Covid virus in phoenix (homeless, buildings, Hispanic)
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
The PPE issue you describe is nuts. Seems like the type of precautions you'd take with Ebola.
Ebola requires “contact” precautions- the lowest level of PPE - below “droplet” precautions, which is what is required by cdc for covid.. Ebola is less infectious than covid, even if the infection itself is more often fatal than covid.
unless you’re testing for covid with a swab up someone’s nose - which requires “airborne” precautions- simply because the act of sticking a swab up someone else’s nose almost guarantees that you’re going to make them cough & that will “aerosolize” the virus if they have it. This is why you’ll see workers in bunny-suits & tents with negative pressure in covid testing areas.
Changing all of your PPE after every encounter with a suspected patient, preferably with a “spotter” present is standard, good practice of healthcare & isn’t “wasteful” or wrong..
If a healthcare worker makes the last patient they had cough, then they bounce up to you in the same PPE, or re-uses any of the gear they used on the last patient on you, they’re risking your health.
Think this through.. If a positive patient coughs and covers the worker with droplets, then they touch you or anything that touches you - one wrong move & you’re infected.
Having “enough” PPE to put on one gown & proper n-95 respirator for a 12 hour shift isn’t actually having enough PPE. It’s only having enough PPE to put on a safety “show” for the public. This really isn’t any different than the “security theater” show that the TSA puts on at airports- lots of staff with fancy costumes picking on people for having nail clippers & batteries, and missing 90%+ of the actual firearms that pass through a checkpoint.
I pulled some shifts as a nurse at a nursing home recently.. the new (and unsafe) procedure is to take your gown off, leave it in the room with a “suspected” patient & put it back on the next time you enter the room. And, to wear the same Chinese “kn-95” mask for twelve hours and “avoid” taking it off or touching it for 12 hours. Try that sometime & get back to me if you’re able to do that.. hint - you’re going to contaminate yourself and everyone else that you’re in contact with. There’s no effective “procedure” for re-using PPE, there’s no effective and safe way to do it. Even if you personally were able to do it, you’re going to get contaminated by others who don’t do it as well as you.. they’re going to touch something that you touch during their shift, and then the party is on.
I work in a nursing home and the AZ governor has issued an executive order that we are required to take our COVID-19 patients back. We're resisting but the hospitals are fighting us tooth and nail. We have hospital executives visiting us to meet with our Executive Director demanding that we take COVID-19 patients back. We're under tremendous pressure from the hospitals and the insurance companies to take COVID-19 patients and put our other healthy residents at risk. Executive Order 2020-22 item #3.
We're not receiving PPE to care for covid patients like the hospitals are. All the medical supply companies are prioritizing the hospitals over everyone else. Our staff are forced to wear surgical masks over and over for multiple days. I went to be tested at a Banner testing site and I could not believe the amount of PPE being wasted during my short 15 minute visit. The gal checking me in on the computer changed her mask twice while I was with her and I was only with her for 5 minutes at the most. She would walk into a shaded and air conditioned tent and each time she would take off the mask and discard it and put on a new one when she came out. The five nurses in the testing tent remove and discard their gowns, gloves, and masks after each test given. Even though I only dealt with one nurse that gave me the test, there were five in the tent during my test and I watched them all change their PPE prior to me driving into the tent. The hospitals have the PPE to behave like this, we don't have enough to get through the day and we have to ration to accomplish that.
I agree that covid patients shouldn’t be in facilities that don’t have dedicated covid units - and those covid units need to be stocked to the gills with PPE and heavily over staffed to allow the PPE to be actually used properly. It isn’t humanly possible to don and doff PPE fast enough to care for 20-30-40 patients per nurse as is the standard in ltc currently. One nurse & one CNA per 10 patients might be do-able, but still exhausting..
What you witnessed as far as PPE wasn’t wasteful, even if it was alarming based on how unavailable PPE is right now.
True story - I’m a nurse & had the “pleasure” of having a CMS “survey” at my last gig in dialysis. For those that don’t know, a “survey” is when the feds send a team of people in to selectively and unobtrusively watch everything that staff does related to safety and infection control- to see if staff is following their company procedures.. within minutes of their arrival, a surveyor had determined that I was the newest staff member and therefore they wanted to watch me “put a patient on” the dialysis machine, and that patient should be using a “dialysis catheter”.
That process isn’t actually “sterile”, merely “clean technique”, even so - the procedure requires seven glove changes in the best case, more glove changes if you do the steps out of order, or touch the dialysis machine, etc. My dialysis technicians routinely “put a patient on the machine” in less than 10 minutes, whilst carrying on a chat about new recipes, the weather, etc, without breaking a sweat. And they did their glove changes seamlessly - since I’m the nurse, I’ve had to watch each tech do it, when they don’t know I’m watching - to protect our patients & my license.
In front of a surveyor, I think my patient took closer to 20 minutes - the surveyor actually snorted and left while I was still programming the machine - I had made a couple of minor mis-steps like touching the machine (to stop the beeping) that required extra glove changes.. There’s no penalty except time if you make a mistake, you just have to change your gloves again..
The point of the story is that even someone who’s specifically getting paid to make sure you change your PPE enoughtimes can get frustrated at how long it takes to do it properly and safely. The natural temptation to skip a glove change can kill a patient in just a few days.. That’s just normal, pre-covid, PPE usage.
Covid is abnormal & requires workers to think every step through completely, every patient encounter - especially if they’re compromised, like everyone in ltc is. So even fetching someone in ltc a cup of ice is just as dangerous as accessing a catheter that we used in dialysis - if there’s even one patient in the building with covid. Skipping a glove change, or touching that mask you’ve been wearing all day, (or multiple days) can kill vulnerable patients.
Ebola requires “contact” precautions- the lowest level of PPE - below “droplet” precautions, which is what is required by cdc for covid.. Ebola is less infectious than covid, even if the infection itself is more often fatal than covid.
unless you’re testing for covid with a swab up someone’s nose - which requires “airborne” precautions- simply because the act of sticking a swab up someone else’s nose almost guarantees that you’re going to make them cough & that will “aerosolize” the virus if they have it. This is why you’ll see workers in bunny-suits & tents with negative pressure in covid testing areas.
Changing all of your PPE after every encounter with a suspected patient, preferably with a “spotter” present is standard, good practice of healthcare & isn’t “wasteful” or wrong..
If a healthcare worker makes the last patient they had cough, then they bounce up to you in the same PPE, or re-uses any of the gear they used on the last patient on you, they’re risking your health.
Think this through.. If a positive patient coughs and covers the worker with droplets, then they touch you or anything that touches you - one wrong move & you’re infected.
Having “enough” PPE to put on one gown & proper n-95 respirator for a 12 hour shift isn’t actually having enough PPE. It’s only having enough PPE to put on a safety “show” for the public. This really isn’t any different than the “security theater” show that the TSA puts on at airports- lots of staff with fancy costumes picking on people for having nail clippers & batteries, and missing 90%+ of the actual firearms that pass through a checkpoint.
I pulled some shifts as a nurse at a nursing home recently.. the new (and unsafe) procedure is to take your gown off, leave it in the room with a “suspected” patient & put it back on the next time you enter the room. And, to wear the same Chinese “kn-95” mask for twelve hours and “avoid” taking it off or touching it for 12 hours. Try that sometime & get back to me if you’re able to do that.. hint - you’re going to contaminate yourself and everyone else that you’re in contact with. There’s no effective “procedure” for re-using PPE, there’s no effective and safe way to do it. Even if you personally were able to do it, you’re going to get contaminated by others who don’t do it as well as you.. they’re going to touch something that you touch during their shift, and then the party is on.
Ebola passes from clothing/bedding to people (per CDC).
CV from CDC:
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads, but we are still learning more about how this virus spreads.
Ebola passes from clothing/bedding to people (per CDC).
CV from CDC:
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads, but we are still learning more about how this virus spreads.
I’m well aware of that - “contact precautions” are the lowest-level of precaution necessary & that’s all that was required for healthcare workers caring for Ebola patients. Despite that, even with nurses in bunny-suits, negative pressure rooms & workers having spotters watch them put on and take off their PPE, we still had a couple of nurses get infected with Ebola.
Covid requires a higher level of protection & you’re not going to be able to provide that protection with re-used gowns & masks that you’ve been wearing for a week. That’s why it’s going to continue to spread in nursing homes and group care facilities - even if you had adequate PPE and enough of it, there are very few healthcare workers capable of maintaining perfect technique for a 12 hour shift, at the current staffing levels.
I think Ebola is the easiest way to explain the difference in infectiousness, because it’s so awful - if you got it, you weren’t going to be asymptomatic. But no one could give it to you by coughing on you. You had to touch something or someone - like your PPE when you were taking it off. Then, you had to touch yourself, without having washed your hands. Easy-peasey!
You know 100% that the workers caring for Ebola patients were being double-extra careful.. A couple people still got it, despite the fact that there were only a couple patients & everyone was pulling out all the stops to prevent it from spreading.
No one would have ever suggested that anyone re-use a mask, go in without one, or re-use a gown with an Ebola patient. Covid is easer to get, and we’re denying people masks. Suspending healthcare workers for wearing their own masks when facilities can’t or won’t provide them. Stuffing them back into facilities that can’t care for them without endangering everyone else in the facility. Bad stuff.
Last edited by Zippyman; 05-29-2020 at 12:08 PM..
Reason: More detail
I agree that covid patients shouldn’t be in facilities that don’t have dedicated covid units - and those covid units need to be stocked to the gills with PPE and heavily over staffed to allow the PPE to be actually used properly. It isn’t humanly possible to don and doff PPE fast enough to care for 20-30-40 patients per nurse as is the standard in ltc currently. One nurse & one CNA per 10 patients might be do-able, but still exhausting..
What you witnessed as far as PPE wasn’t wasteful, even if it was alarming based on how unavailable PPE is right now.
True story - I’m a nurse & had the “pleasure” of having a CMS “survey” at my last gig in dialysis. For those that don’t know, a “survey” is when the feds send a team of people in to selectively and unobtrusively watch everything that staff does related to safety and infection control- to see if staff is following their company procedures.. within minutes of their arrival, a surveyor had determined that I was the newest staff member and therefore they wanted to watch me “put a patient on” the dialysis machine, and that patient should be using a “dialysis catheter”.
That process isn’t actually “sterile”, merely “clean technique”, even so - the procedure requires seven glove changes in the best case, more glove changes if you do the steps out of order, or touch the dialysis machine, etc. My dialysis technicians routinely “put a patient on the machine” in less than 10 minutes, whilst carrying on a chat about new recipes, the weather, etc, without breaking a sweat. And they did their glove changes seamlessly - since I’m the nurse, I’ve had to watch each tech do it, when they don’t know I’m watching - to protect our patients & my license.
In front of a surveyor, I think my patient took closer to 20 minutes - the surveyor actually snorted and left while I was still programming the machine - I had made a couple of minor mis-steps like touching the machine (to stop the beeping) that required extra glove changes.. There’s no penalty except time if you make a mistake, you just have to change your gloves again..
The point of the story is that even someone who’s specifically getting paid to make sure you change your PPE enoughtimes can get frustrated at how long it takes to do it properly and safely. The natural temptation to skip a glove change can kill a patient in just a few days.. That’s just normal, pre-covid, PPE usage.
Covid is abnormal & requires workers to think every step through completely, every patient encounter - especially if they’re compromised, like everyone in ltc is. So even fetching someone in ltc a cup of ice is just as dangerous as accessing a catheter that we used in dialysis - if there’s even one patient in the building with covid. Skipping a glove change, or touching that mask you’ve been wearing all day, (or multiple days) can kill vulnerable patients.
It was most certainly wasteful. I only had one nurse involved in my test, the other four were just sitting in the tent and not part of my test. Yet they all changed PPE after each vehicle left the tent. I think they were rotating which nurse administered each test to each vehicle that entered the tent. The others that were not involved in my test should have left the tent and not required PPE until they gave a test. Instead all five sat in the tent in PPE and changed it when I left the tent. I watched this all happen while I was waiting (and watching) for the car in front of me to be tested.
I am social distancing but not wearing a mask, whether to shop, walk down the street or drive. When cops begin arresting me for doing these things, I will move elsewhere. I expect you will love the high taxes imposed to pay for the thousands of cops necessary to enforce the eternal face condoms.
If someone was shooting at you, would you refuse to wear bulletproof vests and helmets too?
I don't understand the rationale for not wanting to protect yourself or your loved ones from possible severe consequences of danger. We have a novel disease with no fool-proof treatment, no vaccine, and the only logical, sensible, and cheap reduction of the danger are masks. And we have people who think like this...what the heck?
If your car had a bad brake system and would likely fail at any time over the next month making you drive off a cliff, would you proudly do nothing about it and complain about the government enforcing safety standards?
Wearing masks helps you out, and your family, and other people. Yet some want to behave like a child and scream it's your right not to do the right thing and most sensible thing?
I feel like I'm living in a simulation world where the makers of this simulation are trolling with us players by throwing in non-sense and irrational behavior just to see how we would react.
If someone was shooting at you, would you refuse to wear bulletproof vests and helmets too?
I don't understand the rationale for not wanting to protect yourself or your loved ones from possible severe consequences of danger. We have a novel disease with no fool-proof treatment, no vaccine, and the only logical, sensible, and cheap reduction of the danger are masks. And we have people who think like this...what the heck?
If your car had a bad brake system and would likely fail at any time over the next month making you drive off a cliff, would you proudly do nothing about it and complain about the government enforcing safety standards?
Wearing masks helps you out, and your family, and other people. Yet some want to behave like a child and scream it's your right not to do the right thing and most sensible thing?
I feel like I'm living in a simulation world where the makers of this simulation are trolling with us players by throwing in non-sense and irrational behavior just to see how we would react.
It’s simple. It’s one of three things: They still think this is some sort of a hoax. They are stupid (maybe this should be 1.b.). They are selfish. I’ll certainly give a caveat to those with a medical condition that makes mask wearing impossible. Other than that, it’s a straightforward conclusion.
There is no doubt that there is a difference in brainpower. Follow the money.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
