps me from complaining about my assignment, workload, schedule, etc. Travel/contract nurses (particularly in ICU) are making crazy money right now but these hospitals need to make sure they're taking care of their own staff nurses too. For my part, I need to start getting better about bringing in food and coffee for my coworkers more often. They've been awesome and little things like that go a long way.

I'm working in a small ICU in a very small hospital. All six ICU beds are full. 5 out of 6 are covid and the last I knew there was another critical covid in the ER. At this point, if you're an ICU nurse, you're a COVID nurse. Speaking of....we have one travel nurse from NYC who was working there during the worst of it. He got out of there to "get away from COVID". I probably don't need to tell you that's impossible....especially in CA. A nice person and fairly bright but he's a newer nurse and gets very down when we have a pt that starts declining.....which I understand but we just need to be very cognizant and careful about. These people are already terrified bc of everything they've seen on the news. Some of them have family and friends that are sick or worse from covid. The last thing they need is somebody walking in with bad energy. So I spend a lot of time encouraging these pts and telling them (often in bad Spanglish) that they're doing a good job and they need to keep it up. Here's why in a quick snapshot of what could be your average ICU covid pt: Intubation and mechanical ventilation is sometimes necessary but it worsens a covid pt's prognosis so we try our hardest to avoid it. That means we have have a lot of pts on heated/humidified high-flow nasal oxygen (Airvo, Vapotherm, Optiflow) and some on BiPAP. And we often have to tolerate seeing their lower levels of oxygen bc we don't want to intubate them. And one thing that can really help these pt's oxygen levels is to turn them so they are laying face down on their stomach or at least their side. This can be uncomfortable for a lot of people, particularly many of the obese people that covid tends to hit hard. So now you have this pt who is not completely sedated bc they aren't on a ventilator. You isolate them from their family or any other visitors. You tell them they need to lay prone on their stomach and wear an uncomfortable mask that blasts O2 in their face. You put them on steroids which can make people anxious and emotional. You give them nothing but time to think about their predicament. They may also feel short of breath (although many of these COVID pts aren't short of breath which is another strange phenomena). Hopefully they can eat but some on BiPAP can't. Pills, injections, IVs, blood draws, getting tangled in their own monitoring wires, limited sleep, no privacy due to the constant monitoring, complete strangers in full PPE taking care of them, being told not to move too much bc their oxygen levels go too low.......it's **** miserable. So sometimes they need somebody to acknowledge that it sucks right now but that they're doing a good job and they need keep doing it....to give them a little motivation and encouragement and sense of agency and control over their situation. I won't lie to them or sugar-coat their medical status but they certainly don't need me walking in there with any sort of negative attitude.

OK, so all that said.....my confession is that I can't always keep it together on these video calls with family from inside the pt room. Often I can.....but some of these calls completely freaking destroy me. There is more to this than I can possibly explain here, but basically under normal circumstances my belief is that family members usually have other family members (that know them best) to console them. So while consolation and compassion is definitely a part of my job, it is more important that I educate them, that I communicate clearly and project calm, competence, and experience. That I can answer their questions at their level of understanding and tell them what's going on and what the game plan is. But it's all a little different now with covid and with almost no hospital visitation. Sometimes these families are relying on you for a little more. And seeing their faces rather than talking on the phone changes things too. I could probably keep it together if I let my mind be more distant or thought about baseball or some other little trick....but that doesn't seem entirely fair. Some of these family members have covid themselves. Often they are very worried, or grateful, or mourning. And like I said, I can usually keep it together.....but depending on the circumstances, sometimes these poor families are talking to a grown-ass man that can't even wipe away the tears or snot under his spacesuit. At one point a while ago somebody was saying a prayer on a video call and started crying. The prayer was in Farsi....I didn't understand a single word....but still the waterworks started on my end. If you asked a young yinzburgher what he thought he'd be doing for a living, nothing like this ever even enters the discussion. I'm no stranger to critical illness or death and dying......and my very first job years ago was probably good preparation for this, but things have just been different this year with covid. I'm optimistic overall, but I think I'm just sad for the way things are right now and will probably be for the coming months. Anyway, that's what I'm thinking for the moment. I hope everyone here is doing well.

[TheJohnP]

Please don't stop venting, rambling, getting things off your chest [mention]yinzburgher[/mention].
We are here for you always.

This pandemic has gone on for longer than many could've anticipated (or should have).
We can go into sprint without thinking about it, but it's hard to find yourself in a marathon without preparation.
Even the best of us are going to feel drained from the constant "new normal," that's normal.

We're glad you're here. We hope this site provides a respite from what you're dealing with on a daily basis.
And to echo what [mention]ManOnTime[/mention] said, we are proud of you and what you do.

Thank you.

[Stretch44]

This could be rambling and disorganized bc I'm not sure I really have any thoughts together.....but I just wanna spit some of this out before I go back to work again Thursday night. To be completely honest this is more about catharsis for me than it is about any useful information for anyone that might read it.

I had a little bit of time off. I got to see my parents (which was great for me) and I briefly saw one friend but that was about it. When you work with covid pts every day, it's a bit like wearing a scarlet letter.....I guess people are probably worried you could infect them. I'm certainly not trying to make anyone uncomfortable so I didn't really go out of my way to connect with anyone. They all have their bubbles at this point and I'm not a part of those bubbles. The irony here is that I'm probably one of the safer people you could be around. I see some of the sickest people so I have this cognitive bias that keeps me from behaviors that are considered risky with regard to covid. I certainly don't go to indoor locations with a lot of people. And I wear a PAPR when I'm with covid patients and a surgical mask around everybody else. Anyway..... On a related note, you find that most covid pts have a pretty good idea of how they got covid. They often know the setting or type of setting they got it, if not exactly who transmitted it to them.

After my break I worked six 12-hour nights in a row. One of those was an extra shift bc of how busy things are. I could probably work every single night if I wanted to. They asked me to work again tonight but my night off last night felt so good that I just wanted to do it again. And that would have been 11 out of 12 straight so I declined. They did bump my pay though, which is good. There is already plenty of motivation to do my best at work but the increased pay just adds to it.....and it keeps me from complaining about my assignment, workload, schedule, etc. Travel/contract nurses (particularly in ICU) are making crazy money right now but these hospitals need to make sure they're taking care of their own staff nurses too. For my part, I need to start getting better about bringing in food and coffee for my coworkers more often. They've been awesome and little things like that go a long way.

I'm working in a small ICU in a very small hospital. All six ICU beds are full. 5 out of 6 are covid and the last I knew there was another critical covid in the ER. At this point, if you're an ICU nurse, you're a COVID nurse. Speaking of....we have one travel nurse from NYC who was working there during the worst of it. He got out of there to "get away from COVID". I probably don't need to tell you that's impossible....especially in CA. A nice person and fairly bright but he's a newer nurse and gets very down when we have a pt that starts declining.....which I understand but we just need to be very cognizant and careful about. These people are already terrified bc of everything they've seen on the news. Some of them have family and friends that are sick or worse from covid. The last thing they need is somebody walking in with bad energy. So I spend a lot of time encouraging these pts and telling them (often in bad Spanglish) that they're doing a good job and they need to keep it up. Here's why in a quick snapshot of what could be your average ICU covid pt: Intubation and mechanical ventilation is sometimes necessary but it worsens a covid pt's prognosis so we try our hardest to avoid it. That means we have have a lot of pts on heated/humidified high-flow nasal oxygen (Airvo, Vapotherm, Optiflow) and some on BiPAP. And we often have to tolerate seeing their lower levels of oxygen bc we don't want to intubate them. And one thing that can really help these pt's oxygen levels is to turn them so they are laying face down on their stomach or at least their side. This can be uncomfortable for a lot of people, particularly many of the obese people that covid tends to hit hard. So now you have this pt who is not completely sedated bc they aren't on a ventilator. You isolate them from their family or any other visitors. You tell them they need to lay prone on their stomach and wear an uncomfortable mask that blasts O2 in their face. You put them on steroids which can make people anxious and emotional. You give them nothing but time to think about their predicament. They may also feel short of breath (although many of these COVID pts aren't short of breath which is another strange phenomena). Hopefully they can eat but some on BiPAP can't. Pills, injections, IVs, blood draws, getting tangled in their own monitoring wires, limited sleep, no privacy due to the constant monitoring, complete strangers in full PPE taking care of them, being told not to move too much bc their oxygen levels go too low.......it's **** miserable. So sometimes they need somebody to acknowledge that it sucks right now but that they're doing a good job and they need keep doing it....to give them a little motivation and encouragement and sense of agency and control over their situation. I won't lie to them or sugar-coat their medical status but they certainly don't need me walking in there with any sort of negative attitude.

OK, so all that said.....my confession is that I can't always keep it together on these video calls with family from inside the pt room. Often I can.....but some of these calls completely freaking destroy me. There is more to this than I can possibly explain here, but basically under normal circumstances my belief is that family members usually have other family members (that know them best) to console them. So while consolation and compassion is definitely a part of my job, it is more important that I educate them, that I communicate clearly and project calm, competence, and experience. That I can answer their questions at their level of understanding and tell them what's going on and what the game plan is. But it's all a little different now with covid and with almost no hospital visitation. Sometimes these families are relying on you for a little more. And seeing their faces rather than talking on the phone changes things too. I could probably keep it together if I let my mind be more distant or thought about baseball or some other little trick....but that doesn't seem entirely fair. Some of these family members have covid themselves. Often they are very worried, or grateful, or mourning. And like I said, I can usually keep it together.....but depending on the circumstances, sometimes these poor families are talking to a grown-ass man that can't even wipe away the tears or snot under his spacesuit. At one point a while ago somebody was saying a prayer on a video call and started crying. The prayer was in Farsi....I didn't understand a single word....but still the waterworks started on my end. If you asked a young yinzburgher what he thought he'd be doing for a living, nothing like this ever even enters the discussion. I'm no stranger to critical illness or death and dying......and my very first job years ago was probably good preparation for this, but things have just been different this year with covid. I'm optimistic overall, but I think I'm just sad for the way things are right now and will probably be for the coming months. Anyway, that's what I'm thinking for the moment. I hope everyone here is doing well.

I think about you on occasion and wonder how you're doing. This is a heavy burden you carry and I appreciate everything you and our other front line workers are doing. I cannot imagine a day in your shoes, let alone 12 hour shifts everyday. Thank you for sharing.

[Split-Time]

[mention]yinzburgher[/mention], you are in my thoughts daily and will be in my prayers as well. None of us outside of your profession can understand what you are going though. You know that you have friends here. How special is that...friends you have never met?

I worry about our health care professionals in general during this time and think about the difference between sympathy and empathy. Your friends and family can sympathize but very few of us have any similar experiences to which we can relate...even on a small scale. Someone told me recently that they wish that they had the "secret sauce" when it comes to comfort during hard times. As they said that, I realized that the secret sauce may just be in knowing that you are not alone.

As for you emotions, clearly you have been though and are going though a lot. Even the toughest of us are not built for this. You hurt because you care and have a heart for your patients and their families. You are who I would want taking care of me or my loved ones!

[yinzburgher]

I really appreciate all the kind words and the show of support. It's great to see that. I imagine I sound like a wreck.....but to be honest I feel like I'm holding up pretty well. All things considered, I feel good. Those zoom calls with families are just a new and very emotional part of my job that I was not fully prepared for. After a few of the more difficult ones busted me up a bit, I was asking myself whether I was OK.....and I really think I am. I think it would be more of a problem if such an emotional thing didn't affect me at all. Or if I start to become distant or numb. Anyway, it occurred to me that it might actually help to post about it here, where I'm semi-anonymous. I suppose a watch forum is a strange place to share your pandemic woes but if it helps, I think I might as well. And yes, this place really has been a great respite from work and COVID. I remain watch-obsessed and I enjoy sharing this space with everybody here. Many thanks folks. Stay well!

[The Sultan of SoWhat]

I emailed a copy of yinz's post to several people. Here is one response:

"Heartbreaking, frightening and should be read — no heard for greater impact — by everyone."