wathe
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Posts posted by wathe
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4 hours ago, Ausmumof3 said:
What do we know about spread of RSV? I’m assuming masking should help for that as well but is it also more surface spread? I know the R0 is typically lower than covid.
In healthcare we treat it as "droplet contact", meaning protecting against both respiratory droplets and surface spread. Conventional wisdom cites that it can live on hard surfaces for hours. I don't have studies to back that up, but should be a quick google.
Our understanding is shifting with respect to all respiratory viruses, though, and it's very very likely that RSV is also airborne - at least short-range airborne. RSV-containing aerosols have been found in the air surrounding RSV+ inpatients thats capable of infecting human ciliated epitheleum (Kulkami et al., 2016). A more recent article outlining our shifting understanding of respiratory transmission , with big name aerosol scientists as co-authors (K. Prather, J. Jiminez, L. Marr).
There is still much resistance to this shift in the IPAC (Infections Prevention and Control) medical establishment. Likely because of the practical and regulatory implications of a formal shift to airborne IPAC practices for common resp viruses; current hospital infrastructure simply physically cannot accommodate airborne precautions at scale.
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3 hours ago, chocolate-chip chooky said:
That sounds like an amazing opportunity and experience! 40,000 people? Wowsers. What does IST mean?
I'm off to South Korea soon too, but there will be no scouts or camping.
International Service Team. I'll be doing some sort of job to support the jamboree for part of the time, and enjoying the jamboree for the other part of the time. Most of the jobs are pretty social, so the work is also "play".
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Anyone going?
Both my boys are going as participants (Canadian Contingent). I'm going as IST.
I'm both excited about it and dreading it - it's a once in a lifetime amazing opportunity to attend with my kids, but also 40 000 people camping in a field sounds like a nightmare....
UPDATE July 20, 2023. We are leaving for this next week! The kids are super-excited.
UPDATE April 25, 2024. As many of you know, this jamboree turned out to be a bit of a shambles. The 25th World Scout Jamboree: Report of the independent Review Panel was published last week. Requires registration to access.
Korean Times has published an article summarizing, which is free to access.
Key quotes from the report:
“...demonstrably high-risk site”
“...a clear gap between promises made and expectations set by the Host in the bidding phase, as well as updates received during the planning phase, and the reality of the event that was delivered in 2023.”
“...failed to deliver on its responsibility and promises to organize the planning and delivery of a safe and successful event.”
“[Organizers]...deliberately misled the World Scout Committee, World Scout Bureau, and National Scout Organizations in its communications on the state of the event’s preparations”
"The medical situation was marked by an alarming lack of preparedness"
"The medical facilities and resources were severely inadequate..."
"The Opening Ceremony lacked effective safety management"
"In reviewing the core basic requirements of the 25th World Scout Jamboree in terms of safety, security, safeguarding of young people, medical support, food and dietary requirements, sanitation and hygiene, movement around site, and mitigation of weather impacts, there were significant challenges and deficiencies, as well as a failure to consistently deliver core services – at the standard promised by the Host, and legitimately expected by the key stakeholders – and essential to keep all youth participants and adult volunteers safe."
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1 hour ago, Not_a_Number said:
For sure.
I'm especially interested in people who've had Omicron twice.
Some of my pts mentioned in my prev post were omi x 2 (based on timing. No sequencing to prove it)
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I've seen mutliple pts through emerg and the covid/cold/flu clinic with repeat infections, who've insisted that what they had at the time of their visit couldn't be covid, because they'd had it before and their symptoms this time were different (and worse). Of course it was covid.
So, a very self-selecting tiny data set that at least shows that repeat infections aren't always milder.
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bump for update in first post
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48 minutes ago, Jean in Newcastle said:
It didn't occur to me until you posted this that I could google the ER wait times at our local hospitals. Shortest average wait time here is 1 hour 56 minutes. Longest two are 4 hours 19 minutes and 5 hours 9 minutes respectively. Both the long waits are at our regional trauma centers. All the "normal" ERs are around 2 hours for an average wait.
I am trying to remember how long it used to take me at my biannual ER visits - usually around an hour, I think. Of course, it probably depends greatly on your need - I never used the ER for common complaints like flu etc. like some people do.
But we have a high Covid vaccination in this county and while I've heard reports of overwhelm at our regional children's hospital, they don't publish their ER wait times.
You can. They aren't all accurate though - they are only as good as the algorithm. They tend to display an unwarranted level of precision.
My hospital's ED wait time tracker caps at 5+ hours. So no matter how much longer the wait time is, it will only ever display a maximum of "5+ hours". It also simply displays the wait time of the current longest waiting patient. So if, for example (highly improbable, but just to illustrate the point), 50 people register all at once into an empty department, it will display a wait time of 0 minutes (because none of them have waited, yet), even though of course we can't see fifty people at the same time, and all of them except the first will wait longer than 0 minutes (many of them much longer). It's not very sophisticated.
ETA: where I was going with this is to say that some ED wait time trackers are tuned to make wait-times look shorter than they actually are (or clearly will be).
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21 minutes ago, Mom_to3 said:
Agreed - but I wish there were similarly honest and frequent reporting about conditions in the US. We largely don't get to really see the horrors of waits in ERs, the effects of suboptimal care, the concerns of parents with fragile kids that fear for their lives and worry about access to schooling and medical care etc etc. A lot of pediatricians and ER docs tweeting about impossible and frightening conditions - but you have to look for it (and of course largely even then we still don't see it).
This is London, Ontario, today. Emergency department wait times of 20+ hours for low-acuity complaints. They will never state that actually emergencies also wait, but of course they do. And that it can be very hard to pick the sick needles out of the giant lower-acuity haystack when waiting rooms are packed and flowing out onto the sidewalk.
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Canada. Yes. Sexual orientation is a non-issue. Scouts Canada does not discriminate based on sexual orientation. We "Ensure all services are available to everyone, without regard to any personal characteristic which is considered a prohibited ground under human rights legislation, and that support structures are in place to do so"
(I assume you mean Scouts BSA, but you didn't specify, so I thought international experience might be welcome)
Are the PDA in your case consensual? Because managing sexual harassment is a whole different level issue than consensual PDA between teenagers.
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Study with CO2 data from public city buses:
https://www.sciencedirect.com/science/article/pii/S0013935121017527
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Another one with lots of data on VIA rail trains. I expect most inter-city passenger trains in North America are similar.
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A Twitter thread with Aranet4 data from a train. Peaked at 3038ppm:
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Re Car data:
I ran a little experiment on my trip to and from work today
On the way to work, I set the ventilation to recirculate. Fan speed 4/7. 20km trip, 12 of which are rural highway at a cruising speed of 90 kph, trip time just under 20min. CO2 rose rapidly and kept on rising. Peak CO2 1743ppm, with a steep slope that had no signs of leveling off (suggesting that the CO2 would have kept rising if the trip had been longer)
On the way home, everything the same, except set to fresh air instead of recirc. Peak CO2 582ppm, with the peak right at the beginning of the trip (I assume because there is a minute or so of time where I am in the car without the ventilation running before I get the car turned on) with a slow fall to 515ppm.
Dramatic difference.
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1 hour ago, kokotg said:
I remember the days before seatbelt laws: my mom had a chevette hatchback, and my brother and I called the back of it our "playroom" because we had a bunch of toys back there and would just hang out playing. We lived sort of out in the middle of nowhere, so we spent a lot of time in the car. It was fun--way more fun than being buckled in and having to sit still for a couple of hours a day while we were shuttled back and forth to two different schools/preschools. Then one day my mom lost control of the car somehow and we spun around and went off the road, and after that we always had to wear our seatbelts. That would have been right around 1980, when the traffic fatality rate was nearly double what it is today in the US.
I also remember going airborne inside a vehicle. We had a cargo van that my dad had converted into to a sort of camper. We were loose in the back.
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14 minutes ago, kokotg said:
...if your point is more something like, "why don't we TALK as much about how dangerous driving is?" i.e. why aren't there 20 threads about car safety on the front page of the chat board, then I think the explanations are that covid is newer, that it's more dangerous (even with "low" covid numbers, 3x as many people die daily of covid in the US than car accidents, although of course that varies by age), that driving has become much less dangerous over time because of the precautions we DO take, and, probably mainly because the precautions we take both personally and on a structural level around driving and cars are generally not particularly controversial. Thinking people shouldn't wear seatbelts is a very niche position in a way thinking people shouldn't wear masks is very much not. To the extent that risk mitigation having to do with cars and driving IS controversial, it's not at all difficult to find those conversations going on and getting very heated (take a look at any parenting board when someone asks when they should turn their toddler forward facing).
And seatbelt laws were very controversial back in the day. i'm old enough to remember that first hand. A google search of "seat belt law controversy"brings up numerous articles on the topic, both retrospective written recently, and articles written at the time in the 80's.
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In other news, our schools are closed for at least the next week due to a labour protest/strike-but-not-a-strike. Which is its own big hairy deal because of suspension of constitutional rights for workers based on sketchy grounds.
The silver lining of that is that at least school-driven transmission will be interrupted for at least a week.
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23 minutes ago, Happy2BaMom said:
Its happening in the US, too. Flu hospitalizations are at their highest level in 12 years, and it’s early November. Feds just declared a flu pandemic and are preparing to deploy troops and ventilators if needed. (note: RSV and Covid are part of the issue as well).
Flu just crossed the line into epidemic status here too. It's a mess. I am dreading work today.
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Re car ventilation. There are some studies on car ventilation that are interesting:
Airflows inside passenger cars and implications for airborne disease transmission
Air change rates of motor vehicles and in-vehicle pollutant concentrations from secondhand smoke
The second one has data in the abstract: "With the vehicle stationary and the fan off, the ventilation rate in air changes per hour (ACH) was less than 1 h−1 ........For closed windows and passive ventilation(fan off and no recirculation), the ACH was linearly related to the vehicle speed over the range from 15 to 72 mph (25 to 116 km h−1)"
Cars are not air-tight. There is passive air leakage. But the air in a closed car without mech ventilation turned on does get stale quickly.
My own CO2 data: I can keep ppm CO2 to less than 800 with 4 people in the car, with just the ventilation going at 3/4 speed, windows closed. When the vent system is set to recirc, the CO2 shoots up (DH did this inadvertently once, and the CO2 monitor happened to be with us)
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Wordle 505 3/6
⬜⬜⬜🟨🟨
⬜🟨🟩⬜⬜
🟩🟩🟩🟩🟩-
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11 hours ago, wathe said:
Yes. Link directly to CBC article. Combine high infections resp illness rates with what seems like increasing severity (cue covid induced immune suppression hypothesis) with paediatric over-the-counter med shortages (can't find liquid tylenol or advil anywhere), with some clinics and primary care practices still refusing to see patients with infectious resp illness symptoms, with severe emergency department staffing shortages (a full nursing complement in my ED is something like 15-18. My last night shift we had 11. We've had nights with as few as 7) and you have a disaster.
And paeds ICUs are full. We are having to push kids 14+ into adult ICUs. This is a huge deal.
And it's not just kids. I saw 3 back to back respiratory resuscitations (infectious resp illness) on my last night shift, and 2 of those were younger, healthy adults, with flu and covid respectively. Adult covid hospitalizations and emerge visit are climbing steeply - number of admitted covid pts in my hospital has more than doubled in the last month. (And that doesn't count flu, RSV, other infectious resp illness admits)
ED departments are severely overcrowded and understaffed. I had, at peak, 107 patients in my 40-ish bed, short-staffed dept last night. This is now normal. They are stacked in chairs and hallways. On any given day, at least 20-ish of those, and on very bad days, up to 35 or those, will be admitted patients - so at least half of my beds are blocked can't be used to move ED patients through.
Conditions are impossible.
My professional life is pretty horrid right now.
We know that schools and daycares are major drivers of spread of infectious resp illness. We know that universal masking in indoor public spaces and schools works to decrease transmission. But, nope. Masking is unpopular. So, this is fine, I guess.
Quoting myself: 135 patients in the ED at the beginning of my shift. That's not number per day, that's the number in the dept all at the same time. All at the same time. That is >300% capacity. And many of them children there with parents, or elderly there with essential care-givers. The sheer number of people in the space is overwhelming. A personal record for me. And short staffed to boot.
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1 hour ago, mommyoffive said:
What level do you unmask indoors for?
We aimed for ppm CO2 less than 800.
I stayed masked Unless eating, and while eating Strategically parked myself right beside an open window.
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1 hour ago, kbutton said:
I still don't understand this, especially when we've gotten so fatalistic about the virus. If we have to learn to live with it, you'd think a PCP could put on an N95 and designate one room for isolation or ask people to wait in the car until they are called back, etc. Dentists have been doing that the entire pandemic.
To be fair, many PCP are seeing infectious illness patients in their offices and have been all along.
The problem, I think, is the public health requirement to have these patients separated in the waiting room, PPE requirements, cleaning requirements etc. I think it’s easy for many clinics and practises to just not have to deal with them. And demand is such that they can get away with it.
Dental practises are competing for patients here in a way that primary care providers simply aren’t.
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And an amoxicillin shortage. First-line for paediatric pneumonia, ear infections and strep. Fantastic.
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Another example: I will unmask and eat in a very well spaced break-room in the hospital now, because the pattern of excellent ventilation is reliable and has repeats over time. I don't need to worry about it anymore.
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2023 World Scouts Jamboree in South Korea UPDATE first post
in The Chat Board
Posted
I hear you on a network. My kids are super fortunate that there are others going from their troop, and their Jamboree patrol leader is also from our group - and is someone who I really trust. I don't think I would send them otherwise.
I don't know what a MAC flight is? Some sort of funding?