Monday, March 30, 2020

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.

75 comments:

  1. Keep as safe as you can ...

    This was what touched me the most:

    "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."

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  2. Been self isolated with my wife and three kids. I have had a fever for the entire time. Zero indication of sinus infection, which makes me think we are lucky 80%. Medical folks are courageous, going to work day after day....God Speed

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  3. Aesop;
    I just want to tell you how much I appreciate your no-BS posts.
    I'm really appreciative of your serious-as-a-heart-attack, but not hysteric posts.

    Keep writing.

    Thanks!

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  4. Like the first person said "Keep as safe as you can..." WE know you understand what we are up against and i am sure that helps. They changed the definition of what a high risk case is so i have to go back to work. Being over 60 but under 65 causes this. I will be taking all my clothes off in the garage, then wash them, then myself. I do not do any medical stuff so that makes it a bit safer but there are plenty of people who are sick but do not know it.

    Joe

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  5. Things are generally good here. We've been attempting to be extra good - go out as few times as possible. When I go in to work, it'll be the same two people most of the time, if I'm in the office. At least it's not a revolving door.

    There are infected folks around here now. I imagine the number is 20x what has been reported, so it's even in places that are literally in the middle of nowhere. Wish HIPPA didn't exist, or was suspended so we had lists of infected to know who they were and who was likely to be infected next. Heard rumors that a person with Corona came shopping here to find things they couldn't find at their local store.

    Mighty neighborly of him to share.

    At home, it's going well. Not even boring. Pugsley is doing homework. The Boy has a college test tonight at 7:30. The Mrs. is doing her thing amid regular calls from my mother-in-law. Made a brisket Saturday. Mmmm. Beer, white bread and barbeque. Plus 20 extra pounds of cooked meat in the fridge.

    You can get most things in the store, with the exception of fresh meat, eggs, ramen, and rice/beans. Bread was limited to three items per customer. If people are prepping, choosing fresh foods that are hard to preserve is a silly way to do it.

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  6. Fiddlin John CarsonMarch 30, 2020 at 2:11 PM

    "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."

    Damn, Just damn.

    While the media long ago sold it's soul, the internet has provided us with the words of ordinary people who write extra extraordinary things.

    Godspeed

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  7. I received a scan of a letter from the NY Health Department that said, basically, if youre a health care worker who has been exposed to a confirmed case.....you're ok to go to work at your facility, just be careful.

    The between-the-lines, to outsiders like me, seems to be that the system is failing to the point that even the walking wounded need to stay at their posts.

    Interesting stuff.

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  8. IN reference to auxiliary medical facilities, the Corps of Engineers and the Ohio NG evaluated the IX Convention Center for use as an aux medical facility.

    The IX Center is the largest exposition center under a single roof in the US, with 1 million square feet of exposition space and 2+ million square feet under one roof.


    This IS gonna sucque balls.

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  9. Stay safe, Aesop, and prayers to you. I fully credit your posts and warning for giving me the kick in the a$$ I needed to make those last preps I'd been putting off and so we're hunkered down while today the MD gov announced a stay-at-home order, followed by DC and VA. Not that it seems to mean much - I can still go out to get 'essential' things and all - but it's the next step I suppose. Sadly half the population is indeed below average IQ...even today I saw people wearing no PPE at all while picking up the wife's meds, and several of them were older, clearly 60+. If only this thing could target the dull of wit and leave the rest of us alone.

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  10. "Sadly half the population is indeed below average IQ...even today I saw people wearing no PPE at all while picking up the wife's meds, and several of them were older, clearly 60+. "

    If I leave my apartment even to go to the mailboxes, I go with mask, gloves, a cap, etc.

    One little old lady saw me in the hallway and asked why I was wearing that stuff. I said, "Because of that Chinese coronavirus."

    She said, "What virus?"

    This was yesterday.

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  11. My deepest gratitude and prayers for the men and women in hospital and emergency organizations that are literally risking their lives to help their fellow human beings in what history will say is human kinds darkest hour.

    Nemo

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  12. This does and will target the dull of wit. The problem is that they in turn can target US.
    Still have about 72 hours to sweat Bride's health. Her dull of wit boss was symptomatic before the organization sent folks home. Praying like it's all up to God and working like it's all up to us. Looking forward to a clean bill.
    Picked up scrip refills and was in the minority of those gloved. Getting purty good at the whole glove-thing.
    Stay chilly Brother and haul add when the time comes. We want you around for the "Toldya, dumbass" phase.
    Boat Guy

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  13. We're all praying for the ER workers here. Some close to home.
    I would ask everyone do the same.

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  14. My wife just walked in the room and said that with the .gov breaking us down into smaller and smaller groups and further and further apart that it’s starting to feel like we’re all taking part in that M. Night Shyamalan movie The Happening where the only way you lived was by doing the above or else Mother Nature killed you. I guess if this mess got started in that Wuhan market with someone going all Ozzie Osbourne on a bat.... which I doubt... then maybe it is a natural “Happening”

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  15. Wonder if this virus can be transferred from mosquitoes?

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    Replies
    1. Now there's a pleasant thought.

      Time for more Deet and Permethrin, in case the ticks can spread it as well...

      MN Steel

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  16. World changer for me. Large academic medical center I work for in Midwest just issued directive: No procedures that have a high risk of aerosol generating without full PPE. (Gown, gloves, face shield, N95 respirator)

    Guess what, CPR is one of those high risk procedures that was explicitly mentioned, even for compressions only. Code in hospital, no touch until PPE eguiped staff get there. Grandma coding in bed...sorry need to wait for staff in PPE to do CPR, which doesn't matter anyway, no visitors allowed in hospital.

    Have a heart attack in public? Maybe a brave soul or family member will do compressions. EMS will soon be following these suggestions. Unless you have an AED handy, you are gone.

    Been nursing for years and I don't know how to process this...

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  17. Aesop, I trust and pray you will know when That Day has arrived, whereby at the end of your shift you clock out, leave, and never come back.

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  18. Serious question: If you are one of those at risk and get so sick that you know you will be on a respirator OR denied a respirator AND you don't really want to go die in a hospital, What other option is there. I don't want to put a gun to my head and have my wife find me. What is available to me to take and end it peacefully? I am 76, two lung operations each removing a lobe don't want to die on a respirator, I sat with my dad while he died that way in a hospital. If I get it I want to go suddenly and while unconscious not over a 72 hour period.

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  19. "Praying like it's all up to God and working like it's all up to us."

    Thanks for that. It's a quote to remember.

    "Serious question: If you are one of those at risk and get so sick that you know you will be on a respirator OR denied a respirator AND you don't really want to go die in a hospital, What other option is there."

    I have the same thought. If I get sick I plan to stay home and take my own cold and pain meds. If I recover then great. If I die my wife can call 911.

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  20. Wish HIPPA didn't exist, or was suspended so we had lists of infected to know who they were and who was likely to be infected next.

    It has a public health exception, the question is why public health departments view privacy as more important than saving lives. Liberal taboos against stigma, and I suppose the real problems that would arise are more important.

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  21. Aesop: on a plus side, I have seen, here and there, genuine gratitude. Folks being thankful for truckers, who deliver EVERYTHING that we take as if granted to us.

    Folks being appreciative of physicians, nurses, and everybody who keeps any and every hospital operating.

    People performing small, and heartfelt, acts to help protect others (I'm looking at YOU, all you home mask crafters. As well as y'all shopling, so elderly/vulnerable neighbors don't have to go out.) And very one of these acts touches the vestigal organ where my heart used to be.I

    Folks being grateful for the efforts of grocery clerks.

    Dare I hope that we learn to appreciate small blessings, out of th ese change s?

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  22. Aesop-

    I'm sure you've seen this but if not, plz read and comment. Yes, it's anecdotal, but it seems to have worked - at least on a small scale - assuming the info is legit. Thanks.

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  23. My humble apologies if I read this from here and am not giving credit.

    I found this and posted on FB to my NP/PA local group.

    I read this from another site. Whether the author exists or not is immaterial. The message is clear - In a pandemic, there is no such thing as an emergency. The first rule in rescue - don't become the victim.

    "Rishabh Kothari-- With the news of 13 Italian doctors dying from COVID-19. If you do not have proper PPE, do not go in. No matter what.

    This post is for my healthcare workers, docs, surgeons, Nurses, aids, and ems, and all staff.

    There is no emergency in a pandemic

    You as a healthcare worker are a force multiplier. Your training and experience is invaluable moving into this crisis. So, you're going to be faced with some very difficult moments. You're going to have to put your needs first.

    I'm speaking specifically about PPE and your safety.

    If you're an ICU nurse, or an ICU doc, and you become infected, not only are you out of the game for potentially weeks (or killed) But your replacements could be people without your expertise. Your remaining co workers are short staffed now, more likely to make mistakes and become ill themselves. You stop being a force multiplier and start using healthcare resources.

    You going in may save the patient, it may not. But you cant save any patients in the weeks your laying in a hospital bed or using a vent yourself.

    People are going to die. Do not become one of them.

    There is no emergency in a pandemic.

    During the Ebola outbreak, people were dying. But at no point did we rush in, we took the 10 minutes to put on our PPE with our spotter. If we didn't have proper PPE we did NOT go in.

    There is no emergency in a pandemic.

    You may work in long term care, and want to rush in to save a patient you have had for years. Do not go in without your PPE

    There is no emergency in a pandemic.

    You may have a survivor in the room, screaming at you to come in because their mother is crashing. Do not go in without your PPE.

    There is no emergency in a pandemic.

    You may have an infected woman in labor. Screaming for help. Do not go in without your PPE.

    There is no emergency in a pandemic.

    You may have A self qaurentined patient with a gun shot wound and is bleeding out. Do not go in there without your PPE

    There is no emergency in a pandemic

    Doing nothing may be the hardest thing you've ever had to do in your life.

    Many of you say, I could never do that. I wouldn't be able to stop myself from rushing in and saving my patient.

    Liberian nurses and doctors said the same thing, and many did run in to help, saying PPE be damned. My patients need me.

    Then they became infected, they infected others. And they died. They didn't help anyone after that.

    Do not let the deaths of hundreds of healthcare workers be forgotten."

    Stay safe!"



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  24. Posting this as a continuation of above (ran out of character space)

    I also posted the below as a reply to a comment on above.

    The HARDEST thing to do is NOT going in when every emotional fiber is saying and those around you are screaming "do something!" Whether its a house fire, fully involved, without a secure water supply, with people trapped on the second-floor behind barred windows with flames coming out those same windows; a traffic accident with an overturned tanker placarded 1017, leaking, with teen-agers in the car pinned underneath that same tanker; or a suspected Ebola patient brought in coding, while bleeding from every orifice. So WHAT exactly do the above have in common?? They all represent an immediate danger to those who are trying to save those involved. I am NOT saying we callously decide to NOT send our people in. I AM saying we deal with life-death decisions every day....and these decisions that MUST be made stay with us, forever. Again, 99.9% will NEVER get it. The 0.1% who do, need no explaining. Its why we have a black sense of humor, why we drink, why we don't do so well socially (outside our fellow brother and sisters). If you've never had to make these decisions, be grateful. For those who've never had to make these decisions, and you interact with someone who has, be GRATEFUL.

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  25. Remember that Petty officer on the Forestall in the 1967 inferno that ran to the burning Skyhawks with a simple fire extinquisher? The bombs were already cracking open from the heat and he went on anyway. Some people just seem destined to die as a hero.

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  26. Read you everyday and appreciate your no nonsense approach to things. I just wish that folks would take this "oh, it's just the flu" thing as seriously as they should. Imbeciles getting tickets for driving 100+ mph on Cali Freeways. Home Depot and Lowes packed with shoppers. Our local Folsom malls are open and seeing an uptick in business. Crazy! I guess when we have bodies for burial lined up next to 50, it might make Target close for 12 hours. The city council has council members, volunteers, and others ready to run groceries, pharmacy meds, etc by a phone call. No charge. Yet..........
    Stay safe in that hostile environment you enter every evening. We need your wisdom!

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  27. Redundant to say thank you again for your posts and your work here..and your work there. As an old ER nurse, I do get ya...not in this way, though. If there is a pause in posts here, shit I understand...get some extra sleep to keep your own ass safe. We'll get it.

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  28. Frag's thinking ahead......

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  29. Seconding what Geo True said. If you can, please just let us know you are OK but off grid. Don't take any stupid chances. Odds are many of the pts you'll see were stupid and that is why they are giving you business.

    As for masks and gloves: far too many people w/o one, the other, or either last time I ventured out. With my mask and gloves on I got some funny looks. (to be honest, I did get a few looks like I've seen drunk guys give any female at bar closing time) Pretty much the same look I got in Jan with my cart full of prep topping off. I've looked foolish before and will again so I don't give a fig (and I'm not just talking about that lovely boot camp hair-do).

    @John Wilder: Could be they are prepping in a silly manner. Could be they are like us only topping off perishables while we can until we have to get into the larder. Heard a stat that around here only about 20% of the population routinely cooks at home. Even with trucks running normal it would be/is difficult to suddenly support 100% cooking at home. If nothing else this thing ought to put a pretty big dent in the obesity problem.

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  30. Aesop, please administer yourself a huge bro-hug on my behalf. One day our paths may cross, and I'll buy you many many beers.

    ~Behind Enemy Lines

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  31. To all you folks who are wearing gloves, and N-95 masks to walk the dog, or pick up the mail, or go to the store and you are not running a fever, or coughing/sneezing all over--STOP IT!! You are taking desperately needed supplies away from medical people who need those supplies in the hospitals, nursing homes, and home care agencies.

    I have been an RN for 29 years and was an LPN for 12 years before that. I have always used a mask/gown/gloves/face shield when doing wound irrigations that are going to spatter, or when someone is on respiratory precautions. And I used a fresh set before I moved on to the next patient.

    I work in a Home Care Agency as a per diem RN, which means in simple terms, I can tell the agency what days and how many patients I want to see, then they let me know if they need me.

    Now, due to the shortage of PPE, I get 1 dinky little surgical mask PER WEEK --- Not an N-95 mask -- I get a cheap $2 plastic raincoat instead of an impermiable gown with cuffs-- and no duct tape to secure said sleeves, or the hood. Thank God this is "just a virus" instead of something that might kill me like Ebola. I am seeing between 16-20 patients a week, and many folks want us to put on a mask, gloves and shoe covers!!!! To see them in their own homes. But they don't understand that this cute little surgical mask wont do jack if I did have the Kung Flu. Not to mention the fact that this mask is probably a greater source of germs then just me going without it.

    Aesop is 110% correct. This is gonna be a shit storm. Not just bad on toast. REALLY bad. It already is here in NY. and I am not talking about NYC -- I am talking Upstate NY.

    I went to the store today to get some groceries. There is no TP, there were 2 packages of napkins, and 2 boxes of the folded paper towels. No canned meat, no fresh meat, limits of 2 per customer for soap, soup, rice, pasta, and on and on. There has been no Clorox, or antibacterial anything for over 3 weeks in ANY store, not Walmart, not the local grocery stores, not the big warehouse stores, no place. Not for the little consumer, not for the big health consortium trying to get us wipes to be able to clean our equipment like BP cuffs, thermometers, pulse ox's and our computers that we are supposed to clean before we go on to the next patient.

    Folks need to stay away from each other, and WASH THEIR HANDS, and keep their hands away from their face/eyes/mouth/nose and stay the hell home in isolation if you are sick!!!

    And for the sake of your loved ones, if you are NOT infectious, or immune compromised, or have serious COPD/Asthma, or serious cardiac disease, do not wear PPE if you are not a medical person, or an EMS person. If you are not working in an ICU, or ER, or doing scoop and runs with the local ambulance/fire department...because the PPE that you just use to walk the dog, or go wandering around the grocery store or outside is PPE that could be used to save your Gramma's life, or your spouse's life, or your baby's life -- because do not doubt that this is not just hitting the frail elderly -- this is hitting the teens, the 20somethings, it is hitting everyone. So cover your mouth, and wash your damn hands!! And stay away from everyone else. Open the windows, let some fresh air blow through your home.

    So that those of us who are working with Covid-95 patients can protect ourselves, and be there to care for them.

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    Replies
    1. Ok, I'll stop wearing them, will just leave them in the closet the.

      Delete
  32. https://journalstar.com/lifestyles/health-med-fit/unmc-study-gives-more-indication-of-airborne-transmission-of-coronavirus/article_4a08b9e6-bd53-5a2a-a16a-7ccf26f5cdcf.html#tracking-source=home-top-story?utm_medium=social&utm_source=facebook_Lincoln_Journal_Star

    This is the premier BL-IV facility...

    KGH

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  33. so if we have ~163000confirmed cases and have tested ~1million what is the likely penetration of the virus when you take into account the 80% resolve at home and that some percentage of them never get tested?

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  34. @suz, I appreciate your impassioned plea, but that guy not wearing his gloves isn't going to make them appear in your office. Him not wearing his mask isn't going to make it appear in your bag. But he sure could bring it into his house and kill his wife if he's not careful

    All my PPE were purchased years ago and were out of date then. They are certainly not being taken away from anyone when I use them. I've got family I don't want to infect from touching some surface that an asymptomatic carrier coughed all over, like the mail. FFS, the mail is filthy on a good day.

    If you can't to your job safely YOU have an obligation to refuse it. Masks are available, some orgs don't want to pay what is being asked. Disinfectants and bleach are available. You can order 3M Quat on ebay and it's not even that expensive. If ebay quit canceling listings for masks, there would be masks available tomorrow.

    Bleach tablets are available on ebay, and I'm sure elsewhere. Try the pool supply houses or pool supply section of your big box if you have to have it liquid and local. I've pointed out Mold Armor is listed as a disinfectant and viruscide- it's available online and at local big box stores.

    Take a breath and a step back. Please don't kill someone's granny with your poor PPE practices. Your org will do exactly as little as you let them do.

    And if you are looking to blame someone for the shortages, look no farther than your org management. They made the choices for how much PPE to stockpile. CDC's been beating the drum for pandemic for a decade. NO EXCUSES from management, board of directors, or shareholder activists, are acceptable. When you start beating up the people who are directly responsible for your current state, I'll take it seriously. Turn your anger on them, not ordinary people trying to protect themselves and their loved ones as best they can.

    nick

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  35. *MOHR THOUGHTS*

    There was much discussion in the past about disasters & demoncrats. And it has been said: if you prepare very well for any one disaster, you will be (at least) partially prepared for ALL the others! ...and yet, here we are with the Kung-Flu...

    I see this as a "Lyte" apolcalypse... (of course, for healthcare it is TEOTWAWKI) indeed, the world is now at the milestone. I said "Lyte" because i had imagined a sudden apocalypse...like the way "Resident Evil" spread like wildfire...

    So, a nice slow-moving disaster...at least until the clusters explode, as they did in Wuhan, Italy, NYFC & NOLA... (yes, i've omitted many others...)

    As with *SO* many other things, i tried to imagine how events would unfold, and yet, they actually unfolded quite DIFFERENTLY than i imagined?

    If you don't have a relationship with "the almighty" i testify that it helps greatly...my first example: the soldier who was standing right next to his buddy whom the sniper decided was the better target...how it greatly affects your mind with "survivor guilt" why him? (or her?)

    such will be the unanswerable question for the atheist...but for *most* believers, it is much easier...such is the will of ALLAH/God/Buddha/etc,etc,etc...

    and as the BoatGuy has said: pray like it is all up to him, work like it is all up to you!

    I hope these ramblings of mine helps at least one person...perhaps a year from now, or maybe even longer?

    (m'kay, we now return you to your regularly scheduled Kung Flu reporting!)

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  36. Er...the milestone is: before/after COVID-19

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  37. @Suz: I understand and sympathize with your POV. However, a few points. First, in my AO (SE New England) ALL masks were gone by end of Jan. Based upon who I saw buying all they could get it seems highly likely they went back to China - when KungFlu was 'fake news' on this side of the Pacific. The N95 I have are a few years old and only on hand because they were left over from attic/insulation work. If I could, in good conscience, donate them I would. However, I have a family to care for. I did order some other masks b/c I have little ones that N95 won't fit properly. No hoarding here I just bought what we needed/might need. Gloves were similarly already on hand as I use them for various jobs as a DIY guy.

    I do wear gloves to get the mail and do the grocery shopping for two reasons. The first is that, as we can see on the nightly news, stupid is a serious force multiplier for KungFlu. Sorry, but I'm not trusting my health and that of my family on the assumption that the pigs I've watched for years take a dump and not wash have suddenly become regular hand washers. Second, NEJM published the life time of KungFlu on surfaces including cardboard. Does this include paper? Don't know but will not find out the hard way.

    As nick pointed out the bulk of this problem lies in the C-suite.

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  38. Some are saying that Vitamin C IV works and others are saying that Hydroxychoroquine and Z-Pacs work.

    I dunno. I am self medicating with Ethanol.

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  39. Fiddlin John CarsonMarch 30, 2020 at 8:40 PM

    Was about to go turn the garden over one last time before planting begins this Friday, but this caught my eye.

    https://twitter.com/mikesacconetv/status/1244736042273583105/photo/1

    500 Massachusetts healthcare workers tested positive. Game over Boston.

    Infections are in full swing in the NYC and Chicago pds.

    Corona is now in Parris Island and on board an Aircraft Carrier.

    ICUs and Hospitals are at the brink now and idiots are still gathering in large numbers at church, in NYC to welcome USNS Comfort, to watch so called idiot street racers driving rice rockets with $15,000 motors do donuts(That I can do in my 1998 s10 2.2 5 spd), and to top ALL THAT OFF, IDIOTS ARE STILL GOING ON CRUISES. WHAT THE FUCK?

    Wow, just fuckin wow. You know, like you Aesop I stand accused of being a mean, callous, bastard because like you, I call em like I see them, especially when it comes to life and death. I am not a welcome sight at funerals because I refuse to portray people that die because they do stupid shit as victims. But I am really not like that at all. I dont wanna see anyone suffer, except for pedophiles.

    But you know what? We a month into this, if people are still being selfish and stupid then there aint no hope. The only way we had a chance was for people to isolate early on. Wuhan got locked slap the fuck down Jan 25th and is still not truly reopened.

    And we still haven't seen the second wave yet.

    I am 15 minutes west of Atlanta airport. I am in a strong position in a nice neighborhood in the county that I grew up in. I am on good terms with the local sheriff department. I am well stocked and well armed. However, my situation will become untenable eventually. I knew this. But I thought I had time to harvest my garden and can some stuff. I was guessing we would make it to September at least before Hunger Games 2 bugaloo started in earnest.

    Nope. Shit is going downhill fast. I'm about to liquidate, consolidate, cut losses and get the fuck out of here to bumfuck East Alabama while I still can. They already running rolling checkpoints and pulling over anyone who aint essential or obviously a law abiding local. Wont be long until that turns into armed drones and crew served weapons. It is being staged here in Georgia now, they are planning on locking down the entire state at gun point and letting the urban Atlanta youth run wild. I aint getting caught in that. Aint nothing worth saving here. Cant save it by myself.

    I hope you have plans to do the same.

    Godspeed







    ReplyDelete
  40. Fiddlin John CarsonMarch 30, 2020 at 9:41 PM

    Get a load of this happy gas bullshit straight from cdc and hhs.

    Local Atlanta reporter asks why an infected couple of a cruise ship was flown commercial home? Airline says they didn't know(Bullshit)

    HHS and CDC said couple was not considered infectious because it had been 3 days since fever broke. (Bullshit, it was actually two)

    https://twitter.com/NicoleCarrWSB/status/1244772754102071298

    NEW:Airline confirms it wasn’t notified of these passengers boarding. Today,HHS tells me it’s bc they didn’t consider couple infectious,cites recently updated policy that 3 days w/o fever following + test cleared them. Issue:Mom says she had a fever 2days b/f flight. @wsbtv https://twitter.com/nicolecarrwsb/status/1244060498410246144

    We are doomed. It is over.

    ReplyDelete
  41. 70 year old, COPD, Emphysema, Life Long Smoker.
    If I contract it I'm going to ask for the hot shot.
    Hope I've a doctor or nurse brave enough to do so.
    You take care of yourself Aesop. Stay healthy. Live long.

    ReplyDelete
  42. @suz, you said Upstate NY--

    Lowes in Waterloo has Mold Armor, one gallon size, for $20. Seven in the store, shipping available.

    "

    One step disinfectant, cleaner, sanitizer, fungicide, mildewstat and virucide

    Inhibits the growth of mold and mildew

    Kills 99.9% of household bacteria and viruses

    "

    FWIW, they show bleach in stock too. And over 100 gallons of pool chlorine bleach.





    nick

    ReplyDelete
  43. @Suz like others here I bought my masks, gloves, Tyvek coveralls and safety glasses a long time ago. In fact it was because of the information Aesop was posting back during the Ebola outbreak a number of years ago. It is all expired and well past it's best use date so I don't feel like I am denying any HCW PPE when I use my own existing stock to go to the post office and grocery store. I am not hoarding or denying HCW's any supplies. I understand where you are coming from and sympathise. God Bless you and your patients and I hope you stay safe.

    ReplyDelete
  44. Aesop,

    Look at Phil Kerpen twitter feed. India is using Chloriquine compounds as a prophylaxis.
    Would that help you and your fellow miracle workers?

    ReplyDelete
  45. PPE

    I have 3 N-95 masks, all 10+ years old, stored in plastic storage bags.
    Going to use a couple cloth masks a friend is running up for me.
    I have a single 6 year old Tyvek suit which I was going to use for an attic job.
    Have not used them yet. They are for emergencies, like caring for family.
    I have a small stock of nitrile gloves 1-1/2 boxes that I mostly use for cooking, and then for cleaning.
    You can reclean nitrile gloves if necessary by washing your hands with the gloves on.
    I do that when cooking and switching between meat and vegetable tasks.
    Or in a literally shi--y cleaning job.
    If you take them off and put the same used gloves on, likely you will just contaminate yourself.

    Take Clorox wipes with you in your car. Wipe down your hands after you return to your vehicle and wipe your keys.
    No clorox wipes? How about those moist baby butt wipes? Scrub the viruses off your hands. Wash your hands as soon as practicable.
    Or a hand towel wet with bleach water or alcohol and water? Store it wet in a gallon Ziploc bag.

    Really afraid of contamination? Shed clothes in garage, or at doorway, Clean up immediately. Then decon the clothes and car.

    I am Simplifying life by forting up, and not going off my 10 acres.

    ReplyDelete
  46. I think you may get your homeless population epidemic, because the braindead liberal do-gooders are doing exactly the wrong thing.

    https://www.breitbart.com/health/2020/03/29/cdc-japanese-data-show-coronavirus-transmission-18-7-times-more-likely-eric-garcetti-indoors/

    ReplyDelete
  47. Always nice to hear a calming comment.

    Hospitals wiped out, law enforcement a dream of the past, zombies walking the streets.

    Just like H1N1, SARS, MERS and Ebolas I and II.

    Seriously, though, I'm getting tired of being wiped out by the latest hysteria. The novelty's just kind of worn off.

    ReplyDelete
  48. Yeah misha, having been missed by some bullets, if you're bored of the snap sound going pastyour head, then keep sticking it up. Maybe the novelty of one between the running lights will end your ennui.
    Boat Guy

    ReplyDelete
  49. DW and I have been self quarantined for a month now. Surprisingly enough, we are getting along better that we have ever been. We are fortunate enough to live in a part of the country that is not heavily affected with the virus, yet.
    I really appreciate your no holds barred reports and predictions.
    God bless and stay safe.

    ReplyDelete
  50. Whelp, it's never going to be the best case scenario but then again it'll never be the worst.

    Of the two best lines in this thread - "Praying like it's all up to God and working like it's all up to us." and "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." - one has to make the personal decision as to how to prioritize.

    For myself, it's in that order.

    I appreciate this site if for no other reason than it does help me prepare as if it's all on me however I'm sobered by reality.

    The wife has is the living outlier with her cancer as she's still get'n it 5+ years on with stage 4 having riddled her body. Have learned that there's stage 4 then there's STAGE NASTYASSWITHPIECESFALLINGOFF 4.
    She's the latter but good genetics (long lived, hearty disposition going back generations) and determination make exceptional people exceptional.

    She has treatment or she dies.

    I'm going to hold her hand (after we've both washed them), hug her (after she hits the shower and I throw her mask and clothes in the laundry with bleach, Oxyclean, soap, and hot water) make dinner for her, her mother (91 - cognitive mess but disposition of a cock roach, Sweet Saint of Wuhan, do your thing, no that's just wrong, a little) and me.
    I'll pick up the mail - will probably start letting it sit for a spell in a vapor jar and/or order a UV-C lamp or best yet, suspend it since it's pretty much only bills.
    I'll shop but touch little and breathe less while using a gator (last time I was fit tested for any of my jobs it leaked and barely sealed because I grow beard like a Chia and had the wheezing and infections to show for it), pay by card while wiping everything with sanitizer if for no other reason than for the next poor bastard that has to use it, and generally stay away from almost everyone because at this point I'll assume I've been exposed until there's been more time to truly see how this evil chit really lives (and more importantly, DIES) and there's viable testing to determine the peeps that actually do and/or have had it.

    I've been one of the idiots that has responded at personal risk even knowing that you don't make yourself the second patient onsite but at my age have learned to exercise some discretion as noted above about not putting others at risk and am not considered a key player so peace has been made with decisioning.

    Again, Saint Wuhan, have your way on me but not on thee.

    There is going to be a cross over point where this will be so terrible (or not) that the cure will kill the patient so you just have to get on with it. Have experienced this for years like watching establishing an airway on a senior patient knowing that sometimes the procedure tears the chit out of the airway and getting to watch them blow up and die on the table - still stuck in my memory.

    But at some point one must resign oneself to the knowledge that like an Old Testament Jew, you'll never fully uphold the law and you will will slip up.

    I'm learning quite a bit here and elsewhere - try to do so every day - but am struck by the obvious procedural elephant seldom mentioned:

    Inform everyone to the best of your knowledge and ability as constructively as possible*, stay away from those that don't even try to get it right, work with and support those who do, forgive everyone - including yourself - when the inevitable occurs then lay yourself down and rest because while we must work like it's up to us, it really is up to GOD.

    * sometimes it's most constructive to kill 'em/let 'em die, very constructive object lesson to others - just say'n

    ReplyDelete
    Replies
    1. Good on you Brother wish more people had your attitude...Like you said do the best you can and leave the rest up to God since it's in his hands anyway...

      Delete
  51. "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."
    My wife and I have been together for 51 years - our entire adult lives. This is just one more shit meteor to contend with.
    _revjen45

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  52. 1) Thank you Aesop. This site is THE source I trust for the unvarnished truth.
    2) I haven't believed anything from .gov or their Lamestream Media lackeys since reaching the age at which I could think for myself. I'm not going to start now.
    3) I have been housebound as a result of Kellgren Lawrence Level IV hip pain since late January (one trip out) and The Beloved takes Andromeda Strain measures as much as possible when venturing forth. We are taking this shit seriously regardless of what anybody is saying.
    _revjen45

    ReplyDelete
  53. The "Reader's Digest" had a story eons ago about an outbreak of a cold virus at a base station in Antarctica. The cold kept going around and around and they finally tried everyone wearing a handkerchief soaked with iodine and got the cold stopped. Called it a 'killer hanky' if memory serves me.
    Just FYI for what it's worth.

    ReplyDelete
  54. I believe I had this in early December, before it was identified. Thought the pneumonia was walking pneumonia at first, as I'd had that a few times and sounded kind of like that in the beginning (light crackles while breathing). No walking in this one as in other walking pneumonias.

    Never experienced shortness of breath or energy loss like this before. I thought I had emphysema or COPD. Worst coughing I can remember.
    Unproductive at best. My midsection felt like Rocky and the side of beef after a few days. There was no getting out of bed for several days except to use the bathroom.

    Most severe sore throat I've ever had. Eating was torture. Only greasy cold-cuts could be tolerated; they coated the throat for a short moment.

    Getting sleep was extremely difficult. Nyquil helped a little. Thank God I had a CPAP; I never would have considered going to the hospital as I believed I only had "walking pneumonia". My mistake. This lasted a long time. Far, far longer than any flu. Far more severe. Flu is easy compared to this.

    This was the worst fucking thing I've ever experienced in my life. God forbid if it mutated and became more virulent since then.

    ReplyDelete
    Replies
    1. Who knows? You may have had it back then. But I personally doubt it. No disrespect intended just trying to think this through.

      I keep seeing people say this. But I have to ask if so many people had this back in December, then where was the spreading like wild fire like this virus is doing today? If you and others had it in December we should have been by late December or no later than January where we are right now....several massive hotspots in the country with thousands dying and people making runs on grocery stores and buying up all the PPE equipment so that @suz (way above in comments) gets pissed at us even though the company she works for was negligent in its purchasing for its employees.

      Also we should have seen this going on elsewhere in the world in December like Italy and Spain Instead of couple of weeks before it got bad here. They should have gotten bad in early to mid December.

      I don’t think it’s a case of it’s mutating to something worse or either or else it would still be changing. There were plenty of articles out about something truly evil quickly spreading in Wuhan. It was already nasty back then.

      I am glad you got over whatever it was.

      Delete
  55. Aesop-

    I'm sure you've seen this but if not, plz read and comment. Yes, it's anecdotal, but it seems to have worked - at least on a small scale - assuming the info is legit. Thanks.

    Addendum: Forgot to insert the link for your perusal. Mah bad. What a maroon!

    https://uslibertywire.com/ny-doctor-successfully-treats-patients-with-drug-cocktail-zero-deaths-zero-hospitalizations-zero-intubations/

    ReplyDelete
  56. @Suz

    While I understand your ire, IMHO, it is directed at the wrong place/people.
    I wear a N95 respirator and nitrile gloves when I go out in public. I also wear a SPF50 "water resistent" fishing balaclava. It helps keep the mask and my eyewear in place. I have been doing this well before the Wu-Flu. Like many others, our supplies were purchased well in advance of this current crisis as part of our prepping. My N95 respirator is not one that would have been approved for healthcare work previously, and it is "expired".


    I already have significant scarring in my lungs and limited pulmonary function. Most of my childhood was spent either out of school recovering from some respiratory issue of the day, or in hospital on IV antibiotics. I've had several bad cases of pneumonia - and I wouldn't wish it on anyone. My lungs upon a recent xray/CT were described by the Navy doc as the "lungs of a 3 pack a day smoker". I have never smoked a day in my life, or been around asbestos, silica, etc. I have hyper reactive airways and some shitty luck.

    My daughter has a compromised immune system, recovering from a "lifetime dose of radiation" as part of her cancer treatment. I also have elderly, very frail people in the household who depend on me. My husband works TDY for extended periods of time to keep us all in kibble and litter. God Bless him.

    I take such precautions to not end up in the ER, and, believe it or not - out of care and concern for health care workers. I realize that I am the type of patient that if I become symptomatic, I am going to crash hard and take up resources, if past history is any guide. I have been in self-isolation with minimal outside contact since JANUARY. I venture out for specific tasks and make sure I am doing so not at peak hours. The precautions I am taking are reasonable, and to protect me from becoming infected with a huge viral load, as well as transmitting that to other loved ones in my home who are even more vulnerable than I.

    Would you prefer I put myself at risk, become infected, and then show up at the local hospital ER? One of the recent videos put out by the British nurse shows that an index patient in King County infected 100+. Is that what you would prefer? Such finger pointing and calling people out is unwarranted, and unhelpful.

    I am extremely agitated that our front line health care workers don't have the supplies they need. They need far more than just an isolation mask, gown and some gloves to adequately protect themselves. At this point, I feel some of the administrative incompetence is ....by design, as is "missing supplies" from institutions in epicenters. Cue up my cynicism a la warehouses stocked to the gills with necessary supplies, but hoarded and not distributed, after the hurricane in PR.

    I actually thank people that are out and about in gloves and/or mask for doing their bit. Most of them are minimializing their interaction and staying on task to get in and out. In contrast, I see lots of people still bringing the entire family and wandering the stores because "they're bored at home". Perhaps that would be a better target for your ire.

    The whole point of prepping ahead of time, and using common sense when venturing out, is to take the burden OFF the health care system. If people like me don't use some common sense PPE, we are going to end up in your ER potentially putting alot of people at risk, when some simple proactive measures reduces that risk.

    Rant off.

    ReplyDelete
  57. This whole situation reminds of the next evolution from the last bird flu pandemic 2008 - 2009. The anointed Lightbringer, the Chosen One, was Prezzident of these United States. The CDC had developed a phone app so that people could anonymously report anyone they were suspicious had the bird flu. I was stunned - and disappointed - and the number of young people who "helpfully" snitched on their barracks mates and pals.

    This is like V2.0 of the original CDC "pandemic" snitch patrol, but on steroids.

    Helpfully, some counties in Texas are continuing to track - and report to the public confirmed cases of both flu and wu-flu. Seasonal flu is still winning, by a large margin, most confirmed cases, more deaths - but the Mockingbird Media just doesn't want to seem to get people all wee weed up about that. And no brrrr brrrr brrrr printing press happiness because of seasonal flu.

    ReplyDelete
  58. Under Governor Arnold S, California had a stockpile of 50 million masks, 2,400 Ventilators, and three mobile hospitals.

    Jerry Brown aka Gov. Moonbeam defunded it.

    https://www.lawenforcementtoday.com/california-used-to-have-mobile-hospitals-and-a-stockpile-of-ventilators/

    ReplyDelete
  59. I read an anecdotal piece that hospital administrators in NYFC are threatening front line staff. Everyone must report to work, no matter what. If you are sick, report to work. If you are exhausted to the point of collapse, report to work. Etc. According to the viral message, the only excuse for not reporting to work is if you are symptomatic, and are being admitted to hospital yourself.

    Those keyboard warrior administrators who want to threaten should lead by example. It would take minimal instruction for them to man the triage tents in the parking lot. You shouldn't be tying up experiences, trained HCW taking temperatures and some patient history. Such like a good redeployment of administrative resources. Unless they are willing to literally be on the front lines - with re-used nominally sanitized masks and gloves, then they can STFU. No more threats from the safety of "work from home" to those in the middle of the suck.

    As far as Cuomo's demand that HCW from all around the country swarm NYFC and help them out, and "they'll return the favor aka let me eat the hamburger today and I'll pay you tomorrow", I'm sorry, but in my personal triage, they can go fuck themselves. This was the epicenter of people who have openly called for the death and destruction of myself and my kin, that we were "less than", and all of a sudden Cuomo arrogantly expects we should abandon our own communities to go ride to his rescue? Fuck. Them. All. This crisis, manufacturer or not, is of their own making to a large extent. Watching how the smartest people in the world find their way out of this paper bag.

    ReplyDelete
  60. @Anon 1221: Not to mention if you watch the evening news NYFC is full of retards going on about their business in crowded areas w/o PPE. Even with PPE they should not be out 'enjoying the weather' or 'watching the hospital ship come into harbor'. Then you have the idiots that have been mentioned many times on this blog - wearing PPE in such a way as to only be wasting it. Last night 2 'men on the street' were wearing surgical masks... over their beards. Now, those that can are fleeing and bring KungFlu with them.

    I live close enough to NYFC to tell you that many resident there really do think they are special. Too bad its in a short bus and football helmet kind of way.

    Unfortunately, stupid is not confined to NYFC. Choir in WA or OR got together recently (well, the stupid 1/2 did). 45/60 now have KungFlu and 3 are dead. Then we have the pastor in FL (I think) who went ahead with services. The examples abound.

    Stupid flu will make KungFlu much worse than it needs to be. It is most unfortunate that it won't only be the stupid who will suffer.

    ReplyDelete
  61. Hospice RN here in Wyoming with a big shout out to Aesop, all the healthcare workers putting it on the line, truckers delivering it, clerks stocking shelves and selling it, families of cops and healthcare workers of all stripes dealing with it. There are the true superheroes of today. I would also give kudos to those smart enough to stay home.
    I have passed along links and articles from Aesop to many of my coworkers. All have been very appreciative. Keep up the good work Aesop.

    ReplyDelete
  62. We have a leetle problem in the pacific.

    https://www.bbc.com/news/world-us-canada-52110298

    Not good.

    ReplyDelete
  63. Last night 2 'men on the street' were wearing surgical masks... over their beards.
    That doesn't do a thing for them, but it catches a lot of what they exhale. If they're sick, it's helping the people around them. Wearing a bandana would probably help just as much.

    ReplyDelete

  64. Mixed messages on general public wearing masks...

    Surgeon general: Data doesn't back up wearing masks in public amid coronavirus pandemic

    https://www.foxnews.com/media/surgeon-general-explains-masks-public-coronavirus

    Anthony Fauci: White House Coronavirus Task Force is giving ‘serious consideration’ to suggesting Americans wear face masks

    https://www.marketwatch.com/story/anthony-fauci-white-house-coronavirus-task-force-is-giving-serious-consideration-to-broadening-guidance-on-face-masks-2020-03-31


    ReplyDelete
  65. Every day this is more like a John Ringo novel. I hope they get the guys off the ships and into care.

    n

    ReplyDelete
  66. Sweden is trying the contrarian approach.........at least for now.

    https://unherd.com/2020/03/all-eyes-on-the-swedish-coronavirus-experiment/


    And as per the Jerusalum Post, Israeli researchers have made real progress on a COVID-19 vaccine.
    Bibi has been informed it's ready for animal testing.

    https://www.jpost.com/HEALTH-SCIENCE/Israeli-researchers-made-significant-progress-in-coronavirus-vaccine-623133

    ReplyDelete
  67. Wendy:
    They can both be right at the same time.

    ReplyDelete