Nurses vs. Coronavirus

From 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

(no subject)

1. Watched the flick A Beautiful Day in the Neighborhood via On Demand. It was the most positive film I could find. Also took place in 1998. I miss the 1990s.
Anyhow, it's a moving film about a magazine writer who interviews Fred Rogers for a story - and Rogers instead helps the man deal with his relationship with his father.
I cried during it. Very cathartic.

2. ( personal stuff )

3. Spring appears to be here. The red maple outside my window is in bloom. Little red leaves sprouting from it. Soon it will turn to green. And the yellow flowering bushes are in bloom as well.

It's a beautiful blue sky gently fading into twilight. I thought of going out into it, but decided I'd been wandering around a wee bit too much this week.

4. Trying not to worry too much about work. ( Read more... )

Wales: I have no imagination. With yours - you must be going crazy.
Me: Yep. And it does not help that I've was writing a sci-fi novel with this scenario, albeit it was far worse. Or that I've read quite a few and seen them. I already know what will happen next - that's the problem.

Mother: I feel like I'm in science fiction movie.
ME: Yep, and I want better writers.

New York City Public Schools are Closed

Update:

They just closed The New York City Public Schools

New York City’s schools will close Monday and remain shut till at least April 20 — and possibly the rest of the school year, Mayor Bill de Blasio said Sunday.

“To say the least, this is a very troubling moment, a moment where I am just distraught at having to take this action,” said de Blasio, who had been facing a coup from parents and teachers over his refusal to close the schools amid the coronavirus.

“But I became convinced over the course of today that there was no other choice,” de Blasio said — adding that New York City is now up to five dead and 329 confirmed cases of the virus.

“We may have to go out” for the rest of the school year, “we may not have the opportunity to re-open them,” he warned.

The mayor said remote learning for students would begin March 23, with teachers undergoing “battlefield training.” The mayor added that over the next five days, schools would be open for “grab-and-go meals” for needy students, but that would only last this next week.

“It is quite clear that this crisis is growing intensely,” de Blasio said.

Of the schools closing, he added, “This is a decision I have taken with no joy.” He said the decision was “something not in a million years I could have imagined” having to do.

“We’ve never been through anything like this.”

Schools Chancellor Richard Carranza spoke after the mayor, calling it “a very sobering day for all of us.

“We’re at the last resort,” he said.

Addressing parents and kids, Carranza said, “We want you to think of tomorrow as a snow day. So everybody stays back.”

He said those qualifying for free breakfast and lunch can go to their school for the next week for “grab and go” meals without entering the premises.

The schools chief said teachers will be asked to come to school Tuesday, Wednesday and Thursday for training while still “practicing social distance.”

He said the goal is to make sure every student can continue to get their lessons online.

“Enrichment centers” also will be set up at various sites for the kids of healthcare and emergency-services workers, Carranza said.

...

The move came after Gov. Cuomo appeared to reverse course on the issue, too.

“Bureaucracies do not adjust quickly, but sometimes they have to, and this is one of those times that they have to, and I want them to sit down, figure it out,” the governor told reporters earlier in the afternoon.

He later added on 1010 WINS radio that “all schools down state” would close. His office soon issued a press release saying city schools were closed.

The city now “must develop a plan within the next 24 hours to ensure children who rely on school breakfast and lunch programs will continue to receive that support, and parents — especially critical healthcare workers and first responders – will be provided access to child care as needed,” the governor said.

He said schools in Westchester County also would shutter as would those in Nassau and Suffolk counties.

The governor had also said he had concerns about what city healthcare and emergency responders with school-age kids would do if schools closed, as well as over students who rely on government food programs during the week.

De Blasio acknowledged earlier Sunday that his administration did not have a finalized contingency plan in place for an across-the-board closure, despite weeks of warnings about the contagion.

Now, let's see what happens at crazy workplace tomorrow.

Commuting tomorrow will be interesting. Oh well, at least the trains will be mostly empty.