Covid 19 Struggle: Southern California

[JPA Cate]

It was with great sadness that I read this article this morning. We have friends and family there. https://www.abc.net.au/news/2021-01-...o-die/13035334

Part of what it means is a huge increase in everyone's stress levels, because EMTs (emergency medical technicians) are not generally trained in triage (the separating out of the ones they can help from the ones they cannot). They are also not usually allowed to declare death; that is an emergency room doctor's job. There's also the question of where do they put the people they have to triage out?

These kind of dire situations were predicted last February, so we can see how long it has taken the pandemic to gain a strong foothold. It takes time for the new cases to develop to overwhelming numbers.

Please be careful, folks. Wear your mask so others know you care, and stick to essential travel only.

If we can quarantine the disease, we will come out of the situation way better than if we do not. Go back and read about the actual numbers of hours of work that will be lost: way more if we fail.

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Ann

[Tayana42]

Well said Ann. Living in Long Beach, in Los Angeles, California my wife and I have been isolating at home for many months now. We haven’t seen our kids and grandkids who live fairly close by. No holiday parties except online. If we all pull together and follow the health recommendations we can minimize the terrible impact of the pandemic.

[chris mac]

That's heart breaking!
I sure hope this gets under control everywhere in the world soon.

[JPA Cate]

In an update I just had from Jim, it is the cardiac arrest cases that they will not transport.

It eliminates the chance for a miraculous recovery and it is sad, without a doubt, but I watched my beloved sister in law struggle on the ventilator for days before she passed. It seemed to me that there was suffering there, too, before she passed.

Maybe, we need to encourage ourselves to really consider what quality of life is when it comes to our last days, or hours.

Ann

[AZUS]

I couldn't agree more. Our daughter is an ER doc in one of LA's biggest and most active hospitals and, from the stories she tells, this article expresses only about half of it. She describes it as 'wartime medicine'. It's not only the risk to those very sick with COVID, it's the heart attack, stroke and trauma patients who can't get treated, or can't be treated quickly and to normal standards. It's not from lack of effort - she and her colleagues are working 150% of full-time shifts. There is physically not enough space, qualified people, and supplies to handle the numbers. The medical system there is truly overwhelmed, and COVID hasn't peaked yet - we hear about great strains every shift. Moreover, other places, like AZ have even higher growth rates.
So, please keep your heads down. This is not the time to have a broken hip, heart attack from unusual exertion, or a car accident.

[Thumbs Up]

This is the directive:http://file.lacounty.gov/SDSInter/dh...diacArrest.pdf
It pretty much says "Don't bring patients with no heart beat to the emergency room."

I don't know where else to post this but is more good news for Ivermectin. Preprint (not yet peer reviewed) of recent study (randomized,
double blind placebo controlled, dose response, parallel group study) just out today: "Ivermectin shows clinical benefits in mild to moderate COVID19"https://www.medrxiv.org/content/10.1...131v1.full.pdf

[denverd0n]

So what the heck is going on in California? I work in Florida, in the IT department of a university, supporting its College of Medicine and an associated hospital. As such, I'm pretty much tuned into this stuff every day. The hospitals here are not over-whelmed, nor running out of PPE, ventilators, or anything else really. They are busier than usual, yes, but definitely not over-whelmed.


What is happening in California that is NOT happening in Florida? I wish I knew.

[ArmyDaveNY]

Thank you Thumbs Up for posting the directive. It provides some much needed clarity for what it actually means. In a nutshell, it directs the ambulance crew in very specific and limited situations to not expended critical resources that would be wasted with almost no chance of a good outcome. It isn't as dramatic as it first sounds. It is NOT an all encompassing directive to abandon patients.

Some quick background on my experience with this: I worked on a paramedic rig for six years, mostly while I was in college. I still keep in touch with a few of my co-workers and still occasionally do a ride along. This directive is a verbalization of something that most crews are familiar with and have done in many cases since ambulances first started.

This directive is NOT talking about cases where grandpa is at a store and goes down in front of everyone, in a town, and the ambulance gets there in a reasonable amount of time. It is talking about a case where the patient had the heart attack or stopped breathing some time before being discovered. They also talk about cardiac arrest from trauma, and in specific situations that patient is not to be transported. The directive does talk about initiating treatment and contacting the trauma center in order to make an assessment.

We used to exercise similar discretion all the time. What it different is that often an ambulance crew would transport knowing the chances of survival were nil or almost nil. This was done for a number of reasons, but now the directive reduce the wasting of resources.

[GordMay]

Many Canadian Hospitals are now implementing Virtual Emergency Departments, that provide same-day virtual assessments, with emergency department physicians. Diverting unnecessary visits to our ED will result in increased overall capacity, and reduced wait times, for those who still need to attend an ER in person.

ie: Thunder Bay ➥ https://tbrhsc.net/urgent-care-from-...cy-department/

[ArmyDaveNY]

Originally Posted by GordMay

Many Canadian Hospitals are now implementing Virtual Emergency Departments, that provide same-day virtual assessments, with emergency department physicians. Diverting unnecessary visits to our ED will result in increased overall capacity, and reduced wait times, for those who still need to attend an ER in person.

ie: Thunder Bay ➥ https://tbrhsc.net/urgent-care-from-...cy-department/

This is a great idea, and should be continued even after they declare an end to the epidemic. There are a lot of visits to the ER that really don't require a trip to the ER.

[jmschmidt]

Covid Alert: Do you know how to determine if your mask is working? If it dangles from your ears it doesn't. If you wear it on the tip of your nose it doesn't. If you wear it below your nose over your mouth it doesn't. And, if you wear it on your chin it sure as hell doesn't. If it is not a certified N95 with dual straps that run behind your head to hold it firmly in place it probably doesn't.

[Cpt Mark]

Originally Posted by denverd0n

So what the heck is going on in California? I work in Florida, in the IT department of a university, supporting its College of Medicine and an associated hospital. As such, I'm pretty much tuned into this stuff every day. The hospitals here are not over-whelmed, nor running out of PPE, ventilators, or anything else really. They are busier than usual, yes, but definitely not over-whelmed.


What is happening in California that is NOT happening in Florida? I wish I knew.

California, especially so cal is a very densely populated state. That alone would account for the higher numbers. I know people down there personally who still don't think covid is a big thing and will travel out of state to Arizona so they can party, go to restaurants and not wear a mask. Never mind the fact that Arizona just made it to the top of the world list as the highest rate of covid. Sadly, you can't fix self entitlement attitude's and stupid.

[GordMay]

Originally Posted by jmschmidt

Covid Alert: Do you know how to determine if your mask is working? If it dangles from your ears it doesn't. If you wear it on the tip of your nose it doesn't. If you wear it below your nose over your mouth it doesn't. And, if you wear it on your chin it sure as hell doesn't. If it is not a certified N95 with dual straps that run behind your head to hold it firmly in place it probably doesn't.

If you can blow out a match, through a properly fitted mask, it probably isn't.

[valhalla360]

Originally Posted by denverd0n

So what the heck is going on in California? I work in Florida, in the IT department of a university, supporting its College of Medicine and an associated hospital. As such, I'm pretty much tuned into this stuff every day. The hospitals here are not over-whelmed, nor running out of PPE, ventilators, or anything else really. They are busier than usual, yes, but definitely not over-whelmed.

What is happening in California that is NOT happening in Florida? I wish I knew.

Different state but my sister is head of one of the convention centers that were converted to treat covid patient overflow. She can't get the local hospitals to send the low severity patients to her center because the hospitals don't want to give up the big govt payments associated with treating a covid patient. Basically it's more profitable to run the staff ragged paying overtime than to send some to other facilities.

Not suggesting it's not a bad situation but by now we've seen enough situations where we get distorted news...that it's logical to be skeptical of outrageous claims.

[conchaway]

Many years ago, a study was made called "rats in a box". Scientists started by putting 2 rats in a box with plenty food and water. They got along well. They gradually added more and more rats, and after a while, the rats became increasingly agitated, began to fight, and developed diseases, and died off until they reached a manageable level, called a "carrying capacity". The foregoing was apropos of nothing, it just came to mind.