Nurses vs. Coronavirus
Mar. 15th, 2020 12:01 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
shadowkatFrom an ICU Nurse on FB, Sara Clemens:
Hi everyone. I’m an internal medicine doctor in Philadelphia. I work in the hospital and in the intensive care unit (ICU) where we already have cases of COVID-19. I’m putting this out there because I’m very worried, so I’m going to ask you all for a favor. I’m worried that if we do not take drastic measures to slow the spread of this virus, in a few short days or weeks I will be asked to decide who gets access to critical care resources- in other words, who lives and who dies. This is currently happening in northern Italy, where the number of critically sick patients is higher than the number of available ICU beds.
PLEASE heed the advice of public health officials and STAY HOME. If you are asking:
* “Does this include X”, the answer is YES. The gym, restaurants, bars, EVERYTHING. If you can work from home, please do it. It will suck to miss the birthday party/concert/dinner/whatever you were planning, but this is too important and things can be rescheduled.
[The closing of NYC Public Schools is problematic, because we have a lot of kids that have no homes, living in shelters, etc...not to mention parents who can't make alternative arrangements, some of whom are health-care providers. Yes, I've thought this through in detail about ten years ago. I wrote in my head a novel about this very thing happening and had just started putting it in writing.]
* “What about getting groceries?” Yes, please keep yourself well fed and healthy. Try a grocery delivery service if that’s within your means. If not, please utilize grocery stores and pharmacies.
* “Should I wear a mask if I have to leave the house?” No. The virus is transmitted by tiny droplets when an infected person coughs or sneezes and these travel about 6 feet. Maintain this distance between yourself and others and this will reduce your risk. My hospital is already experiencing a shortage of masks. This is devastating for health care personnel who are trying to take care of confirmed cases. [If you have masks donate them to hospitals where they actually need them.]
* “But I’m in my 20s or 30s so this probably won’t make me that sick.” While it’s true that you have a lower risk, we think the mortality rate for people in this age group is about 0.2%. This may seem low, but if you have 500 facebook friends in their 20s and 30s and they all got COVID-19, statistically one of them would die. The risk is higher for your parents and grandparents, so do this for them.
* “If I feel sick should I go to the emergency room?” Treat this like you would any other cold or flu, even if you have a fever. If you would otherwise have stayed home and binged Netflix with a box of tissues and some soup, do that. The emergency room is a great place to get yourself exposed to COVID-19, and having too many people there is one way that we won’t be able to provide good care to everyone. That being said, if you start having trouble breathing, please come in so we can take care of you. Call your primary care doctor if you are concerned. If you don’t have a doctor, many states are starting hotlines for people to call. Google it for your state. [ I have a virtual doctor app via NYU Langone, which I can use. I can also use it to get refills. I do have one problem - I need to go to the doctor on June 19th for more monitoring of blood pressure and diabetes. I'm not on anything for the diabetes.]
* “Why???” Because at this point, we can’t stop the spread, we can only slow it down. Staying at home will help slow it down, or “flatten the curve” as you might have heard. Basically if everyone gets sick at once, as happened in Italy, more people will need ICU care than we have available. If we spread it out a little, less people will die for lack of resources.
Many health care professionals are feeling like we are being drafted into a war. We didn’t sign up for it, but we're putting on our battle gear. We are being asked to prepare for wartime triage. Please help me avoid the need to make horrible decisions that I don’t ever want to make.
Resources:
*CDC (US): https://www.cdc.gov/coronavirus/2019-ncov/index.html
*WHO (International): https://www.who.int/emergen…/diseases/novel-coronavirus-2019
*Recent infectious disease conference with statistics: https://special.croi.capitalreach.com/…
News articles:
*Triage in Italy: https://www.politico.eu/…/coronavirus-italy-doctors-tough-…/ & https://www.upworthy.com/coronavirus-doctor-hospital-italy…
*It could happen here: https://www.nytimes.com/…/coronavirus-biggest-worry-hospita…
#flattenthecurve
Hi everyone. I’m an internal medicine doctor in Philadelphia. I work in the hospital and in the intensive care unit (ICU) where we already have cases of COVID-19. I’m putting this out there because I’m very worried, so I’m going to ask you all for a favor. I’m worried that if we do not take drastic measures to slow the spread of this virus, in a few short days or weeks I will be asked to decide who gets access to critical care resources- in other words, who lives and who dies. This is currently happening in northern Italy, where the number of critically sick patients is higher than the number of available ICU beds.
PLEASE heed the advice of public health officials and STAY HOME. If you are asking:
* “Does this include X”, the answer is YES. The gym, restaurants, bars, EVERYTHING. If you can work from home, please do it. It will suck to miss the birthday party/concert/dinner/whatever you were planning, but this is too important and things can be rescheduled.
[The closing of NYC Public Schools is problematic, because we have a lot of kids that have no homes, living in shelters, etc...not to mention parents who can't make alternative arrangements, some of whom are health-care providers. Yes, I've thought this through in detail about ten years ago. I wrote in my head a novel about this very thing happening and had just started putting it in writing.]
* “What about getting groceries?” Yes, please keep yourself well fed and healthy. Try a grocery delivery service if that’s within your means. If not, please utilize grocery stores and pharmacies.
* “Should I wear a mask if I have to leave the house?” No. The virus is transmitted by tiny droplets when an infected person coughs or sneezes and these travel about 6 feet. Maintain this distance between yourself and others and this will reduce your risk. My hospital is already experiencing a shortage of masks. This is devastating for health care personnel who are trying to take care of confirmed cases. [If you have masks donate them to hospitals where they actually need them.]
* “But I’m in my 20s or 30s so this probably won’t make me that sick.” While it’s true that you have a lower risk, we think the mortality rate for people in this age group is about 0.2%. This may seem low, but if you have 500 facebook friends in their 20s and 30s and they all got COVID-19, statistically one of them would die. The risk is higher for your parents and grandparents, so do this for them.
* “If I feel sick should I go to the emergency room?” Treat this like you would any other cold or flu, even if you have a fever. If you would otherwise have stayed home and binged Netflix with a box of tissues and some soup, do that. The emergency room is a great place to get yourself exposed to COVID-19, and having too many people there is one way that we won’t be able to provide good care to everyone. That being said, if you start having trouble breathing, please come in so we can take care of you. Call your primary care doctor if you are concerned. If you don’t have a doctor, many states are starting hotlines for people to call. Google it for your state. [ I have a virtual doctor app via NYU Langone, which I can use. I can also use it to get refills. I do have one problem - I need to go to the doctor on June 19th for more monitoring of blood pressure and diabetes. I'm not on anything for the diabetes.]
* “Why???” Because at this point, we can’t stop the spread, we can only slow it down. Staying at home will help slow it down, or “flatten the curve” as you might have heard. Basically if everyone gets sick at once, as happened in Italy, more people will need ICU care than we have available. If we spread it out a little, less people will die for lack of resources.
Many health care professionals are feeling like we are being drafted into a war. We didn’t sign up for it, but we're putting on our battle gear. We are being asked to prepare for wartime triage. Please help me avoid the need to make horrible decisions that I don’t ever want to make.
Resources:
*CDC (US): https://www.cdc.gov/coronavirus/2019-ncov/index.html
*WHO (International): https://www.who.int/emergen…/diseases/novel-coronavirus-2019
*Recent infectious disease conference with statistics: https://special.croi.capitalreach.com/…
News articles:
*Triage in Italy: https://www.politico.eu/…/coronavirus-italy-doctors-tough-…/ & https://www.upworthy.com/coronavirus-doctor-hospital-italy…
*It could happen here: https://www.nytimes.com/…/coronavirus-biggest-worry-hospita…
#flattenthecurve
no subject
Date: 2020-03-15 04:25 pm (UTC)It is a problem, but at least they could close the middle and high schools (allowing students to drop by their closest school once a day to pick up breakfast and lunch... and allowing elementary kids who are home to do the same thing.)
I understand that lack of online access is also a problem, but they could mail work packets home for those kids who really can't get online (and do this for elementary kids who have been pulled out as well).
no subject
Date: 2020-03-15 06:38 pm (UTC)Elementary is problematic though.
I care less about the kids getting an education than I do about the healthcare workers being able to go to work, though. The kids will survive without school for four months. School's out in June.
That's what I mostly concerned about is enough healthcare workers. We can't afford a shortage of healthcare workers. And from the press briefings that I've seen to date - that appears to be the Mayor, Senator, and Governor's concern as well.
What caused Italy to collapse was the shortage in healthcare workers and hospital beds. That's what the nurse in the post above is worried about.
So the challenge is "how do we close the NYC public schools, without losing essential workers that we desperately need to keep everything running?"
no subject
Date: 2020-03-15 06:49 pm (UTC)no subject
Date: 2020-03-15 08:20 pm (UTC)no subject
Date: 2020-03-15 08:23 pm (UTC)The problem isn't the parents anyway, it's the neighbors. You never know who's gonna get a bug up their butt and call child services.