Monday, March 9, 2020

Reality Alert

Via previous comments:

Silvia Stringhini @silviast9
"I may be repeating myself, but I want to fight this sense of security that I see outside of the epicenters, as if nothing was going to happen "here". The media in Europe are reassuring, politicians are reassuring, while there's little to be reassured of. This is the English translation of a post of another ICU physician in Bergamo. Read until the end."
(Bergamo, Italy)  "After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible. I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder. I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly "emptied", elective activitieswere interrupted, intensive care were freed up to create as many beds as possible. All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity. I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least. The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace. The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia. Now, explain to me which flu virus causes such a rapid drama. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is"temporarily" put in crisis, the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us. Cases are multiplying, we arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing. Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized. Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before. The staff is exhausted. I saw the tiredness on faces that didn't know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask "what can I do for you now?" Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can't save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny. There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols. Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death. So be patient, you can't go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate. We just try to make ourselves useful. You should do the same: we influence the life and death of a few dozen people. You with yours, many more. Please share this message. We must spread the word to prevent what is happening here from happening all over Italy."           - Dr. Daniele Macchini.
"I finish by saying that I really don't understand this war on panic. The only reason I see is mask shortages, but there's no mask on sale anymore. We don't have a lot of studies, but is it panic really worse than neglect and carelessness during an epidemic of this sort?"

This is a Western healthcare system in total freefall meltdown. And they're not dealing with "just the flu". This is some thermonuclear level of shit going down.

From WaPo (h/t CA @ WRSA):
Italy plans to restrict movement throughout the entire country, Prime Minister Giuseppe Conte said Monday, effectively locking down some 60 million people in an unprecedented move to contain the coronavirus.
The announcement came a day after Italy imposed similar restrictions on one-quarter of the country. The rapid acceleration shows that Italian policymakers have come to believe that hard-line measures are the best way to slow the virus’s spread.
We warned you this was no-sh*t serious five days ago.
Before the stock market cratered, and while the .Gov has been pumping out an endless stream of happygas.


Anonymous said...

In my best phony Italian accent, as I wave my arms emphatically:

"Atsa no good."

Hypothetical for the assembled geniusii and our esteemed host:

Would you spend 4 1/2 days in close quarters (car, hotel room) with someone who had spent ~3.5 hours in a California ER last weekend? Said ER is located in a county (Marin) which is home to 50+ passengers who were on the same voyage of the Grand Princess that gave the Golden State its first Covid death. Many of those 50 have been out and about in the community since they got off the boat on Feb. 21 according to the local newspaper.

I'm thinking no, but I'm a big ol' scaredy cat. Your thoughts?

Steady Steve said...

With the rate of infection doubling every 4-5 days, everyone will have been exposed by around mid May. Unless you are quarantined now and stay that way till 30 days after the last death and/or recovery. We will no doubt see this situation in the US because people are too selfish and don't want to do what may be necessary for their community. YOYO time people!

Anonymous said...

Steady Steve has it right when he said "people are too selfish and don't want to do what may be necessary for their community".

Just this morning in Australia there is a report (and video) of a woman on a Sydney train intentionally coughing in another mans face after he asked her to cover her mouth. My last shopping trip there was a palatable sense of anxiousness in the air. Toilet paper for some reason is the focus of people's panic buying (interesting side note, I have had a years supply for my household for about a decade now, rotating stock. I don't need to justify why. Anyway, even though I'm fully stocked I'm a little apprehensive about seeing the TP aisle at the supermarket completely bare)

Aesop said...

People coughing in other people's faces won't have to worry about Kung Flu, they're going to get a serious case of ass-whuppin', curb-stompin', and a side-order of brick-face.

Rex said...

The Czech edition of the EU report.

Here is a translation of a Czech news article:

Tourists returning from Italy: People are calling us retards. We didn’t do anything wrong.

“We found out about the closing of ski resorts before lunch on Sunday. We went skiing in the morning. Now we are heading home,” said the father of a family, who declined to share his name due to the fact that he had already faced harsh criticism on social media after sharing that he and his family had been skiing in Italy.

“I put a few photos up on my profile and drew an avalanche of comments saying that we should have stayed there and that we are retards endangering all Czechs. But we didn’t do anything wrong. We had only left with our children a week ago to go to the mountains to get some fresh air, move around, and be healthy,” the man told Právo.

“We saved for this vacation for more than six months. We couldn’t just cancel it. We are counting on staying quarantined. My wife is on maternity leave and I am self-employed, so I can work from home. We will keep our children at home. We aren’t showing any symptoms, we are healthy, rested, and satisfied,” he added.


And the comments after that article are really something to behold. They do give one a bit of hope. Unfortunately, there were more than 16,000 on the left end of the bell curve (people who spent lots of time packed close-quarters in ski lifts and cable cars multiple times per day for a week or two) that are more than enough to make things interesting here in CZ. The Czechs returning from Italy are supposed to self-quarantine for 14 days or risk up to a 3 million CZK (cca 130,000 USD) fine. Rumor has it that there are a some who can’t be bothered do the whole quarantine thing. Looks like me and the wifey got front row seats to a right and proper culling. Hopefully Mother Nature doesn’t draw our number.

Anonymous said...

Can’t remember how many inoculations I gott in the military. Seven anthrax shots.

This bull shit will pass.

Anonymous said...

Steady Steve has it right when he said "people are too selfish and don't want to do what may be necessary for their community".

Meh. If you are talking about my neighbors, mostly they are decent folk, and more or less prepared anyway. I'll help fill in the voids. If you are talking crapholes in blue states/communities who have been voting for years to steal my stuff, screw 'em. Devil take the hindmost.

We've had decades of warning, and unprecedented prosperity to prepare. There's no excuse for not having at least a year of rice and beans on hand. Show up at my driveway with your preps and I'll have some mercy. Otherwise, the fresh bass and bison and all the preps we have stored are for me and mine.

Only ones I have any sympathy for are those who chose to stay behind and treat the congenitally stupid. And even for them, it only goes so far.

T-Rav said...

Anonymous @2:50

How many of those inoculations were for coronavirus?

nick flandrey said...

How many were for pneumonia?

That'll kill you just fine.


nick flandrey said...

I had someone I love tell me I am way over reacting because Italy only quarantined a tiny little corner of the country where most of the sick people were. Today they announced there will be travel restrictions for the whole country.

Today is today, and already old news. You cannot make decisions about this based on today. You have to look weeks ahead. Nothing is stopping the spread EXCEPT the things people are afraid of and unwilling to accept- quarantine, travel restrictions, restrictions on gatherings, social distancing. Those are the only tools available.

Who knows what the magic number is, 5000 cases? 10000 cases? You can be sure TPTB have a number in mind and when we hit it, not IF, it's still gonna catch people by surprise.

CDC has warned of NPIs and "severe disruptions" in our lives. Fauci warned of widespread travel restrictions. That is WHY we have those guys interviewing, to prep the battlespace. DeBlasio says "we're only gonna close the schools if things get really bad." He knows they will get worse until they reach "really bad" and then he'll close the schools and say that people were warned...

All of the same tactics are coming here that have been deployed elsewhere (except possibly the burning of plague houses and locking people in, because we have guns.) At least they'll have to hold off on that until people are too sick or too weak from hunger.


Steady Steve said...

Anonymous @ 2:50,
Unfortunately I "live" in South Florida, home of many blue vote idiots. I'm away working in the Caribbean but my wife is back home. She used to think our preps would never get used and is now greatful we have them. I'll be returning by end of April which is about when most idiots will realize that we may have a serious problem on our hands. Aesop, I haven't said it before, thanks for this blog and its' in your face veiw of reality. I think very few Americans are even somewhat prepared for what is likely to happen. For the rest of us preps and prayer is all we have.

June J said...

At a Sam’s Club in Texas on Saturday TP, no bottled water, lots of empty shelves in the food section, very few large bags of rice and beans.

June J said...

At church on Sunday, a few people walking in the door coughing....too oblivious to stay home and not infect everyone else.

I’ve started telling everyone that we all have probably be exposed and so they better be prepared with food, water and OTC meds to self quarantine at home.
No one really wants to hear the hard truths about ICU and general hospital bed availability.

Dinochrome One said...

News of Italy restricting travel nationwide reminds me of the same situation in Tom Clancy's "Executive Orders"; to stop the spread of weaponized ebola, President Ryan ordered the closing of all interstate highways and told everybody to quarantine-in-place, even if it's not home.

Could happen here.

After hearing about what happened at the CPAC convention, I'm waiting to hear about the results of the President's Covid-19 test.

Anonymous said...

All of the same tactics are coming here that have been deployed elsewhere (except possibly the burning of plague houses and locking people in, because we have guns.) At least they'll have to hold off on that until people are too sick or too weak from hunger.


March 9, 2020 at 3:58 PM

I don't want to be that guy but the anniversary of the Waco Massacre was just the other day. Throw in an accusation of being a Nazi death cult intentionally spreading Coronavirus hoping to start a race war and all of a sudden patriots are cheering.

Either that or no-one will have the internet / cell phone available to them and no-one will know what went down. Maybe their compound just burned down started from candles?

Hope@ZeroKelvin said...

Two of the flagship hospitals on The Woodlands, Texas, have severely restricted access for family and staff. One of these hospitals has a confirmed case and a dozen staff are on self quarantine. Visitors are restricted to 2 entrances, are screened per CDC guidelines, and given a color coded single day use only bracelet. Hospital staff are restricted to one entrance, badge access only. All supplies, like masks etc are locked up and doled out per hospital admins "risk adapted" model.

The other 2 big hospitals are about to follow suit.

Laborp and Quest Diagnostics now are accepting nasopharyngeal swabs for testing. Turn around is 3-4 days.

Hubbie went to Walmart for some plumbing supplies. No alcohol, bleach, hand sanitizer or chlorox cleaning wipes. And that is the Walmart near Lake Conroe, at least 60 miles north of downtown Houston.

My clinic patients, except the ones on active chemo, are rescheduling like crazy. Elective surgeries are also being rescheduled.

The 2nd and 3rd order effects are just starting, I fear.

Hawkin'Gal said...

Here in Michigan, we don't yet have a confirmed case, and many I know are still chanting their mantra--"it's being blown out of proportion." Our Democrat primary is tomorrow, and the news broadcasts were full of Bernie and Biden rallies. All those people, among press and politicos who have been traveling the country in close quarters...

I'm just trying to keep my parents alive...

Again, thank you, Aesop. Please keep posting as long as you can.

Anonymous said...

Thanks very much for all you have done. Warnings heeded. I hope you stay safe.

Barb said...

Many thanks Aesop while I have the opportunity to say it, as many others have. Been a lurker since December, so glad I stayed tuned. Greetings and good luck to everyone.

Anonymous said...

Here in Virginia, we recently had our first case confirmed - a Marine who was overseas (funny they didn't say where) who returned to Fort Belvoir in Fairfax County. No one seems to be saying anything about the plane he rode on, the Airport he came into (National or Dulles most likely), the driver who picked him up or the people on base he interacted with before he was tested. Who know how many cases we actually have.

So here I am in Culpeper County, two hours south of DC, wondering if I should go out and top off already towering preps (been at it since the H5N1 plague in 2005) or go into lockdown. My husband and I are 69, have boocoo medical issues, and live alone on a small farm miles outside of town.

And then my father died last weekend. I am the Executor and sole heir. Like it or not, I had to deal with the Hospital, Funeral Home, Clerks of the Court for Probate, the Retirement Community management people, clear out the apartment, deal with the banks, yada yada. I am desperately hoping I can get all this done before people are dropping dead in the street in Fairfax. And nothing can be finalized until the state issues Death Certificates (a week or more, at least).

None of this is negotiable and nothing I can share with anyone else.

So dammit, I went shopping so at least the rest of my family is completely squared away when I get infected and die. I will distribute what I can and leave the rest for them to find when they come to take care of the livestock. I figure it's better to be eating fresh and canned foods instead of the ultra-expensive 25-year storage freeze-dried foods I've stockpiled. They can eat that NEXT year when CV runs its second round.

Which brings me to the stores: a few things missing in a few stores (I've hit 4 in the past week). WalMart, Safeway, Giant, Lidl. Plenty of TP and even Clorox, but getting thin on the non-scented. Some of the usual stuff thinning out, but that's been going on for some time. There are always items on my list that are out of stock or have been permanently discontinued. Missing: stuff like alcohol and cold meds in certain brands. Plenty of handwipes, no masks or gloves, of course. But yesterday, no aspirin in any size, brand, purpose. I use a lot of aspirin for severe arthritis. Weeks ago, I read that aspirin would be one of the first things to disappear and I've been paying attention to it.

Now, the best part - here I am, a lil ole lady, corralling 4 carts up and down the aisles (not unusual for me, and Im good at it). Lots of stares, and the usual comments - "must have a large family," "having a reunion?", etc. I usually just grin and laugh. But finally, I started telling the truth - Im stockpiling for the Coronavirus. Eight out of 10 people laughed and went on. One out of 10 looked a bit worried - and went on. One out of 10 looked worried and asked if I was serious.

"Do you think there won't be FOOD?" gasped one of the baggers. (Staffing is already minimal. One lane open and they had to drag a manager in to help bag my haul.)

I replied in all seriousness, "There might or might not be food, but who is going to drive the trucks, and unload the ships and planes, and stock the shelves? It takes people to do that, and people are going to be sick." I didn't mention Italy and shutdowns and school closings that we here all anticipate. That would have been way too much info for one day.

So I paid my bill (thank God for credit cards) and loaded up and drove home.

A Texan said...

A few things:

1) "Just this morning in Australia there is a report (and video) of a woman on a Sydney train intentionally coughing in another mans face after he asked her to cover her mouth." If she did that to me, she would be in the hospital for a broken nose or jaw, if and when she was diagnosed for Kung Flu.

2) Went to Sam's today (San Antonio), just because. Water that was rationed a few days ago to 5 cases per account is now down to 2/account/day. I got 2 cases, again just because (to add to the 17 I have at home, and we're refilling the gallon ones when they run out). No hand sanitizer in 2 different locations or in Wallyworld. Rice only available as part of other meals (like with cheese & broccoli). Toilet paper...on Friday there must have literally been 1,000 packages of their house brand stacked all over the store (45 rolls each); they are GONE - now they had maybe 50 boxes of 45 rolls in cardboard boxes, plus about a dozen similar-sized boxes from Scott's. Paper towels - less than a dozen boxes. Nitrile gloves - only about 8 2-packs of large left in one store, and about 12 2-packs of small and medium in the other. EVERYONE is buying 2 cases of water.

3) It just isn't going to get any prettier out there until this thing blows over...probably several months from now. I just don't believe Mr. Xi about China being done with Kung Flu - he announced it in a deserted room while wearing a mask.

4) My mother just got out of the hospital yesterday after nearly a month inside for flu followed by pneumonia. She's 82, and now looking, sounding and feeling quite nearly 100%. But let me tell anyone reading this, they were ANXIOUS to get her out and free up a bed (this is Methodist in the Medical Center in San Antonio, perhaps the 2nd largest in the entire city). On Saturday, they also started with questioning everyone coming in for a visit about how they were feeling and if they had traveled overseas in the past week. WOEFULLY inadequate, with not so much as a temp or ID check, but they had hand sanitizer and surgical masks right there and at multiple locations in the hospital (MUCH more so than usual, and a big change vs. just a few days before). They are CLEARLY getting ready for something big, and everyone knows what it is.

5) However, stupid is as stupid does. I was walking out of Wallyworld earlier, and passed a guy talking to an older woman (presumably his mother) that he was with, telling her "it's just like the flu." Yeah, keep saying that, its probably easier than whistling past the entire length of a graveyard. Who quarantines entire cities, metro areas, regions of the country for the f'ing flu, genius? It ain't, moron - it is 30 or more times lethal than the flu, and far more communicable (not the least of the reasons why being that there is literally no vaccine, so EVERYONE is susceptible).

6) Just ordered 4 big bottles of Sambucol (an Elderberry extract that has proven anti-viral effects) on Amazon. 4-5 day wait, vs. next day delivery on 2 bottles last week. Just saying....

nick flandrey said...

United airlines just sent me email telling me that this was the time to "Experience Breathtaking destinations...."

That's a bit tone deaf...