Effect of intervention on Covid-19 spread, why we should be on lockdown

Effect of intervention on Covid-19 spread, why we should be on lockdown

FISHEV | March 15, 2020

"Overloaded hospitals and shortages of ventilators in intensive care units would result in people dying unnecessarily from the coronavirus as well as from heart attacks and other ailments."

As pointed out in another thread, there are many secondary medical facilities that can be utilized, Ambulatory Surgery Centers are perfect as they will typically have four respirators and about 20 beds and full nursing staff. Each bed is a hospital level bed with O2, suction, EKG. They add roughly 10% to hospital beds available and 30% to available respirators.

Hospitals can move health patients to them to free up rooms or send sick patients there for care.

Most can also help with crowded ER's by directing ambulances with broken bones, lacerations and other injuries to the ASC's, typically heavily orthopedic.

It requires top down organization to do this as logistics on everything from O2 to med supplies to food have to be setup. We are seeing it a bit at state level but nothing at Federal level.

FISHEV | March 15, 2020

"Healthy" = stable patients.

andy.connor.e | March 15, 2020

We should have hospitals like we have peak power plants.

jimglas | March 15, 2020

we need a healthcare system, not a healthcare industry

andy.connor.e | March 15, 2020

+99.420 @jim

FISHEV | March 15, 2020

"we need a healthcare system, not a healthcare industry"

Be sure to vote.

hcwhy | March 15, 2020

We need the producers of hand sanitizers and sanitary wipes to be going 24/7 until the supply is met. There are plenty of people who could use the work. A hand wipe is easier to make than a respirator....more pleasant to use, too.

FISHEV | March 15, 2020

"Americans have been alarmed by empty grocery shelves, but while food suppliers and retailers say they are struggling with surging demand, they insist the supply chain remains strong."

Uncle Paul | March 16, 2020

Stores are only out of supplies because frightened consumers are taking home more than they need.

When the popular items show up on the shelves, people seem to be taking all they can carry.

Looking at toilet paper and hand sanitizer as trophies.

jimglas | March 17, 2020

Previously healthy 40 yo ER doctor just died in the USA after contracting Covid-19

SCCRENDO | March 17, 2020

It’s all about odds. Ideally everyone should avoid everyone else and then in 2 weeks the virus will be gone until the Chinese pick it up again from birds, bats or whatever. If we are 100 % sure that a group of people has no virus then no problem. Of course you are always at risk for other infections like plain old flu. What limits us is the testing which gives us a majority unknown. So we work on probabilities. In areas where there is a lot of disease we should go to complete lockdown. In areas where there is zero to low disease the risk is far lower. Everyone is still potentially at risk but from asymptomatic carriers but proportionately the risk is far lower. One should still limit contact such as shaking hands and being more than 6 feet from a sneeze or cough zone.

As a physician I had to see patients and washed hand afterwards and got them to wash hands. My patients are very low risk because they don’t come for lung problems or infections. I went to work yesterday and every patient showed up. My group has tried to limit staff. I was asked to cancel all non urgent patients and I ended up being able to cancel everyone. I am at home enjoying my isolated beach. I am dealing with stuff on the phone. If I need to go in I will drive in. If we have a big epidemic of cases I will go in, put on my protection gear and help up. As a physician I have a moral and ethical responsibility to put patients first

rxlawdude | March 17, 2020

@SCC, +1!

Shesmyne2 | March 17, 2020

Thank you SCC. Be safe.
Not all heroes wear capes. Some wear scrubs.

Still Grinning ;-)

Darthamerica | March 17, 2020

@SCC you and I don't agree on much but I wanted to wish you well and I thank you for what you do.

Tesla2018 | March 17, 2020

Sccrendo- I concur with Darth. Please make sure you are screening your patients. I spoke with the office manager for a doctor that handles some of the players that are here for spring training and have injuries that are Ortho related. He cancelled most surgeries but athletes from other countries and sports have recently arrived from Europe within the last week or so just before the travel ban expired and we're calling to get appointments.

SCCRENDO | March 17, 2020

Thanks guys. I appreciate it.

FISHEV | March 18, 2020

Real key is checking people all the time and if fever, isolate, test and then track their contacts and repeat procedure. Basic epidemiology response

The WalMart greeters our outside, with TB masks, gloves and temp scanners. Same for Tesla factory every shift.

Due to US being unprepared for this (all those wasted Homeland Security wall dollars), shutdown while that is organized so you an open up as screening can be done on mass scale.

Government needs to be diverting mfg to making those items in mass quantities where it can, similar to converting industry to wartime production. Should have been stockpiled after the WMD scare but those promoting the WMD scare didn't believe it...but lesson learned. Or not as same people are in charge and not doing that.

FISHEV | March 18, 2020

"so you can open up"

sabbia | March 18, 2020

Thanks SCC and thanks to all who have dropped their vituperation towards SCC realizing that he is "on your side."

And then there is Uncle Paul. OMG.

FISHEV | March 18, 2020

"And then there is Uncle Paul."

He's not wrong. Stores are making an effort to show full shelves so people don't panic buy. Also people have been able to stock up so they don't fee as insecure. Families with kids have to buy almost twice as much as normal vs. kids getting two to three meals at school so don't be too critical when you see folks loading a cart they might not normally do.

SCCRENDO | March 18, 2020

@Fishev. I think @sabbias comments on Uncle Paul were tongue in cheek. His concern has been that we shouldn’t reform the health care system because poor people should t get priority of hospital beds before him. Sadly if we are overwhelmed his fears may come true. Most physicians do not look at your income before deciding who gets an ICU bed.

I agree as regards the stores. People are in panic mode because the response has not been coordinated from the top. The rules change by the minute. People are lining up outside Costco at 5 am for a 10 am opening. Large crowds mingling for hours. Andrew Cuomo has the right idea. We should bring in the military to organize food distribution and the army Corp of engineers to build hospitals.

jimglas | March 18, 2020

I am a recently retired doc (1/1/20) and have been put on notice that I may be called in to volunteer if physician shortages occur.
This is real.

rxlawdude | March 18, 2020

The only saving grace of this mess is that, for the most part, people are realizing we are all in this together. You can see even here that those with very different politics are putting their metaphorical pitchforks and torches down.

FISHEV | March 18, 2020

"His concern has been that we shouldn’t reform the health care system because poor people should t get priority of hospital beds before him."

His comment here did not say that, just commented on the panic buying which, in fairness to all was based on CDC say get two weeks of supplies so you if you get sick you have food and supplies.

FISHEV | March 18, 2020

"You can see even here that those with very different politics are putting their metaphorical pitchforks and torches down."

Generally true on the street though we did some early signs of people competing for food supplies. Supermarkets have done a great job of keeping a sense of normality and people have responded. It is now a common cause we see in war time. A sense of in all in it together we haven't seen since maybe 1st Gulf War.

rxlawdude | March 18, 2020

With all the doom and gloom, it's time for something a bit uplifting. And somewhat prescient.

NKYTA | March 18, 2020

Wow, Tom is pretty young there.

jimglas | March 18, 2020

Nice RX!

rxlawdude | March 18, 2020

Next up: The Masochism Tango. :-)

sabbia | March 18, 2020

@FISH. It's not worth beating. I'll just leave it by saying I don't think so. Won't debate about it.

sbeggs | March 18, 2020

I'm all set for lockdown. Picked up another thirty bottles of wine at Ralph's on Sunday. Blue Apron meal kits and fresh fish being delivered.

We are going the route of bolstering the immune system. And hand washing.

I wonder if it's true that taking baking soda in warm water keeps the body alkaline, and virus can't thrive in such an environment. Doctors, please weigh in!

SCCRENDO | March 18, 2020

Stocking up with food, wine and getting exercise is good. Keep safe distances when out and forget about all the snake oil. It will do nothing to your immune system.

Tesla2018 | March 18, 2020

Sccrendo-. My mom had lung cancer and was taking Tarceva and Iressa. It somehow attached to the cancer cell and mutated them so they couldn't spread. I'm not a genetic or DNA or biology expert. But couldn't they find out what part of the virus screws up the lungs and come out with a chemical that attachs to it and changes it or the DNA which would cause it not to affect the lungs.Does the virus affect all nodes of the lungs or just one or two? Sloan Kettering in NY seemed to be the best place for this research and I think Dr Pao? was the one that was working on this. Or do viruses act differently than cancers. Glad that we have the best experts in the world in this country and have preventative measures. If this was 100 years ago and we could travel around the same way we do now, we would be like the dinosaurs. Maybe we need to mix coackroach DNA with ours so we will be around forever! The idiot spring breakers on the beach around here deserve the Darwin Award. The will go home have and have no food and crowd stores in their hometowns causing more shortages and infecting those around them. Wish I could just stay home and hibernate for a few months with no human contact. It's like it's a1965 worst case scenario and we have to stay inside for months until the radiation from a nuke bomb goes away.

rxlawdude | March 18, 2020

"The idiot spring breakers on the beach around here deserve the Darwin Award."

No, they deserve the Asshat Award for infecting others.

SCCRENDO | March 18, 2020

Viruses are pieces of DNA or RNA encapsulated in an envelope that take over the cells of the body. And get your body’s cells to produce proteins. So you almost have to destroy your own cells to get rid of them. Meds against viruses are not great as compared to antibiotics against bacteria. There are some meds that slow cell division etc You are presently better of developing a good vaccine..

sabbia | March 19, 2020

Maybe Tesla2018 can yell at the viruses.

blkice | March 19, 2020

Just heard Tesla will continue to deliver all the MY they have already made. Seems like the right move as it might be hard to keep all at a minimum charge. Don’t know if that’s true, be safe

Tesla2018 | March 19, 2020

Sabbia- I am having more fun watching all the snowflakes having meltdowns blaming Trump for their impending deaths. Guess future climate change doesn't seem to matter when there is no one left to pollute.

rxlawdude | March 19, 2020

And we have our very own examples of Trumptardism. ^^^^^^

NKYTA | March 19, 2020

@rx Darwinism awards upcoming.

SCCRENDO | March 19, 2020

@tesla2018. Just as most on this forum don’t think that yelling at babies is appropriate, many of us recognize the fact that Corona virus is serious. It spreads among asymptomatic people and people die from this. If we do nothing it will overwhelm our medical system and doctors will need to chose who to treat. When you develop your diabetic heart attack you may not get an ICU bed. So I guess most of us are not having fun with this and do not think it is a joke. Those who understand science take precautions. Heroes are Andrew Cuomo, Gavin Newsom and Jay Inslee. Trump gutted the pandemic response team, played this down to the MAGA hatters and Foxnews and was woefully neglectful. He only came on board when he saw the stock market tank and realized that this was bad for the economy. But he is still saying stupid things. Most of the Fox hosts have come around and some MAGA hatters are too. But ongoing bravado and stupidity remains among many MAGA hatters. Possibly yourself. But indeed those who do not listen fare more likely to get the virus and Darwin’s law of natural selection may play it’s part

FISHEV | March 20, 2020

"I am having more fun watching all the snowflakes having meltdowns blaming Trump for their impending deaths."@Tesla2018

Snowflakes = MD's, RN's, Pathologists, Epidemiologists, people who have to expose themselves to millions of people who have no testing, n mass screening procedures, no tracking and isolating and no equipment due to ignorance and ideology of Trump/Fox'ers who claimed it was just the flu while other governments like Korea went with science and co-ordinated government/industry in example of what good government does.

tew ms us | March 20, 2020

@SCC I'll give you that Andrew Cuomo and Gavin Newsom have set their personal hatred of Trump aside in order to work with him. I wish the national Democrats - Pelosi, Schumer, Biden - could do the same. If you recall, Italians greeted Chinese tourists with hugs and kisses while Trump blocked entry to people from infected areas to the screams of "Xenophobic Racist!" from national Dems. Imagine the Italian problem scaled up to US magnitude then thank President Trump for not being stupid. Watch one of the daily news conferences with Trump and the experts on his Chinese Virus team being asked by members of the propaganda media why he's hurting the feelings of Chinese Americans.

But national Dems aren't stupid - Di Fi dumped 6 million in stocks before us plebians took the big hits. Yes, Repubs joined in the dumpage. Why do you think people who know what goes on Washington call it "The Swamp"?

FISHEV | March 20, 2020

"Watch one of the daily news conferences with Trump and the experts on his Chinese Virus"

But Trump says there's no virus, no reason for action.

"Jan. 22: “We have it totally under control. It’s one person coming in from China. We have it under control. It’s going to be just fine.” — Trump in a CNBC interview."

Time lost that will not be made up.

In US we call it the Trump Virus as Trump and Fox News denial of C19 for so long is largely responsible for US poor response now. The Trump/GOP'ers will likely not get out from under this. The pandemic belongs to them. It shows what happens when ideologues run the government and don't listen to scientists and doctors.

sabbia | March 20, 2020

@fish: Someone who screams at crying babies is not an "ideologue." Someone who wants to deny healthcare to the poor because it means there are fewer beds for themselves is not an "ideologue." Someone who has fun mocking the compassion of others is not an "ideologue."

Other words come to mind.

Tesla2018 is not running the government...but their ilk is.

SCCRENDO | March 20, 2020

@tew. Trump screwed this up from the beginning. There was a total leadership void and in fact he was counterproductive. He woke up when he saw the stock market tank. Pelosi led with a bailout package and got him to agree. The dem governors have stepped up to the plate. And foxnews has finally woken up. I am confident we are mostly doing the right thing. We need to stand together and try not to squabble. But come November these buffoons need to be kicked out

FISHEV | March 20, 2020

'Trump screwed this up from the beginning..."

A suggestion so it doesn't decline to just word volleys is post a factual example on each.

Looking at the right response in Korea and wrong response in US with factual examples is good. We do need to imitate what works.

November is upon us and we do need to restore US government. The Trump experiment that ignorant and inexperienced people can run US government has the prove result with the GOP's response to the Trump Pandemic.

Tesla2018 | March 20, 2020

Wasn't it China that covered it up by saying it couldn't be transmitted human to human? In any case,it's more important that we all work on a solution and work on the blame later.

I think everyone should be responsible and not depend upon the government to bail them out. Not happy about people who never planned for an emergency or getting laid off or their house value going down getting government bailouts. The weathermoron was responsible and had insurance yet he is mocked for taking government money. If he didn't have insurance that was equally available to all then it would be Ok to chastise him.

I honestly think the government is giving everyone free money since they don't want to have people rioting and looting since they are broke be and starving. Venezuela ran out if toilet paper before all hell broke loose and their currency started being used as toilet paper because it was worthless, now ours will be useless as we will share the same fate. I will be withdrawing my money in singles so it will last longer.

FISHEV | March 20, 2020

"Wasn't it China that covered it up by saying it couldn't be transmitted human to human?"

Sounds like Trump. What we can say for sure is China faced the problem and has done so effectively with China and Korea being places that did what needed to be done and their governments responded and their policies worked.

tew ms us | March 21, 2020

Jan 31st - Trump bans foreign nationals who traveled to China on coronavirus fears

Mar 14th - Good Grief! Biden insists on no travel bans, even from China