More Local Color

I'll take Kung Flu over Arkansas Flu any day.

We can hear the footsteps.
Last week we had Kung Flu rule-out patients in the single digits.
This week, almost 20. Two confirmed are most worrisome: one from a local convalescent hospital; the other from the county jail. That's two future clusters we can look forward to seeing explode locally over the next month. The latter will ripple through the entire jail population, the sheriff's deputies, then the prisons, courts, and the local homeless bunch, followed by the local addicts/psych patients, etc.
The former through that hospital's patients, then staff, then the families of both.
Most of whom we'll get as well.

One of them was classic: Came in talking, but not feeling well. Within hours, full respiratory distress, then intubation. Cardiorespiratory arrest within 24 hours, got him back. Tried proning him while intubated to increase oxygenation. Couldn't tolerate it by the second day. Arrested multiple times throughout the next day, finally made a DNR, and managed to die before 72 hours in-hospital.

Two more nearby hospitals are getting hammered by respiratory distress patients. Most are either Kung Flu, or highly likely, pending test results.

We're spiders in a jar, and the jar is filling with water.

EMS is coming in with varied levels of protection. Keep telling them be safe, not sorry, but some of them just haven't got the PPE available. They're going to get this. Then they'll share it unknowingly, and take it home. Then get sick, go into quarantine, and we lose another medic crew, or a fire station full of guys.

Local PDs, same-same. They're practically rolling on nothing but violent crimes now; don't want the risk, jails won't take anyone else anyways. The homeless, the crooks, even the crazies are avoiding the ER now like we've got the plague. Which, actually, we kind of do.

Nursing staff registries are offering crazy stupid amounts of money to fill holes everywhere. Anybody near retirement is punching out early. Younger ones, or with families, staying home. They're just not feeling it. (I told you people would walk.) L.A. County is doing herculean work to get homeless out of their cardboard hovel towns, and into buildings, with full staff - PD, medical, shelter management, etc. regular temperature checks. Anyone suspicious for Kung Flu gets the boot. The homeless turn other residents in for coughs and sneezes. They don't want this thing either, and they're only as crazy as they have to be.

More pedestrians in the streets, and less airplanes in the sky. It's giving me post-9/11 flashbacks, where seeing airplanes was non-existent for weeks. For most of the people I work with, they have no recollection; they were in grade school then. But it feels a lot like it.

I see more couples walking. And they hold hands. That's more commitment than rings and wedding vows now. You're literally telling that partner "If you go, I go too; I'm with you, thick or thin."

Then there's the other side: had two domestic violence cases this weekend. Put people in the same house non-stop for days, and tempers flare. Weak and wobbly relationships aren't going to survive this thing, even if the people do.

More cars on the road than there should be, and more each day. People are trying to slide by the stay-home orders. That's going to get us the Notional Guard response at the on-ramps, sooner or later, just like R.I.

Oh, remember this? Wherein I told you .Gov was going to have to set up Kung Flu Centers in convention centers and sports arenas?
Called it.
Called it again.
And again.
And again.
And yet again.
This isn't hard. .Gov telegraphs its plays, it's just that most people a month ago couldn't conceive of them needing this much capacity. I could, because I know what the system can and can't handle.

Anybody in full-blown denial about this still, is having a psychotic breakdown, and can't deal with reality.

Nawlins ER Doc's laxative-substitute (because it'll make you sh*t yourself) field clinical report is pointing towards what I'm afraid will become standard protocol: no one's worried about 100,000 ventilators, or any such nonsense, because the survival rate once you're intubated (for the 3-5% of everyone who get that sick) is from 30-14%. From about 1 chance in 3, to 1 chance in 7. Which, I suspect, is going to lead to standard of care to become "If they need intubation, don't bother. Medicate for pain, and move to hospice tent." It's a futile intervention, and it generates more aerosol viral load, so it isn't worth the risk to practitioners to intubate, and we cannot justify the effort and expenditure of staff time and resources, for something that's 70-86% fatal anyways. In short, practice will be to let you die, because you're going to anyways. If possible, in a narcotic haze to ease the pain of the transition.320M of you will never have to worry about it, but for some number of the last 10M, you may get an unfortunate POV angle on this, either in person, or the patient in the cot next to you. That's not actual Hell, but the smell of brimstone from there will be annoyingly close.
 
We're getting more and more reports of younger patients, too. Not a lot, but it turns out that youth does not equal immortality. Bummer, children. Not so bitchin' when Kung Flu can whack you, too, is it? Maybe now you'll stop going to beach parties, and learn to wash your hands. Or not. Suture self.

That's most of things, but I've got to get some rest before going back in again. I'm not in the sh*t yet; but the day is coming likely as not, and one of these nights, I'm going to zip in to work, and walk into the Baghdad ER during The Surge. Then it's on like Donkey Kong.

Stay frosty, and if you're in an area where this is a distant tale, count your blessings. This will be over, sooner or later, and things afterwards aren't ever going to be like they were before it happened. Keep an eye peeled for the good and bad proceeding from that.

We're going to get a lot of both.