COVID-19

[ulukinatme]

Yeah, that's not gonna do it for me.

 

[dublinirish]

<blockquote class="twitter-tweet"><p lang="en" dir="ltr">These are iPad stations being prepared for virtual ICU end of life visits by a palliative care doc I know. Jesus. <a href="https://t.co/lIgbg0FhaL">pic.twitter.com/lIgbg0FhaL</a></p>— i cant drive, n95 (@roto_tudor) <a href="https://twitter.com/roto_tudor/status/1334534101265682434?ref_src=twsrc%5Etfw">December 3, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>

 

[Legacy]

With the surge in South Dakota, their five largest cities - Sioux Falls, Rapid City, Brookings, Mitchell, and Brooks - are implementing mask mandates of a kind. The Rapid City City Council approved one 9-1. Their mandate is as follows:

Requiring the public to wear a mask in public indoor places where six feet of social distancing was not possible, businesses and other facilities that have an occupancy of 50 people or more will be able to opt out of the regulations.

Council voted on the ordinance and removed “houses of worship” from the indoor public places definition and changed the signage information so businesses will be required to post signs that state masks are required or recommended. Businesses or facilities that opt out of the ordinance will have to have signage stating they chose to opt out.

So, businesses have the choice to post signage that masks are recommended or a sign that says they are opting out of the Council's ordinance. For those that do not opt out, the procedure for the businesses in violation are:

Enforcement will be through “an administrative process” rather than criminal. The city would notify the business of the violation, provide the information on the ordinance and ask for compliance. If further violations are noted, the city will contact the business again either in writing or through the City Code Enforcement division. The total fine and cost of the violation will be $100. Each day the violation occurs could be considered a separate offense.

Despite the White House Coronavirus Task Force recommending South Dakota ensure masks at all times in public and face covering requirements have been shown to “improve adherence and lower transmission” of COVID-19, the Governor is not going to follow those. Her spokeswomen said,

“I’m still waiting for someone to point me to where in the world mask mandates are working.”

 

[phork]

With the surge in South Dakota, their five largest cities - Sioux Falls, Rapid City, Brookings, Mitchell, and Brooks - are implementing mask mandates of a kind. The Rapid City City Council approved one 9-1. Their mandate is as follows:



So, businesses have the choice to post signage that masks are recommended or a sign that says they are opting out of the Council's ordinance. For those that do not opt out, the procedure for the businesses in violation are:



Despite the White House Coronavirus Task Force recommending South Dakota ensure masks at all times in public and face covering requirements have been shown to “improve adherence and lower transmission” of COVID-19, the Governor is not going to follow those. Her spokeswomen said,

#1 Why give them an opt out, and then also penalize the businesses that opt-in. That makes no sense, you want 100% compliance not some half assed strategy.

#2 Do they have the internet in South Dakota? Or was google and/or other search engines blocked?

 

[Legacy]

Two different analyses show that Covid was circulating in the U.S. in mid-Dec or earlier. Researchers from the CDC analyzed nearly 7,400 blood samples collected across nine states by the American Red Cross between mid-December and mid-January. Of those, 106 showed antibodies for the virus, according to the study.

COVID-19 May Have Arrived in US in December: Study
SARS-CoV-2 antibodies detected in blood donor samples indicate infections could have occurred in the US more than a month before the first confirmed case, but some experts remain skeptical.
Excerpt:

Among the 7,389 samples, 106 had SARS-CoV-2 antibodies, of which 39 were collected from California, Oregon, and Washington between December 13 and December 16. Another 67 were collected from Connecticut, Iowa, Massachusetts, Michigan, Rhode Island, and Wisconsin between December 30 and January 17.

Of 90 samples the researchers could perform follow-up tests on, 84 showed some evidence of antibodies blocking SARS-CoV-2 from binding to ACE2, a receptor the coronavirus uses to enter host cells.

Positive SARS-CoV-2 antibody tests suggest a prior COVID-19 infection, but they do not provide definitive proof, as prior exposure to other coronaviruses—some of which can cause a common cold—can produce a false-positive result. The authors conclude that it is unlikely that all 84 samples represent false positives, and therefore at least some reflect COVID-19 infections in December or early January.

One of the primary symptoms of Covid is excessive coughing which can last long after the infection is over. During the time period from December, ER and clinic visits for cough went up significantly. The limitation is the reliance on those who present themselves to the healthcare system and cannot quantify an increase among people without health insurance including some minority populations.

Excess Patient Visits for Cough and Pulmonary Disease at a Large US Health System in the Months Prior to the COVID-19 Pandemic: Time-Series Analysis

Conclusions: A significantly higher number of patients with respiratory complaints and diseases starting in late December 2019 and continuing through February 2020 suggests community spread of SARS-CoV-2 prior to established clinical awareness and testing capabilities.

From the CDC a retrospective look at the Percentage of Outpatient and Emergency Department Visits for ILI (Influenza Like Illness) and CLI (Covid like Illness)

The horizontal line's numbers reflect the year and week of the reported totals.

 

[Greenore]

<blockquote class="twitter-tweet"><p lang="en" dir="ltr">These are iPad stations being prepared for virtual ICU end of life visits by a palliative care doc I know. Jesus. <a href="https://t.co/lIgbg0FhaL">pic.twitter.com/lIgbg0FhaL</a></p>— i cant drive, n95 (@roto_tudor) <a href="https://twitter.com/roto_tudor/status/1334534101265682434?ref_src=twsrc%5Etfw">December 3, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>

This is a very powerful photo.

Cheers and Go Irish!!

 

[Legacy]

Interferon beta-1a may help COVID-19 patients recover faster (CIDRAP)

The study is posted in the Science thread.

 

[SonofOahu]

This is a very powerful photo.

Cheers and Go Irish!!

I have a lot of physician friends who work in emergency and critical-care medicine; many of them are on the west coast. A few were commenting that this picture made them mad, because their first thought was "what hospital has that much money that they can buy so many ipads?" Then they felt bad for getting upset. Many of them are shook by having to be the last person so many of their patients see.

This disease is really taking an emotional toll on professionals.

 

[Legacy]

Usually the last person who is not a family member that someone dying sees in a hospital or palliative care setting is a nurse, who administers IV Morphine or other meds to ease someone's breathing. A nurse holds their hand to reassure and comfort them if they were alone during the process of dying. The emotional toll on a nurse who does this multiple times at people's bedside day after day must be extreme and almost unimaginable. To know that unlike palliative care for patients whose cancers have brought them to this point is one thing with less emotional toll. I imagine that there's an additional emotional burden for a professional whose life is dedicated to saving patients would be that unlike cancers or war deaths many of those people's death one sees face to face could have been mitigated or prevented.

Always powerful

As with other healthcare professionals, she'll be there if he becomes critically ill or is dying.

 

[Old Man Mike]

I THINK that guy in the picture is just waiting for his check-in to see the medical people or a family member. She's marking the social distancing spot and giving him the info what and why. He'll probably be given a mask at the checkpoint. THAT's my happy interpretation and what I'm going with.



By the way (for those who care ... and I've been astonished to read things here on IE which lead me to think that a small group of posters do NOT in fact care all that much), there is something which has been alluded to in this thread but which hits me strongly as the days creep by. COVID is killing in two ways of importance. It's killing the way we naturally interpret that word, but it is also killing the souls of many persons. I see it in this retirement "hotel-like" structure that I live in now (since February --- lockdown occurred here near the end of March I think.)

The Fountains retirement community has done very well in protecting our bodies from COVID. Only some isolated "Memory Care" patients have gotten it, and no independent living residents. But there is a feeling of ... depression? ... loss of "living"? ... loss of goals in these last few years that we have left? (I'm 80 and on the younger end of this spectrum.) Very few of these people are "duds" or losers or fundamentally useless citizens "so who cares?" (and you know, I shouldn't say this, but we have a few {thankfully few} regular posters whose jovial denseness leaves me with exactly that impression --- "so who cares?")

I see, and it's getting rarer to see any of them at all as they retreat to the security of their apartments, folks that I was beginning to know back in March, who now have very little upbeat to say about anything, and sometimes little to say period. Folks are fussing more about their physical ailments, the small things hampering their lives structurally, the loss of Wholeness which once was Life. My days don't seem to knit together anymore. "Life" is one fragmented agenda list item after another. Days aren't part of anything. Without wholeness there is no joy in any of the bits.

This is the second important way that COVID is killing. This is why, if we have any empathy at all, we need to do anything --- ANYTHING --- to end this @#$# thing as an isolator, and get us all "back together" seeing, talking, and being with one another. That would take real sacrifice over quite a bit of time. It's been suggested to us. Some of us won't do it. ... so this damnable killer continues.

 

[ab2cmiller]

Well said OMM.

 

[yankeehater]

Guess our leaders still haven't learned much. Now a nursing home in Massachusetts is going to allow covid positive patients. Doesn't make me feel confident they are really trying to protect the most vulnerable.

https://www.theblaze.com/news/massachusetts-nursing-home-coronavirus

 

[IrishLax]

<blockquote class="twitter-tweet"><p lang="en" dir="ltr">Breaking - UPS and FedEx trucks carrying the first U.S. shipment of coronavirus vaccine have left Pfizer’s facility near Kalamazoo, Michigan. <a href="https://t.co/Cf32ki9gCF">pic.twitter.com/Cf32ki9gCF</a></p>— Pete Muntean (@petemuntean) <a href="https://twitter.com/petemuntean/status/1338116009190944769?ref_src=twsrc%5Etfw">December 13, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>

 

[Irish YJ]

<blockquote class="twitter-tweet"><p lang="en" dir="ltr">Breaking - UPS and FedEx trucks carrying the first U.S. shipment of coronavirus vaccine have left Pfizer’s facility near Kalamazoo, Michigan. <a href="https://t.co/Cf32ki9gCF">pic.twitter.com/Cf32ki9gCF</a></p>— Pete Muntean (@petemuntean) <a href="https://twitter.com/petemuntean/status/1338116009190944769?ref_src=twsrc%5Etfw">December 13, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>

Pretty impressive speed. How do we compare to other countries?

 

[Legacy]

A friend''s spouse had to be admitted to a metropolitan KC hospital for an acute (non-Covid) condition onto one of their three medical floors. Two of those had already had to be converted to Covid floors to handle the surge with appropriate sealing of the units and airflow adaptations. The ER was packed with patients in hallways who had been admitted but were waiting for a bed either a floor bed or a critical care bed.

Under usual procedures the ER would have gone on temporary Divert status to other hospitals as their rooms became full while waiting for beds to open up. With admitted patients in their ER hallways, it means that other hospitals in the area were in the same situation. It also means that smaller hospitals and those in rural areas could not transfer their patients - and may mean that long term care facilities etc. may have to care for their own.

Missouri's guidance on readmission to LTC facilities is probably the same as in other states.

Facilities may also consider readmitting residents with a recent COVID-19 diagnosis based on their ability to care for such patients and with proper infection prevention control in place. Readmission to long term care for eligible patients from hospitals will help ensure availability of hospital beds for COVID-19 patients with acute care needs.

In preparation to handle Covid patients on non-critical care floors, not only would equipment such as ventilators and procedure kits have been repositioned to those floors, but staff would have been familiarized to handle procedures usually done in ICUs should the patient become critical.

Symptoms from a Covid transmission from a Thanksgiving interaction can take up to fourteen days, though people are at highest level of transmission 24-48 hours after infection when they are asymptomatic.

I imagine many of you are hearing the same sorts of stories?

 

[SonofOahu]

Pretty impressive speed. How do we compare to other countries?

I'm not sure what this question means, but if you mean "do the dozen or so other Pfizer/Pfizer-contracted production sites have the same shipping schedule as Michigan does?" then the answer is sorta yes:

1. I don't' know the exact number of production sites, but I think it's at least a dozen worldwide, for obvious reasons. Many of them have been shipping for days, even weeks. Besides the holidays, this is another reason why your packages/mail have been so delayed. The vaccine takes top priority for air-cargo space.

2. It's an mRNA vaccine that's been in RnD for more than twenty years, now. (Not literally for COVID, but for stuff like HIV, Zika, and SARS.) It wasn't widely distributed because those viruses were JV compared to SARS-CoV-2 (not HIV, obviously.)

3. Yes, this vaccine is actually pretty safe. Our pharmacy director was giving the basics of the tech, distribution, etc.

This last week has been a crazy, crazy time. We've had daily calls, conferences, and meetings for, like, ten days straight. The real Operation Warp Speed is trying to figure out who gets the vaccine and when. This is the largest distribution project the world has ever seen. That's not hyperbole, that's fact. What an amazing time.

 

[SonofOahu]

Guess our leaders still haven't learned much. Now a nursing home in Massachusetts is going to allow covid positive patients. Doesn't make me feel confident they are really trying to protect the most vulnerable.

https://www.theblaze.com/news/massachusetts-nursing-home-coronavirus

A friend''s spouse had to be admitted to a metropolitan KC hospital for an acute (non-Covid) condition onto one of their three medical floors. Two of those had already had to be converted to Covid floors to handle the surge with appropriate sealing of the units and airflow adaptations. The ER was packed with patients in hallways who had been admitted but were waiting for a bed either a floor bed or a critical care bed.

Under usual procedures the ER would have gone on temporary Divert status to other hospitals as their rooms became full while waiting for beds to open up. With admitted patients in their ER hallways, it means that other hospitals in the area were in the same situation. It also means that smaller hospitals and those in rural areas could not transfer their patients - and may mean that long term care facilities etc. may have to care for their own.

Missouri's guidance on readmission to LTC facilities is probably the same as in other states.



In preparation to handle Covid patients on non-critical care floors, not only would equipment such as ventilators and procedure kits have been repositioned to those floors, but staff would have been familiarized to handle procedures usually done in ICUs should the patient become critical.

Symptoms from a Covid transmission from a Thanksgiving interaction can take up to fourteen days, though people are at highest level of transmission 24-48 hours after infection when they are asymptomatic.

I imagine many of you are hearing the same sorts of stories?

Yankee: If the patient doesn't need an acute bed, the patient will stay in a sub-acute setting. That's what triage is about, and that's what systems have to do when beds are short. It's not rocket science. Nursing homes were told around August/September to prepare isolation units within their facility to house CoV patients. So, if by "leadership" you mean CMS, then yes, we apparently haven't learned anything.

Legacy: Hawaii is not so bad, right now, but our ICU utilization is way high considering the fact that we don't have that many CoV patients in them. Flu is also low, so I'm wondering if this is the result of patients putting off their treatments and getting sicker.

 

[Old Man Mike]

Oahu: this is what happened at my retirement community. We had no positives in a comprehensive sweep as far as independent living residents were concerned, but in an ancillary part of the community for memory care there were three. These three persons were deemed not emergency need cases (may have been asymptomatic, I don't know --- we're not privy to details) and were not sent into the hospital system but were stated to be "self-isolating" in their apartments in that separate area. Since they were already in a special care area, they would still get all the attention/help/service of the facility, but wouldn't go "out." I'm just another "Joe" with no need to know, so that's all I've got --- The high administration of the business sends around COVID situational news about what's happening here, so that is how I know that part.

An aside: Kalamazoo is home of the Mighty Pfizer. We'll see if we get the vaccine any quicker than most.

 

[yankeehater]

Yankee: If the patient doesn't need an acute bed, the patient will stay in a sub-acute setting. That's what triage is about, and that's what systems have to do when beds are short. It's not rocket science. Nursing homes were told around August/September to prepare isolation units within their facility to house CoV patients. So, if by "leadership" you mean CMS, then yes, we apparently haven't learned anything.

Legacy: Hawaii is not so bad, right now, but our ICU utilization is way high considering the fact that we don't have that many CoV patients in them. Flu is also low, so I'm wondering if this is the result of patients putting off their treatments and getting sicker.

Oahu: In not one article I read about the Massachusetts situation was the fact the decision was made based on a shortage situation. Even if that was the case, why have they not come up with better options in the last nine months. What happened to field hospitals and the like?

 

[yankeehater]

Yankee: If the patient doesn't need an acute bed, the patient will stay in a sub-acute setting. That's what triage is about, and that's what systems have to do when beds are short. It's not rocket science. Nursing homes were told around August/September to prepare isolation units within their facility to house CoV patients. So, if by "leadership" you mean CMS, then yes, we apparently haven't learned anything.

Legacy: Hawaii is not so bad, right now, but our ICU utilization is way high considering the fact that we don't have that many CoV patients in them. Flu is also low, so I'm wondering if this is the result of patients putting off their treatments and getting sicker.

I read a story from a pharmacist back in NY who said they are currently in the middle of flu season yet he has not received one prescription for Tamiflu. In 43 years in the business with 30 of those as a pharmacist, he had never seen such a thing. He decided to call his pharmaceutical rep for the brand who told him that none of his 75 independent pharmacies had ordered any yet either. Pretty strange!

My neighbor just returned from a two week stay in Hawaii. As you are aware I am sure, they were tested for covid before leaving and Hawaii has very few cases. A day or two after arriving home four of the family members became extremely ill. Fever and vomiting where they couldn't keep anything down. They all tested negative for covid and the wife who was the sickest took the rapid test and then two days later took the test with the results coming back in 3-5 days and was once again negative. Both the family doctor and pediatrician said they all had covid the whole time. Maybe a prescription of Tamiflu would have helped and eased some of their suffering?

 

[phork]

I read a story from a pharmacist back in NY who said they are currently in the middle of flu season yet he has not received one prescription for Tamiflu. In 43 years in the business with 30 of those as a pharmacist, he had never seen such a thing. He decided to call his pharmaceutical rep for the brand who told him that none of his 75 independent pharmacies had ordered any yet either. Pretty strange!

My neighbor just returned from a two week stay in Hawaii. As you are aware I am sure, they were tested for covid before leaving and Hawaii has very few cases. A day or two after arriving home four of the family members became extremely ill. Fever and vomiting where they couldn't keep anything down. They all tested negative for covid and the wife who was the sickest took the rapid test and then two days later took the test with the results coming back in 3-5 days and was once again negative. Both the family doctor and pediatrician said they all had covid the whole time. Maybe a prescription of Tamiflu would have helped and eased some of their suffering?

Respiratory flu and stomach flu are not the same thing. The flu vaccine and tamiflu do not work on stomach flu.

 

[Legacy]

Oahu,

As a background to metropolitan KC, on the Missouri side there are some older residential areas but much of that side is where minorities reside with higher unemployment rates. The Kansas side except for KC, Kansas on the north is suburban, higher income, more white residents.

Yes, due to higher rates of uninsured as well as higher minority areas may be contributing to the lack of bed capacity as they may well be putting off interaction with the health care system.

Two other factors - Missouri allows cities to institute mask mandates which KC Mo has done. Politics in both states controlled by Republican majrities are resistant to public health measures despite pleas from health care authoriities. Missouri, for one, has put on hold cuts to their Medicaid program which would make many more of these rural hospitals close their doors.

The other factor is covered pretty well in this article, which highlights Kansas and Missouri. The two healthcare systems mentioned have hospitals in both states.
Rural Areas Send Their Sickest Patients To The Cities, Straining Hospital Capacity (NPR, Nov23)

Three weeks later, this is a much worse situation. Rural hospitals generally serve an older population with more chronic diseases and are more reliant on government insurance reimbursement, which is much less, as you may know. Over the last decade, many have closed. With virtually all the KC metro hospitals out of bed and/or staff capacity, higher risk populations, and a rural population that are not taking precautions, there is no room for transfers.

In a recent study by Kaiser Health News, three fourths of both Kansas and Missouri rural hospitals do not have an ICU beds. Those counties rely on transferring critical care patients normally.

At this point, I imagine, the Covid patients on the floors who are crashing will be competing for any critical care bed with those admitted and waiting for a bed in the ER. The rural hospitals will have to do the best they can as will metro KC. I don't know and haven't heard what their triage policies are now for Covid positive patients in senior living facilities in the area.

 

[Greenore]

A few posters in this forum tested positive. Can/would you supply some real-time information on your symptoms and/or condition?

I don't want to out anyone but an approximate age and any pre-existing conditions might be useful.

I've had several friends that tested positive or were exposed and they went through isolation like champs. They are all in great physical condition so that may have been a variable.

Relatively speaking, we are getting hit pretty hard in Alberta. Surprised, because by my very limited observations, everyone is wearing masks, distancing and sanitizing.

Cheers and Go Irish!!

 

[Irish YJ]

Totally bummed tonight. My best friend, who I was looking forward to hanging with over the holidays when I travel back, is down with the virus. Not tested yet, but lost taste and smell, and bad body aches. He's now depressed too, as he was looking forward to drinking way too much during the ND and Colts games. I'm depressed because of that, and even more because he's got a few pre-existing health issues. F'ing sucks.

 

[Greenore]

Totally bummed tonight. My best friend, who I was looking forward to hanging with over the holidays when I travel back, is down with the virus. Not tested yet, but lost taste and smell, and bad body aches. He's now depressed too, as he was looking forward to drinking way too much during the ND and Colts games. I'm depressed because of that, and even more because he's got a few pre-existing health issues. F'ing sucks.

Really sorry to hear that YJ. I think not being depressed might be irrational. Keep your head up Brother!

Cheers and Go Irish!!

 

[calvegas04]

Totally bummed tonight. My best friend, who I was looking forward to hanging with over the holidays when I travel back, is down with the virus. Not tested yet, but lost taste and smell, and bad body aches. He's now depressed too, as he was looking forward to drinking way too much during the ND and Colts games. I'm depressed because of that, and even more because he's got a few pre-existing health issues. F'ing sucks.

You're in luck, nothing lifts spirits like reading the Irishenvy gameday thread live.

 

[notredomer23]

Saw the FDA approved an OTC at home rapid test today. Would have been nice if we had that back in April

 

[NDRock]

A few posters in this forum tested positive. Can/would you supply some real-time information on your symptoms and/or condition?

I don't want to out anyone but an approximate age and any pre-existing conditions might be useful.

I've had several friends that tested positive or were exposed and they went through isolation like champs. They are all in great physical condition so that may have been a variable.

Relatively speaking, we are getting hit pretty hard in Alberta. Surprised, because by my very limited observations, everyone is wearing masks, distancing and sanitizing.

Cheers and Go Irish!!

My wife just tested positive. She’s 43 and has no medical issues. Runs/swims/yoga probably 5+ days a week. Symptoms include head ache and muscle ache. Her chest feels tight (although no issues breathing). Feels better after lying on her stomach. She looks miserable so I’m hoping to avoid it.

Had about 15 people on my shift get it the last few weeks. Guys from 20’s-40’s. Only one seemed to have a pretty bad reaction. Said he almost went to the hospital for problems breathing. He’s probably the oldest (46) and most out of shape. Lost 13 pounds.

 

[Irish YJ]

Really sorry to hear that YJ. I think not being depressed might be irrational. Keep your head up Brother!

Cheers and Go Irish!!

Thanks man. Haven't hung with him all year. Normally we do a guys trip once a year, one family trip to Naples together, and a hit a few big games and concerts. Going to miss seeing his kids and wife too. Huge kick in the nuts. Just hope he gets better soon.

You're in luck, nothing lifts spirits like reading the Irishenvy gameday thread live.

I told him the upside was that I'll have twice the booze to drink since he won't be there..

My wife just tested positive. She’s 43 and has no medical issues. Runs/swims/yoga probably 5+ days a week. Symptoms include head ache and muscle ache. Her chest feels tight (although no issues breathing). Feels better after lying on her stomach. She looks miserable so I’m hoping to avoid it.

Had about 15 people on my shift get it the last few weeks. Guys from 20’s-40’s. Only one seemed to have a pretty bad reaction. Said he almost went to the hospital for problems breathing. He’s probably the oldest (46) and most out of shape. Lost 13 pounds.

Prayers to you guys.

 

[Greenore]

My wife just tested positive. She’s 43 and has no medical issues. Runs/swims/yoga probably 5+ days a week. Symptoms include head ache and muscle ache. Her chest feels tight (although no issues breathing). Feels better after lying on her stomach. She looks miserable so I’m hoping to avoid it.

Had about 15 people on my shift get it the last few weeks. Guys from 20’s-40’s. Only one seemed to have a pretty bad reaction. Said he almost went to the hospital for problems breathing. He’s probably the oldest (46) and most out of shape. Lost 13 pounds.

Thanks for sharing NDRock and all the best to your family, friends and co-workers. I have been pretty surprised at the number of positives for healthy people in their 40-50's. They are all in great shape and recovered well with little side effects... so far. Teachers and Health Care workers seemed to be the common denominator.

Cheers and Go Irish!!