Coronavirus Discussion Thread

[Akulahawk]

One interesting effect that COVID-19 has had on hospital operations (at least where I work) is that it's forcing us to create (temporarily) rooms that can be used for respiratory isolation. These include anterooms for donning/doffing PPE. It's also ensuring that healthcare personnel are actually gaining experience in conducting healthcare activities while wearing various PPE. Expect, in the short term, occasional shortages in this stuff as hospitals begin to realize that their stores of PPE won't last all that long in practice. It's one thing to have a patient that needs airborne isolation every once in a while but if you have 6 or 10 all at once, that can be a problem.

Please do note that I'm NOT referring to tertiary facilities that get "isolation" cases as nearly a routine matter. Those facilities are going to be set up for this. I'm referring to community/local facilities. They're going to get hammered pretty badly if COVID-19 turns out to be a particularly bad bug.

 

[Summit]

One interesting effect that COVID-19 has had on hospital operations (at least where I work) is that it's forcing us to create (temporarily) rooms that can be used for respiratory isolation. These include anterooms for donning/doffing PPE. It's also ensuring that healthcare personnel are actually gaining experience in conducting healthcare activities while wearing various PPE. Expect, in the short term, occasional shortages in this stuff as hospitals begin to realize that their stores of PPE won't last all that long in practice. It's one thing to have a patient that needs airborne isolation every once in a while but if you have 6 or 10 all at once, that can be a problem.

Please do note that I'm NOT referring to tertiary facilities that get "isolation" cases as nearly a routine matter. Those facilities are going to be set up for this. I'm referring to community/local facilities. They're going to get hammered pretty badly if COVID-19 turns out to be a particularly bad bug.

We have figured out how to turn a whole ward negative. FYI anterooms are not a requirement and add engineering difficulties. We are not doing those.

 

[KingCountyMedic]

Things are getting interesting. My friends in Washington State are nervous. 12 firefighters are now quarantined after the nursing home debacle.

Even if they're NOT sick, the quarantine will have a big impact on staffing.

If I had to quarantine 12 EMTs at my service, we would have to go out of service. It would have a huge impact on staffing

It's more like 50 if you include Firefighters, Paramedics and Private Ambulance folk. Most are in quarantine some have moved to isolation showing some mild symptoms. All of the deaths and super sick folks have been elderly with lots of bad heart/lung disease to begin with. The exact same folks that regular old fashioned flu kills by the thousands every year. Your Washington State friends that are nervous should wash their hands, stop touching their face, use their PPE, follow proper donning/doffing procedures and not listen to the news media.

 

[FiremanMike]

Things are getting interesting. My friends in Washington State are nervous. 12 firefighters are now quarantined after the nursing home debacle.

Even if they're NOT sick, the quarantine will have a big impact on staffing.

If I had to quarantine 12 EMTs at my service, we would have to go out of service. It would have a huge impact on staffing

That makes me want to get exposed to coronavirus.. 2 week vacation?? Sounds great!

 

[Akulahawk]

We have figured out how to turn a whole ward negative. FYI anterooms are not a requirement and add engineering difficulties. We are not doing those.

Not easy to do to an ED... Much easier to do to inpatient wards.

 

[NomadicMedic]

It's more like 50 if you include Firefighters, Paramedics and Private Ambulance folk. Most are in quarantine some have moved to isolation showing some mild symptoms. All of the deaths and super sick folks have been elderly with lots of bad heart/lung disease to begin with. The exact same folks that regular old fashioned flu kills by the thousands every year. Your Washington State friends that are nervous should wash their hands, stop touching their face, use their PPE, follow proper donning/doffing procedures and not listen to the news media.

It’s not that they are concerned about dying. They’re concerned about a 2 week quarantine.

 

[Summit]

Not easy to do to an ED... Much easier to do to inpatient wards.

Can't do it to m open Ed bays, but you can convert individual rooms with minimal work on a crisis basis

https://www.health.state.mn.us/diseases/hcid/negpressure.pdf

 

[PotatoMedic]

https://www.nejm.org/doi/full/10.1056/NEJMe2002387?query=recirc_curatedRelated_article

An interesting read.

 

[johnrsemt]

2 week vacation? When I worked busy services, I would have gotten exposed just for 2 weeks of sleep

 

[RedBlanketRunner]

It's okay to go to work with...
Typhoid Mary, meet #CovidDonald.

 

[Akulahawk]

Can't do it to m open Ed bays, but you can convert individual rooms with minimal work on a crisis basis

https://www.health.state.mn.us/diseases/hcid/negpressure.pdf

Which is what we've done. My ED already has two neg pressure rooms and they've converted a couple more rooms using techniques described in that PDF. Fortunately for us, most of our ED is set up as individual rooms vs open bays, so we could convert 20+ rooms additionally within the ED. What that would do to staffing requirements is an entirely different matter.

 

[RocketMedic]

It’s not that they are concerned about dying. They’re concerned about a 2 week quarantine.

Exactly. It’s not even if they get sick or not- the nature of EMS means that an infected/asymptomatic or mild case that doesn’t bother us at all can still provide a lethal infection to someone we encounter. Ergo, we can’t safely work or provide care without some significant PPE investments. We are literally threats to our patients if we’ve been exposed and are carrying Covid-19.

Are they being paid?

 

[VFlutter]

St. Louis is primed to turn into Washington. A college student returning from Italy tested positive and was told to quarantine and home along with her entire family. The father and younger daughter broke the quarantine and attended a father-daughter dance, house party, and visited multiple stores. People really are insanely ignorant. Now reports of multiple presumtive positvie tests in the area.

 

[VentMonkey]

 

[RedBlanketRunner]

In a clinical environment it's so easy to forget PPE is only half the battle. Out in the field it's actually only a small fraction. Once you've attended to someone you become a potential vector, for both yourself, others around you, and your work in the next house or village. There is no convenient sink and changing station. You have to free form decontaminating yourself then figure out what to do with the contaminated protections then decontaminate the container, then your vehicle. Then wash, rinse, repeat, sometimes 10-20 times a day. And don't forget to have side trips planned to the commercial hog farms if available just so you can drive through their wheel decontamination baths. Freaking nightmare.

 

[KingCountyMedic]

I'm really curious how we will deal with our "Urban Camper" problem here.

You really think the guy that just shot up black tar heroin, tossed his dirty needle on the ground and proceeded to poop on the sidewalk before robbing you at knife-point is going to self quarantine?!?

 

[Phillyrube]

Feeling panicked about coronavirus? Media coverage of new epidemics often stokes unnecessary fear

By the way, CDC estimates that influenza has resulted in between 9 million – 45 million illnesses, between 140,000 – 810,000 hospitalizations and between 12,000 – 61,000 deaths annually since 2010, including an estimated 61,000 during the 2017-2018 flu season

View attachment 4785

2021......zombies formed from failed attempts at a coronavirus vaccine are gonna kill us all.

 

[FiremanMike]

On the lighter side of things - my blended physiology class will have the next 2-3 labs done from home with made up data, and our exam next week is now to be done at home and is open note..

So that rocks

 

[Phillyrube]

Interesting thought....I was reading some of the course stuff I got from DMAT training at Ft Detrick. Any thoughts this wuhan flu is actually a beta test for something stronger, seeing as it came from the area of a bioweps lab?

 

[GMCmedic]

This coronavirus thing is getting really old.