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It's such an extraordinary gift to be retired during this pandemic - and not needing to commute on buses or subways or light rail to work, and not needing to work a job for a paycheck.
There is such a huge difference between being in the working world during a pandemic and being retired
And don't think for one solitary second, that you're not commuting on buses, subways, light rail, that you're safeguarded from getting it. One trip to the grocery store could do it!
If you mandate masks for everyone, insist on hand hygiene, and maintain some amount of separation, I see no reason why most things can’t open back up. As long as everyone in society cooperates, we can keep the transmission rate down. That doesn’t mean 1,000+ church gatherings or big sports/music events or crowded bars & restaurants. High risk people in nursing homes remain locked down and older people & high risk people need to take appropriate measures but things should otherwise get back to something closer to normal.
How would it work for people who do fall in the high risk category? What is an appropriate measure for someone who works in an office or needs to take public transportation to get to work?
And don't think for one solitary second, that you're not commuting on buses, subways, light rail, that you're safeguarded from getting it. One trip to the grocery store could do it!
There are levels and degrees of risk. I'm retired and also much appreciate my safety. If bars or restaurants or theaters become open again, I can't see myself attending. Friends my age who work in direct healthcare back East are much concerned, of course. One close friend who works in geri psych is home sick and positive for COVID.
"Two months after leaving the intensive care unit, Rob Rainer returned to his law practice in Revere, eager to resume his old life after surviving a severe lung infection that tethered him to a breathing machine for a month.
But as he sat down at his desk, the former hard-driving multitasker found he couldn’t stay on track with even one task. Phone conversations left him overwhelmed. He was baffled by a computer program he himself had developed.
Today, five years later, Rainer’s life is very different — his law practice shuttered, his two houses sold. At 58, he lives modestly with his wife in a small condo in Hudson, N.H.
While the novel coronavirus didn’t exist in 2015, today thousands of COVID-19 patients in the United States are enduring the same experience that Rainer did, lying in a medication-induced coma as a ventilator pushes air into their weakened lungs for days or weeks on end."
"The cognitive effects can be hard to detect at first, especially in high-functioning, high-IQ people, said Dr. Carla Sevin, director of the ICU Recovery Center at Vanderbilt University Medical Center.
Sevin recalled having “a lovely conversation” with a man who seemed to be doing well after an ICU stay. But when a psychologist gave him a basic mental status exam — asking such questions as what year it is, who the president is — she was shocked to see that the man did not know the answers. “His wife was equally shocked,” Sevin said.
When these seemingly recovered patients return to work, they often end up having their duties reduced or getting fired, she said."
It appears that victims who need a ventilator suffer life long cognitive decline.
I'm very curious as to the cause of mental decline following long-term ventilator use. Could it be that the brain is more active than we realize during normal life? Calculating distances, colors, voice levels, face movements, environmental sounds, smells...? Perhaps being in a coma denies the brain that "exercize"? And like any muscle, the brain atrophies?
I worked in geriatric dementia for some time. It certainly seemed that people often had severe dementia or exacerbation of existing dementia following anesthesia, say for a broken hip or something. I think the anesthesia needed for a medical coma could have the same effect.
Could also consider the lack of oxygen absorption that brought a person to the ventilator level of compromise in the first place.
Just speculating. I'm not a doctor or researcher, but direct care RN with a master's in public health and a lot of infectious disease (AIDS hospice).
I can't believe what some states are going to open first. Barbers, hair and nail salons, and tattoos should be the last to open, not the first. One to one contact should be last.
I wondered about that too. My thought was that those businesses will have way less patronage than restaurants, bars, theaters, etc.. Probably just a very few, or only one, at a time. At least, if they do get sick they can pretty much pinpoint who and where.
I've been thinking about the testing too. As of now I'm still hearing that you can only be tested if you show symptoms of the virus. If people get tested, just to test, and come up negative, what's to stop them from getting sick in two weeks or a month? Especially if they decide to go back to whatever their 'normal' is and get the virus. How often would you have to test just to be sure and would they even let you do multiple tests?
I'm very curious as to the cause of mental decline following long-term ventilator use. Could it be that the brain is more active than we realize during normal life? Calculating distances, colors, voice levels, face movements, environmental sounds, smells...? Perhaps being in a coma denies the brain that "exercize"? And like any muscle, the brain atrophies?
Does anyone have knowledge in this area?
There are many theories. This was first seen in open heart patients who were on ventilators and "on pump" which allowed the heart to be worked on or transplanted while blood was delivered by a pump. It was found that cognitive decline occurred in those patients similar to what you describe.
Long term ventilator use, and the use of mediations to keep the individual in a depressed or coma like state all can produce effects after the person is successfully weaned of mechanical ventilation. These medications include but are not limited to paralytics, pain control, sedation (a wide variety) and other medications. It can also be due to the fact that prior to intubation, frequently the person is deprived of oxygen and this may produce an anoxic brain effect. So you can see there are many reasons cognitive decline can and does occur.
Frequently, these persons require speech and language therapy as well as occupational therapy and physical mobility training. Muscles atrophy and the brain can be assisted with these therapies. This occurs in illness as well as trauma cases.
Finally, it is not unusual during illness and disease while on ventilators, people have cerebral vascular accidents or strokes. This is more common in cardiac patients who may need anticoagulation although by no means is the CVA confined to these patients. It is among the most disappointing in the intubated patients.
Until the airborne issues of COVID are conquered either through a vaccine or other means, I don't see how anyone can visit a popular restaurant, attend a concert, attend church services, or other indoor events.
I've posted before the Chinese bus study which discusses how the virus is airborne through the HVAC system and infected two sets of passengers. Only those with masks did not get infected:
Now, Chinese have learned same thing occurs in restaurants - people seated at tables near an infected person contract virus through restaurant's air circulation system.
Quote:
Three seemingly healthy families were struck by COVID-19 in January after dining at neighboring tables in a windowless restaurant in Guangzhou, China.
Researchers studying the case think that the restaurant's air-conditioner blew the viral droplets of one person who was asymptomatic farther than they might have normally gone. Nine other people across the three families later got sick.
Researchers think the source of this outbreak was a 63-year-old woman who did not show symptoms — such as a fever and a cough — until later in the day.
She went to a hospital and tested positive for COVID-19.
Within two weeks, four of her relatives had also gotten sick, as did five other diners in two other families, who seemed to have no other connection except for their time in the restaurant.
Looks like life as we knew it won't be the same for quite a long time - as audiences and participants in every large indoor gathering - symphony, opera, church, etc., etc., - are susceptible to this form of transmission. The financial ramifications are incalculable.
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Far reaching consequences......
