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.
If you're having a heart attack and walk into the ER, they won't turn you away.
But being on bypass isn't some out of the ordinary thing either - it happens with regularity through the year, covid or no covid.
100% correct. I worked at a small community 300 bed + hospital. We've gone on bypass a couple of times, and once was for the H1N1 pandemic. It can happen for staffing issues as well. Now imagine your only hospital in a rural town with limited beds goes on bypass because it's over whelmed with Covid. What happens to that car accident, heart attack, stroke that comes in and there is no ICU bed available and the ER is full? Realize that you have to have a room with oxygen piped in to run a ventilator. You can't just pop them in the hallway. If every room is full they stay in the ambulance and they are turfed to another hospital. That also takes precious time. What if the nearest hospital is 25 miles away?
Here's an interesting scenario that I witnessed at that small community hospital.
A man came in with a full blown heart attack. He was intubated and I was breathing for him manually and we were on our way to the cath lab immediately. I called a fellow therapist to bring me a ventilator. She was setting it up and the cardiologist already had that artery open before she was finished setting up the ventilator. (guess who's my cardiologist ) Had he been delayed in that ambulance because Covid cases had over run the ER and available rooms, he would not have made it. He would have been collateral damage because of this pandemic. Don't think that there isn't collateral damage every day because of this virus. There is. We see it on the "fake news" where people are dying in waiting rooms from Covid because the hospitals are over whelmed. We saw the decisions that Italy had to make as to who gets a ventilator. The young one or the old one? You guess who. You know the answer. These are difficult times with difficult decisions that have to be made.
Our cases are exploding again here, and we all know that people aren't giving up their all important holidays. Many people are going to die because of it, whether you're a Covidiot or collateral damage.
It is not practical to airlift patients from one overwhelmed facility to another within or out of state.
Actually as the Pandemic progressed, transports have become more fluid and easier. With proper training, experienced crews and equipment are much more available. At least in AZ. Inter and intrastate.
100% correct. I worked at a small community 300 bed + hospital. We've gone on bypass a couple of times, and once was for the H1N1 pandemic. It can happen for staffing issues as well. Now imagine your only hospital in a rural town with limited beds goes on bypass because it's over whelmed with Covid. What happens to that car accident, heart attack, stroke that comes in and there is no ICU bed available and the ER is full? Realize that you have to have a room with oxygen piped in to run a ventilator. You can't just pop them in the hallway. If every room is full they stay in the ambulance and they are turfed to another hospital. That also takes precious time. What if the nearest hospital is 25 miles away?
Here's an interesting scenario that I witnessed at that small community hospital.
A man came in with a full blown heart attack. He was intubated and I was breathing for him manually and we were on our way to the cath lab immediately. I called a fellow therapist to bring me a ventilator. She was setting it up and the cardiologist already had that artery open before she was finished setting up the ventilator. (guess who's my cardiologist ) Had he been delayed in that ambulance because Covid cases had over run the ER and available rooms, he would not have made it. He would have been collateral damage because of this pandemic. Don't think that there isn't collateral damage every day because of this virus. There is. We see it on the "fake news" where people are dying in waiting rooms from Covid because the hospitals are over whelmed. We saw the decisions that Italy had to make as to who gets a ventilator. The young one or the old one? You guess who. You know the answer. These are difficult times with difficult decisions that have to be made.
Our cases are exploding again here, and we all know that people aren't giving up their all important holidays. Many people are going to die because of it, whether you're a Covidiot or collateral damage.
Great post. Thanks for everything you are doing. We all need to be doing our part in our families and communities.
Being "realistic" means being able to understand that virus outbreaks do not occur equitably across the country. If they did, then you might have a point. But they don't.
You are SO right.
I mean no one got infected at any of the protests, burning and looting events that drew thousands of participants across the nation, in different cities.
If you turn out to be in the 5% of people its not effective for, couldn't you still get an asymptomatic infection or even a milder infection and then infect others if you went without a mask?
We get tested for COVID every two weeks at my hospital. So I would have to be one of the 5%, and on top of that, when I contract and become infectious would have to be timed just right for me to become infections. And in this scenario, I would probably step up my testing to once a week, so it would be extremely unlikely for this to happen.
Once the masses get the vaccine, I would imagine the masks would be unnecessary. If COVID cases were only 5% of what they are now, especially if almost all of those 5% were milder cases, then the concern is infinitely lower than it is now.
We get tested for COVID every two weeks at my hospital. So I would have to be one of the 5%, and on top of that, when I contract and become infectious would have to be timed just right for me to become infections. And in this scenario, I would probably step up my testing to once a week, so it would be extremely unlikely for this to happen.
Once the masses get the vaccine, I would imagine the masks would be unnecessary. If COVID cases were only 5% of what they are now, especially if almost all of those 5% were milder cases, then the concern is infinitely lower than it is now.
Do people know that if a person tests positive multiple times that every test is considered a new case?
I saw an RN talking about this. How every time ANY medical personnel tests positive and has a retest that is positive and then gets a nose swab it actually counts as 3 cases even though it's the same person.
Why is this MD, a dermatologist, using the overly dramatic term, lockdown? There have been no lockdowns in the US.
There is no question older people are more likely to die of Covid complications than younger people.
There is a huge range of experiences between asymptomatic and death and that is not limited to older people.
This MD, a Dermatologist, seems to suggest older people should isolate and have their groceries and stuff delivered.
It ignores that more than 20% of households in the US are multigenerational, more than 64 million households. The percentage increases annually as the population ages.
It ignores that younger people take care of older people in assisted living environments. Covid enters the environment through the employee entrance.
It ignores that basic things like masks and gloves in a hospital environment are protecting patients and staff.
It ignores that typical holiday gatherings are multigenerational.
It assumes the masses actually wash their hands.
Having said this, it is a curious thing the difference among states and regions within, in terms of reactions, , especially concerning dining. Some have banned all indoor dining. Others attempt to control the spread by:
Table distancing
% of occupancy
Number of patrons seated at a table
Time of day.
Does Covid only come out to play after dark?
My state has closed all interior dining. The large corporate chains seem to be complying. Not so much for independently- owned, non- franchised dining establishments.
Some have pivoted to carry out/ delivery and are doing OK. May be a record year for pizza and Italian beef sales.
Do people know that if a person tests positive multiple times that every test is considered a new case?
I saw an RN talking about this. How every time ANY medical personnel tests positive and has a retest that is positive and then gets a nose swab it actually counts as 3 cases even though it's the same person.
That inflates the numbers.
An "RN talking about this" doesn't tell me anything. A lot of people say a lot of things, a lot of which is not true.
I am not saying it is not true, just that I have not heard of it, and I place zero value on hearsay.
If you give me a link to a publication, I can evaluate what they say, and make an informed judgement.
Do people know that if a person tests positive multiple times that every test is considered a new case?
I saw an RN talking about this. How every time ANY medical personnel tests positive and has a retest that is positive and then gets a nose swab it actually counts as 3 cases even though it's the same person.
Back in March, for the first week or two, we intubated people early. We didn't know any better at the time, because this was all new to us, and under normal conditions, the correct response to someone with an oxygen saturation of 60%, with labored breathing, was to intubate them, so that is what we did.
As more information became available, we changed the policy to only intubate when death was imminent. We would use high flow oxygen on all, and bipap on some. We literally waited until the patients had agonal respirations that were unsustainable, and incompatible with life, before putting them on the ventilator. And we were so inundated with severe cases that statistically, that was still a lot of people being put on ventilators. We were intubating 30 patients a day, but the only other option was to sit there and watch them die within an hour or so. We were left with either a terrible option, or a worse one.
ECMO was the option of choice, but as you know, the availability of ECMO is practically nil. We have 2 machines at our hospital, which is 2 more than most hospitals have.
We have gotten a lot better at treating severe disease since then, which is probably, thankfully, why your father pulled through. At the time, we were avoiding steroids because we didn't want to weaken the immune system. It turned out that it was the immune response that was killing a lot of these patients, so now decadron is a mainstay treatment, and it and other immunomodulary drugs have kept many people from getting to the point where you have to choose between ventilator vs death. With the resurgence, our hospital is only 25% full vs 100% full the first time around, and we are only intubating 5-10 people per week, vs 30 a day.
I only said to be careful in the way you word it, because most people dont understand this. They go around saying that we are killing people with the ventilators, and that they are the wrong treatment. Then other people hear or read that and they repeat it. They dont understand that the people that are on ventilators would have already been dead if they were not placed on them.
Thank you for the "front line" medical perspective. The media doesn't cover it much, but it feels like from what you say that we've got a lot better at treating this illness.
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.
) Had he been delayed in that ambulance because Covid cases had over run the ER and available rooms, he would not have made it. He would have been collateral damage because of this pandemic. Don't think that there isn't collateral damage every day because of this virus. There is. We see it on the "fake news" where people are dying in waiting rooms from Covid because the hospitals are over whelmed. We saw the decisions that Italy had to make as to who gets a ventilator. The young one or the old one? You guess who. You know the answer. These are difficult times with difficult decisions that have to be made. 
