Thursday, November 5, 2020

While You Were Busy Ignoring Reality, The Consequences Called...

"You can ignore reality. You cannot ignore the consequences of ignoring reality." - Ayn Rand

Just a small update from the pandemic trenches:

1) Had two patients last week, both suspected for Kung Flu, who turned out to have it, absolutely.

First confirmed cases we've seen in over a month in the hospital that required hospitalization.
(And to be fair, only two patients out of several hundred, in a patient load best described as lighter-than-average.)

That coincides with the average lag between case spikes (about which IDGAF, generally), and hospitalization spikes. 
(Next come death spikes, like winter follows fall.)

2) But this was the significant takeaway.
One patient was confirmed to have been infected with it back last spring.
Double positive.
But minor symptoms, and never needed hospitalization. Like about 90+% of Kung Flu victims.

Then, once lockdowns largely ended in the U.S., he had a minor surgical procedure scheduled, which had been postponed earlier. 
So, COVID tests were done, and showed negative, two times, before being allowed to have the procedure. That was back around August.
So far, so good.

Now, three months later, in the ED last week, with sudden-onset shortness of breath, low oxygen saturation on room air, and a beautiful case of raging bilateral diffuse multi-focal pneumonia, and a positive rapid COVID-19 swab test.
In his 40s, and no co-morbidities.
Otherwise healthy.

Short answer:
You can get this again.
And again.
And again.

And subsequent infection is worse the second time.

You can kiss mythological "herd immunity" good bye when infection confers no immunity from subsequent infection waves.

Any Gilligans out there, keep preaching that "just the flu, bro" line of utter bullshit.
Lick handrails, and pee on electric fences, while you're at it.

{Hint: Don't screw around. Don't catch this. It isn't fake, and it isn't funny. Period. Full stop.}

3) Just to drive the point home, we also had a non-critical patient some weeks back, confirmed not to have it, who was hospitalized with another non-critical patient unsuspected and totally asymptomatic. Who, it turned out, was fully infectious with Kung Flu.

And gave it to patient #1.

Who subsequently declined, ending up sick enough in short order to be put in our ICU in critical condition.

But before COVID was diagnosed as the problem on that ICU visit, and the infected patient placed in respiratory isolation, they infected 10 ICU nurses, several of them seriously enough to be hospitalized.

The nurse with the worst case died of Kung Flu last week, after about a month's struggle.
Our ICU is currently (and perpetually) running at 1/2 capacity because of resultant staff shortages, and there's no one, anywhere, to bring in.
We've tried.

{This results in closing our ED regularly (to any incoming ambulances), forcing us to care for critical patients for days, rather than hours, and impacting medical care for the entire county, and by extension, a surrounding region encompassing 10% of the population of the entire U.S. of A. That's the razor-margin we work on even in good times. If things are fine for you in Mayberry or BFE, good for you. Your 0.001% success rate in an area with less than 0.1% infection is noted. You will, we hope, pardon us for a decided lack of interest in your infinitesimal success, against a virus you largely never encountered. Unlike, say, the 50 largest cities and suburban regions in the country suffering a far greater impact.}

No one wants to come play in COVID Land anymore, for any amount of money.


I yell because I care.

4) BTW, our PPE is still cobbled-together horsesh*t, including souvenir-stand raincoats usually found at taco stands near tourist traps. Totally serious.

Remember than anytime you hear Fraudpeddler Fauci tell you "We can handle _______."
Like he said about Ebola in 2014.

People are going to fiddlefuck around on this, until they achieve the exact results predicted in worst-case scenarios, because the entire population is well-marbled with 80-IQ morons.

One Gilligan keeps seven castaways stranded forever, and one jackhole "just the flu, bro" asshole who takes zero precautions, because this is obviously an internet hoax, rather than some Frankenbug engineered virus, is going to be the actual super-spreader, eleven times out of ten.

For the oblivious @$$holes who will think this is pimping for another economy-killing shutdown, f##k off with that noise. It's probably a good argument for trimming activity back somewhat, only in the areas where this is raging, and by appropriate legislation, not imperial fiat.

But it's absolutely an exception-proof argument for you wearing a snot mask - not to protect you, but to protect everyone else from you - to curb the spread of the virus, and washing your g## d###ed hands, without exception, in 50 states and 7 territories, until this is either stamped out, or beaten by a Hail Mary vaccine. Wearing a sneeze mask is not communism, and washing your booger hookers is not Hitler, no matter about your pwecious feelz, Snowflake. Exactly like about 90% of you aren't doing, by observation, far outside of the local area.

And that's why you'll keep screwing yourselves, harder and faster, until even the dimmest bulbs amongst you figure that out.
Almost like Joseph Lister, Louis Pasteur, and Ignaz Semmelweiss all knew what they were talking about 150 years ago.

On those cheery notes, Have A Happy Day.


From Norway said...

This gives me hope. And overlaps with a previous recommendation of yours.

Hiddenhollow said...

AESOP, My wife works in a ICU in upstate New York. All of the patients she sees that have covid that have got sick enough to make it to the ICU all have glass opacity in their lungs. Are you seeing the same thing out there?

Aesop said...

That's exactly what we see. It's virtually COVID diagnostic.

Normal pneumonia (PNA) is usually only in one lung, usually at the bottom.
COVID looks like someone sandblasted the entire lungs, and the pneumonia is everywhere simultaneously. That's why they get so much worse, so fast, and die.
Nothing else AFAIK, and at least nothing in common circulation, does pneumonia like that.

Toirdhealbheach Beucail said...

Aesop, I have to tell you that I was thinking on some these issues this morning. We are getting to point where they will have to decide at our office what to do: minimally I think they will extend essential personnel through June, but I am betting through all of 2021 now.

Given all that this virus is capable of and all we do not know (and the fact I have little hope in a vaccine appearing and if so, being effective on the scale it needs to be), I am effectively radically rethinking the rest of my life and the activities therein. It leaves for a somewhat more grim future.

Unknown said...

One other thing that should maybe be mentioned: WEAR THE MASK PROPERLY. It has to cover your nose but people in my area are struggling with grasping that part.

I was told the other day that people are getting sick in spite of wearing a mask. A quick survey of the area shows it's filled with geniuses who can't manage to cover mouth and nose both with a mask. Invariably, their nose shows.

And they wonder why COVID is going around even though people who get sick are self reporting that they "wore a mask." 😒


HCTraveler said...

Saw a lung xr this summer at a clinic. had a plum-sized mass at the top of the lung.
Dr said, "that's ground glass syndrome; they've definitely got it, admit to the hospital". Just like that.

Aesop said...

@ Rhea,
Remember, the masks we're talking about, for the most part, aren't even surgical masks.
just squares of cotton jersey T-shirt material.
They aren't meant to protect the wearer from getting sick, and anyone who thought otherwise is a thorough-going moron.

Those mask need to be worn to protect you (for any value of that word) from getting anybody else sick.

People complaining they wore a mask and still got sick are on a par with people who wear a seatbelt, and complain they still got in an accident.

Somewhere in their misty childhood past is Fetal Alcohol Syndrome, a and steady diet of lead paint chips.

Nick Flandrey said...

@aesop, I've got a case of full body tyvek-like aprons and a case of shoe covers if that's the sort of thing that would help. No one locally was particularly interested, and it's not something I need.

Email is my last name at A O L . com


Mike Doyle said...

Under the circumstances, and given the number of Gilligans I'm seeing where I live (love that term, I'd like to borrow it!), it seems inevitable that this bug is going to burn through the population like napalm in a paper mill, no matter what we do... I'll do what I can, but it's not looking good for the home team.

BTW,and off-topic, we're turning 245 next week. Happy Birthday, Marines! Hang tough and Semper Fi!

John said...

You're 100% right - very low rate of encountering the 'Rona in Mayberry, and a much less than 1% death rate. I've commented on our experiences just to share what we're seeing here. Honestly, I can go a week without seeing more than twenty different people, so the number of people I interact with is small. The fact that I see the same clerks in Wal-Mart each time I go there makes it that much smaller.

Thank Heavens we don't have the experience you have.


What's your progression on the end game on this? How bad will it get?

Aesop said...


"No one ever went broke by underestimating the intelligence of the average American." - David Sarnoff

Unknown said...

Captain Marsupial
I tested positive for covid. My symptoms were a mild, persistent cough.
It was gone in a week.

If it is possible for me to get this again, and in a more virulent form, what is the point in getting a vaccine? A vaccine is supposed to help one develop antibodies, correct?
If after having the virus itself I didn't develop antibodies, how will a vaccine help?

OvergrownHobbit said...

...But this was the significant takeaway. One patient was confirmed to have been infected with it back last spring.

How confirmed? Not all coronachan confirmations are created equal. Since the homeless still aren't dropping like flies, the reinfections might be an artifact of sloppy testing. We shouldn't still be operating on guesses and hopium at this point. What the blazes are our researchers doing?

BTW, I've found a humane sneeze guard that's easy to sanitize and works the same as the magic craft projects without the filthy bacterial soup:

Read that the data from the Spanish American flu confirms that cloth masks were worse than useless (being unsanitary), and that when surfaces in a hospital CCPherpes room were tested for the virus, minimal amounts were in the room proper,but masses in the toilets. So, barring the sneeze guard, cloth masks are still a symbolic gesture (you could cough or sneeze into your elbow for the same effect). Still on board with the hand washing though as it (and staying out of crowds & hospitals) seems like the only real preventative.

And speaking of PPE, why in the Sam Hill are you folks on the front, not to mention the wider public, still short on safe, disposable, real N-95 masks? What the blazes are our companies like 3M doing? It's all bloody crook.

Aesop said...

"How confirmed?"

Two positive tests, one rapid and one send-out.

And 3M had all output from their N95 factory (in China) nationalized.
Until further notice.
At the outset of this whole kerfuffle.

At last report, they were scrambling to establish production in other locales.
A month after the pandemic starts, that's a wee bit too late.

Unknown said...

Question: if a person can get sick repeatedly from this virus, doesn't that make a vaccine for it rather useless? If the body can build up no immunity to it, I'm not sure what a vaccine will be able to do.


Unknown said...

Sorry, did not see that the question was already asked. 😳

Happy Monday.


The Overgrown Hobbit said...

That's really bad news.

It not only means we don't have herd immunity (any more than we do for the common cold) but that this thing acts more like the Killer Sniffles than the 'flu.

Which means there's a good chance that it goes from the CCP Herpes to Wuhan Gurgling death by the process of re-infection once you've already got it.

We're STILL scrambling to get this set up? Dang. WW2 didn't take this long.

And while you still haven't convinced me of the magic semi-permeable cloth membrane, I can add another nail in the coffin of Gilligans. One of the reason I have such a hard time convincing my co-workers to wash their hand religiously and often ("even when they don't need to") is that they're convinced their magic craft projects are keeping everyone safe from them.

Such a mess. Keep well and safe, and thank you for your service.