The Official CORONAVIRUS oh *&^! thread. Time to start stocking up on food?

[SedRate]

9 hours ago, Reality Check 2 said:

https://www.yahoo.com/news/nurses-die-doctors-fall-sick-184822765.html

This story is horrifying.

A hospital admin saying come to work - sick or not....

The same PPE for days on end....

I am still in disbelief that hospitals are willing to have medical workers die or sustain permanent lung damage for this. I don’t have a good alternate plan but the current situation is overwhelming. There doesn’t appear to be a rational solution. 

Selfish or whatever you want to label it - I am not willing to die for this.

What have we done? Will we learn anything from this? What will the legacy be?

The current estimate of fatalities is 100,000 to 200,000 - the same as  my entire childhood hometown disappearing...

Sorry - the emotional impact of this is almost too much to handle.

Please everyone - be safe.

It's not selfish at all. 

The fragility of life is very real, with or without something like this virus. We all take risks every day when we wake. Take solace in knowing that you're staying well-informed and protecting yourself and those around you. At this point, that's all we can do. And understand that you're not alone. We are all experiencing this together and we will get thru this. 

As for what we'll learn... I do hope it's that we no longer take life for granted and do what we can to live our best lives while we're here. Our country is very sick and we need a wake-up call. It's unfortunate that a pandemic is what will show us that what we're doing in healthcare (admin, insurance companies, infrastructure, "treat it not prevent it" mentality, etc) isn't working. I do hope to see significant change once this is all over.

[Cideous]

Just watched the California Governors speech on loosening of restrictions for health care providers...

He mentions "Nurse Practitioners"......No mention of us Assistants.

 

I wonder why....

[SedRate]

1 hour ago, Cideous said:

Just watched the California Governors speech on loosening of restrictions for health care providers...

He mentions "Nurse Practitioners"......No mention of us Assistants.

 

I wonder why....

Ugh. I love being a PA but sometimes I really second guess my decision not to pursue medical school. It's not too late, although medical school would set back my early semi-retirement goals... 

[GetMeOuttaThisMess]

What this is really showing is how HC admins and gov't officials are the ones who have dropped the ball on this, having been told for years of an impending crisis from one source or another and not "saving for a rainy day" (supplies, etc.).  They drop the ball and expect HCP's to run into the traffic to go retrieve it.

Edited March 31, 2020 by GetMeOuttaThisMess

[rev ronin]

So, this has come up a bit here and there, and I wanted to address it in a systematic way: Businesses and government organizations are not incentivized to plan for 'black swan' events--that is, those that occur very infrequently and are devastating in impact.

I learned this in IT security, working in a Fortune 100 company, that was both quite profitable and had quite a lot of money to address concerns.  For the most part, it did not, because numbers didn't add up.

1) Most threats don't materialize within the planning horizon. While a 1% chance of a $4 billion impact might justify a $40 million mitigation plan on paper, there's a 99% chance that won't happen.

2) Your competition is not saving for a rainy day.  Whether they can or not, the competitor who wants your job or customers has decided to cut corners, to deliver more goods, or services, or reduce taxes, or whatever.  That money that might go for an IT hot site, or a rainy day fund, or extra N95s can instead be used for more marketing, or to reduce hold times, or to migrate to LED lighting.  There's always something better to do with money than park it in a "break glass in case of emergency" case.

3) Disaster recovery plans don't work.  It's simply too time consuming to keep them up to date as business processes change.  By the time you NEED the disaster recovery plan, it's outdated. Or you missed some big contingency that you didn't know about because no one thought to tell the IT DR guys that critical system B depends on system F which was deemed non-mission-critical, because no one knows the ways in which complex systems will actually fail.  That's almost the definition of "complex system".

4) There are too many black swan events to plan for.  This time, it's an airborne coronavirus.  What if it were a meteor? A terrorist attack? A digital Pearl Harbor?  Which ones do you fund, and which ones do you not fund?  If you fund all of them, there goes your dividends or fiscal reserves or earnings per share...  And, again, the vast majority will not happen during the planning horizon.

5) The supply chain is not your friend in a time of disruptive change.  All that stuff you WERE counting on being able to get?  All your cheaper vendors, driven to that by the bid process, have outsourced everything to China or other low-cost geographies, so even if you specify American-made stuff, you're at most going to get it assembled or finally packaged here. When the world all needs X at once... you're not going to be able to get X, because the suppliers of X have optimized their supply chains, manufacturing processes, and delivery methods to be most efficient and the usual demand for X.

So yeah, we're screwed.  We were never NOT going to be screwed.  It doesn't matter who was fired or not, or who spent money or not, because deep down underneath the finger pointing, our efficiency-driven system has engineered out the capacity to respond to unpredictable events. We have a Formula 1 race car, and we need to go 4x4ing.

[SedRate]

43 minutes ago, rev ronin said:

So, this has come up a bit here and there, and I wanted to address it in a systematic way: Businesses and government organizations are not incentivized to plan for 'black swan' events--that is, those that occur very infrequently and are devastating in impact.

I learned this in IT security, working in a Fortune 100 company, that was both quite profitable and had quite a lot of money to address concerns.  For the most part, it did not, because numbers didn't add up.

1) Most threats don't materialize within the planning horizon. While a 1% chance of a $4 billion impact might justify a $40 million mitigation plan on paper, there's a 99% chance that won't happen.

2) Your competition is not saving for a rainy day.  Whether they can or not, the competitor who wants your job or customers has decided to cut corners, to deliver more goods, or services, or reduce taxes, or whatever.  That money that might go for an IT hot site, or a rainy day fund, or extra N95s can instead be used for more marketing, or to reduce hold times, or to migrate to LED lighting.  There's always something better to do with money than park it in a "break glass in case of emergency" case.

3) Disaster recovery plans don't work.  It's simply too time consuming to keep them up to date as business processes change.  By the time you NEED the disaster recovery plan, it's outdated. Or you missed some big contingency that you didn't know about because no one thought to tell the IT DR guys that critical system B depends on system F which was deemed non-mission-critical, because no one knows the ways in which complex systems will actually fail.  That's almost the definition of "complex system".

4) There are too many black swan events to plan for.  This time, it's an airborne coronavirus.  What if it were a meteor? A terrorist attack? A digital Pearl Harbor?  Which ones do you fund, and which ones do you not fund?  If you fund all of them, there goes your dividends or fiscal reserves or earnings per share...  And, again, the vast majority will not happen during the planning horizon.

5) The supply chain is not your friend in a time of disruptive change.  All that stuff you WERE counting on being able to get?  All your cheaper vendors, driven to that by the bid process, have outsourced everything to China or other low-cost geographies, so even if you specify American-made stuff, you're at most going to get it assembled or finally packaged here. When the world all needs X at once... you're not going to be able to get X, because the suppliers of X have optimized their supply chains, manufacturing processes, and delivery methods to be most efficient and the usual demand for X.

So yeah, we're screwed.  We were never NOT going to be screwed.  It doesn't matter who was fired or not, or who spent money or not, because deep down underneath the finger pointing, our efficiency-driven system has engineered out the capacity to respond to unpredictable events. We have a Formula 1 race car, and we need to go 4x4ing.

100% yes

[ventana]

1 hour ago, rev ronin said:

S 

So yeah, we're screwed.  We were never NOT going to be screwed.  It doesn't matter who was fired or not, or who spent money or not, because deep down underneath the finger pointing, our efficiency-driven system has engineered out the capacity to respond to unpredictable events. We have a Formula 1 race car, and we need to go 4x4ing.

agree with some of this but not all

 

We are not making widgets.  We are in the care delivery model and the insurance companies dictate everything these days and they are soley driven by profit

 

BUT

 

We as a society needs to realize that we can not force medicine to operate at 98% all the time and then be ready for disasters.  

Medicine is a social safety net and society needs to invest in it.  

 

[Cideous]

32 minutes ago, ventana said:

 

 

We as a society needs to realize that we can not force medicine to operate at 98% all the time and then be ready for disasters.  

Medicine is a social safety net and society needs to invest in it.  

 

Your exactly right!

[GetMeOuttaThisMess]

Interesting idea, and he's local to DFW.  https://www.nbcnews.com/news/us-news/texas-mom-pop-business-flooded-orders-helmet-ventilators-amid-coronavirus-n1173466

[SedRate]

Received this info from a friend in NY who's having to reuse masks. Stay safe, everyone. 

[Joelseff]

So got this in doctor's guide. The first Pic was from yesterday and 2nd Pic is from today.... 1000 ish new deaths in one day? Gotta admit I downplayed this a little before but man... Whew... Praying for our nation and the Frontline of Healthcare personnel. You guys out there working I'm praying for you! (I have been on disability since October so I haven't been practicing...)

 

 

 

 

 

Sent from my SM-G975U using Tapatalk

 

 

 

 

 

 

 

 

[SedRate]

On 3/23/2020 at 11:14 AM, mgriffiths said:

One of our mid-level administrators has had their picture plastered all over facebook by hospital staff wearing an N95 mask at the grocery store.  The photo was taken last Friday, the same day that the hospital sent an email to staff that N-95 masks were unavailable for any outpatient clinic and would be reserved for ED and inpatient use only.  To make it worse, she WAS my favorite of our administrators.  The "good" part is that of course nothing will happen so she'll still be around for a long time...

 

Edit: and this is the same administrator that told my NP colleague that she could not wear her N95 masks she purchased with her own money while working in our hospital's "covid clinic" since they weren't "purchased by the hospital and therefore their effectiveness can't be guaranteed."

Is your middle man still singing the same tune now that we're a week later into this mess? I'll just leave this Joint Commission announcement right here... I wonder what OSHA would have to say about the mask sitch?

[mgriffiths]

1 hour ago, SedRate said:

Is your middle man still singing the same tune now that we're a week later into this mess?

As far as I know we are still not allowed to bring our own PPE...but I'm also not working in our COVID clinic so not exactly in the thick of it.

[SedRate]

24 minutes ago, mgriffiths said:

As far as I know we are still not allowed to bring our own PPE...but I'm also not working in our COVID clinic so not exactly in the thick of it.

Wow. Just wow... That right there is some bullcrap. I smell a lawsuit if an employee contracts it and dies due to improper protection and admin not allowing them to protect themselves. I urge you to inform your coworkers to keep record of all this and to share the statement by JC.

I do hope they are protecting themselves... 

[DarwinStarwin]

Got this from HR today.....

US DOL employee rights re: paid sick leave and expanded FMLA under "families first coronavirus response act". Provisions apply from April 1, 2020 through Dec 31, 2020:

Paid leave entitlements:
Generally, employers covered under the Act must provide employees:
Up to two weeks (80 hours, or a part-time employee’s two-week equivalent) of paid sick leave based on the higher of
their regular rate of pay, or the applicable state or Federal minimum wage, paid at:
• 100% for qualifying reasons #1-3 below, up to $511 daily and $5,110 total;
• 2/3 for qualifying reasons #4 and 6 below, up to $200 daily and $2,000 total; and
• Up to 12 weeks of paid sick leave and expanded family and medical leave paid at 2/3 for qualifying reason #5
below for up to $200 daily and $12,000 total.
A part-time employee is eligible for leave for the number of hours that the employee is normally scheduled to work
over that period.

QUALIFYING REASONS:
(Employee is entitled to take sick leave if they can't work, including unable to telework) because:

1. is subject to a Federal, State, or local quarantine or
isolation order related to COVID-19;
2. has been advised by a health care provider to
self-quarantine related to COVID-19;
3. is experiencing COVID-19 symptoms and is seeking
a medical diagnosis;
4. is caring for an individual subject to an order described
in (1) or self-quarantine as described in (2);
5. is caring for his or her child whose school or
place of care is closed (or child care provider is
unavailable) due to COVID-19 related reasons; or
6. is experiencing any other substantially-similar
condition specified by the U.S. Department of
Health and Human Services.

Dol.gov/agencies/whd

[GetMeOuttaThisMess]

Interesting graph regarding fatality rate of COVID-19 compared to other common causes of death.  Watch it play out and skyrocket toward the top of the chart.  https://digg.com/2020/coronavirus-deaths-vs-cancer-heart-disease?utm_source=digg&utm_medium=email

Edited April 2, 2020 by GetMeOuttaThisMess

[cbrsmurf]

We have now breached 1000 deaths per day caused by Covid19 in the US

[Cideous]

1 hour ago, cbrsmurf said:

We have now breached 1000 deaths per day caused by Covid19 in the US

It's going to get a lot higher than that per day.  I could easily see 10,000 per day dying once it takes off in all the other big cities like it is doing in NYC.

Edited April 2, 2020 by Cideous

[mgriffiths]

Final update regarding the patient I tested on 03/21/2020.  The below is a quote sent to me by the State of Michigan regarding the status of the test results:

"At this time your lab test is not considered high priority, and therefore will not be run.  Due to the lack of priority the swab has been discarded as of 3/30/2020.  If you have concerns or would like to discuss the priority status of your patient please call XXX-XXX-XXXX."

So I can call to discuss the priority status to argue the swab should be run...but they already discarded it?  You would think that as this has been ongoing they would have increased capacity to know the full picture within the state as Michigan is shaping to be one of the hardest hit states (currently #4 in cases, #3 in deaths) and doesn't appear to be slowing down.  But, as I have said before, I'm not surprised with the result at this point and honestly I would agree that the priority to run the swab 12 days after collecting is low priority...

[GetMeOuttaThisMess]

24 minutes ago, Cideous said:

It's going to get a lot higher than that per day.  I could easily see 10,000 per day dining once it takes off in all the other big cities like it is doing in NYC.

One potential variable here is that many other metropolitan areas aren't as densely populated as NYC.  DFW for example would be a better comparison to say LA/Orange counties.  La.?  Uh, I think we know why they ballooned and yet they want to blame it on the feds because "they didn't give us any insight" regarding Mardi Gras.  Really?  Florida is another example.  I hate to be associated with these folks but the UT-Austin crowd that polluted themselves in Cabo?  Goobers.  Sometimes you have to use common sense.  I can see a lot of incumbents going down during the next election cycle.  It would be like shooting fish in a barrel for a challenger to take down some of these folks.

Edited April 2, 2020 by GetMeOuttaThisMess

[DarwinStarwin]

Final update regarding the patient I tested on 03/21/2020.  The below is a quote sent to me by the State of Michigan regarding the status of the test results:
"At this time your lab test is not considered high priority, and therefore will not be run.  Due to the lack of priority the swab has been discarded as of 3/30/2020.  If you have concerns or would like to discuss the priority status of your patient please call XXX-XXX-XXXX."
So I can call to discuss the priority status to argue the swab should be run...but they already discarded it?  You would think that as this has been ongoing they would have increased capacity to know the full picture within the state as Michigan is shaping to be one of the hardest hit states (currently #4 in cases, #3 in deaths) and doesn't appear to be slowing down.  But, as I have said before, I'm not surprised with the result at this point and honestly I would agree that the priority to run the swab 12 days after collecting is low priority...

Lawd. How frustrating. How did the patient respond to the news?

[mgriffiths]

6 minutes ago, DarwinStarwin said:

Lawd. How frustrating. How did the patient respond to the news?

The patient's PCP had already called by the time I got the news, but the patient is super nice.  I'm sure the patient is frustrated, similar to me, but at least understands it's not our doing...

[GetMeOuttaThisMess]

C'mon MG, it's the new method of COVID-19 testing.  Delay the actual running of the test until the patient is ~14 days out and if still alive report the test as negative.  If patient warrants repeated harassment calls to the lab then actually run it and then report it as a "positive".  

[Reality Check 2]

FEMA just requested 100,000 body bags from the Pentagon.

The single best comment on the article - someone said - How does the Government have 100,000 body bags but not enough PPE or ventilators?.......

How does it feel to get PPE from Russia? Why do they have extra?

There is so much about this whole disaster that just doesn't add up.

[mgriffiths]

2 hours ago, Reality Check 2 said:

How does the Government have 100,000 body bags but not enough PPE or ventilators?

I think one simple answer for this is that due to the purpose of body bags I highly doubt they have an expiration date.  Plus, that would be something that the military should pretty much always have stockpiled due to the potential for war...not that that means they shouldn't also have PPE and needed medical equipment.  I will also say that I wouldn't be surprised if the military has PPE and other medical equipment stockpiled, but it is not making it available for civilian use due to national security (because everything is done in the name of our supposed "national security"...)