COVID-19 Impacts- No Conspiracy Theories

[Sporkboy]

The hospital I work for (I am in a research building), is stopping elective surgery starting Wednesday and are scheduling out 6+ weeks. The cafeteria has converted to ‘grab and go’ with no seating. Not sure where visiting families are supposed to eat, but they have to do what they have to do.

The measures that are being taken would be fascinating to study with regards to what is done regionally and the impact on the spread of the disease. Hopefully people are taking this seriously. I want to get back to work and all of my wonderful toy... I mean tools.

Just got a slack message with someone having connection issues, and so it starts.

[Bbrou33]

The hospital I work for (I am in a research building), is stopping elective surgery starting Wednesday and are scheduling out 6+ weeks. The cafeteria has converted to ‘grab and go’ with no seating. Not sure where visiting families are supposed to eat, but they have to do what they have to do.

I know most hospitals I go to up here are only allowing 1 visitor per patient. Some only 1 visitor per patient per day.
My company being a third party outsider who comes into these hospitals, I'm getting to see how many of the top trauma hospitals in the NYC/NJ/LI area are responding. Pretty much all are implementing the same protocols.
Much of the surgeries we cover are elective so yesterday we basically lost 90% of our business momentarily. Luckily we also work with some of the best vascular and Neuro surgeons around so we still have some stuff going on.
I was home yesterday and today. Thinking maybe I'll get scheduled somewhere tomorrow if there's surgeries on our schedule to do so.

Such a weird time.

But don't worry guys. Despite NY governor and NYC mayor closing down businesses and urging people to stay inside, they are still enforcing street cleaning and handing out parking tickets.



Let's be Instagram friends @bbrou33

[The Sultan of SoWhat]

"My hope is that at age 79, Anthony Fauci is remembering this little bit of biology in the midst of long days involving numerous interviews with sometimes aggressive reporters."


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They're not the ones who are his (and our) problem.

[Rabirnie]

Forgot this tiny tidbit when I posted my situation the other day, but my wife happens to be 31+ weeks pregnant. She met with her midwife today and they took all the precautions to maintain a sterile environment and recommended my wife basically avoid the most commonly used places, such as grocery stores. We are not overly concerned but just trying to follow recommendations from health experts to limit her possible exposure. Baby is developing as expected and my wife is in good health/spirits. Hopefully, we can maintain course and get to the end unscathed.

With regards to surgeries, my dad is scheduled for shoulder surgery tomorrow and as of this moment, the hospital has not cancelled or delayed it. My dad turns 63 today and is in good health, but assuming the surgery goes ahead as planned he will be laid up at his house for a few weeks.

It is truly amazing how many dominos there are in our connected world and just how de-stabilizing these events can be. Pulling for all of you and your families during this time (and really, all the time, not just because of a pandemic).


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[Stretch44]

I just got word from my local Superior Court (Monterey County) that all non-emergency hearings and trials through May 20th will be continued to the next available date. The Monterey County board of supervisor is also having an emergency meeting as I type this on whether to issue a "shelter in place" like the Bay Area counties to the north. It is very eerie out here. Almost no one on the road, restaurants closed, no people walking around.

[TheJohnP]

"My hope is that at age 79, Anthony Fauci is remembering this little bit of biology in the midst of long days involving numerous interviews with sometimes aggressive reporters."


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They're not the ones who are his (and our) problem.

And let's just leave it at that.
Thank you.

[Stretch44]

Monterey County will be in a shelter in place beginning Wednesday 12:01 a.m. All of the Bay Area and surrounding counties are in a shelter in place.

[Sporkboy]

My hospital is restricting use of N95 masks to procedures likely to generate the floating bits that transmit the virus (technical term eludes me). Other than that, ear loop masks are to be used. Furthermore, N95 masks are to be reused.

My wife’s hospital is asking all research labs to turn over any gloves and masks that could be used in the clinic.

[BostonCharlie]

Re. N95 masks, I actually had one left over from a sanding/painting job at our rental. I gave it to my FIL whose health and age makes him vulnerable. He hasn't worn it yet.

If face covering becomes the fashion, I have a tan neck gaiter I can pull over my nose, lol.

(this is not my gaiter, but it's funnier)

[yinzburgher]

As of today, the hospital where I'm working has restricted all visitors except for some limited visiting in the Mother-Baby areas. We are also now being instructed to wipe down our PAPR shields for re-use. N95 masks are also going to be re-used. I'm not working today so maybe this has already been developed.....but last I know they haven't yet provided instructions or a policy on how to re-use n95s and where to place them when they are not in use. Donning a potentially contaminated N95 is not the same as putting on a brand new one out of the box. I only have 3 more 12-hour shifts left at this hospital and then it sounds likely that I'll be staying in the same general area but starting at a different health system so it will be interesting to see how different things are at a new facility.

Here is something I've been thinking about......a lot. In the US, the CDC provides guidance for hospitals and healthcare workers with regard to the safest precautions for care of patients with potentially contagious diseases. Most respiratory illnesses fall into one of two categories or required precautions; either droplet or airborne, with airborne precautions being more protective than droplet precautions. Info here. The CDC explains that they classify COVID-19 as mostly transmissible by droplet but then goes on to say that it might possibly be transmitted through smaller particles than your typical respiratory droplet. Info here. In other words, nature doesn't give a f*** about our normal and traditional classifications, rules and guidelines. Now, given our relative shortage of N95 and PAPR respirators in this context, the CDC is recommending standard surgical masks for care of most patients with COVID-19 and are only recommending N95s and negative pressure isolation rooms for for patients that will be having aerosolizing procedures. See the previous link. The problem is that almost every single COVID-19 patient that requires hospitalization will likely be getting nebulized medications of some sort. So a nurse or respiratory therapist who goes in that room with a coughing patient getting an aerosolized treatment should be equipped with more than a standard surgical mask or they are likely at risk. So I'm thinking maybe there needs to be more thought put in to a way to keep some COVID-19 patients at home and not taking up a hospital room but still getting all the necessary and beneficial nebulizers. Or alternatively we'll need to ramp up production of N95s and convert a lot more rooms to negative pressure. Otherwise we just won't have enough isolation rooms or respirators to go around.

HERE is a study in the New England Journal of Medicine that discusses the aerosolization of the novel coronavirus and compares it to the coronavirus that caused the SARS epidemic of 2003. It was only published in the Journal and put up HERE on the NIH site today as far as I can tell but HERE is where I found it originally a number of days ago. It seems a lot of docs and other healthcare workers aren't familiar with it yet but hopefully now they will be. It looks at how long SARS-CoV-2, which is the novel coronavirus that causes COVID-19, can be detected in comparison to SARS-CoV-1 (previously just called SARS-CoV) which is the virus that caused the SARS outbreak. You can see how long the virus lasts on surfaces but the part most relevant to my thoughts above is that the viruses are similarly still detectable at three hours post-aerosolization. Unfortunately you'll find that some publications are saying things like "the virus lives for up to three hours" but what they neglect to say is that the levels were not checked 4 hours later, or 10 hours, or a day. I just wish they would be more careful with their words and provide a little context. Side note: same goes for the World Health Organization when they published the info that COVID-19 had a 3.4% mortality rate. The number wasn't exactly wrong given the numbers we had at the time. But without any added context about why those numbers would not definitely not hold steady, I think they risked undermining people's trust. But more importantly about the aerosolization of the virus, I think hospitals and health professionals have to be giving more thought to the nuances of this particular virus, and certain procedures that are normally routine but could now become dangerous, and about our shortage of equipment.

[59yukon01]

I'm not a medical professional, but I get confused when I see these numbers globally, and yet we go about business as usual under a normal flu season that kills thousands more, both young and old. But this creates shear panic.

[MoT]

The United States flu season using 2018-2019 numbers from the CDC had a death rate of 0.09%. 34,000 people died.

As of noon Eastern, March 17 the US has seen (according to the CDC) 4,226 infections and 75 deaths, for a rate of 1.8%.

If the same number of people in the US (35,520,883) become infected with COVID as did the flu during the 2018-2019 flu season and the current 1.8% rate doesn't rise, that means 639,375 deaths.

Hopefully, that makes it clearer on why it is significantly more serious than "just a flu".

[Stretch44]

First, those numbers show a death rate of 4% whereas the flu is only .01%. That makes the virus 40 times more deadly. It seems the actual death rate is 1% but that's still 10 time more deadly. This doesn't even address the fact the the death rate is much higher in the elderly and those with underlying conditions.

Second, no one has immunity to this virus yet and it is so new we have no idea if it will mutate and become even more deadly. It would not be prudent to allow the virus to spread uncontrolled.

Third, given how infectious the virus is, it will (and is) spreading fast. Let's say 10,000,000 Americans get the virus. At a 1% death rate that is 100,000 deaths plus many more in need of hospitalization. The fact remains that if that were to occur in a couple of months span our health system would be overrun. People with completely unrelated medical issues would suffer as well. I read an interesting article (I'll try to find it) written by Italian doctors that they are resorting to battlefield medicine. I.E. choosing to help those that will survive and allowing other to die. This relates to even patients without coronavirus.

There are more reasons but hopefully that helps.

[BostonCharlie]

Since the precautions employed against coronavirus also work against traditional "flu" viruses, I've read that Japan has seen a dramatic drop in seasonal flu cases as they combat coronavirus.

If there is a positive impact of the coronavirus epidemic, look for it in Japan, where people are observing better hygiene and the number of influenza cases is far below a typical year.

The trend hasn’t been clearly seen in Europe or the U.S., where the threat of the epidemic has begun to hit home only in recent weeks, but if people elsewhere begin to take flu-prevention measures, thousands of lives could be saved.

...

Source: https://www.wsj.com/articles/japan-sees ... 1583073526

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[Stretch44]

Interesting article with simulations of the spread of covid-19.

https://www.washingtonpost.com/graphics ... simulator/