Sunday, December 27, 2020

Anecdotally: Keeping It Real, Yo

 












About that pandemic you might think we're not having:


Nameless SoCal Hospital is full, bottom to top, wall to wall.

Because elective surgeries are cancelled, those nurses normally doing anesthesia recovery are now caring for overflow patients.

Nurses on floors normally holding stable telemetry patients are caring instead for ICU patients, because the ICU is full, wall-to-wall, and has been for days, so when someone gets worse, they can't be moved to higher care, and the floors are stuck with them.

ER is holding ICU patients, now for multiple days. Entire ER is now set up for COVID isolation, which is running 75-90% of patients seen, 24/7. And those are only the ones too sick to send home.

Morgue overflow conex cold storage is now full of corpses. Who died from COVID, not just with COVID. We ran out of body bags day before yesterday, so until we got more, deceased patients had to stay in occupied rooms. Even with getting decedents out, new dead are piling up faster than we're getting old ones off to coroner or mortuaries.

In the only state out of 50 with mandatory safe nursing:patient staffing ratios, those ratios have been thrown out indefinitely because of the current emergency. Because apparently an international emergency means we can use magic to do what we can't do when we're not redlined, at 110% of capacity and ability. (Roll two D6 to cast Spell Of Magical Healing.) I haven't asked, but I'm pretty sure the Official Answer to overcrowded hospitals will be: Bunk beds! No, really.

Nearby hospitals have gotten so bad, some nurses have walked off the job. No small part of that is the ongoing insufficient supplies of PPE necessary to do the job without getting sick. We're not there yet here, but morale is low, and the troops are pissed. And if someone calls in and says "I have a fever", there's not much anyone can say. It's coming, in 3, 2,...

Between staff shortages and actual sick staff, we're starting the day with 50% staffing in some units, and it's virtually impossible to get hired guns to come in. Everyone is over this, and all they get by picking up registry work or extra shifts where they work, is more sh*t sandwich, every day, into infinity. And you can't spend bonuses if you're dead.

And in L.A. County, everything I just wrote? Worse. Squared.

Oh, and we're still weeks away from the peak of the current surge, which is simply the sum total of people who decided Halloween and Thanksgiving get-togethers were more important than silly COVID restrictions, with predictable results.

We're all dreading what happens when we get the Christmas/New Year's Stupidity Surge, 3-5 weeks from now, but it's definitely coming.

Things are spiffy where you are? Outstanding. Goody for you. No, really. Hope your luck holds.

Meanwhile, I'm hearing from nurses who blog in other states, e.g. Texas, that they're getting, now, what we had here in Apr-July, and hospital manglement (not a typo. -A.) there learned nothing from what happened in NYFS, NJ, Atlanta, Nawlins, or CA, and accordingly planned for no such thing.

No points for guessing how that's paying dividends for them now. (Two of the reasons I'm lifetime-banned from hospital administration is because I tested with an IQ over 80, and my parents were married, to each other.)

The next phase beyond this is when the healthcare system starts to collapse. That is already nibbling around the edges of things now. When we get to full collapse, we'll be Italy: we're going to have to start to decide who we see, and save, and who we move over to the "It was a good life, and best wishes" area for no further treatment. No one has broached the topic openly, so the docs haven't decided whether they'll sort out the oldest, the sickest, or just throw darts at the Big Board when they're forced to actually decide who lives, and who dies. Mainly, they're just hoping real hard we don't get to that phase, ever. If we do, the word "unprecedented" is hardly going to cover our New Normal.

Of course, all this is just like we've done in every seasonal flu season for the last 90 years. (/sarc) NOT.

Keep pushing horsesh*t theories and crackpot stayed-in-a-Holiday-Inn-Express-once medical mail-order diploma explanations of what's REALLY happening. We need the comedy relief.

Those of us holding the shitty end of the stick with gloved hands are too busy to give a wet fart for such prognostications, but to a person, everyone of them has expressed that the Internet jet-fuel geniuses who think this is a scam should STFU, and pull a shift here, any day of the week, with their eyes and ears open, and their pieholes shut.

Most of you would last about half an hour before you left skidmarks out the back door.

We don't want thanks, or Starbucks gift cards, or hazard pay raises (though we wouldn't turn any of those down). We knew the job was tough when we took it. We just wish the Gilligans driving this day in, day out, would stop being such overachieving jackholes, and use some common goddam sense, just for the novelty, if for no other reason. It stopped being cute to be blisteringly stupid about nine months ago.

And if you think there isn't going to be a reckoning down the road that grabs you by the short curlies for the jackassery we're seeing and dealing with now, once this is over with, I'm here to tell you, you've got another think coming.Think long and hard about that. TPTB in the medical field have memories like elephants, and you aren't going to like what you get, nor get what you like. And health insurers will once again be driving the No Sense Of Humor bus, regarding future lifestyle choices. Mark my words.

The brighter lights among you, which has thankfully been a majority, had best make plans accordingly.

You will see this material again, and probably sooner rather than later, but even if not, being prepared for anything even roughly similar means you don't have nearly as much to worry about, no matter what rolls down the pipe at you the next time Fate pulls the chain on the Flush Bowl of Life.


UPDATE: For those who aren't trolls or retards, and able to read and comprehend, here's a link to a yuuuuge amount of collected data on COVID 19 from L.A. County.

A couple of points to note from that pdf, (beyond the fact that hospital capacity for 10M people is going down the shitter at warp speed just now): 

Page 6: ethnicity of hospitalizations in the LA County public hospitals, 3/1/20-present: 

72% Hispanic. 2% white.

Go back and read that again. Yes, it said what you thought it said.


Pg 7: 

Age of hospitalized in county DHS hospitals. Highest percentage, every week since this started.

Generally 50% or more Age 18-49

Next highest Age 50-64.

65+ is almost always in third place, until very recently.

So if you think 18 is elderly, keep thinking this only kicks old peoples' @$$#$. 

Suture self.

Our profound apologies if facts and Reality have yet again left hoofprints on your ass.

66 comments:

Michael said...

Aesop I *think* your aiming too high in your efforts to educate. Let an old NCO pass it on.

WASH your Damn HANDS especially before touching your face!, wear the mask properly, not under the chin, NO leaving your nose out, do you ZIP up or let your privates hang out eh?, stay away from crowds (Hat tip to old Remus RIP, I miss your wisdom).

If your brighter that that maybe add some Immune Support. Yes, larger words, deal with it.

Keep Hydrated, if your peeing yellow after your first mornings pee DRINK WATER. Aim for near clear. WHY? You immune system needs the help. Get out and exercise even a brisk walk OUTSIDE each day (not just to the fridge and bathroom Ok?) Fresh air and SUNSHINE are GOOD FOR YOU. Vitamin D is called the sunshine vitamin for some odd reason. If it's too cold to show some skin to the sun take some Vitamin D. Look it up for dose, I'm not your Doctor.

In case you missed the Memo CO-Morbidities are BAD with COVID. You know being Obese and not able to walk a mile outside? Excessive smoking and all that is not a positive when your bodies trying to fight off COVID. A healthy daily walking 80 year old is in FAR better shape to fight COVID than that Sofa surfer.

It's YOUR HEALTH, it's YOUR DAILY BATTLE. Move it or Lose it.

Skip said...

RN daughter works at VA Palo Alto. Same there, nurses a dragging up in lots. They cannot find anyone, Drs. or nurses.

mobius said...

Scary scene, not much to go on. What's different about SoCal?

Angantyr said...

Kinda glad I had my hernia surgery on the 10th... Looks like I just missed the crowds!

Unknown said...

I would prefer to never see this material again, tbh, but if wishes were horses...

The sad part is, lots of people still won't believe this is happening until reality kicks their ass up between thier ears. We won't turn into Italy because we're Murica! And Reasons! We don't need no stinking reality!

I grow a little more concerned about my loved ones in the medical field every day. I wish I could convince them to quit and take up something safer before this part of flyover land looks like Italy.

I'm sorry Aesop, because the anti mask brigade has decided that you and your coworkers and my family in the medical profession are expendable in all of this. That's what angers me most of all these days.

~Rhea

jen said...

ER nurse, north of Dayton Ohio. Every bed full, using hall beds and boarding inpatients in ER. Running low on PPE. ICU charge nurse in tears when I tried to give report. ICU nurses taking 4 pts each, tele taking eight. Half the staff out with Kungflu. We never get extra pay; now they're offering double. New proning protocols rolled out on Christmas morning; there're new protocols every time we go in. You get whiplash from all the changes. The extra pay just not worth it; I'm taking a week off. We just got moderna vaccine this week.
Jennifer

jen said...

P.s. two pts rolled in on Sunday just up and died within the hour; both CXRs completely whited out. We lost a nurse from my nursing school and one RT, and a doctor's wife.
Jennifer

Unknown said...



Blah blah blah! WHY is the hospital nameless? 'Cause you work there? Don't worry I really don't give a fat rat's ass about you or your identity and I'm not gonna go there to try to look you up. Are you talking about San Diego? I live here and I'll pull a shift there IDGAF, don't try to call my bluff with your slick mouth either! NAME the hospital! I want to go there with my iPhone and conduct some citizen investigative journalism because as a Reaganite, I believe in "trust but verify" and I don't like your condescending attitude and your hyperbole, and you probably don't like mine and we're even! I WALK all over downtown daily from the Gaslamp up several blocks to Little Italy and interact with a LOT of people, including dozens of dirty vagrants and homeless and that's a LOT of square blocks and I WALK them daily and I touch everything include two filthy 7-eleven doors where the bums loiter and I don't wash my hands and most of the time I do NOT wear the face diaper either! Cops have given me warnings and IDGAF! Let 'em show me the ORDNANCE where I have to wear the face diaper or they can arrest me. They don't bother! I DO wear it on the trolley because I'm forced to, which I also ride daily many stops east going out to El Cajon to visit a fellow retired NAVET. I touch the trolley vertical poles handled by many low class people and I touch the buttons to open the doors. Speaking of touching, the nurses at VAMC La Jolla have touched the back of my sinuses twice with their swabs and I've tested negative both times! I'll agree a mask is effective at preventing MY cough/sneeze from affecting others IF I had a cough and sneeze but I have neither, and I'm not carrying the virus, but SURELY you'll AGREE I'm putting myself at GREAT RISK by mingling with all these people downtown and touching all these surfaces X the past 4 months RIGHT?!? Daily trolley rides, visits to two different 7-elevens, two cafes, and the Princess Pub at night which is about the only bar open up here, and people are waiting in line to get in because they want to MINGLE and I suspect they too, like me, think this COVID SCARE is PURE HORSESHIT! How's that grab ya? That pub should be a COVID breeding ground shouldn't it? I should have definitely contracted the virus by now dont'cha think?!?! I mean it is a PANDEMIC right? So WHERE the !@#$%^ is it? If it's in your hospital, fine, give me the NAME and I'll go there and VERIFY and if what you're sayin' is true I'll go sit in a corner with a jumbo cup of STFU! Also, I'm not hearing a lot of SIRENS either! Yes the normal 2-4 a day, but if this were really as BAD as YOU say, I'd be hearing ambulance sirens CONSTANTLY wouldn't I? It just doesn't add up for me, and yes I'm a contrarian and I'm goin' on gut feeling and I'm SICK to the back teeth of the FEAR MONGERING from people like YOU and your hyperbole! Raconteur huh? I'm Italian and we use "chiacchierone" (chatterbox, blabbermouth, taleteller etc.) to describe guys like you. Give me the NAME of the hospital...

Russ said...

So who are these people, are they ederly with health issues. Are they younger or middle aged. Any certain races. Here in colorado we arent seeing this. My group of friends have finaly known people who have had it. A variey of ages most with mild to minimal sympton. Evem my 2 elderly friends. Both in 80s withmultiple health issues only had loss of smell and taste mothing else.

Ropro said...

Sorry, but I’m just not seeing what you describe. Who am I? Well, I’m a hospitalist physician that owns two practices with 6 doctors and three ARNPs covering 4 hospitals, about a dozen SNFs, half a dozen ECFs and three ALFs. We practice in Pinellas County FL with one of the oldest populations in the world with EVERY comorbidity you could imagine and none of our ICUs are full. Not one. ER wait time is under 30 minutes and so is the average wait time from ER doc calling me to patient exiting ER and getting a bed upstairs. There are no patients alive or dead stacked up in the hallways, the morgue, or anywhere else for that matter.
I’ve taken care of well over a hundred COVID pts from start to finish. Only three have died. All over the age of 78, one with ESRD and one with cancer. Only five of the hundred plus have needed intubation. Three survived.
None of the doctors or nurses I speak to are burned out, pissed off, scared or fed up.
For most of us, COVID has just become another diagnosis with set protocols (that here in SW FL seem to be working) and extra precautions for the staff.
In terms of the ‘ vaccine’ Hell NO. Not for me or my family. And that’s a hard NO. Nonnegotiable.
It’s a definite line in the sand that will be met with force if pushed
Anyway, these are my experiences/observations. Obviously you can call me an asshole, or a dumb ass that’s going to get his...that’s fine. I will still enjoy your writing and appreciate your insights and efforts
Thank you

tweell said...

Take care of yourself, Aesop, and don't let the hospital guilt you into working with inadequate PPE.

I have an older sister in the greater LA metro area, she's a retired nurse. She's been getting lots of calls and emails asking her to put on the gown and gloves again. They offer her free recertification training (she's let them lapse), high pay, etc. Not interested, she's done.

She told me the only way she'd go back is if she was forced to don uniform again (she did 4 as Navy enlisted, got her degree and went AF nurse, retired as O5). I don't see a state of emergency being declared and retirees put back in harness, at least not right now.

John said...

This sounds simply awful. Any thoughts on when you guys will peak?

Aesop said...

@mobius,

What's different is that 10% of the U.S. population lives here, most of it in an area about the size of Connecticut.

@Ropro,

Doc, I'm glad, sincerely, that your world there is different than mine is here. You're bright enough to get that your reality and mine can both be true simultaneously. But as noted above, your entire county pop. is about what 2-3 cities here (out of 20+) comprise. It's just my hip pocket estimate, but I'm pretty sure IQ is a constant, but it's divided by population, which is growing.
Best wishes.

John,

I'm guessing 3 wks to a month after New Years'.
I'd be happy with 5 minutes ago.
If it turns out to be Easter, I won't be surprised. Just depressed.

Slick said...

I appreciate the different level headed responses from different locations. Healthy immune system and personal hygiene escapes some people, to their peril. Thanks for your unwavering services and postings.

Whitewolf said...

I was diagnosed with lung cancer two weeks ago waiting for a PEP scan because they are all booked up. Don't know what happens then, guess I will be told go sit in a corner and die as I am 78 y4ears old and we cant waste time on you. I spent my life in service to this country or what was this country, military, law enforcement. Now I am too old to bother with so just go away, maybe I should have done that years ago and let the chips fall where they would

Unknown said...

Escape from LA.

A. J. Pendelton said...

AESOP... what are you smoking dude?

Nothing what you posted above regarding Los Angeles is true at all. I have been monitoring the hospital emergency room situation of six major hospital in the Los Angeles area--all are operating normally (empty for the most part).

There are no ambulances screaming down the roads loaded with sick and dying. No long lines of sick, sniffling, coughing people waiting for treatment at Urgent Care Clinics or hospital emergency rooms. The hallways of hospitals are not stuffed with the sick and dying out of some dystopian pandemic Hollywood propaganda film. There are no stacks of bodies in refer trailers waiting for burial.

Where are you getting this information
Just who is feeding you this line of rot?

I just recently brought a friend into the UCLA emergency room for emergency stroke treatment in Santa Monica. Just outside the emergency room entrance (under the driveway cover) are a line of tents being used for Covid triage--all were empty except for one with a woman inside with the sniffles and a slight fever. The triage nurse attendants were busy sitting on their hands doing practically nothing.

The same applies to Harbor UCLA, Kaiser Harbor, Torrance Memorial, Little Company of Mary and Saint Joseph's in Santa Monica... all with major, major emergency treatment rooms.

Governor Newsome is on the TV daily practically with the news shit-birds relaying every syllable of covid-vomit that streams out of his mouth.

This is a massive scam that is being pulled on this state and it seems like you've fallen for it hook, line and sinker with your post above.

. said...

Here in Cenla(central Louisiana), my experience is similar to what Ropro is posting.

My mother(82) had COVID, nothing worse than seasonal flu. Both of my daughters(in their 20s) have had it along with their husbands; less than regular flu, except for loss of taste. My oldest sister, a PT, tested positive after she had what she thought was a "standard" head cold; no loss of taste.

A 74 yr old man in our local EAA chapter lost his 72 yr old wife "to COVID", but she had diabetes, high blood pressure, and serious pulmonary issues already. His symptoms were about like regular flu.

Our hospitals aren't overflowing either. And here in Cenla, mandatory mask wearing is considered optional by most folks.


Not denying Aesop's report on his area, it's just that we aren't seeing it here, and I'm hearing similar stories from other states.

Termite

Swrichmond said...

"What's different is that 10% of the U.S. population lives here, most of it in an area about the size of Connecticut."

Who thought THAT was a good idea?

Sorry about your situation, but I had my fill of Kali and its massive and entirely negative influence a long long time ago. Get out while you still can, sounds like the bill is due.

Knuck said...

Mortality rates...year to year comparisons. No noticeable increases according to multiple sources including Johns Hopkins. Miniscule flu deaths. Boxes of masks say on the side,"will not stop transmission of disease." Why aren't the homeless stacked like fucking cordwood in the streets. No sanitation,no masks,no hand washing,run-down immune systems,drug and alcohol addiction.99.5% survival rate.Covid tests being conducted outside established protocol according to the founder of the testing procedure. Run faulty tests enough times and everyone has this nasty shit. Hospitals full and stacking bodies in reefer trucks...okay you say this is happening. I believe you.
Lockdowns haven't worked. Masks haven't worked. Social distancing hasn't worked. Why in blue blazes fuck would I believe all the fucking "experts" when nothing has worked to date. "Let's do it again for a longer period of time." Kiss my ass! I don't think most of these so-called experts are competent. Mis-truths,half-truths,propaganda,political agendas,monetary gains,lying cocksuckers..and you wonder why folks are calling bullshit? What is the use in living in squalor,mental illness,poverty and despair with a boot on your fucking neck. Big stores and business can open. Mom and Pops cannot. I don't believe 95% of the mainstream horseshit. Good luck.I hope you don't die from this shit. Die from something else..years from now. You don't have enough ammo.

Robin Datta said...

They say Florida is The Sunshine State, and Vitamin D is The Sunshine Vitamin.

But of course Your Mileage May Vary. Link will update each time it is (re)loaded, and included countries can be edited.

kurt9 said...

Aesop and Ropro, what factors do you think account for the differences in COVID-19 incident in your respective locations? Identification of such factors might be useful in dealing with this business.

GLA said...

COVIDIOTS

Unknown said...

Too much kool-aide being being consumed here regarding covid. I work at a 300 bed tier 1 hospital in NorCal and our patient numbers are normal per this time of year. Covid is massively complicating our processes though, but it's because the public has been convinced that covid equals death. As an example, this time last year John Doe may have experienced headaches, runny nose, upset stomach, body aches, fever, etc... and concludes he has the flu and stays home to recoup. This year John Doe has the same symptoms and runs to the ER, because he's convinced he's going to die from covid, and thus the weak minded are over running the hospitals. I treat them as any other patient, but the fact that they are laying in a hospital bed in their pajamas requesting pudding and popsicles and complaining why dinner is late is a reminder that people are sheep and easily swayed. Covid is simply the most evil, heinous, clever, satanic, hoax ever carried out on the public and just wait until covid21. They say it's even more contagious... of course it is. So, will our hospital systems collapse? Absolutely, because anytime the inmates are allowed to run the asylums only failure can result.

Aesop said...

@A.J. Pendleton,
If you're going to talk out of your ass, it's probably better if your farcical assertions can't be disproven with about two mouseclicks:

http://file.lacounty.gov/SDSInter/dhs/1070348_DHSCOVID-19Dashboard.pdf

With those hospital census figures for L.A. County current through a week ago, L.A. County has 1/3 of all ICU beds full of just confirmed COVID patients, and out of 2500 licensed ICU beds in the entire county, they had 55 available ICU beds out of 80 hospitals. So 26 of those available ICU beds were in 4 county hospitals, and out of the other 74 hospitals in L.A County, there were 29 beds. IOW, the ICUs in roughly 45 hospitals out of 80 were full, and 29 hospitals had 1 open ICU bed apiece. And things have gotten worse in the county since 12/24, not better. Hospitals are paying stupid money to nurses right now, like $1-2K/shift, and they still can't staff themselves.

So maybe look around, and realize that if things were anything like you imagine -because you clearly have no wild idea about the reality - just from driving by the front of the hospitals you're "following closely", those numbers wouldn't be the case.

In a medical system where there's usually only a 5-10% cushion of open beds, COVID is sucking up 33% and more of capacity. That means people who would otherwise get hospitalized aren't getting in, and most of them aren't optional. If you die from an infection because people sick with COVID blocked your admission, you're just as dead as if COVID had killed you directly.

Nobody said dead bodies were stuffed to the rafters and falling out the windows; I said the beds in those hospitals are full of patients, which means if your ass gets in a car accident, your nearest open ICU bed may be 1-3 hours away. While you're bleeding to death.

Well played.

Now, take your cleats out of your dick, and try again. After you heal up some.

Aesop said...

Two more mouseclicks, and you get this tale, including the head of the L.A. County+USC Med Center saying "We are getting crushed"". And that was a week ago, and it's only gotten worse since then, not better.

https://deadline.com/2020/12/los-angeles-covid-19-update-im-not-going-to-sugarcoat-this-we-are-getting-crushed-says-county-usc-hospital-chief-1234659251/

For those of you talking fluent smack out of your ass, your version of reality doesn't accord with the actual truth on the ground. You're the guy flying the plane into the mountain, and convinced that the map is right, and the mountain isn't supposed to be there. Best wishes with that plan.

There are parts of the country not experiencing what SoCal is. Duh. you have a population density measured in cows/square mile, and a virus penetration in the single digit percentages.

You wonder what's driving this bus? look at the demographic pie chart lower down in that pdf, above.
Hospitalizations: 72% hispanic. 2% white.

Lemme see: large extended families, from age 1-84 in the same household. 12 people in a 2-bedroom apartment. No insurance. No access to normal care, only the ER. Poor compliance with normal medical instructions or medications. Science-illiterate, and an average 8th grade education, averaged across the lifespan. Not following the news or healthcare PSAs. Not coming in to see anyone until they're half-dead, as a rule, or because they "have to work" to feed all those mouths. Afraid to seek care because they're illegal, or have no money, and no insurance.

So: In a region, and a state, with at least 4M+ illegal aliens (and probably closer to 10M, from TJ to Oregon), and a huge underclass even among the legal citizens, why d'ya suppose this is blossoming like it is?

Look at the pie chart of pg. 6, and change my mind.

Anyone? Beuller...? Beuller....? Ferris Beuller...???

And I posted several Rant-tards' blovations here, so you can see how blockheadedly thick some people are, even when reality is smacking them across both cheeks like a frozen mackerel swung by an NFL linebacker. I'm telling you what I see every week, and they're telling you it can't be true, because they're sure it can't be true, so I shouldn't believe my lying eyes.

Google "gainsaying", and get back to me.

But things got better last night. We moved four patients out of the E.R.; two into ICU, and two to other floors.

Why did we suddenly get beds, after waiting for days for openings?
Because two people died in the ICU last night, and two people died on other floors, in just one shift, and all from COVID. How curious.

Apparently Death didn't get your memo about this not happening the way I'm telling you it's happening.

. said...

Something else from Louisiana: apparently our governor and his "medical advisor" are at odds with some doctors and other political figures over case numbers.

Several Sheriffs and coroners have repeatedly told the governor that his case numbers for their parishes/counties are wrong, considerably too high. They are saying that total positive tests are being called total cases, instead of total persons infected. Often people are getting 2-3 tests after their first positive test, either to determine when they can go back to their job, or simply to confirm the first test.
This skews the numbers badly if not taken into account.

Termite

. said...

To Knuck:

Social distancing and sanitation DO WORK. Lockdowns, not so much.

Sanitation is self-explanatory.

Social distancing is similar to living in rural areas with few people around. Fewer bodies for the "cooties" to jump on yields a much slower spread.

Couple of good things to come out of the current situation:

(1) People are much more conscious of sanitation methods, and are using them.
(2) For campers, preppers, and hikers, fuel for alcohol stoves is EVERYWHERE, and CHEAP. BTW, the 90% stuff works best.


Termite

Pragmatic Skeptic said...

Soo… My wife, a retired ER RN, loses sense of taste and smell on the 19th gets tested on the 21st and is diagnosed positive on the 22nd. Other symptoms... fever up to 101.4 for one reading but average 99.6 accompanied by fatigue and occasional flu symptoms. NBD… yet, and now the 28th, fatigue, smell & taste are all that’s left.

And this leads to the following…

Masks...

Since March... the house has been cleaned like an OR between procedures, washing hands... scrubbing floors, walls... disinfect EVERYTHING... I barely have skin left after the scrubbing, masks on anytime outside the home except with family… and we all know where we have been and all follow our retired RN’s protocol… so far so good… except for my work (essential employee that gets tested) minimal excursions for necessities is the exception to a continuous self-quarantine since March… yet here we are, my wife recovering and I am asymptomatic 33 days after we are exposed to COVID by the resident family idiot who felt it more important to join the family for thanksgiving than stay home (She tested positive after a month of not feeling well when she said her low grade fever spiked after the holiday). WTF. SOooo after the first exposure we quarantine 3 weeks… 11 days longer than the state health department requires, and nothing… until 3 ½ weeks… soo now my 2nd self-quarantine begins… for 14 days after my wife no longer shows symptoms. This all courtesy the idiot family member who didn’t want to miss a family holiday for a low grade fever. So masks apparently don’t work… ever… because you can’t solve for stupid breaking protocol. And me... going on month 3 of self-quarantine... apparently COVID knows I'm "essential" and leaving me alone... for now. I hate the masks as much as the rest of you... BUT if you feel just a little under the weather... do us all the favor and stay home because I am tired of doing time for your whine. Wear the damn mask to at least prevent you from being the next Typhoid Mary.

Robin Datta said...

I retired in 2009, (ED doc), presented with pancreatitis 2020.12.03 & had the bilebag yanked 2020.12.05 at Kaiser Fresno where I had worked. Did not see the ED this time. Accomodated in a tent extesnion. I have no doubt that LA county & Orange county horsespittles are up $#!^[]^ creek without a paddle. And the rules of hygiene will apply to humans and to any terrestrial vertebrates that may replace them as the dominant species: face hygiene -- eye shields for incoming, mask for incoming and outgoing mouth & nose; hand hygiene; and contact surface hygiene.

As many as 20+% of humans have innate immunity to SARS-CoV-2 and of those with adaptive immunity ⅓ to ½ may be seronegative, having exclusively cellular immunity (which works great for viruses). And the RT-PCR checks for the bodies of viruses, not the immune response. The Good Lawd in His Wisdom has allowed free rein to a goodly number of Homo paucisapiens.

Charlie said...

Sounds to me like the kung flu might just solve some of So Cal's illegal problems. Not that I wish death and illness on anyone. But it is hard to develop any sympathy for folks that have been either wanting or allowing this to go on.

As for pop density, living in the middle of that is a choice. Kung flu is just one of many problems inherent with being the thick of that kinda crowd. No thanks.

I get ya'll are having some serious problems, but we are not. And hopefully won't.

Sgt.Sausage said...

Hey, got a friend who wants to volunteer help ...

Not really: The dude just wants to stir the shitpot - so I called him on his bluff: "Yeah, like if it's *really* an emergency, I'll volunteer ... but since there's no public call from the State for volunteers ... it must not be a *real* problem ..."

So ... The. Show. Must. Go. On (right):

If one were to want to volunteer services to your particular anonymous institution (or any in your SoCal area - just to keep yours un-named ) ...

Who does one contact an how does one get in contact with them to ... volunteer... ?

Enquiring minds want to know ...

Tobias said...

I am baffled by all the hate. I work in Spokane Wa at the region's largest hospital. We are making plans to expand into our parking garage. I wouldn't say we are overwhelmed but we are busier than I have ever been in my 21 year career. We aren't taking people of support that we don't think will make it to free up a bed but that is probably going to happen in the next few weeks. If you get transferred in from Idaho (where I guess Covid doesn't exist) expect a slightly different level of care than you would have received a year ago. True the majority of patients aren't 30 year olds that do triathlons on the weekends but we have had young healthy people (20s) having liver and kidney biopsies, and those with severely elevated cardiac enzymes (heart failure). I have lost my patience with the covid deniers. It is a simple matter of self-preservation. Wear the damn mask. or don't. I really don't care anymore. I am getting as much overtime as I could ever want. floor nurses are getting pulled to the ICU and OR nurses are working the floor. If we get to the point of 4:1 assignments in the ICU patients are definitely going to get substandard care and there isn't a thing anyone can do to change it. (especially since we aren't allowing visitors) I don't understand all the freedom lovers that arent willing to take some responsibility for themselves and do the right thing and stay home and wear a mask. If you come to the hospital looking for help you are in the wrong place at the wrong time.

My girlfriend tested positive on Dec 26 and has been in bed and on the couch for the last couple days. Her company is going to fail to ship millions of dollars in product because they didn't take covid seriously and their year-end audit is going to be a shit show because key staff are out. You reap what you sow.

. said...

Robin Datta said:

"As many as 20+% of humans have innate immunity to SARS-CoV-2 and of those with adaptive immunity ⅓ to ½ may be seronegative, having exclusively cellular immunity (which works great for viruses)."

That's what some other MDs and medical researchers are saying, and You Tube will yank down their videos if they post them.
Apparently it doesn't "fit the narrative" of TPTB, who seem to want the general public to believe that SARS-CoV-2 is "Captain Tripps come to life".


Termite

ruralcounsel said...

My brother, an MD and nephrologist, says he is losing lots of his dialysis patients. He is also concerned about getting it. Guess he'll be glad to retire in another year or so. Sucks to be in medicine these days. Of course, that's the whole point of those jobs now, isn't it.

That said (i.e., I'm not denying the pandemic, just our reactions and policies to it), I'd like to hear your take on the overall national mortality numbers that I keep seeing. Apparently the overall national mortality for 2020 isn't that much different than 2019, or 2018 ... in other words, the ChiCom virus seems to be just culling the same number of people who would be otherwise vulnerable to something else, on average. Well within the natural variability. Looks to me like Darwin is just being validated yet again ... Nature has a way of culling out the weak or vulnerable, despite our modern medicine's best attempts to grant everyone immortality. We weaken our own gene pool by increasing survival time for lots of people who would have otherwise died early in life, and then act surprised when Nature (or Chinese virologists) find a way to sweep through and clear the decks again.

PPE, education, and behavior can only do so much. Living in sardine-like big cities may not be the best adaptation modern man has come up with, particularly in a globalized world with international trade and travel.

Aesop said...

@Charlie,
"As for pop density, living in the middle of that is a choice. Kung flu is just one of many problems inherent with being the thick of that kinda crowd. No thanks.

I get ya'll are having some serious problems, but we are not. And hopefully won't.
"

Bonus points, and a grade of 75%. That's a C+ most times and places.

Now, a few notes:

1) Hope ain't a plan.
2) The word missing from your penultimate line was "Yet".
This disease has spread to islands in the middle of nowhere, and ships at sea. There's no magical rainbow that's going to keep it out of Pigknuckle and Podunk either. It'll just take longer to get there.
3) Living in BFEgypt is a choice too. You'll have fuck-all for resources when your day comes, having 1/10th to 1/100th the medical capacity or resilience of any megalopolis in this country. So you'll do orders of magnitude worse, with much higher rates of death among the severely infected. That means you'll lose 5% or 10%, instead of 2.5%. From a smaller subset, but you'll likely know them personally, in comparison. And you won't be shipping anyone off to Big City, because their capabilities will already be toast.
That's the 25% of this you didn't get. We're getting our asses handed to us daily, despite every resource known to man available within arm's reach. You won't have any of that when your day in the spotlight comes along. Not the most capacity, the most reserves of supplies or personnel, the most beds, nor the best and brightest (or likely any) specialists. You'll be dealing with this with country practice GPs and family practice guys, PAs, a few paramedics, and a lot of nothing else, unless you want to bring veterinarians and dentists - or worse - into the mix. And you're the archtype for everyone who's not dealing with what bigger cities are - yet.
4) Yes (and this was news to me, until I saw that same graphic), CA may, indeed, be getting a leg up on our illegal problem. To a very small degree. It's killing them by the dozens, maybe even hundreds, statewide, but not by the millions.
So work with me for 15 seconds: what happens when this overwhelms the nations that stretch unhindered from Brownsville and San Diego all the way down to Tierra del Fuego, and they all decide to unass their AO, and come north in droves to the Land of the Big Hospitals and the Endless Welfare Teat Of Plenty? What happens here in megalopolis? What happens in Bumfuckia? What happens everywhere in between? Bearing well in mind that we can't keep them out (and have no national will to do so) in the best of times? I'll wait, while you puzzle that one out. Cheer up, man, your epiphany will still come a month before it dawns on most people, and two months ahead of TPTB.

Aesop said...

@Sgt. Sausage,

We sent all students and all volunteers home when this wave began, back just before Thanksgiving. We had nursing students, paramedic students, EMT students, and a full corps of hospital volunteers, and I had stayed over into day shift the very hour they sent them all packing, "immediately", at about 10:30 one bright Monday morning.

It is unethical and indefensible to ask students and unpaid staff to risk potential death or serious infection amidst a pandemic, doubly so because they simply haven't the experience nor training to be expected to deal with things like donning and doffing PPE and moving amidst and in direct contact with the exact hordes of seriously infected patients we're now dealing with. They wanted to stay, and we wanted them to stay, but they do not have the requisite training at this point to be put at risk.
It's also dumb to ask them to do so, despite their lionhearted wish to be of help.
And there simply isn't enough PPE for them too.

Not to put too fine a point on it, the risk management lawyers, and infection control specialists wouldn't (and shouldn't) sign off on it either, both for the immediate problems, and for downstream liability and lawsuits.

BTW, the average age of most hospital volunteers is 68.

Thanks for asking, and showing the intrinsically American trait not shared by a lot of internet blowhards: "What can we do to help?"

BTW, the sole exception to sending everyone home has been medical students and medical residents, i.e. future doctors, and babygrad doctors who still have new car smell on their diplomas.
Remember that the next time you think that doctors are a bunch of selfish greedy sumbitches just out for a buck: docs and future docs, most of whom won't ever get any closer to emergency medicine than now, or when they have a heart attack, simply show up for work like they always have, for less than minimum wage, and amidst a raging pandemic, because that's the career they've chosen.

Those are the 20-somethings (along with anyone who swore a certain oath and put on a uniform) in whose hands I have no trouble consigning and entrusting the future fate of the country.

Anybody wants to tell me "Doctor X is a dick", go ahead on. Some people are dicks.
Anybody wants to tell me all doctors are dicks, is going to need a good one, and a dentist, when I get done with him.

When things get really bad, it'll be Italy last spring, or Liberia during Ebola: they'll need peole to help shift the body bags, and they'll tell the final-year nursing students: "Congratulations, you just graduated six months early. Tomorrow, you report to Hospital XYZ for your first shift. Good Luck."

Aesop said...

@ruralcounsel,

You may wish to reconsider your premise in light of this:
https://apnews.com/article/us-coronavirus-deaths-top-3-million-e2bc856b6ec45563b84ee2e87ae8d5e7#:~:text=But%20preliminary%20numbers%20suggest%20that%20the%20United%20States,all%20the%20deaths%20from%20this%20month%20are%20

Trauma deaths this year, i.e. car crashes, other accidents, stabbings, and shootings are waaaaaay down over average times. Notably so.

Those deaths are being replaced by 40-50-60 years olds with nothing but COVID pneumonia.
The people who might have died in December or next spring with heart attacks and strokes with 3-10 underlying pathologies, which don't just kill people in swaths every day, were dying of COVID pneumonia and cardio-respiratory failure in great swaths, last April-May. Except we're getting more now.

When deaths, anywhere, in any given country, hit 1440 or more per day from one specific cause, people are dying at one/minute. That's definitely not average, under normal conditions, when it becomes the death rate in smaller areas than that from anything. (FTR, the death rate from Everything, i.e all causes combined, most years, runs about five-six/minute for the U.S.)

Anecdotally, the number of people who die in any ER I've worked in, is usually less than 2/shift, worst days. The rest of the hospital might be 1/day, total. Most days, no one dies. We're bagging and tagging people multiple times/day now hospitalwide, routinely. That's absolutely abnormal.

The people who look at national death numbers and figure we're automagically just calling what would be normal deaths COVID deaths are fucktards, first class. (Not saying that's you, because you're not.) But I keep seeing that horsesh*t in the blogosphere enough times that It's A Thing:

Stupid People Are Stupid Because They Don't Know What They Don't Know.

SecDef Rumsfeld was one of the brighter ones when he called those unknown unknowns.
(cont.)

Aesop said...

(cont.)
But yes, more or less, the pandemic deaths, which are pandemic deaths, not disguised and made-up deaths, are replacing to a rough equivalency those deaths we'd normally get in any year. Which phenomenon is exactly hiding the magnitude of this to those who aren't as bright as they think they are, and aren't afraid to speak from their fund of massive ignorance.

And the key difference being, I can probably avoid dying from lightning strikes or snakebites by not going stupid places and doing stupid things to win stupid prizes. I can freely choose not to be in the hood, or not getting money from the ghetto ATM at 2AM, or not crossing the street drunk across a busy highway blindfolded. I have some choices there, that make a yuge difference in my personal outcome. What I can't do is go out in public and do my daily activities, and choose not to breathe. Since I can't get stupid people to agree not to exhale, asking them to wear a spit mask in public places is a small compromise that doesn't impinge on their basic freedoms amidst a pandemic. But they're stupid, so here we are.

At my mostly-neglected Other Blog, I specifically note that working in the E.R., I'm a lifeguard in the shallow end of the gene pool, 24/7/365/ever.
I've reached the point in my career where I'm willing, in fact itchingly so, to let some of them slip under without any second thoughts or regrets.
(E.g., in this pandemic, any drug overdose should be stamped "DNR" - Do Not Rescuscitate - on the forehead in indelible ink, and left to decompose where found by EMS. And the FDA should ban all Narcan administration for the next 12 months, to cull the herd of a lot of wastes of skin and oxygen, for a generation. Public intoxication that lands you in the ER should be an automatic assignment to a chain gang starting the morning after, with summary trials conducted on the ambulance ramp of the hospital, for a six month stint of hard labor filling potholes in the desert in summer, and shoveling mud and snow all winter, full 180 days, sunup to sundown, Monday-Saturday, no parole for anyone, neither age nor gender considered. The second offense should be a yearlong stint in the state prison, same punishment, felony conviction. I doubt we'd ever see a third offense. "Change My mind".)

And Blue Oyster Cult got their lyrics right (although the absolute numbers may need some adjustment):

"40,000 men and women every day;
Don't fear the Reaper
..."

I've got a fever.
And the only prescription is more cowbell.

Unknown said...

Termite,

It could be that taking the videos down is some great evil plot, but there's a simpler explanation too: the videos were taken down to keep the anti mask brigade from self-diagnosing as immune and using that to decline to wear a mask.

It doesn't really matter to me whether or not anyone is immune. I would like to know if I am because if I am it's time for me to switch careers into the medical field. Not because I like people or really want to help them - as the last few months have made it abundantly clear that most people are not capable of giving a tinker's damn about anyone other than themselves - but if I could keep my loved ones in the medical field out of the plague pit by working in it myself under merit of being able to be around patients who have it and not get it, that would be great.

Back when this first began, I had to endure people self diagnosing as having already had Kung Flu because they had a bad head cold that wouldn't quit for a couple of weeks and therefore they had had Kung Flu and it was nothing to worry about. Not on the basis of any distinguishing symptoms, like loss of taste and smell, but just "my cold wouldn't quit."

So yeah, I would have yanked the videos too, before people seized on them as a self diagnostic tool to get themselves out of wearing a mask.

Incidentally, did the videos happen to mention if the immune were able to still carry the disease? Because technically Typhoid Mary was immune too. Her being immune didn't exactly help anyone she was making dinner for.

~Rhea

Aesop said...

Rhea,

Had to explain the facts of life to a baby duck nurse @ work.

Me: "Just because you get the vaxx, doesn't mean you can't pass this on to other people."
Baby Duck Nurse: "That's not true! If I get the shots, I can't pass this on! It's impossible!!!"
Me: "Okay, Stud, So you handle your patients, or a dirty shopping cart handle, or track in onto your shoes, and then take it home and give it to your wife or kids. Explain to me how your shots stop any of that...?""
BDN: >blinks< Dead silence. Walks out of the station.

BAP45 said...

What PPE are you short on? I've been seeing pretty good quantities of N95 etc at some of my store locations.
Still surprised how bad LA has been. Just east or south of you and the reports we usually hear are "pretty busy but nothing excessive"

Toirdhealbheach Beucail said...

@ Tobias - Your question is one that I have asked on another site where an author related their experience of actually, verifiably having Covid. The response from a fair amount of the commentators was exactly as you stated: Hate. Virulent, hate, calling them an outright liar.

I do not understand this. If every person that expresses a contrary opinion has now become a vessel of ire and wrath, then what hope is there that in any kind of "real" (to use their term) emergency, the people you have called liars and idiots are going to rally to you or support your cause?

As Aesop has stated numerous times, the virus can be real and the government response can be terrible and objectionable and both things can exist at the same time. The fact that - at least from what I am seeing - many people cannot deal with this fact simply depresses me.

At the risk of asking a rhetorically foolish question, if you do not trust health professionals about this, will you take any of their advice about your health in the future? Or only what comports with your own personal pool of knowledge?

Peter B said...

"Anybody wants to tell me "Doctor X is a dick", go ahead on. Some people are dicks."

And some, but not all, of those dicks are good at what they do.

My late stepfather (45 years practicing medicine) told me years ago "You don't hire a surgeon for his bedside manner."

Aesop said...

@BAP45,

We regularly burn through so much PPE, that frequently what they're passing out as serious protective apparel are multi-colored plastic rain ponchos (kid sized, with sleeves that end at my elbow) that you would normally buy in an emergency, from a souvenir/taco cart, for about a buck apiece during an unseasonal downpour.

That's been happening for months.

When I'm caring for four (or more) known or suspected infected patients, each sealed into their own plastic bubble, I may have to go into and exit each room 10-20 times a shift, each. That means for me, personally, I'm potentially going through 40-80 cover gowns in a 12-hour shift. Or more.. There are 24-48 of the decent ones in a case. There are 8-12 nurses, 4 techs, and 6 doctors/PAs per shift. Plus RTs, CT, Ultrasound, and XRay techs, registration personnel, and various admitting/attending MDs. Call it 30-40 people.
That's two pallets, 30" x 48" x 60" high, per 12-hour shift, in a moderate-sized ER.
Minimum.

We're lucky if we get issued two cartons of gowns per shift for the entire department. So obviously, people aren't getting enough PPE to safely do their job, and getting that quantity would clean out entire warehouses, daily.

Times every other department and floor in the hospital.
Times 120 hospitals just in the two of the most populous counties in SoCal.

Then figure out what that looks like at the other end, when they take out the trash.

And we haven't even mentioned head coverings, shoe covers, and surgical masks.
N95s, formerly single-use pre-pandemic, are now worn until they're no longer usable, crushed, and soaking wet with perspiration and exhaled breath vapor, thus no longer of any use.
Because otherwise, you throw away your mask, and there's nothing to replace it.

That's been an open scandal in every hospital dealing with this since Day One, but no one wants to adress the reality of it, from bedside to Congress.

Charlie said...

@aesop

There are locations between shoulder to shoulder population density and bfegypt ya know. Your coastal bias is showing! bwahahaha

Outside Cleveland OH actually.
And though I trust npr as far as I can throw a uhaul truck full of tax dollars.....

https://www.npr.org/sections/health-shots/2020/12/09/944379919/new-data-reveal-which-hospitals-are-dangerously-full-is-yours#lookup

Shows county avg for kung flu beds 17% and overall beds filled at 67%.

While not as insane as newsome, dewine has done his best to promote, create and perpetuate the panic to the best of his tyrannical abilities.

I have not seen any tictoc dancing nurse videos out of Cuyahoga county yet. What I have seen personally is we are having a very hard time getting my mother in law an appt with new doctors.

streamfortyseven said...

I've got a box of N95s at home, they're used, coated in sawdust, which comes off with a vacuum cleaner. I use one of those when I go out grocery shopping, once a week, for 20 minutes, max. I got into a convo with a frontline doc in Rhode Island, he told me I should send him the box, I told him he shouldn't screw around with paper masks, instead ordered one of these - https://www.mirasafety.com/collections/frontpage/products/cm-6m-tactical-gas-mask - with filters, of course - for him. With discount, it only came to about $270. I've got the money, no big deal for me, but a potential lifesaver for him, so I just went ahead and did it. Hospitals are making scads of money off of this, they ought to be providing their staff with similar protection, for some reason or other, they're not.

and here's some boilerplate which I regularly post, to what effect I know not: "A big part of this is knowing who can spread the disease, and even though it's been known for months how to do this in a minimally intrusive manner, the US government isn't doing it, because there's more money in doing things the way they're doing them. Simple, cheap stuff, like measuring endogenous D3 levels, then giving supplemental D3 by injection, or by daily supplementation - a year's supply of D3 at 2000 IU per day is a bit over $10; supplemental zinc at 30mg/day, plus green tea or quercetin (zinc ionophores) - maybe $40/year; vitamin C, 1000mg/day - $20/year; vitamin B in stress formulation - a year's supply less than $10. And antigen testing with paper strips - $1 to $2 per day... Box fans in gatherings provide good ventilation which reduces viral load. ”FOR PUBLIC-HEALTH PURPOSES, speed and frequency of testing are vastly more important than sensitivity: the best test would actually be less sensitive than a PCR test. As Mina explains, when a person first becomes infected, there will be an incubation period when no test will reveal the infection, because the viral loads are so low. About “three to five days later, the PCR test will turn positive, and once that happens the virus is reproducing exponentially in a very predictable fashion.” At that point, critically, “even if a rapid test is 1,000 times less sensitive than a PCR test,” Mina says, the virus is increasing so rapidly that the test “will probably turn positive within eight to 15 or 24 hours. So the real window of time that we’re discussing here—the difference in sensitivity that makes people uncomfortable”—is so small that public-health officers would be missing very few asymptomatic people taking the test in that narrow window of time. Given that the current testing frequency in most states, using highly sensitive but expensive and delayed PCR tests, is not even once a month, he points out—“Really, it’s never.”
So even though a saliva-based paper test wouldn’t register a positive result for as long as a half or even a full day after the PCR test, it would have great value in identifying pockets of infection that might otherwise be undetected altogether.
The strength of this system is that it would actually abrogate the need for contact tracing, says Mina. “If your goal is not to have a heavy hand over the population” (implementing onerous public-health restrictions on businesses and recreational activity), this is the way to do it, he explains, because it strips away “all of that complexity.” Most people who test positive will have done so before they become infectious, and can easily self-quarantine for the six days or so until they cease being infectious. Even if some people don’t quarantine, and the test cuts off just 90 percent of all the infections that might spread, “you’d immediately bring the population prevalence of the disease to very low numbers, to the point where all of a sudden society would start to look safe again.”
https://harvardmagazine.com/2020/08/covid-19-test-for-public-health

Aesop said...

@Charlie,

I'm aware of the entire gamut of pop. densities, and nothing hereabouts could be described as "shoulder-to-shoulder".
I have no such "coastal bias", either.

I'm simply telling you what is, hereabouts.
And unless someone has a Magic Force field, what other areas can eventually look forward to.

Even vaccinations (for those who'll even get them) won't spread to the hinterlands for most of next year, but the virus can get there via one person in less than a day, and in most cases is already there. And last I looked, malls in the hinterlands look and function just like malls do in the big city.

Which, yet again, is the ultimate point.

Aesop said...

@streamfortyseven,

Besides mil-spec field protective masks, I've got a 3M mask like that.
The problem, besides intial outlay, is that they each require full decon, each and every time you wear one into a "hot" room, before you can bring it out.
Otherwise, you're just spreading the virus around to "safe" areas every time you fail to do that.
10-80 times/shift/person.

And we stopped having decontamination wipes available in any quantity around April.
No, really.
Still haven't got anything like enough of them.

As a wise cleaning guru explained to us in Basic Training: "In order to get anything clean, you have to get something else dirty."
TANSTAAFL
All high-tech high-price masks do is shift the cost over to disposable wipes instead of disposable masks.
Decent rain gear would replace iso gowns too, but with the exact same problem.

So, what's your other idea?

Believe me, if there was any cheap, easy way to do this, we'd have found it long since.

BAP45 said...

It's a drop in the bucket at those quantities but Ferguson plumbing locations have been stocking some of the N95 and booties. No gowns that no one buys so there's a decent quantity sitting on the shelf. No one really shops for ppe there and usually only trades people come in normally anyways. So it could at least help supplement your staches

streamfortyseven said...

Disposable everything is pretty stupid, actually, when we know that 70% alcohol to water kills the virus. So what you do is get cloth towels, and a jar, one per person, stick the cloth(s) in the jar with enough alcohol/water mixture to cover them, take one out, use it, stick it back in. Same case for gowns, use cloth, and run it through the laundry or autoclave it. That way you aren't generating a mountain of hazardous waste. Your entire ward - not just "hot rooms" - is going to be a hot zone, like it or not, because you've probably got a ventilation system running - sort of like cabin air on an aircraft. If you get pts who don't have covid, keep them far away from the covid ward and its ventilation system. See this for other ideas - the guy who made this works in LA, you might have heard of him - https://www.youtube.com/watch?v=NM2A2xNLWR4

Hell, you could get a MOPP suit and set up a decon shower, and that would fix things, too, figure out some sort of positive pressure scheme so you have The World, a transition zone, and the ward.

And, as I've said several hundred times, and no one can possibly understand, we need to pinpoint who can spread it, there's a cheap and easy way to do this - see https://www.youtube.com/watch?v=CjphzlV5DYo - and you can use this to cut down on the number of people who need to show up in the first place. Or we can keep doing the same as we've been doing for the past 9 months, and expect a different result. Good luck with that.

streamfortyseven said...

BTW, the reason for all of those Hispanic people coming in is that they probably have low levels of endogenous D3 - they get out in the sun, and they don't make as much as people with white skin. Same case for people with black skin. So the smart thing for your public health people to do is to go out into the Latino community and measure endogenous D3, if deficient, give a bolus, otherwise send them out the door with a bottle of 2000 IU D3 supplements - 2 per day, a bottle of zinc supplements, 30mg/day, and green tea (zinc ionophore). See https://www.youtube.com/watch?v=ha2mLz-Xdpg for details.

Granny Nonny said...

In good news for this rural county, the active hospitalizations and deaths remained steady even after what I would have expected from a Thanksgiving surge. People around here are mainly mask wearing and cautious though. California rural may be different from rural in Nebraska, possibly. What also may be helping is that people move up here to be alone a lot of the time (we have a large share of writers and researchers living here), and so their lifestyle has seen no real change except that now this county finally has Door Dash and Instacart even out to the more boondock areas, which makes distancing even easier.

I watch the Coronavirus dashboard daily for this county and cases are even leveling off in the Eastern part of the county as it gets socked in by lots of snow.

I miss suburbia a lot of times even after a decade of living up here (mostly just the silence can get to you after a while if you were raised around airports and traffic), but Aesop, please do consider a move to at least the hills of this state when you can. I've been to the hospitals here and they're lovely and you might prefer the slower pace here comparatively. In fact in comparing the ERs here to say, Stanford... I would choose to work up here if possible once I was over the 40 year old mark, really. The work is still there, but the "on the edge" feeling isn't. So hopefully you consider getting out when you can, though I do appreciate how much work you're putting in now and salute you for it.

Aesop said...

Actually, every room in the E.R. is isolated, with a dedicated negative-pressure HEPA-filtered air handling system.

It took them until now to get there, but 9 months is better than never, right?

Gowns have to be fluid-resistant, so if not disposable, you're talking about MOPP suits.
No one who's ever worked in one for more than 15 minutes would ever suggest trying it for 12-hour shifts, for months on end.

It would be quicker to save time, and simply execute all staff members and patients with a pistol shot to the head.

And jars of alcohol and using medical oxygen, in a department where we're defibrillating people during full arrests?
What could possibly go wrong with that plan?
Google "Apollo I", and get back to me. I'll wait. :)

@Granny Nonny,
The site of the future Camp Snoopy and Castle Anthrax are, in fact, in the Sierra foothills, far from flatlanders and cityfolk. If I had the wherewithal to retire there now, early, I'd leave skidmarks out of suburbia, pull up the drawbridge, and leave out the "F##K OFF!" mat at the gate.

I already have a sign posted at the fence line by the gate:
https://www.amazon.com/Property-Protected-Marine-Poster-7-8X11-8/dp/B07NVCZ3RC

Miss Conduct said...

Yes, we're all very stupid for not wanting to sacrifice the whole country to make your workday easier. We know you have our best interests at heart because you talk about covid only in terms of how hard it all is for YOU. We should believe everything you say.

Only medical professionals demand both sympathy AND worship (and more $ ofc) just for going to work in hard times. Working-class stiffs in high-fatality-risk jobs BTFO.

Night driver said...

SGT SAUSAGE:

I'm a trained and experienced Paramedic (street experience) as well as clinical experience (ED and ICU experience), understand PPE and donning and doffing all the goodies, and have been trained in a number of "beyond certification" interventions and procedures. Insofar as volunteering in a hospital environment I would VERY strongly suggest find some other way to help. Like in Logistics. warehouse. Security or Parking enforcement.

If you don't have clinical experience, lose it when someone decides to profusely bleed all over the floor and yourself, you don't want to be in a clinical area.

In all honesty, my local neighborhood hospital would have to quite literally shanghai me or the bride (both of us have equivalent experience/training profiles and the ER guys know our histories) to get us to help. We wouldn't have said that 20 years ago but we've both learned a thing or two. And also learned a thing or two as to co-morbidities, and additional underlying issues.

Aesop, your folks were ABSOLUTELY RIGHT when they tossed all of the student-anythings out the door. Hopefully they deconned them on the way out.


Night Driver---who praises the Lord regularly that he landed in an over-hospitalled city. Cleveland Clinic, University Case, Metro General, and 3 or 4 others are here.
And given the scuttle-but out of UH-Case and CCF, I expect to see the Corps slide through in stealth rebuilding mode to replace the expansion locations they built last spring and demobbed.

Aesop said...

@Butthurt Brunhilda 10:03A,

"Yes, we're all very stupid..."
So far, just you.

"for not wanting to sacrifice the whole country to make your workday easier."
Feel free to point to where and when that was ever remotely suggested hereabouts. [Hint: Never.] So far, your shit-for-brains score is off the charts.

"We know you have our best interests at heart because you talk about covid only in terms of how hard it all is for YOU."
So, you not only have shit-for-brains, you've never read a single other thing I've written about it here, going back to weeks before YOU even heard of it. If you're going to be this big a shithead in one post, you're going to break the meter. have you ever thought about running for congress? Or maybe getting a job at CNN? You're clearly overqualified for either position.

"We should believe everything you say."
You can't even summarize what we say, and never read anything in the above post, for certainty, but we have no doubt you're usually gullible enough to believe whatever you read last. Unfortunately, it was nothing we wrote. What I expect is that if you can provide counter-arguments to anything we said, you try presenting them. You have an entire post above: feel free, with carte blanche to provide an argument to anything in this post, and provide the evidence for your contentions. I know you were sick that day in school, but that's how intelligent people discuss and even disagree, instead of getting snarky, while lacking so much as a single valid point in an entire reply. Forget Congress; go straight to journalism school.

"Only medical professionals demand both sympathy AND worship (and more $ ofc)"
Assumes facts not in evidence. Sorry you couldn't get into a better career field with a 325 on your SATs, but someone has to scrub those shitters too.

"just for going to work in hard times."
Assumes more facts not in evidence. I haven't seen any "easy" times yet in 25 years. But I will admit to putting a lot more people into body bags this year than in any year up to this point. Since you seem to know so much about a career field you couldn't achieve, tell me more.

"Working-class stiffs in high-fatality-risk jobs BTFO."
I've been in high-fatality-risk jobs my entire adult working life.
So unless you work in either coal mining, logging, chemical plants, or oilfield production/refining, I've got you beat, for only about the last 40 years.
Nobody in those occ. fields would be likely to sound as butthurt about anything I wrote, so in your case, yes, please, do BTFO. And DLTDHYITAOYWO.

Now do the world, and particularly this blog, a big favor: Either learn to comprehend what you read before you kneejerk reply to it, and do a faceplant in a giant puddle of fuckup; or else get back on your broomstick, and fly back to whatever bridge from under which you crawled. You're just wasting bandwidth and embarrassing yourself, and have yet to explain any quarrel with anything posted here not based on your scorching case of hemorrhoids. I'm not a proctologist, but I feel safe in suggesting that both your 'rhoids and your problem would shrink the sooner you pull your head out of your ass.

Hope that clears things up for you.

Michael said...

Aesop I'm unsure If I read your blog for the information (which is good as I have the medical knowledge and research skills to confirm the juicy bits you post) or the ROTFLMAO reading the few butthurt idiots you allow though your moderation and your cats playing with them.

I suppose thing being SO WONDERFUL in 2020 (sarc) Laughter is a good thing.

I hope you have several ways to Camp Snoopy aka Castle Anthrax in case things go sideways quicker than you and I think. I also hope you don't need to stop at the house on the way as you flee work (And WHAT % of our lives are we there eh?) heading out to the *Ahem* bathroom to exit stage left....

BTW what happened to the Kraig rebuild? Are you still in the market for a 40 watt plasma rife?

OH well last day of the year BFD so I shall send in my seed orders for the next two years.

Charlie said...

So unless you work in either coal mining, logging, chemical plants, or oilfield production/refining, I've got you beat, for only about the last 40 years.

I think bridge painting beats those.

From Norway said...

I am reading the LA county pdf and I can see the shit flying after hitting the fan. 26 ICU beds for a population double than my country is not enough. Don't you get hurt attacks or perform transplants or almost drown or stuff like that over there? People are going to start dying of a lot of normally preventable issues soon. And that is nothing compared to corona patients. If 10% of corona patients need hospital, when there is no hospital, 10% of corona patients are going to die.

I do not envy your situation. It looks like your hospital system is going to collapse like in Bergamo and Milan or Madrid. Things get really bad. In Madrid they had to repurpose the ice skating ring as improvised morgue. Not a nice thing to see.

Aesop said...

@Fra Norge,
That sums it up exactly. Which grasp merely underlines how much better public education is in your country than it is in this one.

@Charlie,

Not according the Dept. of Labor. YMMV.

@Michael,
The Krag remains on the workbench, a work in progress. Several other things intervened (shock! surprise!), but as soon as I can spare some attention, and secure a couple of other items for doing it right, the sheet comes off the bench, and I'll finish it up, with suitable before and after pictures, I hope.

At the moment, I cannot justify spending the time on a rifle for which I possess no cartridges (which will change at a suitable time), so for now it's merely a history project. At the moment, rather more pressing engagements occupy the center of my attentions, starting with a literal rack of first-line mil-spec items, and getting Fort Apache into shape, should the year decline into what I dread it will.

Alas, the PowerBall Overnight Retirement Plan worked out exactly as mathematics foretold (i.e. another $2 shot to hell), so I'm left with only Plan A to get to where I want to be: work, save, and prepare. I can spare a bare two minutes for the occasional dipshit troll who's never been here before, but not the several hours or several days to finish the rifle the way I see it in my mind's eye.

Tom Bridgeland said...

Here, Illinois, we seem to be past the hump. There was no Thanksgiving bump, so hoping the same for the winter holidays. Our ICU and stepdown units are at capacity but have not, quite exceeded, mainly by putting what used to be stepdown patients on the telemetry floor. We try to keep one ICU bed open for heart attacks and usually have one. Telemetry, where I work, is about 1/4 covid pts.

ICU staffing is bad. Many quit this winter, since we are getting no bonus pay, and other nearby (Chicago) hospitals are paying big bucks.

We are seeing a return of the 'regular customer' patients, which for much of 2020 were not much in evidence. Patients that during the first surge last spring would not have been admitted are being admitted again, which is highly annoying for the nursing staff.

N95s are provided once per 4 shifts, and gowns are silk that is used once then laundered.

We got the Pfizer vaccine just before Christmas, and will be getting the second shot in a few days. No side effects at all for me.

kurt9 said...

Do Hispanic people have greater susceptibility to COVID-19? I've heard Native American people do. Its believable that Hispanics, being either Native American or Mestizo mix might as well.

Aesop said...

I could be that, but I think it's more a function of sociology than biology:

Larger immediate family households, greater lifespan continuum under one roof (0-80+), poor scientific knowledge, general lack of education, lesser access to healthcare, and greater financial instability which necessitates working at risk.

It's a hazardous concoction to suffer amidst a pandemic.

From Norway said...

I am sorry for you. Collapse seems to have happened. This morning in the newspaper over here say that LA ambulances are not to take patients into hospitals if they seem that they are not going to make it. Now the life of LA people depend on the judgement call of an ambulance driver.

Aesop said...

It isn't quite that bad. The actual instructions are not to bring people in who are clinically dead, with poor chance for recovery from continued resuscitation. And that would be a paramedic, overwhelmingly a fire department paramedic in nearly all cases, and his crew, so you're talking guys with 5+ years medical on-the-job experience, but that in itself is bad enough.

The next step will be when doctors start telling us which patinets come inside the hospital, and which ones start getting left outside with no treatment. We're not there yet, but you can see it from here.