Letter from a hospital worker on the fron... - Cure Parkinson's

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Letter from a hospital worker on the front lines

rebtar profile image
13 Replies

I received this in an email. Bringing it home (I'm in the SF Bay Area). It's long but worth reading.

From county hospital worker in San Francisco who is on faculty at UCSF:

“Dear family and friends,

I am writing to share with you what my experience has been on the front lines of COVID-19 and to make a plea.

I work at our county hospital in San Francisco and am also on faculty at UCSF so I am privy to their hospital response. All county patients with COVID-19 will come to the service staffed by me and my colleagues primarily until they escalate to needing ICU level care. For months since we learned about this pandemic hitting the US in January, our hospital has been preparing, even if the federal government has been suppressing data and impeding public health initiatives. Despite our preparations, and as a direct result of the US federal government's decision to decline the WHO tests in favor of a bungled attempt to develop their own, we lack the critically important capacity to test. This is imperiling patients and staff. Despite what Trump, Pence and his administration say, we have VERY limited capacity to test people. At my public hospital, we are limited to the tests made available by the CDC via the Department of Public Health, which is enough tests for 20 people a day for ALL of San Francisco. Symptomatic physicians and nurses cannot even get tested! We are wasting our dwindling supply of protective equipment waiting for suspected patients to be tested.

While 80% of people who contract COVID-19 will just feel like they have a cold or the flu and will recover, 14% will need hospitalization, ~6 % will need ICU level care. Of those who need ICU level care, up to 80% will die. For those infected, the mortality jumps at age 60. Children are not getting critically ill but can transmit it. Limited data on pregnant women seem to show mom and baby are okay. Many people are asymptomatic carriers and can spread disease and we won't know it because we cannot test them. COVID 19 is spread via droplets in the air and on surfaces with detectability in the air up to 4 hours, on surfaces such as plastic up to 72 hours. It is also spread with fecal-oral transmission, including viral shedding from stool of infected asymptomatic children.

If this continues to spread via community transmission at the rate we are seeing, we will overwhelm the health system. By the numbers, we are 10 days behind Italy where they are rationing ventilators and not even offering ventilators to people over 65 because they don't have enough. People with non-COVID 19 emergencies cannot access essential hospital-based care and are also experiencing increased mortality for routine conditions (eg pregnant women with birth complications, people with heart attack and stroke). As you can imagine, this is morally distressing to all health care workers, 20% of whom contract COVID-19 in the course of caring for infected patients, some of whom have died. The US is more poorly positioned to respond than Italy. Our hospitals already operate at max capacity. We have about half the per capita physicians and ventilators/ICU beds that Italy has, and our fractured health system is more vulnerable due to lack of universal health care, people's personal reluctance to seek health care due to cost, ICE raids on immigrant communities that make them avoid seeking care, America's ideological commitment to social liberties which make them less likely to adhere to social distancing recommendations. As a health system, we do not have the capacity to accommodate the surge and the levels of patients we could see in the coming months so it is imperative that we "flatten the curve" to spread out the infections over time. While our individual risk may be minimal, our collective risk of systemic collapse is very high.

What this means is that every one of us, in an act of compassion for others who are vulnerable to this disease and for the health care workers who will be on the front lines and are at risk, should do the following immediately:

Social distancing! Avoid any unnecessary trips into the community. Cancel/avoid all large gatherings (church, concerts, sporting events, parties, weddings, funerals, conferences, gyms, etc). Avoid all sick people. This may be necessary for months.

Check on elderly or at-risk family members and neighbors from a distance to see if you can grocery shop for them so they can maintain their social distancing.

Avoid unnecessary contact with people over 60 or those with compromised immune systems as you may be an asymptomatic carrier. I plan on not seeing anyone over the age of 60 (including my parents) until this settles down and we can all be tested and I am sure I am not carrying it like Typhoid Mary.

Consider a grocery delivery app so you can avoid the stores, and wash your hands after handling the delivery.

Wash your hands! This is critically important in preventing fecal-oral and droplet oral/mucosal transmission (via mouth, eyes, nose). Wash for 20 seconds (happy birthday twice, or these broadway songs), front, back, between fingers. Wash your hands like you just cut chili peppers and are about to take out your contacts.

Don't touch your face! This is very hard.

Cover your cough with your elbow. Then wash your hands.

Disinfect high touch surfaces including phone, doorknobs, handles, etc. often.

Avoid food prepared by others who may not have washed their hands appropriately.

Invent new ways to greet people that don't involve hugging or shaking hands.

If you have a cough or a fever, assume you are positive and quarantine. <10% have diarrhea. Some people never get a fever, others develop this later in the course. Call your doctor before going anywhere to see if they have the capacity to test you (they likely don't). Go to an emergency room if you have trouble breathing, chest pain, dizziness or are feeling faint or having trouble staying hydrated. In the meantime, you should avoid contact with everyone and assume you are infected.

Support legislation that allows for sick people to stay home (paid sick leave, suspension of mortgage/rent payments, basic income, relief for low wage workers, loan forgiveness, food provisions for public school children who depend on schools to eat; stopping ICE raids, student loan forgiveness)

Support each other! Support artists, musicians, teachers, and servers whose income will be disrupted by social distancing. Develop a socially distanced exercise routine, meditation practice, music practice to calm the nerves and occupy the mind. Reach out to family and friends.

Wash your hands!

Some people are dismissing this COVID-19 as a hoax or criticizing those sounding the alarm as irrational extremists. In a pandemic, all preparation seems extreme and unnecessary until the pandemic takes root, then all preparations seem retrospectively inadequate. We are all in this together. Please let's do our part to stop the spread!

Stay safe out there!”

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rebtar
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13 Replies
M-o-ggy profile image
M-o-ggy

I think it must be even more difficult than usual to be a healthcare worker at the moment.

I also feel that we need more positive responses. We are where we are.

We do need to flatten the curve and advice on how to do that is good. As we have never been in this position before, none of the experts really know what is going to happen or will really know which approach works until this is all over.

Quarantine / Lockdown produces results as can be seen in some countries but what will happen when those measures are lifted? Will there then be another sharp rise in those countries. No one knows although there seem to be a growing number of people who say they do.

The experts are using computer modelling

Where there has been results ask if those in the western world would have accepted those lack of freedoms and increased police powers 2-3 months ago that quarantine demands

We all in our personal lives need to flatten the curve and that is solid advice in all countries.

We all need to take care of each other.

Gioc profile image
Gioc

All corrected data on the severity of the disease and the problem of hospitals. To date in Italy no one over 65 has been denied intensive care. to date our health system has treated everyone, but there are those who died equally.

reedboat2 profile image
reedboat2

Great post, thanks. I am self-isolating as ordered yesterday by our CA Gov Gavin Newsom. Be well and be safe out there.

rescuema profile image
rescuema

"A study awaiting peer review from scientists at Princeton University, the University of California-Los Angeles and the National Institutes of Health (NIH) posted online Wednesday indicated that the COVID-19 virus could remain viable in the air "up to 3 hours post aerosolization," while remaining alive on plastic and other surfaces for up to three days.

"Our results indicate that aerosol and fomite transmission of HCoV-19 is plausible, as the virus can remain viable in aerosols for multiple hours and on surfaces up to days," reads the study's abstract."

The test results suggest that humans could be infected by the disease simply carried through the air or on a solid surface, even if direct contact with an infected person does not occur. That finding, if accepted, would come in stark contrast to previous media reports that suggested the virus was not easily transmittable outside of direct human contact.

thehill.com/policy/healthca...

MarionP profile image
MarionP in reply to rescuema

Correct. Tiny breath and sneeze and cough droplets stay in the air for quite a long time. Ever spray some perfume or cologne in the air and then walk through it to apply it? And those sprays/atomizers create droplets that are far larger and heavier and fall out of the air far sooner than the ones your breath creates, and the droplets are lifted around by little air currents, they travel.

Ever smell a cat box a long way off? Carried all through your home by a breeze, your forced-air conditioner or furnace? What you are smelling are aerosolized particles of poop and urine and bacteria that have entered your nose and triggered your smell nerves, meaning they have been collected and contacted inside you, or you wouldn't be smelling it. Same thing.

Hand-contact alone cannot account for the speed of transmission and acceleration curves of this virus. People create clouds that are transported to us or that we walk through while still viable. That's why eventually just about everyone will contract it. Slowing that rate is the strategy so that the healthcare systems can accommodate is the thing.

rescuema profile image
rescuema in reply to MarionP

I'm hoping there's some traction to this news.

"Chloroquine, an anti-malarial drug, and HIV-suppressing combination lopinavir/ritonavir have both reportedly shown promising results in human tests and made the virus 'disappear' in infected patients."

"South Korean disease experts have begun to recommend the use of a combination of antiviral and anti-malaria drugs for patients of the new strain of coronavirus."

dailymail.co.uk/news/articl...

upi.com/Top_News/World-News...

MarionP profile image
MarionP in reply to rescuema

Wow, bigtime possibilities. Since these are already in the prescription market, they could be applied off label as a treatment now by any prescriber.

Routine100 profile image
Routine100

All the suggestions for safeguarding against the virus are good to follow. The information says not enough test kits available this is not acceptable. This is a worldwide tragedy no excuse for such a basic failure. Can all the money in the world buy test kits for everyone no doubt the funds can be made available. Governments will only help to lead people to blame politicians and look to make political gains for the interest of reelection. Clear statements for test kits should be done a massive petition worldwide to the international monetary fund and the world health organization and the UN would be a good start.

Idofotos profile image
Idofotos

Sorry it had too be a political rant. Really diminished my interest in reading it

MarionP profile image
MarionP

20 per day to properly test-triage all of San Francisco. That's 20 for a population of roughly 7 million.

rebtar profile image
rebtar

The US government totally flubbed getting the vaccine out.

washingtonpost.com/business...

Other countries such as South Korea produced large numbers of tests and tested widely and quickly.

On the news yesterday, a hospital administrator was begging for tests, 200 of his nurses are sidelined after possible exposure and cannot get tested, and his hospital is now full to capacity without sufficient medical personnel to care for them.

There is no clear national guidance (So far) from the US government, leaving each state and local government to determine their own path, leading to a haphazard response.

The US has fewer Hospital beds per capita than most other developed countries. I believe we rank around number 30 in the world.

nytimes.com/2020/03/12/upsh...

All of this does not bode well for outcomes here in this crisis. Tragic.

Hopefully this experience will lead to positive changes.

Despe profile image
Despe

It sounds to me that her email is politically oriented. . .

Despe profile image
Despe

articles.mercola.com/sites/...

Read the comments, you will get an idea of Coronavirus existence. . . :(

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