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Category Archives: Healthcare Providers
This says it all from a Nurse in Michigan
“I am posting, for once, about something other than my dog.
I have seen 4 patients die, 5 get intubated, 2 re-intubated, witnessed family consent to make 2 more patients DNRs, sweat my butt off during CPR, titrated so many drips to no avail, watched vent settings increase to no avail. We are exhausted and at a total loss.
All of this in two shifts in a row.
Some of you people have never done EVERYTHING you could to save someone, and watched them die anyway, and it shows.
I would have no problem if you fools worried about your “freedom” all went out and got COVID. If only you could sign a form stating that you revoke your right to have medical treatment based on your cavalier antics and refusal to abide by CDC and medical professionals’ advice. If you were the only people who got infected during your escapades to protest tyranny, great. But that’s sadly not how this works.
You wanna complain because the garden aisle is closed? If you knew a thing about gardening, you’d know it’s too early to plant in Michigan. Your garden doesn’t matter. If killing your plants would bring back my patients, I would pillage the shit out of your “essential” garden beds.
Upset because you can’t go boating…in Michigan…in April…in the cold-ass water? You wanna tell my patient’s daughter (who was sobbing as she said goodbye to her father over the phone) about your first-world problems?
Upset because you can’t go to your cottage up north? Your cottage…your second property…used for leisure. My coworkers can’t even stay in their regular homes. Most have been staying in hotels and dorms, not able to see their spouses or babies.
All of these posts, petitions online to evade “tyranny”, it’s all such bullshit. I’m sorry you’re bored and have nothing to do but bitch and moan. You wanna pick up a couple hours for me? Yeah, didn’t think so. I wouldn’t trust most of you with patient care, anyway. Not just because of the selfish lack of humanity your posts exude, but because most of those posts and petitions are so riddled with misspellings and grammatical errors, that it makes me question your cognitive capacity.
Shoutout to my coworkers, the real MVPs.”
Cartoon – Sending Our Medical Warriors to Battle
A D.C. protest without people: Activists demand PPE for health care workers on front line of coronavirus pandemic
With mandatory social distancing guidelines and stay-at-home orders in effect throughout the region, and given the grueling demands of their jobs as the deadly coronavirus continues to spread, it would have been nearly impossible to assemble 1,000 health-care workers outside Congress this week.
Instead, volunteers put up 1,000 signs to stand on the lawn in their absence.
Activists who are used to relying on people power to amplify messages and picket lawmakers have been forced to use alternative protest tactics amid the pandemic.
Half a dozen volunteers with liberal activist group MoveOn pressed lawn signs into the grass outside the Capitol as the sun peaked over the Statue of Freedom.
On each sign was a message.
Some, bearing the blue Star of Life seen on the uniforms of doctors, first responders and emergency medical technicians, reiterated a hashtag that has made the rounds on social media for weeks, accompanying posts from desperate front-line workers who say they are running out of necessary protective equipment: #GetUsPPE.
Others showed photos of medical workers in scrubs and hair nets and baseball caps. Some wore face shields and plastic visors. Others donned gloves.
One barefaced doctor in a white lab coat held up a hand-drawn sign. “Trump,” it said. “Where’s my mask?”
Health-care providers in hospitals, clinics, nursing homes, assisted-living facilities and rehabilitation centers have for weeks begged for more PPE to protect themselves and their vulnerable patients.
States and hospitals have been running out of supplies and struggling to find more. The national stockpile is nearly out of N95 respirator masks, face shields, gowns and other critical equipment, the Department of Health and Human Services announced last week.
“Health-care workers are on the front lines of this crisis, and they’re risking their lives to save ours every day, and our government, from the very top of this administration on down, has not used the full force of what they have with the Defense Production Act to ensure [workers] have the PPE they need and deserve,” said Rahna Epting, the executive director of MoveOn. “We wanted to show that these are real people who are demanding that this government protect them.”
Unlike protests that have erupted from Michigan to Ohio to Virginia demanding that states flout social distancing practices and reopen the economy immediately, organizers with MoveOn said they wanted to adhere to health guidelines that instruct people not to gather in large groups.
“Normally, we’d want everyone down here,” said MoveOn volunteer Robby Diesu, 32, as he looked out over the rows of signs. “We wanted to find a way to show the breadth of this problem without putting anyone in harm’s way.”
A large white sign propped at the back of the display announced in bold letters: “Social distancing in effect. Please do not congregate.”
The volunteers who put up the signs live in the same house and have been quarantining under the same roof for weeks. Still, as they worked, several wore masks over their face to protect passersby — even though there were few.
A handful of joggers stopped to take pictures as the sun rose.
One man, who spoke on the condition of anonymity because he is a government employee, said he supported the idea.
“I’m so used to seeing protests out here by the Capitol that it really is bizarre to see how empty it is,” he said. “But this is really impressive to me.”
By sharing images and video on social media of front-line workers telling their stories, MoveOn organizers said they hope to galvanize people in the same way as a traditional rally with a lineup of speakers.
Activists planned to deliver a petition to Sen. Chris Murphy (D-Conn.) with more than 2 million signatures urging Congress to require the delivery of more PPE to front-line workers. Murphy has been a vocal critic of the Trump administration’s coronavirus task force and its reliance on private companies to deliver an adequate amount of critical gear, such as N95 respirator masks, medical gowns, gloves and face shields, to health-care workers.
“In this critical hour, FEMA should make organized, data-informed decisions about where, when, and in what quantities supplies should be delivered to states — not defer to the private sector to allow them to profit off this pandemic,” the senator wrote last week in a letter to Vice President Pence, co-signed by 44 Democratic and two independent senators.
Organizers said the signs would remain on the Capitol lawn all day, but that the demonstration was only the beginning of a spate of atypical ones the group expects to launch this month.
Epting described activists’ energy as “more intense” than usual as the pandemic drags on.
“The energy is very high, the intensity is very high,” she said. “That’s forcing us to be creative and ingenuitive in order to figure out how to protest in a social distancing posture and keep one another safe at the same time.”
The Front Line: Visualizing the Occupations with the Highest COVID-19 Risk
More than 9,000 healthcare workers have contracted COVID-19 as of last week, CDC says
CDC warns the data may not reflect the true scope of the problem, as uneven reporting of confirmed cases likely underestimates the impact.
Healthcare workers who treat patients infected with the COVID-19 coronavirus are at risk of contracting the disease themselves due to frequent exposure and proximity to such patients.
New figures from the U.S. Centers for Disease Control and Prevention detail the extent to which this is true, finding that 9,282 healthcare workers across the country are confirmed to have been infected.
Of those confirmed cases, 27 have died, according to numbers culled from February 12 to April 9. About 55% of all healthcare personnel who were infected only had contact with COVID-19 patients within the healthcare setting.
The vast majority of confirmed positive healthcare workers – 90% – were not hospitalized. Up to 5% of those who were hospitalized ended up in intensive care, while 10 of the 27 deaths were among those workers 65 years old or older.
The CDC warned that the data may not reflect the true scope of the problem, as uneven reporting of confirmed cases across the country has resulted in figures that likely underestimate the number of healthcare workers infected.
WHAT’S THE IMPACT?
The number of coronavirus cases among healthcare workers is expected to rise. While this is due in part to more communities experiencing widespread transmission, the nature of working in the healthcare field understandably contributes to the risk: About 45% of workers who tested positive lived in households or communities in which the virus was present, meaning they risk exposure on two fronts, both inside a healthcare setting and outside of it.
Compounding the problem is that transmission can come from unrecognized sources, including those who are asymptomatic or presymptomatic. Because of that, contact tracing after occupational exposures will likely fail to identify many healthcare workers who are at risk for developing COVID-19.
As with the general population, the higher a healthcare workers’ age, the more likely they were to experience a severe outcome, although severe outcomes – including death – are possible at any age.
Preventative measures meant to staunch the spread among healthcare personnel include screening all workers for fever and respiratory symptoms at the beginning of their shifts, prioritizing such workers for testing, and discouraging working while sick by offering flexible and non-punitive medical leave policies.
The CDC said older healthcare personnel, or those with underlying health conditions, should consult with their healthcare provider and employee health program to better understand their risks. On hospitals’ part, they should consider the enhanced likelihood of severe outcomes among older personnel when mobilizing retired workers to increase surge capacity, especially in light of a shortage of personal protective equipment. One consideration would be preferential assignment of retired workers to lower-risk settings such as telehealth, administrative assignments or clinics for non-COVID-19 patients.
THE LARGER TREND
PPE shortages, insufficient tests, slow results and a dearth of ventilators are all factors that contribute to risk of infection among healthcare workers, and these challenges play off each other in a toxic cycle, an Office of the Inspector General report found last week.
Hospitals said their most significant challenges centered on testing and caring for patients with COVID-19 and keeping staff safe. Severe shortages of testing supplies and extended waits for test results limited hospitals’ ability to monitor the health of patients and staff, and widespread shortages of PPE are putting both groups at risk. Hospitals also said they were not always able to maintain adequate staffing levels or to offer staff adequate support.
We can’t just flip the switch on the coronavirus
It feels like some big, terrible switch got flipped when the coronavirus upended our lives — so it’s natural to want to simply flip it back. But that is not how the return to normalcy will go.
The big picture: Even as the number of illnesses and deaths in the U.S. start to fall, and we start to think about leaving the house again, the way forward will likely be slow and uneven. This may feel like it all happened suddenly, but it won’t end that way.
What’s next: Nationally, the number of coronavirus deaths in the U.S. is projected to hit its peak within the next few days. But many big cities will see their own peaks significantly later — for them, the worst is yet to come.
- The White House is eyeing May 1 as the time to begin gradually reopening the economy. But that also will not be a single nationwide undertaking, and it will be a halting process even in the places where it can start to happen soon.
- “In principle it sounds very nice, and everyone wants to return to normalcy. I think in reality it has to be incredibly carefully managed,” said Claire Standley, an infectious-disease expert at Georgetown University.
The future will come in waves — waves of recovery, waves of more bad news, and waves of returning to some semblance of normal life.
- “It’s going to be a gradual evolution back to something that approximates our normal lives,” former Food and Drug Administration Commissioner Scott Gottlieb said.
What the post-lockdown world will look like:
- Some types of businesses will likely be able to open before others, and only at partial capacity.
- Stores may continue to only allow a certain number of customers through the door at once, or restaurants may be able to reopen but with far fewer tables available at once.
- Some workplaces will likely bring employees back into the office only a few days a week and will stagger shifts to segregate groups of workers from each other, so that one new infection won’t get the whole company sick.
- Large gatherings may need to stay on ice.
And there will be more waves of infection, even in areas that have passed their peaks.
- “Everything doesn’t just go down to zero” once a city or region gets through its initial crush of cases, said Janet Baseman, a professor of epidemiology at the University of Washington.
- This is happening now in Singapore, which controlled its initial outbreak more effectively than almost any other country in the world but is now seeing the daily number of new cases climb back up.
This is all but inevitable in the U.S., too, especially as travel begins to pick back up. Some places may need to shut down again, or at least tighten back up, if these new flare-ups are bad enough.
- Part of the reason to lock down schools, businesses and workplaces is to prevent an outbreak from overwhelming the local health care system. If new cases start to pile up too quickly, leaders may need to pump the brakes.
- “If you go back to normal too fast, then cases start to go up quickly, and then we end up back where we started,” Baseman said.
- The good news, though, is that hospitals should have far more supplies by the fall, thanks to the coming surge in manufacturing for items like masks and ventilators.
What we’re watching: We’ll still need a lot more diagnostic testing to make this process work. Public health officials need to be able to identify people who might be spreading the virus before they begin to feel sick, and then identify the people they may have infected.
- Most of the U.S. does not seem prepared for that undertaking, at least on any significant scale.
- Another kind of test — serology tests, which identify people who have already had the virus and may be immune to it — will also help. We can’t test everyone, but identifying potential immunity could be important in knowing who can safely return to work in high-risk fields like health care.
The real turning point won’t come until there’s a proven, widely available treatment or, even better, a widely available vaccine.
- A vaccine is still about a year away, even at a breakneck pace and if everything goes right. A treatment isn’t likely to be available until the fall, at the earliest.
- In the meantime, all we can do is try to manage a slow recovery, using a less aggressive version of the same tools that are in place today.
The bottom line: “I’m not going back to Disneyland, I’m not going to take a cruise again, until we have a very aggressive testing system or we have very effective therapeutics or a vaccine,” Gottlieb said.
Truth dies in silence. Sadly, so do people.
https://www.kevinmd.com/blog/2020/04/truth-dies-in-silence-sadly-so-do-people.html
I have been writing columns for physicians for twenty years. And year after year, I have had physicians say this: “I’m glad you said what you did. If I said it, I’d be fired.” There are variations on the theme, but they’re much the same. Twenty years, and far more than 20 years, during which the alleged health care leaders in America have been routinely muzzled because they aren’t supposed to speak the truth. Open discussions shut down because they might embarrass someone or upset an administrator. Because it might, heaven forbid, shine a light on a genuine problem.
Some years ago, as the mental health crisis was gathering steam across the emergency departments of the land, I was contacted by a news show in France. The producers wanted to come to South Carolina and follow me on some shifts in my ED. They wanted to see how mental health was working out here. “We have socialized care, but mental health is also a huge problem in our country,” the producer said.
I dutifully, and appropriately, went to administration. “No, we can’t do that,” I was informed. I was given this explanation when everyone knew the mental health system was at the breaking point: “What if they uncover a problem?” Here was a chance for publicity, for potential grant money or to demonstrate that a political solution was in order. How dare we let in fresh air? How dare we suggest that things were not perfect?
The same thing is happening in the midst of the pandemic. Physicians, nurses, and other assorted health care professionals are being threatened for wearing masks. Administrators say, “They make the patients nervous.” Also likely, administrators have realized they don’t have adequate equipment. Facilities and systems with enormous budgets caught unprepared in a pandemic.
I see the stories of these professionals as I follow online forums. Physicians, nurses, and others, threatened with firing because they dared to speak out on the issue of PPE (personal protective equipment).
Like police officers without ballistic vests, these physicians don’t want to go into the rooms of COVID-19 patients without the masks and respirators, gloves, gowns, and face shields that will keep them safe. The equipment that will allow them to return home to their loved ones and prevent them from infecting their families. This isn’t a good look. A hospital that refuses to acknowledge the concerns and safety of its professionals is a hospital that ultimately doesn’t deserve them.
The same veil of silence pervades dialogue on the treatment of coronavirus. When I follow discussions, I see a lot of shaming. “There just isn’t enough evidence to try hydroxychloroquine, Zithromax, convalescent plasma, an untried vaccine, HIV drugs, etc.” Those who suggest we might try are considered reckless or ignorant. As the battle rages and lives are lost, innovation and risk are viewed with disdain. And our medical establishment is locked into the paradigm of double-blinded, placebo-controlled studies involving tens of thousands of people and lasting years. Here’s a view of the same from the U.K. Unfortunately, to suggest that we may need to react faster is only met with ridicule, and often tied to political views instead of expediency. Worse, it ignores the deep, fundamental need to offer hope, any hope, to hundreds of millions of professionals and citizens who are living in fear.
There is a tragic irony here; a painful coincidence. Physicians silenced. Let’s see. Where did we see that sort of thing resulting in a worldwide pandemic? Does China come to mind? The Chinese Communist Party threatened (and who knows what else) physicians who dared to speak out about coronavirus, even when they knew its danger. Even when they knew how easily and widely it spread.
They continued to soft-peddle numbers about total cases and case fatality. The party continued to allow travel to and from China long after the problem was known. They even suggested that Italians have a “hug a Chinese person” campaign to combat alleged racism; a charge delightfully accepted and repeated by gullible Western journalists in pursuit of a narrative.
Truth dies in silence. Sadly, so do people. And certainly when we tell dedicated health care professionals to keep their mouths shut when they have identified problems, offered solutions and simply asked for help. Whether it’s a private business, a totalitarian government, or anything in between, we should insist that the truth be spoken; freely and without fear of punishment.
Because, for the foreseeable future, lives will depend on it.
Cartoon – Thanks to Everyday Heroes
For all the nurses, doctors, EMS, cops, firefighters, truckers, grocery store workers and everyday heroes. THANK YOU!!! ❤️🙏❤️🇺🇸❤️
Cartoon – Reality Check
HENRY KOTULA 