NY hospitals pitch tents, nix surgeries to prepare for influx(bloomberg.com)
bloomberg.com
NY hospitals pitch tents, nix surgeries to prepare for influx
https://www.bloomberg.com/news/articles/2020-03-14/n-y-hospitals-pitch-tents-nix-surgeries-to-prepare-for-influx
144 comments
I've been hearing over the past week a lot of optimism about how things will return to normal in two weeks (ie. schools are "closed until April <so and so>")
Where did these people get the idea that this will be under control in such a short amount of time?
Edit: Just to clarify I am not saying this to sow seeds of negativity, just wondering myself how can anyone announce reopening without any basis in reality.
Where did these people get the idea that this will be under control in such a short amount of time?
Edit: Just to clarify I am not saying this to sow seeds of negativity, just wondering myself how can anyone announce reopening without any basis in reality.
A lot of folks seem to be confusing the confinement period of two weeks for something else.
My mother asked me today, okay, so I’m stuck in the house for two weeks, and then I go out to the mall and get infected then, don’t I?
I had to explain two weeks was just to make sure she didn’t have it yet. she had no clue that two weeks wasn’t the return to normalcy.
My mother asked me today, okay, so I’m stuck in the house for two weeks, and then I go out to the mall and get infected then, don’t I?
I had to explain two weeks was just to make sure she didn’t have it yet. she had no clue that two weeks wasn’t the return to normalcy.
The reason is because the school districts that have closed have specifically almost all said that they'll be closing for a period of two weeks.
They do this because they don't want to panic people, despite knowing almost certainly that this will last far more than two weeks.
They do this because they don't want to panic people, despite knowing almost certainly that this will last far more than two weeks.
I am not a school-age person, and my mother is not a teacher. Additionally, our region’s schools haven’t closed, causing furor.
I’m going out on a limb and saying that’s not where it’s coming from, at least in our context.
I’m going out on a limb and saying that’s not where it’s coming from, at least in our context.
She can get the mail. She should place it indoors, let it sit for a few days before opening, and wash her hands before touching any surfaces in the house.
Because many places have only announced school closings of 2 weeks. If I were betting I’d say realistically it will end up being more like 8-10 weeks when it is all said and done. Also probable that there is a second wave of outbreak later in the year. Historically these things come in waves from what I’ve read.
This was exactly what happened with Spanish flu. Erupted in early Spring of 1918, spread widely until summer, and then a mutated form caused a bigger and deadlier second wave in the Fall. A third wave occurred the following Spring with an equally high mortality rate, but the death toll was lower, likely due to the decrease in troop movements after the war.
Luckily for us, a coronavirus is generally less likely to mutate into more a lethal form than is an influenza virus.
Luckily for us, a coronavirus is generally less likely to mutate into more a lethal form than is an influenza virus.
According to a report out of China, we are already experiencing the mutated version which is less lethal (0.6%) than the original (5%). I am hopeful that as we identify and remove the strains causing more terrible effects via prevention and hospitalization, the remaining strains will mutate themselves away in a year or two.
https://amp.scmp.com/news/china/society/article/3064908/coro...
https://amp.scmp.com/news/china/society/article/3074938/chin...
https://amp.scmp.com/news/china/science/article/3048772/stri...
https://amp.scmp.com/news/china/society/article/3064908/coro...
https://amp.scmp.com/news/china/society/article/3074938/chin...
https://amp.scmp.com/news/china/science/article/3048772/stri...
Oh yeah? Have a look at Italian numbers. And then go to wiki and look at what was the deaths/cases at a similar moment in China it was like 1%! Symptoms occur on average 5 days after infection, hospitalization 6 days after that and death 7 days after that. To get true CFR you have to have at least 2 weeks without a new case
This is likely because Italy has underreporting for younger cases:
https://www.statista.com/statistics/1103023/coronavirus-case...
There’s two reasons that I could guess at: the age of the population itself, and the mild or asymptotic presentation of young folks with the way testing is ordered.
Unless you’re got widespread testing for even mild illness, you’re unlikely to see real numbers. South Korea has wide spread testing, so if you look at their numbers it also explains their low death rate:
https://www.statista.com/statistics/1102730/south-korea-coro...
https://www.statista.com/statistics/1103023/coronavirus-case...
There’s two reasons that I could guess at: the age of the population itself, and the mild or asymptotic presentation of young folks with the way testing is ordered.
Unless you’re got widespread testing for even mild illness, you’re unlikely to see real numbers. South Korea has wide spread testing, so if you look at their numbers it also explains their low death rate:
https://www.statista.com/statistics/1102730/south-korea-coro...
There was a paper that discussed a L and an S strain the former of which is thought to be more deadly and was more dominate in Wuhan. In other areas the two are more equally distributed but the more deadly strain is still a large percentage of cases.
https://youtu.be/7YI2tOoVVpk?t=141 https://doi.org/10.1093/nsr/nwaa036
https://youtu.be/7YI2tOoVVpk?t=141 https://doi.org/10.1093/nsr/nwaa036
That paper was retracted due to lack of evidence.
This is a pure logistics thing.
It is much much more prudent to close for two weeks, monitor the situation, and adapt accordingly. It is pretty painless to extend a closure if you need, but it is basically impossible to un-cancel the semester once you have cancelled it.
It is much much more prudent to close for two weeks, monitor the situation, and adapt accordingly. It is pretty painless to extend a closure if you need, but it is basically impossible to un-cancel the semester once you have cancelled it.
Also in two weeks it’s spring break for many schools. So it’s effectively a three week period to monitor how things go.
It’s easier from a public reassurance standpoint to give a specific date that can be moved after everyone has adjusted to the situation rather than saying that everything is closed indefinitely.
Keeps people from panicking more than they already are.
In their lifetime, it’s not something they’ve seen before . That may sound overly simple but that is the answer.
Probably there's a big concern about civil unrest.
Civil unrest should not occur. Society and order will not disintegrate, and people will keep working (one of the better ways of dealing with the anxiety of this situation for many people, I imagine).
There isn't a food shortage; there will be a slow down of cargo movement because of extra safety precautions and less people working, but there is no reason to expect people to go hungry and riot over this. Food shelters will not be closing down. Water, electricity will continue working.
Things will get quieter for a little while, shopping malls will be empty and then running in a reduced capacity as things return to normal.
There isn't a food shortage; there will be a slow down of cargo movement because of extra safety precautions and less people working, but there is no reason to expect people to go hungry and riot over this. Food shelters will not be closing down. Water, electricity will continue working.
Things will get quieter for a little while, shopping malls will be empty and then running in a reduced capacity as things return to normal.
> There isn't a food shortage; there will be a slow down of cargo movement because of extra safety precautions and less people working, but there is no reason to expect people to go hungry and riot over this. Food shelters will not be closing down. Water, electricity will continue working.
Based on the panic buying I saw yesterday and the reports of the same from elsewhere, a significant number of people do not believe this.
Based on the panic buying I saw yesterday and the reports of the same from elsewhere, a significant number of people do not believe this.
[deleted]
This is not Katrina. We have time to react. State of emergency can be issued, food stocks requisitioned and rationalised until this is over. I have lived during communism, the Chernobyl accident, the 1989 revolutions. We will get over it, eventually. The question is at what cost.
Keep safe, limit non essential travel, preferably cook your own food that you eat at work, avoid crowded places and wash your hands. I alsi don't use taxis and publuc transport. Walk or bike if you can.
Keep safe, limit non essential travel, preferably cook your own food that you eat at work, avoid crowded places and wash your hands. I alsi don't use taxis and publuc transport. Walk or bike if you can.
You need public demonstrations for civil war. Who is going to be out protesting and rioting?
Ya don't say... https://twitter.com/cjjohnsonjr/status/1238868541689880576
That's exactly what you want to do in a pandemic. Stand in line close to a dozen other people so you can buy a gun and shoot the virus. People's stupidity never ceases to amaze.
That's what someone in the Twitter thread said.
But basically, people want guns to deal with all the other people who have guns. Most of them are dreaming, though, because they're not well enough trained to use them effectively.
But basically, people want guns to deal with all the other people who have guns. Most of them are dreaming, though, because they're not well enough trained to use them effectively.
When I was in Jersey City during Sandy, a gun would have been very handy: there were roving gangs of thugs roaming the blacked out streets breaking into homes and looting. Police response was vastly overloaded and the flood waters made mobility a problem. It’s prudent to be able to defend oneself in times of unrest. Just hoping for the “authorities” to do it is naïve. The US military has roughly a million troops, 250,000 cops and 380,000,000 million people spread out over a massive land area.
Realistically though, looting during a quarantine is pretty much the dumbest time to do so. The best scenario for looting is that one gets something valuable with minimal risk (eg. taking from an abandoned store or house).
Looting houses during a quarantine means that the looters would go into houses that are actively occupied, at a time where the occupants are nervous and potentially armed. Pretty much the worst case scenario.
Doesn't mean there aren't dumb criminals, but between looting houses for food or shoplifting food from stores, one is clearly less risky.
Looting houses during a quarantine means that the looters would go into houses that are actively occupied, at a time where the occupants are nervous and potentially armed. Pretty much the worst case scenario.
Doesn't mean there aren't dumb criminals, but between looting houses for food or shoplifting food from stores, one is clearly less risky.
Looting a Twitter office who's sent all their employees home on the other hand.. pretty risk-free.
The problem is that to really be risk-free, you need everyone converging on the idea simultaneously, so that the police are overwhelmed -- this has happened with toilet paper.. whether it'll happen with looting corporate offices is to be seen. For now though, it's still pretty risky.
The problem is that to really be risk-free, you need everyone converging on the idea simultaneously, so that the police are overwhelmed -- this has happened with toilet paper.. whether it'll happen with looting corporate offices is to be seen. For now though, it's still pretty risky.
A bunch of people who misunderstand desperate people are down voting you. Downvoting because people are putting their head in the sand. We live in a society of "just in time" production and shipping. How much food do people have stored up?
Ok, let's think this through.
You buy a weapon and try to intimidate the armed aggressors with your weapon.
They actually know how to handle weapons and shoot you as soon as they see your weapon because they know how dangerous these things are.
You're now shot and are either dead or currently bleeding out.
How did this improve your situation exactly?
Escalating conflict is not necessary in your favor. It can be, but its way more likely to backfire than help you
You buy a weapon and try to intimidate the armed aggressors with your weapon.
They actually know how to handle weapons and shoot you as soon as they see your weapon because they know how dangerous these things are.
You're now shot and are either dead or currently bleeding out.
How did this improve your situation exactly?
Escalating conflict is not necessary in your favor. It can be, but its way more likely to backfire than help you
> They actually know how to handle weapons and shoot you as soon as they see your weapon because they know how dangerous these things are.
Yes, that's exactly it. It's actually quite hard to train people to freely kill others. Most naive people think about using guns for intimidation. The first lesson in my weapons class (as I recall) was to never point a gun at anything you don't intend to shoot. Maybe the second lesson was to point and shoot as an uninterrupted process. Not any faster than you can do smoothly, but not any slower either.
Burroughs, who was quite the gun nut, also recommended that. He also advised to first take out assailants with shotguns.
There's a great anecdote in Hunter Thompson's book about hanging with Hell's Angels. Involving a guy who pointed a handgun at one of them, and got shot with it. Also a great sequence in some Seagal film with an Aikido reverse move with an assailant's shotgun. It's a riff on a sword move.
Yes, that's exactly it. It's actually quite hard to train people to freely kill others. Most naive people think about using guns for intimidation. The first lesson in my weapons class (as I recall) was to never point a gun at anything you don't intend to shoot. Maybe the second lesson was to point and shoot as an uninterrupted process. Not any faster than you can do smoothly, but not any slower either.
Burroughs, who was quite the gun nut, also recommended that. He also advised to first take out assailants with shotguns.
There's a great anecdote in Hunter Thompson's book about hanging with Hell's Angels. Involving a guy who pointed a handgun at one of them, and got shot with it. Also a great sequence in some Seagal film with an Aikido reverse move with an assailant's shotgun. It's a riff on a sword move.
I don't know about a few weeks, but if it spreads quickly the peak could be here sooner than we might think.
I don't think anyone can predict the future, in any direction.
I don't think anyone can predict the future, in any direction.
> Where did these people get the idea that this will be under control in such a short amount of time?
Maybe https://en.wikipedia.org/wiki/Normalcy_bias
Maybe https://en.wikipedia.org/wiki/Normalcy_bias
I almost said this to a friend who is, hopefully, visiting in May. I changed "back to normal" to "the new normal". I think there is going to be a fundamental shift in how societies operate.
Those people are actual heroes.
My girlfriend is a physician at NYP in NY. It feels like there's almost nothing I can do to help and the worst case projections sound like a true hell I never thought we'd experience.
It's even scarier to hear how unprepared the whole system appears to be. The hospitals are extremely concerned about mask supply and they all just received an email on Friday recalling any boxes of masks from anywhere in the hospital to central storage. Apparently patients and others have been walking out with boxes of masks and it's impossible to order more.
I know a 60 year old who hasn't practiced medicine in a number of years who expects to jump into service in a week or two when patients are overflowing makeshift shelters.
It's even scarier to hear how unprepared the whole system appears to be. The hospitals are extremely concerned about mask supply and they all just received an email on Friday recalling any boxes of masks from anywhere in the hospital to central storage. Apparently patients and others have been walking out with boxes of masks and it's impossible to order more.
I know a 60 year old who hasn't practiced medicine in a number of years who expects to jump into service in a week or two when patients are overflowing makeshift shelters.
How many weeks have we had to spin up mask factories? They're not exactly high tech items.
There is only one medical mask factory still in business in the US.
Edit: you can read more about the mask supply issue here. There maybe more than one but very few remain and 95% of masks are imported.
https://www.washingtonpost.com/business/2020/02/15/coronavir...
Edit: you can read more about the mask supply issue here. There maybe more than one but very few remain and 95% of masks are imported.
https://www.washingtonpost.com/business/2020/02/15/coronavir...
“He’s hesitant, however, to ramp up production at the facility outside Fort Worth, scarred by the boom-bust mess that occurred after the swine flu pandemic in 2009.”
“ But after the pandemic, demand declined, and it took months for hospitals and distributors to go through the surplus of masks they had ordered but never used. Prestige Ameritech had to let most of its new workers go. ‘Everybody said they’d stay with us. The day after the pandemic they forgot who we were. We nearly went out of business‘“
“A lack of planning on their part is not an emergency on my part,” Bowen said. “They had their chance. I told them over and over.”
That article contains a great background on the lack of long-term preparation.
“ But after the pandemic, demand declined, and it took months for hospitals and distributors to go through the surplus of masks they had ordered but never used. Prestige Ameritech had to let most of its new workers go. ‘Everybody said they’d stay with us. The day after the pandemic they forgot who we were. We nearly went out of business‘“
“A lack of planning on their part is not an emergency on my part,” Bowen said. “They had their chance. I told them over and over.”
That article contains a great background on the lack of long-term preparation.
Wow. Seems like the easiest and simplest step imaginable for the CDC or some other federal department to step in and give a large minimum volume commitment immediately, and put this particular fear to rest...
Agreed. This seems like an institutional failure to me.
It wasn’t guaranteeing the initial manufactured volume that was the challenge, it was the continuous orders after the crisis. All the US MBA’s and purchasing departments went back to China-supplied JIT supply chains. To compound the JIT mistake, they ignored the owner when he told them the next time this happens, he’s not risking his business to bail out everyone.
This is a US Federal government-scale public utility problem space. Hand the US factory-based US PPE companies a 35-year contract rolled over once a year. They are to build out capacity in several separate facilities for up to 10% of US population per day, paid entirely by federal taxpayer funds. Train skeleton DOD and DHHS staff on how to maintain and run it, keep key personnel in primary facility on alternating shifts with federal equivalents. Run skeleton output for DoD and social welfare-related consumption. Improvements in primary facility are simultaneously performed in national strategic facilities. Company keeps manufacturing on a JIT basis as they are market-forced to today.
Develop standards and protocols to store the PPE for 30 year durations, and intermixing with normal supplies to keep rotating them. Ideally design some kind of factory-reusable retort pouch, and make the PPE reusable with sufficient treatment, and easy-to-use validation testing. Normally let the factory reman the used-once gear to identify and fix field problems. Set a stockpile goal that gives the strategic factories time to spin up in enough time to fluidly cover a pandemic response.
Then turn around and start contact tracing the JIT decisions, and tell them they have 10 years to clean up their act and lay in stockpiles and best practices. Hold natural persons responsible.
I’m guessing some kind of plan like this is languishing in the now-disbanded CDC pandemic response leadership. Extreme risk planning has been a marked oversight of American-style business leadership, and I see no incentive nor reason it will ever change.
This is a US Federal government-scale public utility problem space. Hand the US factory-based US PPE companies a 35-year contract rolled over once a year. They are to build out capacity in several separate facilities for up to 10% of US population per day, paid entirely by federal taxpayer funds. Train skeleton DOD and DHHS staff on how to maintain and run it, keep key personnel in primary facility on alternating shifts with federal equivalents. Run skeleton output for DoD and social welfare-related consumption. Improvements in primary facility are simultaneously performed in national strategic facilities. Company keeps manufacturing on a JIT basis as they are market-forced to today.
Develop standards and protocols to store the PPE for 30 year durations, and intermixing with normal supplies to keep rotating them. Ideally design some kind of factory-reusable retort pouch, and make the PPE reusable with sufficient treatment, and easy-to-use validation testing. Normally let the factory reman the used-once gear to identify and fix field problems. Set a stockpile goal that gives the strategic factories time to spin up in enough time to fluidly cover a pandemic response.
Then turn around and start contact tracing the JIT decisions, and tell them they have 10 years to clean up their act and lay in stockpiles and best practices. Hold natural persons responsible.
I’m guessing some kind of plan like this is languishing in the now-disbanded CDC pandemic response leadership. Extreme risk planning has been a marked oversight of American-style business leadership, and I see no incentive nor reason it will ever change.
This is where price restrictions during disasters run into issues. We either need to allow price to go up, to make it economical for the private sector to maintain offline capacity and stockpiles of these kinds of supplies, or we need a government that plans effectively for these scenarios. We can't get away with neither.
Please provide an accurate source for that claim.
ETA: unsure why the huge up and down vote swings. OP claimed only one company made masks in the US which is not accurate and then they edited with their source. No idea why I’ve went -1 to +5 and back for originally asking for a source.
ETA: unsure why the huge up and down vote swings. OP claimed only one company made masks in the US which is not accurate and then they edited with their source. No idea why I’ve went -1 to +5 and back for originally asking for a source.
I usually try to stay out of downvote discussions -- the HN guidelines ask us to not engage in such -- but I'm going to suggest that you are going to see a lot more trigger-happy downvotes because there's a pandemic on and it satisfies some psychological desire to shut something -- anything! -- down with a vengeance and post haste.
I would be inclined to assume that voting on all forums will be less rational, less calm, cool and collected and yadda for some weeks to come.
And when people are actually sick and running a fever, that will amplify the problem. I live with chronic health issues and other stressors. No amount of provisos is ever enough to get other people to not have knee jerk stupid reactions to me failing to be perfectly calm, cool and collected.
I imagine you are going to see a whole lot of upset and unwell people bouncing off each other and escalating tension instead of calming it down and this will go on for the duration of the crisis. As a wild ass guess.
I would be inclined to assume that voting on all forums will be less rational, less calm, cool and collected and yadda for some weeks to come.
And when people are actually sick and running a fever, that will amplify the problem. I live with chronic health issues and other stressors. No amount of provisos is ever enough to get other people to not have knee jerk stupid reactions to me failing to be perfectly calm, cool and collected.
I imagine you are going to see a whole lot of upset and unwell people bouncing off each other and escalating tension instead of calming it down and this will go on for the duration of the crisis. As a wild ass guess.
It's possible to disinfect masks with ultraviolet light. [1] It's crucial that hospitals don't throw away their used masks. Save them in bags for disinfection later, or if a miracle occurs, just pitch all the bags full of them.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699414/
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699414/
Unfortunately, all US domestic sources of UV-C 222nm lights I’ve been able to locate are 10+ weeks back ordered. All Ali Express suppliers are also similarly backordered.
Part of the problem seems to be the disposability of medical PPE. I’d like to find options for gear that is designed to be reused.
Part of the problem seems to be the disposability of medical PPE. I’d like to find options for gear that is designed to be reused.
> UV-C 222nm lights
Not sure if you've gone down this road, but check out animal/pet stores.
Not sure if you've gone down this road, but check out animal/pet stores.
Also, sunlight has a lot of UV in it. If they can use it for water treatment...
I agree that it seems like this should be a solvable problem, but I'm not sure who would be working on it.
As a side note, to engineers (or anyone) who wants to help design an open source ventilator to alleviate the potentially severe shortage:
https://www.projectopenair.org/
As a side note, to engineers (or anyone) who wants to help design an open source ventilator to alleviate the potentially severe shortage:
https://www.projectopenair.org/
There is also 3M but where does it get the raw materials to make masks? Probably from China which until recently stopped production.
I have heard second hand that 3M has completely stopped manufacturing other items in the US and switched to masks.
Seattle hospitals are also postponing non-life-threatening surgeries, as much to avoid consuming PPE as for beds and staff: https://www.swedish.org/patient-visitor-info/coronavirus-adv..., https://www.uwmedicine.org/coronavirus
The County is converting at least one motel and at least one parking lot to recovery/isolation/medical support: https://www.kingcounty.gov/depts/health/news/2020/March/14-c... (scroll to "Temporary housing, isolation and quarantine facilities")
The County is converting at least one motel and at least one parking lot to recovery/isolation/medical support: https://www.kingcounty.gov/depts/health/news/2020/March/14-c... (scroll to "Temporary housing, isolation and quarantine facilities")
The surgeon general has asked hospitals nationwide to postpone elective surgery.
Just heard from a surgeon friend today that at least a couple hospitals here in California are doing the same. They're expecting to need those beds for CV patients within the next week.
Shit...
I have a thing scheduled for early next month. Not a full on surgery but it is pretty invasive and urgent and they require me to be in the hospital for a few days.
I'm not in New York but I am in hotbed for the current problem.
Interventional Radiology is somewhat specialized so hopefully there aren't any interruptions. But they do have about 20 beds in their unit of the hospital.
I have a thing scheduled for early next month. Not a full on surgery but it is pretty invasive and urgent and they require me to be in the hospital for a few days.
I'm not in New York but I am in hotbed for the current problem.
Interventional Radiology is somewhat specialized so hopefully there aren't any interruptions. But they do have about 20 beds in their unit of the hospital.
I live in China. I have read many horror stories out of Wuhan, China after the local hospital got overloaded with patient.
1. People got infected couldn't be treated and had to stay home. See this video that the daughter of a sick mom trying to get attention by drumming in the balcony and crying for help. "My mom is dying and I am helpless" https://www.youtube.com/watch?v=cuvA0XooI5c
2. people with long term illness or scheduled surgery couldn't be treated, such as leukemia patient need dialysis, because Major hospitals has directed all resources to treat coronavirus patients.
Work from home, cancel meetings, stay away from the crowd.
Wash hands, wear mask if you have to go out.
Get medical advice from your doctors ASAP if you fall into the second category.
Please get prepared for the worse and don't let this happen to you and your loved ones.
EDITED: add a youtube video
1. People got infected couldn't be treated and had to stay home. See this video that the daughter of a sick mom trying to get attention by drumming in the balcony and crying for help. "My mom is dying and I am helpless" https://www.youtube.com/watch?v=cuvA0XooI5c
2. people with long term illness or scheduled surgery couldn't be treated, such as leukemia patient need dialysis, because Major hospitals has directed all resources to treat coronavirus patients.
Work from home, cancel meetings, stay away from the crowd.
Wash hands, wear mask if you have to go out.
Get medical advice from your doctors ASAP if you fall into the second category.
Please get prepared for the worse and don't let this happen to you and your loved ones.
EDITED: add a youtube video
Thanks for sharing your experience. My Mom is undergoing Chemotherapy, with a surgery scheduled in April. She has pancreatic cancer, which is a very tough cancer. They caught it early, and we were hopeful - until Covid 19. Now we have no idea how many delays, etc to expect.
Best wishes to you from an American. We're in this together!
Best wishes to you from an American. We're in this together!
Unfortunately, in Italy, space for other hospital departments has had to be converted to extra space for acute COVID-19 cases. (And they're still overflowing, to the point of doing battlefield triage to determine which severe but potentially viable patients get the ventilators.) It would be very unfortunate for that to also happen here, but unfortunately, Seattle at least seems to be trending that way.
The USA is roughly 16 days behind Italy at the moment.
US are not even testing, theres a ton of evidence that cases upon cases that match the description of corona does not get tested. The US could very well be much much futher ahead already than the current official claims.. Much like China was criticised for.
The USA is a much larger country with dramatically more hospital capacity. It's better to compare state by state numbers to Italy.
Italy has more hospital beds per person than the US, 3.18 (2017) vs 2.77 (2016 ... no Wiki data for 2017).
https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp...
https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp...
Italy actually has a pretty good healthcare system, especially in the North, better than in the States (unless you're rich). The bigger difference is that the Italian population skews older. And with the situation at US airports right now it looks like there is some bad news coming down in another two weeks or so.
If it is urgent, you might reach out to them and see if it can be moved forward.
I'd not count on that going through.
I don't think you can really know. This person needs to speak with their healthcare providers about timetables, possibly moving things up, etc. Some IR procedures are for seriously urgent issues, like cancer, and I don't think it's right to just toss out random assertions about what might happen in a ward we know nothing about.
Here is what is happening: non-emergency surgeries are cancelled all over the place right now to make room for more ICU capacity, to free up personnel and to ensure that those that are post-op and have their immune systems working overtime already are not exposed to one more very nasty virus.
So right now the situation is already changing, and rapidly so. Looking two weeks ahead I'd say that the chances that any non-emergency surgeries will be cancelled are much higher than today.
New York is but one example of the same pattern that you see happening over and over again and with an exponential spread (the early stages of any pandemic) two weeks is a very long time.
So right now the situation is already changing, and rapidly so. Looking two weeks ahead I'd say that the chances that any non-emergency surgeries will be cancelled are much higher than today.
New York is but one example of the same pattern that you see happening over and over again and with an exponential spread (the early stages of any pandemic) two weeks is a very long time.
I'm aware that is happening. It seems like you are jumping from the fact that some non-urgent surgeries are being cancelled in some wards to an inference that this person's potentially more urgent surgery will be cancelled in the particular ward that was going to perform it.
I don't think that's right. There is no need for you to speculate in any case when that person is just sharing their worries. There's no upside.
I don't think that's right. There is no need for you to speculate in any case when that person is just sharing their worries. There's no upside.
Again, two weeks is a long time. All of the non-emergency surgeries in my own circle have been called off already and so far this region is - for now - doing ok. A little bit further South (35 miles) the hospitals are on 'Code Red', which means that there is no ICU capacity available, 'Code Black' is when they will start triaging, which is probably a few days away.
Because every operation has a chance of developing complications if there is no ICU capacity available the operations will be cancelled regardless of whether or not the operation itself is a risky one.
Also, this being a forum and the person making their statement in this forum I feel that I'm totally free to speculate. Forum participation invites speculation, and in this case my speculation is backed up by local experience. If that is not the kind of message you want to be passed on then fine but that's your opinion, which in this case you are more than welcome to spout as long as you realize that you have just as much right to do so as I do.
Oh, and in case you want a citation to go with this then maybe this will help you:
https://twitter.com/ASlavitt/status/1238817274590629888
Because every operation has a chance of developing complications if there is no ICU capacity available the operations will be cancelled regardless of whether or not the operation itself is a risky one.
Also, this being a forum and the person making their statement in this forum I feel that I'm totally free to speculate. Forum participation invites speculation, and in this case my speculation is backed up by local experience. If that is not the kind of message you want to be passed on then fine but that's your opinion, which in this case you are more than welcome to spout as long as you realize that you have just as much right to do so as I do.
Oh, and in case you want a citation to go with this then maybe this will help you:
https://twitter.com/ASlavitt/status/1238817274590629888
Canceling non-urgent surgeries also helps as the hospital can cannibalize ventilators and other life support equipment from the operating rooms and use it as makeshift ICU capacity.
Is the code red in place because ICUs are reserved, or are they already all in use?
Almost all filled up, expected to fill up today or tomorrow.
Dutch:
https://www.omroepbrabant.nl/nieuws/3171310/Code-rood-in-de-...
Dutch:
https://www.omroepbrabant.nl/nieuws/3171310/Code-rood-in-de-...
The hospitals in New York are all preparing for a big surge.
The trauma hospital a few blocks from me has barricaded the entrances, and erected a giant tent as an ward for sick people.
The trauma hospital a few blocks from me has barricaded the entrances, and erected a giant tent as an ward for sick people.
What are you talking about? Sorry, I don’t mean to be rude but what do you mean that there is no need to speculate? That is literally what humans do all the time for all of human existence.
Our medical situation, that is say that of the United States, is much worse than that of italy and it is so by design. That is an objective fact even though it’s not pleasant to think about. What makes you think we will be better off than Italy, even though we are in a weaker medical position? My argument is that panic is warrented.
Our medical situation, that is say that of the United States, is much worse than that of italy and it is so by design. That is an objective fact even though it’s not pleasant to think about. What makes you think we will be better off than Italy, even though we are in a weaker medical position? My argument is that panic is warrented.
> What are you talking about?
I am talking about it being rude to tell a person who needs a surgery, potentially for an issue that threatens their life, that they will not get it, when you don't actually know. It's just basic decency.
I am talking about it being rude to tell a person who needs a surgery, potentially for an issue that threatens their life, that they will not get it, when you don't actually know. It's just basic decency.
Your presumption is fairly incredible. (1) I wasn't talking to you and (2) maybe that person would rather be informed than bamboozled with feel good news that ends up being false.
Basic decency is to assume that people can think for themselves and do not need to be treated like toddlers with feel good lies and cotton balls.
Basic decency is to assume that people can think for themselves and do not need to be treated like toddlers with feel good lies and cotton balls.
Along the lines of assuming people can think for themselves, the person who originally commented clearly knew that there was a possibility that their surgery would be cancelled. They expressed as much in their comment. What did your blunt speculation add? You know less about the situation than the person you were replying to, and on the basis of that ignorance jumped to an unfounded conclusion.
I would have written what you said this way: "you should reach out to your doctor. In my neighborhood a lot of surgeries have been getting cancelled." It is not one whit less truthful or honest than your comment, but it is more sensitive, at least to my ear.
Your approach to this thread calls to mind an imaginary surgeon who leaves the OR and tells the family, "sorry, he's dead." Nothing wrong with that bedside manner, is there? No need to treat them like toddlers.
I'm finished with this. I've said my piece and you disagree. Ah, well.
I would have written what you said this way: "you should reach out to your doctor. In my neighborhood a lot of surgeries have been getting cancelled." It is not one whit less truthful or honest than your comment, but it is more sensitive, at least to my ear.
Your approach to this thread calls to mind an imaginary surgeon who leaves the OR and tells the family, "sorry, he's dead." Nothing wrong with that bedside manner, is there? No need to treat them like toddlers.
I'm finished with this. I've said my piece and you disagree. Ah, well.
You are ignoring the fact that there are official calls to suspend all non-emergency surgery and that there are a lot of hospitals already doing this. My comment was meant informative, not to put that person down.
Your strawman is ignored.
Your strawman is ignored.
elective surgeries are cancelled.
he said his expected surgery is urgent.
you inserted the word emergency.
it's hard to follow an argument that proceeds this way.
he said his expected surgery is urgent.
you inserted the word emergency.
it's hard to follow an argument that proceeds this way.
Urgent is a term that is materially different from emergency in hospital parlance. I was laid up for a week with an 'urgent' surgery pending (twice!) because I kept being bumped by emergencies who needed it still much more than I did.
yes, but I believe that, while urgent can get bumped by emergency, urgent is not covered by elective and urgent can proceed when elective is banned.
Yeah, it is for cancer. From what I gather they need to go in through a vein in my leg and go up into my liver to inject some chemo and a oil to try and kill/starve the tumor. This all seems like witchcraft. I have been dealing with this sorcery for years. I google nothing. I just do what I am told. It is much easier that way. The radiologist and oncologist have agreed that this is the best option. I trust them.
And I will call Monday morning to see if they expect there to be a problem.
And I will call Monday morning to see if they expect there to be a problem.
Best of luck man, that's super tough. Here's to hoping that they let you in, and that that chemo does its job well. That procedure is called embolization, if it works you're in and out on the same day. Hang in there.
Yeah, I hope it doesn't come to it but this is the right first step. Adapted a flu surge model with folks at my company to estimate bed capacity shortage and it's not pretty. https://qventus.com/blog/predicting-the-effects-of-the-covid...
I don't know what to do. I am in LA for school, but my family is in NYC. They want me to come back, but it seems like the last place I should be going right now. Being with family is important, but the idea of traveling and adding another person to the population of NYC seems counterproductive to fighting the virus.
I’m in the exact same boat. I want to fly home and this is the only time I’ll probably ever see super cheap tickets, but I’m young and the possibility that I could expose and infect so many people along the way makes it look as though shelter in place is the most responsible thing to do.
Don't worry about it; if you want to go home now, you should go home. If you're not symptomatic, and if you take even minimal precautions, you're highly unlikely to spread anything.
To me, the far more important consideration is if there's benefit in you and your family/friends being together now. That's what would make my decision.
To me, the far more important consideration is if there's benefit in you and your family/friends being together now. That's what would make my decision.
I'm terrified of what's coming. I feel so helpless.
Did you see the Louis CK skit about flying in a tin can and complaining about not having wifi on your cell phone?
Existence is a very fragile thing. Nature is unforgiving. We as a species have made incredible strides to be where we are today. People all over the world wake up every morning, do their routine, and go about their daily lives.
Around them, they are surrounded by people, care free and oblivious to the absurd amount of work it has taken to come to a point where people can relax their minds and go for a walk, get fresh water to drink, go watch a movie with their friends, or get in a fancy car and go for a drive.
We will make it through this. We are surrounded by all kinds of deadly shit waiting to kill us, and we are still here, thriving. There are many competent teams working on this to the best of their abilities.
Modern medicine is a technological marvel. Two days ago, a team of researchers managed to reproduce the virus which will pave the path to figuring out how to create antibodies.
It will take some time, and it has already impacted a lot of people. The death count will not stop going up, but we won't give up either.
We have given a middle finger to just about anything that could have killed us. We've erected hamlets, villages, towns, cities, metropolises. We have a station floating in space. Built monuments to things we like and things we despise. We've composed beautiful music to inspire ourselves to wage wars against each other. We are relentless and unstoppable.
Hang in there, and don't let helplessness take over you.
Existence is a very fragile thing. Nature is unforgiving. We as a species have made incredible strides to be where we are today. People all over the world wake up every morning, do their routine, and go about their daily lives.
Around them, they are surrounded by people, care free and oblivious to the absurd amount of work it has taken to come to a point where people can relax their minds and go for a walk, get fresh water to drink, go watch a movie with their friends, or get in a fancy car and go for a drive.
We will make it through this. We are surrounded by all kinds of deadly shit waiting to kill us, and we are still here, thriving. There are many competent teams working on this to the best of their abilities.
Modern medicine is a technological marvel. Two days ago, a team of researchers managed to reproduce the virus which will pave the path to figuring out how to create antibodies.
It will take some time, and it has already impacted a lot of people. The death count will not stop going up, but we won't give up either.
We have given a middle finger to just about anything that could have killed us. We've erected hamlets, villages, towns, cities, metropolises. We have a station floating in space. Built monuments to things we like and things we despise. We've composed beautiful music to inspire ourselves to wage wars against each other. We are relentless and unstoppable.
Hang in there, and don't let helplessness take over you.
No I haven't seen that skit, link it if you can.
Louis CK tells a similar anecdote on Conan "Everything is amazing and nobody is happy". The passenger beside him is upset that the on-board wifi went down. https://youtu.be/nUBtKNzoKZ4?t=119 The whole clip is hilarious.
Louis CK tells a similar anecdote on Conan "Everything is amazing and nobody is happy". The passenger beside him is upset that the on-board wifi went down. https://youtu.be/nUBtKNzoKZ4?t=119 The whole clip is hilarious.
Just to clarify, that was a Louis CK bit. I enjoy both of their comedic styles.
Louis does it in a stand-up special, but here is a good Conan clip, with a great title: https://m.youtube.com/watch?v=nUBtKNzoKZ4
Louis does it in a stand-up special, but here is a good Conan clip, with a great title: https://m.youtube.com/watch?v=nUBtKNzoKZ4
Thank you - I blanked out who it was!
That bit of wordplay gave me the chills :) Thanks.
mnm1(1)
It's OK to be scared. You're not alone in that. It can be helpful to have someone to talk to. Even as we're trying to keep our physical distance, know that it's OK to reach out for help. And it's also OK to step away from the news for a beat if it's causing you anxiety.
I work at one of the New York hospitals mentioned in this article. Yes, I'm scared too. [Opinions not that of my employer, etc.] But we're all still showing up every day to take care of our patients, and we'll keep doing so until we can't--and then we have backup lined up. There will be hard days, but those will be in the privacy of the hospital, away from prying eyes. New York will pull through.
I work at one of the New York hospitals mentioned in this article. Yes, I'm scared too. [Opinions not that of my employer, etc.] But we're all still showing up every day to take care of our patients, and we'll keep doing so until we can't--and then we have backup lined up. There will be hard days, but those will be in the privacy of the hospital, away from prying eyes. New York will pull through.
You're not alone; the whole world is facing this together. Please do your best to stay calm, because that is the only thing you really have control of. Be vigilant with your hygiene; washing hands, not touching face, etc. Good luck and best regards!
On the scale of "not worried at all" to "feeling complete helplessness" you should be somewhere in the middle. Maybe 2/3rds of the way up.
Respect the situation for what it is, listen to scientists, and you won't have to feel pessimistic.
Respect the situation for what it is, listen to scientists, and you won't have to feel pessimistic.
In life we deal with things we never could have imagined. But the anticipation of something, or waiting on the edge of the unknown can be even worse.
One thing that consistently helps me when I feel a loss of control is to clean and organize. I also meditate. But cleaning up my environment seems to have the effect of also cleaning my mind.
With three kids 5 and under at home with us for a while — let’s be real it could be a long time — cleaning and organizing today has helped me and my wife feel a bit more ready for what’s coming.
Hang in there, we’re all in this together!
One thing that consistently helps me when I feel a loss of control is to clean and organize. I also meditate. But cleaning up my environment seems to have the effect of also cleaning my mind.
With three kids 5 and under at home with us for a while — let’s be real it could be a long time — cleaning and organizing today has helped me and my wife feel a bit more ready for what’s coming.
Hang in there, we’re all in this together!
Clean Your Room
https://www.youtube.com/watch?v=GGuow4yRtn8
https://www.youtube.com/watch?v=GGuow4yRtn8
A community you may find helpful:
https://www.reddit.com/r/coronavirus_support/
https://www.reddit.com/r/coronavirus_support/
Do you mean https://www.reddit.com/r/CoronavirusSupport/ ?
You support the virus? Personally, I am against it.
Yes, thank you!
Honestly work has been a good distraction for me. Might not be healthy but it helps.
Hang in there
we need more people scared actually, so we change behavior. the people not scared and still acting like normal are propagating the problem.
You’ve got this. Sit tight, and stay occupied.
You can control whether or not you get infected by limiting interaction.
And at the very same time, a bunch of bars are probably packed full of people. Maddening.
They were here in NYC on Friday.
Restaurants had 50%+ drop in traffic in NY state on Friday (opentable data).
We were talking about bars. And some of the bars around the neighborhood were packed on Friday night.
Tents work as long as you have enough artificial respirators and it's not too cold outside. Also, you need to have enough medical personnel, if the Chinese stats are correct about 40% of the Wuhan doctors got sick after 2-3 weeks of the whole thing getting really serious and they had to airlift about 6000 medical personnel from other Chinese regions.
Wish I could be doing something. I’ve just fled to Long Island and am staying in the house reading the news.
It would not surprise me if there is a rallying call (state-sponsored employment?) for younger and able people to help out in the coming weeks, especially if a longer-term lockdown is happening. Things like picking up/dropping off groceries and other tasks on behalf of the elderly and infirm.
This is already happening in my small neighborhood. In about 80 homes, residents range in age from 0.5 years to 86 years. Several younger householders today organized to buy and deliver items needed by older residents so they can continue self-isolation. Spontaneous and heartwarming.
I have already told my parents that I'll do exactly that for them, and have even been asking every time I go to the store myself if they need _anything_ from it.
I'm reasonably sure that I won't die from this, but my parents are old enough to be at serious risk; this is only logical.
I'm reasonably sure that I won't die from this, but my parents are old enough to be at serious risk; this is only logical.
Especially those who have been infected and are immune. (I'm not sure we know to what extend people become immune though?)
I'm really at a loss on this subject because I'm trying to find out answers to two questions that don't have much coverage so far (understandable):
1. The people who "recovered" from this so far, do their CT scans or other tests show alterations to their organs? I've read that survivors of SARS have had permanent damage that later led to issues like cystic fibrosis, and others.
2. Has anyone really become immune to this thing yet? The "UK experiment" is going to be an absolute shitshow if they are walking into this without knowing that it's possible to be immune from it.
1. The people who "recovered" from this so far, do their CT scans or other tests show alterations to their organs? I've read that survivors of SARS have had permanent damage that later led to issues like cystic fibrosis, and others.
2. Has anyone really become immune to this thing yet? The "UK experiment" is going to be an absolute shitshow if they are walking into this without knowing that it's possible to be immune from it.
Regarding the second question, a preprint of study on SARS-CoV-2 immunity in rhesus macaque indicates that they did develop an immunity. [0]
[0] https://www.biorxiv.org/content/10.1101/2020.03.13.990226v1
[0] https://www.biorxiv.org/content/10.1101/2020.03.13.990226v1
Reassuring - thank you!
I wouldn't put any stock in the wild reports of long-term sequelae. I've heard everything from failure of breathing reflex to male sterility, and none of it's worth the paper it's (not) printed on. None of it makes any sense, and besides, people make shit up at times like this, and what survives is what's most startling. (I mean, who'd even be looking at sperm motility right now?) The truth will out in the end.
Still scary, I know. I'm sorry. I wish I had something more reassuring to say. Hang in there.
Still scary, I know. I'm sorry. I wish I had something more reassuring to say. Hang in there.
Sars survivors showed some reduced lung capacity but overall not significant enough to affect quality of life. Morbidity mainly came from poorly executed steroid therapy carried out in a number of hospitals in an attempt to control respiratory failure, which resulted in more permanent disabilities.
Source:https://www.nature.com/articles/s41413-020-0084-5
Source:https://www.nature.com/articles/s41413-020-0084-5
> am staying in the house
You are "doing something" then. Not spreading the disease.
You are "doing something" then. Not spreading the disease.
I came here two weeks ago to downvotes and nonmedical people telling me how I was inciting a panic. Welcome to the show, folks. A lot of my colleagues are going to die soon and I'm beyond sad because of it.
Last night he was headed to work. I saw him saying goodbye to his family with a bag packed. It was horrible. Kids crying, chasing after him...